Can supervise: YES
LeMone, P, Burke, K & Levett-Jones, T 2017, Medical-surgical nursing: Critical thinking for person-centred care, 3rd, Pearson Australia, Sydney.
This set of text provides students with a strong knowledge base, an understanding of contemporary practice issues in Australia and the capacity for sound clinical reasoning.
Levett-Jones, T & Reid-Searl, K 2017, The clinical placement: An essential guide for nursing students, 4th, Churchill Livingstone, Marrickville.
Levett-Jones, T 2017, Clinical reasoning: Learning to think like a nurse, 2nd.
LeMone, P, Burke, K, Levett-Jones, T, Dwyer, T, Moxham, L, Reid-Searl, K, Berry, K, Carville, K, Hales, M, Knox, N, Luxford, Y & Raymond, D 2017, Medical-surgical nursing: Critical thinking in client care, 3rd, Pearson Australia, Sydney.
Berman, A, Synder, SJ, Levett-Jones, T, Burton, P & Harvey, N 2016, Skills in clinical nursing (1st Australian edition).
Levett-Jones, T & Bourgeois, S 2015, The clinical placement: An essential guide for nursing students, 3rd, Churchill Livingstone, Marrickville.
Evolve Resources: The Clinical Placement, 3rd Edition is supported by an engaging series of video interviews with nurses from a diverse range of clinical practice areas.
LeMone, P, Burke, K, Levett-Jones, T, Dwyer, T, Moxham, L & Reid-Searl, K 2015, Medical-Surgical Nursing: Critical thinking for person-centred care, 2nd, Pearson Higher Education AU.
The focus of this product package is to provide students with a strong knowledge base, an understanding of contemporary practice issues in Australia and the capacity for sound clinical reasoning.
Berman, A, Synder, S, Kozier, B, Erb, GL, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D 2014, Kozier and Erb's Fundamentals of Nursing Pack, Vols 1-3, Australian edition, 3rd, Pearson Australia, Sydney.
This third Australian edition has once again undergone a rigorous review and writing process.
Levett-Jones, T 2014, Critical conversations for patient safety: An essential guide for health professionals, Pearson Australia, Sydney.
Critical Conversations in Patient Safety bridges that gap.
Levett-Jones, T.E.A. 2013, Medical-surgical Nursing 3-volume Set.
Levett-Jones, T 2013, Clinical reasoning: Learning to think like a nurse, Pearson Australia, Sydney.
Simmons, C., Williams, W., Sher, W. & Levett-Jones, T. 2012, Work ready: E-portfolios to support professional placements, Office for Learning and Teaching, Sydney.
LeMone, P, Burke, K, Levett-Jones, T, Dwyer, T & Moxham, L 2012, Medical-surgical nursing: Critical thinking in client care (Australian edition), 2nd, Pearson Australia, Sydney.
Levett-Jones, T & Bourgeois, S 2011, The clinical placement: An essential guide for nursing students, 2nd, Churchill Livingstone, Marrickville.
The Clinical Placement, 2nd Edition is fully revised with a fresh new appeal. It builds upon the success of the first edition, while incorporating a wealth of new, topical content written in easy-to-understand language.
Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D 2011, Kozier and Erb's Fundamentals of Nursing, 2nd, Pearson Australia, Sydney.
Reid-Searle, K, Dwyer, T, Moxham, L & Levett-Jones, T 2009, The clinical practicum: A guide for clinical educators (facilitators, preceptors and mentors), Central Queensland University, Rockhampton.
Levett-Jones, T & Bourgeois, S 2009, The clinical placement: A nursing survival guide (UK edition), Bailliere Tindall Elsevier, Edinburgh.
Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D 2008, Kozier and Erb's Fundamentals of Nursing, Pearson Asutralia, Sydney.
Levett-Jones, T & Reid-Searl, K 2007, The clinical placement: An essential guide for nursing students, Churchill Livingstone, Marrickville.
Seaton, P, Levett-Jones, T, Cant, R, Cooper, S, Kelly, M, McKenna, L, Ng, L & Bogossian, F 2019, 'Exploring the extent to which simulation-based education addresses contemporary patient safety priorities: A scoping review', Collegian.View/Download from: Publisher's site
© 2018 Background: There is unprecedented increase in use of simulation-based education in healthcare settings. The key driver is improving quality and safety in healthcare. To date, there is limited understanding of the degree to which this goal has been achieved. Aim: This scoping review aimed to explore the extent to which simulation-based education in healthcare has addressed and impacted contemporary patient safety priorities. Methods: Systematic searches of literature (2007–2016) were based on each of 10 patient safety priorities articulated in Australia's National Safety and Quality Health Service Standards and New Zealand's Health, Quality and Safety Indicators and markers. Included primary studies evaluated transferability to practice and/or behavioural change and improved patient outcomes, based on Kirkpatrick's training evaluation model Level 3 and Level 4. Findings: Fifteen papers met inclusion criteria. Studies aligned with four of ten National Safety and Quality Health Service Standards: (3). Preventing and controlling healthcare associated infections; (4). Medication safety; (6). Clinical handover; (9). Recognising and responding to clinical deterioration. The studies were indicative of potential for simulation-based education to have a significant impact on patient safety. Discussion: Studies that qualify as translational science, demonstrating changes in clinician behaviours and improved patient outcomes, are emerging. Little evidence from Australian and New Zealand contexts suggests that outcomes of simulation-based education in this region are not commensurate with the significant government investments. Conclusion: Translational studies, despite being difficult to design and conduct, should form part of a thematic, sustained and cumulative program of simulation-based research to identify translational science.
Guinea, S, Andersen, P, Reid-Searl, K, Levett-Jones, T, Dwyer, T, Heaton, L, Flenady, T, Applegarth, J & Bickell, P 2019, 'Simulation-based learning for patient safety: The development of the Tag Team Patient Safety Simulation methodology for nursing education', Collegian.View/Download from: Publisher's site
© 2018 Australian College of Nursing Ltd Background: Since the ground-breaking report 'To Err is Human: Building a Safer Health Care System' was published nearly two decades ago, patient safety has become an international healthcare priority. Universities are charged with the responsibility of preparing the future nursing workforce to practise in accordance with relevant patient safety standards. Consequently, simulation-based learning is increasingly used for developing the technical and non-technical skills graduates require to provide safe patient care. Aim: Tag Team Patient Safety Simulation is a pragmatic group-based approach that enhances nursing students' knowledge and skills in the provision of safe patient care. The aim of this paper is to describe the Tag Team Patient Safety Simulation methodology and illustrate its key features with reference to a medication safety scenario. Methods: Informed by the National Safety and Quality Health Service Standards and the Patient Safety Competency Framework for Nursing Students, Tag Team Patient Safety Simulation methodology actively engage large numbers of nursing students in critical conversations around every day clinical encounters which can compromise patient safety. Conclusion: Tag Team Patient Safety Simulation is a novel simulation methodology that enhances nursing students' skills and knowledge, fosters critical conversations, and has the potential to enhance students' resilience and capacity to speak up for safe patient care.
Levett-Jones, T & Jones, M 2019, 'Physical activity for women diagnosed with breast cancer after adjuvant therapy: A Cochrane review summary.', International Journal of Nursing Studies.View/Download from: Publisher's site
Ebert, L, Levett-Jones, T & Jones, D 2019, 'Nursing and Midwifery Students' Sense of Connectedness Within Their Learning Communities.', The Journal of nursing education, vol. 58, no. 1, pp. 47-52.View/Download from: Publisher's site
BACKGROUND:Recognition of the importance of a supportive academic and clinical learning environment for nursing and midwifery students enrolled in health care programs is not new. However, the factors that influence social connections within these environments and the consequences for students' learning are not well understood. METHOD:This study used a multisite mixed-methods design to examine students' learning experiences. RESULTS:Participants stated that to develop a sense of professional connectedness, opportunities are needed to develop meaningful relationships with academic staff and peers through increased face-to-face on-campus learning experiences, as well as through off-campus contexts. CONCLUSION:To enhance nursing and midwifery students' sense of connectedness, the balance between online and face-to-face learning experiences needs to be reexamined, and a renewed focus on the development of quality clinical learning experiences that foster a sense of belonging also is needed. [J Nurs Educ. 2019;58(1):47-52.].
Omura, M, Levett-Jones, T & Stone, TE 2019, 'Design and evaluation of an assertiveness communication training programme for nursing students.', Journal of clinical nursing.View/Download from: Publisher's site
AIMS:The aims of this paper are to (a) outline the design and implementation of an evidence-based assertiveness communication workshop for Japanese nursing students; and (b) report on the evaluation of nursing students' satisfaction with the workshop using the Satisfaction with Assertiveness Communication Training Program Survey. BACKGROUND:A body of research attests to the relationship between assertive communication and patient safety. This paper reports the design and evaluation of an assertiveness communication training programme designed to enhance students' ability to communicate safety in clinical practice. DESIGN:A culturally appropriate and evidence-based assertiveness communication workshop, informed by Gagne's instructional design principles, was implemented for third-year nursing students in two Japanese higher educational institutions in December 2017. A descriptive study design was used to evaluate the workshop. METHODS:Students' perceptions of the workshop were evaluated using the Satisfaction with Assertiveness Communication Training Program Survey, which includes ten items that are rated using a 5-point Likert scale from strongly disagree  to strongly agree . Data were analysed using descriptive statistics. The Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guidelines were used in the reporting of this study. RESULTS:A total of 111 students from a population of 150 participated in the study giving a response rate of 74%. The overall mean satisfaction score was 4.12 indicating a high level of agreement with each of the survey items. With the exception of two items, the mean scores were above 4.0. "Confidence in using assertiveness communication skills" and "Utilising role-plays to practice learnt skills" received mean scores of 3.71 and 3.90, respectively. CONCLUSION:Given the compelling research about the importance of assertive communication in health care, the results from this study support continuing investm...
Wyllie, A, Levett-Jones, T, DiGiacomo, M & Davidson, P 2019, 'Exploring the experiences of early career academic nurses as they shape their career journey: A qualitative study.', Nurse education today, vol. 76, pp. 68-72.View/Download from: Publisher's site
OBJECTIVE:This study aimed to explore the experiences of early career academic nurses as they shape their career path in one Australian university. BACKGROUND:The early years of academic career development can be challenging as individuals learn to adjust to the teaching, research and service mission of universities. Tertiary institutions have an obligation to provide future nursing leaders with relevant and timely support during the formative phase of career development, to be successful in a competitive global environment. DESIGN:A qualitative descriptive approach was used and data were analysed thematically using Braun and Clarke (2006) six phase process. METHODS:Eleven early career academic nurses who were interviewed, had completed, or were near completion of a doctorate and were within seven years of full-time academic employment. RESULTS:The four themes that emerged from the analysis were: embarking on the journey; the toil of the journey; fellow travellers on the journey, and strategies for a successful journey. CONCLUSIONS:Findings from this study can be used to inform customised mentorship programs for nurse academics during their initial stage of career employment.
Levett-Jones, T, Cant, R & Lapkin, S 2019, 'A systematic review of the effectiveness of empathy education for undergraduate nursing students.', Nurse education today, vol. 75, pp. 80-94.View/Download from: Publisher's site
OBJECTIVE:The objective of this systematic review was to identify, critically appraise and synthesize evidence for the effectiveness of empathy interventions in undergraduate nursing education. DESIGN:A systematic review of literature. DATA SOURCES:A three-stage systematic search of six electronic databases was conducted. REVIEW METHODS:The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. English language articles published between 2000 and 2018 were eligible. Methodological rigour was examined using the Medical Education Research Study Quality Instrument. Changes in empathy were assessed using Cohen's effect size correlation (r) and reported as effective when the variance was >0.2 standard deviations (r0.2). RESULTS:Of 23 included studies, four were experimental and four were case-control studies. Of these, the mean effect size was r=0.45 and three were regarded as effective empathy interventions. Although 10 of 13 single group studies demonstrated a significant change in empathy between pre-test and post-test (p<0.05), effect sizes were often low (mean r=0.26). Six single-group studies reported an intervention effect of r>0.2. The most effective empathy education involved immersive and experiential simulation-based interventions. Simulation modalities ranged from role plays, manikin-based scenarios, to 3D e-simulations and point-of-view simulations where students wore a hemiparesis suit\ CONCLUSIONS: Nine of 23 empathy education studies in undergraduate nurse education demonstrated practical improvements in empathy. The most effective interventions were immersive and experiential simulations that focused on vulnerable patient groups and provided opportunities for guided reflection. We noted the research designs were limited in terms of levels of evidence and use of subjective measures. Larger experimental studies are required to provide higher levels of evidence to identify unequivocal outcomes in terms of empathy...
Johnson, M, Langdon, R, Levett-Jones, T, Weidemann, G, Manias, E & Everett, B 2019, 'A cluster randomised controlled feasibility study of nurse-initiated behavioural strategies to manage interruptions during medication administration.', International journal for quality in health care : journal of the International Society for Quality in Health Care.View/Download from: Publisher's site
OBJECTIVES:To examine the feasibility of a behavioural e-learning intervention to support nurses to manage interruptions during medication administration. DESIGN:A cluster randomised feasibility trial. SETTING:The cluster trial included four intervention and four control wards randomly selected across four metropolitan hospitals in Sydney, Australia. PARTICIPANTS:We observed 806 (402 pre-intervention and 404 post-intervention) medication events, where nurses prepared and administered medications to patients within the cluster wards. MAIN OUTCOME MEASURES:The primary outcome measured was the observed number of interruptions occurring during administration, with secondary outcomes being the number of clinical errors and procedural failures. Changes in the use of behavioural strategies to manage interruptions, targeted by the e-learning intervention, were also assessed. RESULTS:No significant differences were found in the number of interruptions (P = 0.82), procedural failures (P = 0.19) or clinical errors per 100 medications (P = 0.32), between the intervention and control wards. Differences in the use of specific behavioural strategies (engagement and multitasking) were found in the intervention wards. CONCLUSION:This behavioural e-learning intervention has not been found to significantly reduce interruptions, however, changes in the use of strategies did occur. Careful selection of clinical settings where there is a high number of predictable interruptions is recommended for further research into the impact of the behavioural e-learning intervention. An increase in the intensity of this intervention is recommended with training undertaken away from the clinical setting. Further research on additional consumer-sensitive interventions is urgently needed.
Muir-Cochrane, E, O'Kane, D, McAllister, M, Levett-Jones, T & Gerace, A 2018, 'Reshaping curricula: Culture and mental health in undergraduate health degrees.', International Journal of Mental Health Nursing, vol. 27, no. 2, pp. 652-661.View/Download from: UTS OPUS or Publisher's site
Australia is a country rich in cultural diversity, with Indigenous Australians having specific cultural values and a variety of spoken languages. In addition, the increasing number of people from migrant and refugee backgrounds requires that health professionals be able to communicate effectively with people from a wide range of cultural backgrounds. This is particularly relevant when undertaking a mental health assessment, because members of diverse communities often face the dual vulnerability of marginalization and stigmatization. This paper reports on the development and evaluation of a virtual teaching and learning resource that prepares health students to be culturally competent in mental health assessment. Four online interprofessional learning journeys were developed. Evaluation of the learning resources was conducted across three participating Australian universities. Quantitative evaluation involved pre- and post-testing using an empathy scale, the Mental Health Nursing Clinical Confidence Scale, and the Cultural Competence Questionnaire informed by the theory of planned behaviour. Qualitative data from focus group interviews explored participants' experiences of using the guided learning journey. Participants reported changes from pretest to post-test in their empathy and attitudes towards culturally and linguistically diverse consumers with significant positive changes in cultural competence, empathy, and attitudes. There was strong satisfaction with the learning materials, indicating that participants valued this 'real world' learning experience. Results require cautious interpretation, given recruitment difficulties in the evaluation phase. However, these learning journeys appear to have potential to be an effective way to challenge attitudes and perceptions, as well as increase cultural competence towards culturally and linguistically diverse consumers.
Courtney-Pratt, H, Pich, J, Levett-Jones, T & Moxey, A 2018, '"I was yelled at, intimidated and treated unfairly": Nursing students' experiences of being bullied in clinical and academic settings.', Journal of Clinical Nursing, vol. 27, no. 5-6, pp. e903-e912.View/Download from: UTS OPUS or Publisher's site
To present findings from a study that explored nursing students' experiences of bullying in clinical and academic settings, the strategies used to negotiate bullying and recommendations for empowering future students.Nursing students are identified as a group who are at particular risk of bullying. Numerous studies have examined students' experiences of bullying in clinical contexts by qualified nurses; however, there has been far less attention to the bullying that occurs in academic settings where the perpetrators are university staff and other students.The qualitative findings presented in this paper form one component of a mixed-methods, multisite study that examined the nature and extent of bullying in one cohort of nursing students.A convenience sample of 29 first-, second- and third-year undergraduate nursing students from one semimetropolitan Australian university was recruited for semistructured interviews in 2014. Interview data were analysed using NVivo.Participants described multiple examples of bullying occurring in both clinical and academic settings. Perpetrators included clinicians, facilitators, academics and fellow students. Bullying ranged from incivility to physical attacks. The impact of the bullying was profound; it caused many of the participants to feel anxious and distressed, it undermined their confidence and perception of competence, and it often led them to question their career choice. Strategies described by participants to cope with or manage the bullying included avoidance, trying to "just survive" and seeking support from trusted academic staff, family and friends. No episodes of bullying were formally reported.Bullying remains a pervasive phenomenon occurring in both clinical and academic settings. Students are, in many respects, a vulnerable and disempowered population who often fear the consequences of making a formal complaint. Thus, reporting structures and support strategies need to be re-examined, and resilience training is...
Johnson, M, Weidemann, G, Adams, R, Manias, E, Levett-Jones, T, Aguilar, V & Everett, B 2018, 'Predictability of Interruptions During Medication Administration With Related Behavioral Management Strategies.', Journal of Nursing Care Quality, vol. 33, no. 2, pp. E1-E9.View/Download from: UTS OPUS or Publisher's site
The aim of this qualitative study was to examine the nature of interruptions during medication administration. Focus groups were conducted with medical/surgical nurses (n = 15), critical care nurses (n = 13), and nurse managers/educators/specialists (n = 6). Most interruptions (78%) were predictable. Nurse-adopted strategies included blocking, engaging, mediating, multitasking, and preventing. Educational content was developed that relates behavioral strategies to respond to predictable and unpredictable interruptions.
Bogossian, F, Cooper, S, Kelly, M, Levett-Jones, T, McKenna, L, Slark, J & Seaton, P 2018, 'Best practice in clinical simulation education - are we there yet? A cross-sectional survey of simulation in Australian and New Zealand undergraduate nursing education', Collegian.View/Download from: UTS OPUS or Publisher's site
© 2017 Australian College of Nursing Ltd. Background: Simulation is potentially a means of increasing clinical education capacity. Significant investments have been made in simulation but the extent to which this has improved uptake, quality and diversity of simulation use is unclear. Aim: To describe the current use of simulation in tertiary nursing education programs leading to nurse registration Australia and New Zealand, and determine whether investments in simulation have improved uptake, quality and diversity of simulation experiences. Methods: A cross sectional electronic survey distributed to lead nursing academics in programs leading to nurse registration in Australia and New Zealand. Findings: 51.6% of institutions responded and reported wide variation in allocation of program hours to clinical and simulation learning. Simulation was embedded in curricula and positively valued as an adjunct or substitute for clinical placement. While simulation environments were adequate, staff time, training and resource development were barriers to increasing the quality, amount and range of simulation experiences. Quality assurance and robust evaluation were weak. Discussion: Simulation program hours are inconsistently reported and underutilized in terms of potential contribution to clinical learning. Benefits of capital investment in simulation physical resources have been realised, but barriers persist for increasing high quality simulation in nursing programs. Conclusion: Transitioning components of clinical education from the clinical to tertiary sectors has resource implications. Establishment of sustainable, high quality simulation experiences requires staff training, shared resources, best practice and robust evaluation of simulation experiences in nursing curricula.
Liaw, SY, Rashasegaran, A, Wong, LF, Deneen, CC, Cooper, S, Levett-Jones, T, Goh, HS & Ignacio, J 2018, 'Development and psychometric testing of a Clinical Reasoning Evaluation Simulation Tool (CREST) for assessing nursing students' abilities to recognize and respond to clinical deterioration.', Nurse Education Today, vol. 62, pp. 74-79.View/Download from: UTS OPUS or Publisher's site
The development of clinical reasoning skills in recognising and responding to clinical deterioration is essential in pre-registration nursing education. Simulation has been increasingly used by educators to develop this skill.To develop and evaluate the psychometric properties of a Clinical Reasoning Evaluation Simulation Tool (CREST) for measuring clinical reasoning skills in recognising and responding to clinical deterioration in a simulated environment.A scale development with psychometric testing and mixed methods study.Nursing students and academic staff were recruited at a university.A three-phase prospective study was conducted. Phase 1 involved the development and content validation of the CREST; Phase 2 included the psychometric testing of the tool with 15 second-year and 15 third-year nursing students who undertook the simulation-based assessment; Phase 3 involved the usability testing of the tool with nine academic staff through a survey questionnaire and focus group discussion.A 10-item CREST was developed based on a model of clinical reasoning. A content validity of 0.93 was obtained from the validation of 15 international experts. The construct validity was supported as the third-year students demonstrated significantly higher (p<0.001) clinical reasoning scores than the second-year students. The concurrent validity was also supported with significant positive correlations between global rating scores and almost all subscale scores, and the total scores. The predictive validity was supported with an existing tool. The internal consistency was high with a Cronbach's alpha of 0.92. A high inter-rater reliability was demonstrated with an intraclass correlation coefficient of 0.88. The usability of the tool was rated positively by the nurse educators but the need to ease the scoring process was highlighted.A valid and reliable tool was developed to measure the effectiveness of simulation in developing clinical reasoning skills for recognising and respon...
Croft, H, Gilligan, C, Rasiah, R, Levett-Jones, T & Schneider, J 2018, 'Thinking in Pharmacy Practice: A Study of Community Pharmacists' Clinical Reasoning in Medication Supply Using the Think-Aloud Method.', Pharmacy, vol. 6, no. 1, pp. 1-14.View/Download from: UTS OPUS or Publisher's site
Medication review and supply by pharmacists involves both cognitive and technical skills related to the safety and appropriateness of prescribed medicines. The cognitive ability of pharmacists to recall, synthesise and memorise information is a critical aspect of safe and optimal medicines use, yet few studies have investigated the clinical reasoning and decision-making processes pharmacists use when supplying prescribed medicines. The objective of this study was to examine the patterns and processes of pharmacists' clinical reasoning and to identify the information sources used, when making decisions about the safety and appropriateness of prescribed medicines. Ten community pharmacists participated in a simulation in which they were required to review a prescription and make decisions about the safety and appropriateness of supplying the prescribed medicines to the patient, whilst at the same time thinking aloud about the tasks required. Following the simulation each pharmacist was asked a series of questions to prompt retrospective thinking aloud using video-stimulated recall. The simulated consultation and retrospective interview were recorded and transcribed for thematic analysis. All of the pharmacists made a safe and appropriate supply of two prescribed medicines to the simulated patient. Qualitative analysis identified seven core thinking processes used during the supply process: considering prescription in context, retrieving information, identifying medication-related issues, processing information, collaborative planning, decision making and reflection; and align closely with other health professionals. The insights from this study have implications for enhancing awareness of decision making processes in pharmacy practice and informing teaching and assessment approaches in medication supply.
Omura, M, Stone, TE & Levett-Jones, T 2018, 'Cultural factors influencing Japanese nurses' assertive communication. Part 1: Collectivism.', Nursing & health sciences, vol. 20, no. 3, pp. 283-288.View/Download from: UTS OPUS or Publisher's site
Culture influences the way health-care professionals communicate with each other and their ability to relate to colleagues in an assertive manner. Cultural barriers can also make it difficult for nurses to speak up even when they have concerns about patient safety. An understanding of the potential impact of cultural factors is therefore needed when developing assertiveness communication training programs. This paper presents the findings from a study that explored Japanese nurses' perceptions of how culture and values impact assertive communication in health care. Semistructured interviews with 23 registered nurses were undertaken, and data were analyzed using directed content analysis. Two major themes were identified: collectivism and hierarchy/power. In the present study, we discuss the cultural values related to collectivism that included four categories of "wa" (harmony), "uchi to soto" (inside and outside), implicit communication/ambiguity, and "nemawashi" (groundwork). The findings highlight the impact of culture on nurses' assertive communication behaviors and can be used to inform the design of culturally-appropriate assertiveness communication training programs for Japanese nurses working both within their own country or internationally.
Kable, AK, Levett-Jones, TL, Arthur, C, Reid-Searl, K, Humphreys, M, Morris, S, Walsh, P & Witton, NJ 2018, 'A cross-national study to objectively evaluate the quality of diverse simulation approaches for undergraduate nursing students.', Nurse education in practice, vol. 28, pp. 248-256.View/Download from: UTS OPUS or Publisher's site
The aim of this paper is to report the results of a cross-national study that evaluated a range of simulation sessions using an observation schedule developed from evidence-based quality indicators. Observational data were collected from 17 simulation sessions conducted for undergraduate nursing students at three universities in Australia and the United Kingdom. The observation schedule contained 27 questions that rated simulation quality. Data were collected by direct observation and from video recordings of the simulation sessions. Results indicated that the highest quality scores were for provision of learning objectives prior to the simulation session (90%) and debriefing (72%). Student preparatiosn and orientation (67%) and perceived realism and fidelity (67%) were scored lower than other components of the simulation sessions. This observational study proved to be an effective strategy to identify areas of strength and those needing further development to improve simulation sessions.
van der Riet, P, Levett-Jones, T & Courtney-Pratt, H 2018, 'Nursing students' perceptions of a collaborative clinical placement model: A qualitative descriptive study.', Nurse education in practice, vol. 30, pp. 42-47.View/Download from: UTS OPUS or Publisher's site
Clinical placements are specifically designed to facilitate authentic learning opportunities and are an integral component of undergraduate nursing programs. However, as academics and clinicians frequently point out, clinical placements are fraught with problems that are long-standing and multidimensional in nature. Collaborative placement models, grounded in a tripartite relationship between students, university staff and clinical partners, and designed to foster students' sense of belonging, have recently been implemented to address many of the challenges associated with clinical placements. In this study a qualitative descriptive design was undertaken with the aim of exploring 14 third year third year nursing students' perceptions of a collaborative clinical placement model undertaken in an Australian university. Students participated in audio recorded focus groups following their final clinical placement. Thematic analysis of the interview data resulted in identification of six main themes: Convenience and Camaraderie, Familiarity and Confidence, Welcomed and Wanted, Belongingness and Support, Employment, and The Need for Broader Clinical Experiences. The clinical collaborative model fostered a sense of familiarity for many of the participants and this led to belongingness, acceptance, confidence and meaningful learning experiences.
Levett-Jones, T, Govind, N, Pich, J, Hoffman, K, Lapkin, S, Yeun-Sim Jeong, S, Noble, D, Maclellan, L, Norton, C, Robinson-Reilly, M & Jakimowicz, S 2018, 'Exploring Nursing Students' Perspectives of a Novel Point-of-View Disability Simulation', Clinical Simulation in Nursing, vol. 18, pp. 28-37.View/Download from: UTS OPUS or Publisher's site
© 2017 International Nursing Association for Clinical Simulation and Learning Background: Empathy is integral to therapeutic relationships and person-centered care. Interventions specifically targeting empathy toward people who have a disability may be of benefit to nursing education. Method: In this article, we describe a novel point-of-view simulation designed to enhance empathy toward people who have a disability as a result of acquired brain injury. Nursing students' perspectives of the simulation were examined using a concurrent nested mixed methods design and using the Satisfaction with Disability Simulation Experience Scale, which includes 18 closed and one open-ended question. Results: A total of 384 second-year nursing students from a population of 488 participated, giving a response rate of 79%. The overall mean satisfaction score was 4.49/5.0 (standard deviation = 0.55), indicating a high level of agreement with each of the survey items. Thirty-five participants responded to the open-ended question, and analysis of their comments revealed three themes: A valuable experience, new insights, and standing in someone else's shoes. Conclusion: Given that there is compelling research about the benefits of empathic engagement with patients, the results from this study support continuing investment in point-of-view simulation experiences.
Levett-Jones, T, Burdett, T, Chow, YL, Jönsson, L, Lasater, K, Mathews, LR, McAllister, M, Pooler, A, Tee, S & Wihlborg, J 2018, 'Case Studies of Interprofessional Education Initiatives From Five Countries.', Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, vol. 50, no. 3, pp. 324-332.View/Download from: UTS OPUS or Publisher's site
Although teamwork and interprofessional collaboration are critical to patient safety, nursing, medical, and allied health graduates often feel ill-prepared to confidently communicate and collaborate with other team members. While interprofessional education (IPE) has been advocated as a way of addressing this issue, there are multiple barriers to its systematic and sustained integration in undergraduate healthcare programs. Despite these challenges, examples of effective IPE initiatives have emerged.This article profiles seven case studies of innovative interprofessional education activities that have been successfully implemented across five countries, for a variety of learners, using different delivery modalities, and with evaluation results attesting to their success.The case studies demonstrate innovative ideas that have the potential to overcome some of the barriers to IPE through the use of creative and targeted approaches. This article provides a wealth of ideas for the successful design and implementation of IPE initiatives and will be of benefit to educators wishing to expand their repertoire of teaching approaches.A body of research attests to the relationship between interprofessional communication, teamwork, and patient outcomes. IPE is imperative for facilitating the development of nursing graduates' communication and teamwork skills; however, innovative approaches are needed to overcome the perceived and actual impediments to its implementation.
van der Riet, P, Levett-Jones, T & Aquino-Russell, C 2018, 'The effectiveness of mindfulness meditation for nurses and nursing students: An integrated literature review.', Nurse education today, vol. 65, pp. 201-211.View/Download from: UTS OPUS or Publisher's site
A growing body of literature has identified a range of beneficial physiological and psychological outcomes from the regular practice of mindfulness meditation. For healthcare professionals, mindfulness meditation is claimed to reduce stress, anxiety and burnout, and enhance resilience.The objective of this integrative review was to critically appraise the literature that related to the effectiveness of mindfulness meditation programs for nurses and nursing students.This review was conducted using Whittemore and Knafl's framework for integrated reviews.Using the terms mindfulness, mindfulness-based-stress reduction, Vipassana, nurses, and nurse education a comprehensive search of the following electronic databases was conducted: CINAHAL, Medline, PsycINFO, EMBASE. EMCARE, ERIC and SCOPUS.The initial search located 1703 articles. After screening and checking for eligibility 20 articles were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers and McMaster's Critical appraisal form for quantitative papers. The final number of papers included in the review was 16.The results of this review identified that mindfulness meditation has a positive impact on nurses' and nursing students' stress, anxiety, depression, burnout, sense of well-being and empathy. However, the majority of the papers described small scale localised studies which limits generalisability.Contemporary healthcare is challenging and complex. This review indicated that mindfulness meditation is an effective strategy for preventing and managing the workplace stress and burnout, which so often plague nursing staff and students. Further studies with larger sample sizes using rigorous research methods would be useful in extending this work.
Omura, M, Stone, TE & Levett-Jones, T 2018, 'Cultural factors influencing Japanese nurses' assertive communication: Part 2 - hierarchy and power.', Nursing & health sciences, vol. 20, no. 3, pp. 289-295.View/Download from: UTS OPUS or Publisher's site
Hierarchy and power characterize health-care relationships around the world, constituting a barrier to assertive communication and a risk to patient safety. This issue is more problematic and complex in countries such as Japan, where deep-seated cultural values related to hierarchy and power persist. The current paper is the second of two that present the findings from a study exploring Japanese nurses' views and experiences of how cultural values impact assertive communication for health-care professionals. We conducted semistructured interviews with 23 registered nurses, following which data were analyzed using directed content analysis. Two overarching themes emerged from the analysis: hierarchy/power and collectivism. In the present study, we focus on cultural values related to hierarchy and power, including differences in professional status, gender imbalance, seniority/generation gap, bullying, and humility/modesty. The findings from our research provide meaningful insights into how Japanese cultural values influence and constrain nurses' communication and speaking up behaviors, and can be used to inform educational programs designed to teach assertiveness skills.
Everson, N, Levett-Jones, T, Pitt, V, Lapkin, S, Van Der Riet, P, Rossiter, R, Jones, D, Gilligan, C & Courtney Pratt, H 2018, 'Analysis of the Empathic Concern Subscale of the Emotional Response Questionnaire in a Study Evaluating the Impact of a 3D Cultural Simulation.', International journal of nursing education scholarship, vol. 15, no. 1.View/Download from: UTS OPUS or Publisher's site
Abstract Background Empathic concern has been found to decline in health professional students. Few effective educational programs and a lack of validated scales are reported. Previous analysis of the Empathic Concern scale of the Emotional Response Questionnaire has reported both one and two latent constructs. Aim To evaluate the impact of simulation on nursing students' empathic concern and test the psychometric properties of the Empathic Concern scale. Methods The study used a one group pre-test post-test design with a convenience sample of 460 nursing students. Empathic concern was measured pre-post simulation with the Empathic Concern scale. Factor Analysis was undertaken to investigate the structure of the scale. Results There was a statistically significant increase in Empathic Concern scores between pre-simulation 5.57 (SD = 1.04) and post-simulation 6.10 (SD = 0.95). Factor analysis of the Empathic Concern scale identified one latent dimension. Conclusion Immersive simulation may promote empathic concern. The Empathic Concern scale measured a single latent construct in this cohort.
Cooper, S, Seaton, P, Absalom, I, Cant, R, Bogossian, F, Kelly, M, Levett-Jones, T, McKenna, L & Collectively - The Education, Simulation.and Safety (ESS) Collaboration 2018, 'Can scholarship in nursing/midwifery education result in a successful research career?', Journal of advanced nursing, vol. 74, no. 12, pp. 2703-2705.View/Download from: Publisher's site
Everson, N, Levett-Jones, T & Pitt, V 2018, 'The impact of educational interventions on the empathic concern of health professional students: A literature review.', Nurse education in practice, vol. 31, pp. 104-111.View/Download from: UTS OPUS or Publisher's site
This review aimed to identify programs that promote health professional students' empathic concern. Empathic concern is a key mediator of important outcomes for both patients and health professionals. However the empathic concern of health professional students tends to decline over the course of their studies. To date studies that have evaluated the impact of educational programs on empathic concern have not been reviewed. The databases ProQuest, CINAHL and Ovid were searched for studies that had evaluated educational programs for health professional students using a validated psychometric measure of empathic concern. Studies were graded using The Quality Assessment Tool for Quantitative Studies. Of 2977 identified studies, fifteen met inclusion criteria. Seven studies separately reported empathic concern scores. Four of the fifteen studies reported increased empathy scale scores after students took part in a program. Two studies received a strong quality rating, six a moderate rating and seven a weak rating. This review did not identify any studies that clearly demonstrated an increase in students' empathic concern after taking part in an educational program. Mindfulness based stress reduction, providing empathy content at each stage of a degree, programs that incorporate the film Wit, and Balint groups, may promote empathic concern. In light of the significant impact of health professionals' levels of empathic concern on outcomes for patients and health professionals, further robustly designed research using appropriate psychometric scales is needed to inform the development of education programs in this area.
Omura, M, Stone, TE, Maguire, J & Levett-Jones, T 2018, 'Exploring Japanese nurses' perceptions of the relevance and use of assertive communication in healthcare: A qualitative study informed by the Theory of Planned Behaviour.', Nurse education today, vol. 67, pp. 100-107.View/Download from: UTS OPUS or Publisher's site
The hierarchical nature of healthcare environments presents a key risk factor for effective interprofessional communication. Power differentials evident in traditional healthcare cultures can make it difficult for healthcare professionals to raise concerns and be assertive when they have concerns about patient safety. This issue is of particular concern in Japan where inherent cultural and social norms discourage assertive communication.The aim of this study was to (a) explore nurses' perceptions of the relevance and use of assertive communication in Japanese healthcare environments; and (b) identify the factors that facilitate or impede assertive communication by Japanese nurses.A belief elicitation qualitative study informed by the Theory of Planned Behaviour was conducted and reported according to the COnsolidated criteria for REporting Qualitative research.Twenty-three practicing Japanese registered nurses were recruited by snowball sampling from October 2016 to January 2017.Individual face-to-face semi-structured interviews were conducted and transcribed in Japanese and then translated into English. Two researchers independently conducted a directed content analysis informed by the Theory of Planned Behaviour. Participants' responses were labelled in order of frequency for behavioural beliefs about the consequences of assertive communication, sources of social pressure, and factors that facilitate or impede assertive communication in Japanese healthcare environments.Although person-centred care and patient advocacy were core values for many of the participants, strict hierarchies, age-based seniority, and concerns about offending a colleague or causing team disharmony impeded their use of assertive communication. Novice nurses were particularly reluctant to speak up because of their perception of having limited knowledge and experience.This study identified Japanese nurses' behavioural, normative, and control beliefs in relation to assertive communication. T...
Johnson, M, Levett-Jones, T, Langdon, R, Weidemann, G, Manias, E & Everett, B 2018, 'A qualitative study of nurses' perceptions of a behavioural strategies e-learning program to reduce interruptions during medication administration.', Nurse education today, vol. 69, pp. 41-47.View/Download from: UTS OPUS or Publisher's site
We sought to evaluate the perceptions of nurses of an e-learning educational program to encourage the use of behavioural strategies-blocking, engaging, mediating, multitasking, and preventing-to reduce the negative effects of interruptions during medication administration.A qualitative design was used to evaluate the impact of this e-learning educational intervention on nurses' behaviour.Two wards (palliative care and aged care) from two different hospitals within a large local health service within Sydney Australia, were included in the study. These wards were also involved in a cluster randomised trial to test the effectiveness of the program.A purposive sample participated comprising nine registered and enrolled nurses certified to conduct medication administration, who had reviewed the educational modules.Two focus groups were conducted and these sessions were digitally recorded and transcribed verbatim. Thematic analysis identified seven themes.The major themes identified included: perceptions of interruptions, accessing the program, content of the program, impact, maintaining good practice and facilitators and barriers to changing behaviour.The use of embedded authentic images of patient interruptions and management strategies increased some nurses' perceived use of strategies to manage interruptions. Nurses varied in their perception as to whether they could change their behaviour with some describing change at the individual and ward team levels, while others described patient caseload and other health professionals as a barrier. The use of this innovative educational intervention is recommended for staff orientation, student nurses, medical officers and allied health staff. Further research is required in how this e-learning program can be used in combination with other effective interventions to reduce interruptions.
Cant, RP, Levett-Jones, T & James, A 2018, 'Do Simulation Studies Measure up? A Simulation Study Quality Review', Clinical Simulation in Nursing, vol. 21, pp. 23-39.View/Download from: UTS OPUS or Publisher's site
© 2018 International Nursing Association for Clinical Simulation and Learning Simulation-based education has become a ubiquitous teaching approach in nursing. However, ensuring the quality of simulation research is critical. We reviewed the methodological quality of 26 quantitative studies published in Clinical Simulation in Nursing, 2017. The Medical Education Research Study Quality Instrument and Simulation Research Evaluation Rubric showed that nearly all studies were of moderate to high quality (rated 50%). Correlation coefficients showed that interrater agreement was high overall (0.94). In conclusion, this was a valid approach for examining simulation study quality. Although most included studies were of high quality, some elements of study reporting can be improved upon.
Dean, S, Walsh, S, Williams, C, Zaslawski, C, Morgan, A & Levett-Jones, T 2018, 'The mystery shopper student learning experience in undergraduate health education: A case study', Nurse Education Today, vol. 70, no. 2018, pp. 69-70.View/Download from: UTS OPUS or Publisher's site
Ward, A, Mandrusiak, A & Levett-Jones, T 2018, 'Cultural empathy in physiotherapy students: a pre-test post-test study utilising virtual simulation.', Physiotherapy, vol. 104, no. 4, pp. 453-461.View/Download from: UTS OPUS or Publisher's site
OBJECTIVES:To investigate how a virtual cultural simulation experience and guided reflection influenced physiotherapy students' intrapersonal and interpersonal cultural empathy, and to explore students' satisfaction with the learning experience. DESIGN:Three research arms within a single cohort: 1) pre-test post-test investigation of intrapersonal cultural empathy; 2) quasi-experimental investigation of interpersonal cultural empathy; 3) post-test measurement of satisfaction. SETTING:An Australian university. PARTICIPANTS:Bachelor and Master physiotherapy students, response rate 98% (162/165). INTERVENTIONS:A self-directed online virtual simulation in which the student assumed the role of a patient who has been hospitalised in a developing country. Students were then guided to reflect on the experience via online questions. MAIN OUTCOME MEASURES:The primary measure was the Comprehensive State Empathy Scale (CSES) of intrapersonal cultural empathy. Secondary measures were the Theory of Planned Behaviour:Cultural Competence Questionnaire (TPB:CCQ) of interpersonal cultural empathy; and the Satisfaction with Cultural Simulation Experience Scale (SCSES). RESULTS:Intrapersonal cultural empathy improved after the virtual simulation, shown in overall CSES scores [pre-test: 95 (81-109) vs post-test: 106 (89-117); median difference 11; P=<0.001]. For the TPB:CCQ, the post-simulation ('intervention') group demonstrated greater 'Perceived Behavioural Control' interpersonal empathy compared to the presimulation ('control') group [4.41 (0.54) vs 4.59 (0.53); mean difference=0.19; 95% confidence interval=0.01 to 0.36; P=0.020]. Satisfaction with the experience was high (mean SCSES score=40/56 (71%)). CONCLUSIONS:A virtual cultural simulation experience and guided reflection led to significant increases in students' intrapersonal cultural empathy, with some influence on interpersonal cultural empathy. Students were highly satisfied with this learning experience.
Andersen, P, Baron, S, Bassett, J, Govind, N, Hayes, C, Lapkin, S, Lasater, K, Levett-Jones, T, McAllister, M, Pich, J, Power, T, Reid-Searl, K, Ryan, C, Shearer, K & Simes, T 2018, 'Snapshots of Simulation: Innovative Strategies Used by International Educators to Enhance Simulation Learning Experiences for Health Care Students', Clinical Simulation in Nursing, vol. 16, pp. 8-14.View/Download from: UTS OPUS or Publisher's site
© 2017 International Nursing Association for Clinical Simulation and Learning Background Innovations in simulation in nursing and health care continue to be developed as creative and committed educators respond to challenges of providing pedagogically sound, engaging and effective learning experiences for large student cohorts. Time-pressed educators may find it difficult to network with others working in simulation-based learning, and thus, it is useful to provide summaries or snapshots to provide a brief overview of activities in various countries using simulation in a variety of ways. Method The purpose of this paper is to profile a diverse range of innovative, cost-effective, and tested simulation approaches that have been implemented in healthcare programs by nursing educators from a range of countries to spark creativity. Each strategy was designed to address contemporary and critical practice issues. Results They facilitate immersion in authentic clinical scenarios, increase students' awareness of cues in the environment that may compromise health and safety. Conclusion These snapshots of simulation prepare students for cultural or clinical realities that they may not routinely encounter because of the inherent restrictions associated with clinical placements.
© 2015 Australian College of Nursing Ltd.Aim: The aim of this review was to explore factors which facilitate or inhibit undergraduate nursing students' willingness to demonstrate moral courage when confronted by poor patient care. Methods: Included papers were those that met the criteria of being qualitative research that explored undergraduate nursing students' depictions of situations where moral courage was or was not demonstrated during clinical placements, with a particular focus on situations that impacted or had the potential to impact the quality of patient care.Papers were reviewed using the Critical Appraisal Skills Programme Qualitative Research Checklist. The 15 papers included in the review were then thematically analysed. Findings: The literature reports, despite feeling a moral obligation to act, most nursing students lack the moral courage to intervene or speak up when faced with poor practice. While students may subsequently report the behaviour, at the time of the event, they often remain passive spectators and sometimes even active participants. The major themes identified in the literature were: just a student, don't rock the boat, fear of consequences, mentor-student relationship, and patient advocate identity. The literature also identified that nursing students suffer ongoing moral distress when they do not have the courage to confront poor practice. Conclusion: There is a need for further research to explore positive examples of how nursing students demonstrate moral courage when undertaking clinical placements. These narratives have the potential to influence future students' attitudes, values and behaviours by providing stimulus materials for teaching.
MacLellan, L, Higgins, I & Levett-Jones, T 2017, 'An exploration of the factors that influence nurse practitioner transition in Australia: A story of turmoil, tenacity, and triumph.', Journal of the American Association of Nurse Practitioners, vol. 29, no. 3, pp. 149-156.View/Download from: UTS OPUS or Publisher's site
BACKGROUND AND PURPOSE: Nurse practitioner (NP) legislation was introduced in Australia in 1998 with the first NPs endorsed 2 years later. Although the number of NPs has slowly increased, they still face significant challenges adjusting to their new role. The aim of this study was to explore the factors that influence the experience of new NPs. METHODS: Ten newly appointed NPs were interviewed three to four times over a 12-month period. Using a summative content analysis, data were reduced to four key factors that influence the experience of role transition: personal, intraprofessional, interprofessional, and organizational. CONCLUSIONS: The findings illustrate that for many participants, transition was a time of turmoil and a great deal of tenacity was required to navigate the journey. However, despite the challenges, some participants were triumphant and able to forge a successful role for themselves. IMPLICATIONS FOR PRACTICE: This study highlights the need for the nursing profession to support new NPs. It also demonstrates that the provision of structured orientation programs is needed to facilitate effective transition to these complex and challenging roles. Clarity of expectations and a gradual increase in responsibilities are likely to optimize adjustment to the NP role.
Sinclair, PM, Levett-Jones, T, Morris, A, Carter, B, Bennett, PN & Kable, A 2017, 'High engagement, high quality: A guiding framework for developing empirically informed asynchronous e-learning programs for health professional educators.', Nursing and Health Sciences, vol. 19, no. 1, pp. 126-137.View/Download from: UTS OPUS or Publisher's site
E-learning involves the transfer of skills and knowledge via technology so that learners can access meaningful and authentic educational materials. While learner engagement is important, in the context of healthcare education, pedagogy must not be sacrificed for edu-tainment style instructional design. Consequently, health professional educators need to be competent in the use of current web-based educational technologies so that learners are able to access relevant and engaging e-learning materials without restriction. The increasing popularity of asynchronous e-learning programs developed for use outside of formal education institutions has made this need more relevant. In these contexts, educators must balance design and functionality to deliver relevant, cost-effective, sustainable, and accessible programs that overcome scheduling and geographic barriers for learners. This paper presents 10 guiding design principles and their application in the development of an e-learning program for general practice nurses focused on behavior change. Consideration of these principles will assist educators to develop high quality, pedagogically sound, engaging, and interactive e-learning resources.
Levett-Jones, T, Lapkin, S, Govind, N, Pich, J, Hoffman, K, Jeong, SY-S, Norton, CA, Noble, D, Maclellan, L, Robinson-Reilly, M & Everson, N 2017, 'Measuring the impact of a 'point of view' disability simulation on nursing students' empathy using the Comprehensive State Empathy Scale.', Nurse Education Today, vol. 59, pp. 75-81.View/Download from: UTS OPUS or Publisher's site
Although empathy is an integral component of professional practice and person-centred care, a body of research has identified that vulnerable patients groups frequently experience healthcare that is less than optimal and often lacking in empathy.The aim of this study was to examine the impact of an immersive point-of-view simulation on nursing students' empathy towards people with an Acquired Brain Injury.A convenience sample of 390 nursing students from a cohort of 488 participated in the study, giving a response rate of 80%. Students undertook the simulation in pairs and were randomly allocated to the role of either a person with Acquired Brain Injury or a rehabilitation nurse. The simulated 'patients' wore a hemiparesis suit that replicated the experience of dysphasia, hemianopia and hemiparesis.Characteristics of the sample were summarised using descriptive statistics. A two-group pre-test post-test design was used to investigate the impact of the simulation using the Comprehensive State Empathy Scale. t-Tests were performed to analyse changes in empathy pre post and between simulated 'patients' and 'rehabilitation nurses'.On average, participants reported significantly higher mean empathy scores post simulation (3.75, SD=0.66) compared to pre simulation (3.38 SD=0.61); t (398)=10.33, p<0.001. However, this increase was higher for participants who assumed the role of a 'rehabilitation nurse' (mean=3.86, SD=0.62) than for those who took on the 'patient' role (mean=3.64, SD=0.68), p<0.001.The results from this study attest to the potential of point-of-view simulations to positively impact nursing students' empathy towards people with a disability. Research with other vulnerable patient groups, student cohorts and in other contexts would be beneficial in taking this work forward.
Sinclair, PM, Day, J, Levett-Jones, T & Kable, A 2017, 'Barriers and facilitators to opportunistic chronic kidney disease screening by general practice nurses.', Nephrology, vol. 22, no. 10, pp. 776-782.View/Download from: UTS OPUS or Publisher's site
Opportunistic screening in general practice (GP) is a cost-effective and viable approach to the early identification of chronic kidney disease (CKD). This study sought to identify the barriers and facilitators to CKD screening practices of GP nurses working in a regional area of New South Wales, Australia.An eight-item elicitation questionnaire informed by the Theory of Planned Behaviour was administered to a convenience sample of 26 GP nurses.Participants identified that the advantages of CKD screening were its early detection and treatment, the reduction of disease burden, and the opportunity to increase awareness and provide disease prevention education. These positive attitudinal beliefs were offset by negative beliefs about the impost of opportunistic screening on nursing time, particularly when there were other competing clinical priorities. Participants reported that practice doctors were wary of the financial costs associated with additional non-claimable services and believed that unfunded services, regardless of patient benefit, were difficult to justify in a private business environment. Screening was enabled in GP settings with existing screening protocols or initiatives, and when patients presented with known risk factors. Barriers to screening were more frequently described and illustrated a strong focus on financial aspects of GP. Without reimbursement through the Medicare Benefits Scheme, screening was not considered an economical use of nursing time. Other competing and billable clinical services took precedence.The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting.
Levett-Jones, T 2017, 'Micronutrient Supplementation in Adults with HIV Infection: Cochrane Nursing Care Field - Cochrane Review Summary.', Journal of the Association of Nurses in AIDS Care, vol. 28, no. 6, pp. 984-986.View/Download from: UTS OPUS or Publisher's site
Omura, M, Maguire, J, Levett-Jones, T & Stone, TE 2017, 'The effectiveness of assertiveness communication training programs for healthcare professionals and students: A systematic review.', International Journal of Nursing Studies, vol. 76, pp. 120-128.View/Download from: UTS OPUS or Publisher's site
Communication errors have a negative impact on patient safety. It is therefore essential that healthcare professionals have the skills and confidence to speak up assertively when patient safety is at risk. Although the facilitators to and barriers of assertive communication have been the subject of previous reviews, evidence regarding the effectiveness of interventions designed to enhance assertive communication is lacking. Thus, this paper reports the findings from a systematic review of the effectiveness of assertiveness communication training programs for healthcare professionals and students.The objective of this review is to identify, appraise and synthesise the best available quantitative evidence in relation to the effectiveness of assertiveness communication training programs for healthcare professionals and students on levels of assertiveness, communication competence and impact on clinicians' behaviours and patient safety.The databases included: CINAHL, Cochrane library, EMBASE, Informit health collection, MEDLINE, ProQuest nursing and allied health, PsycINFO, Scopus and Web of Science. The search for unpublished studies included: MedNar, ProQuest Dissertations & Theses A&I. Studies published in English from 2001 until 2016 inclusive were considered.The review included original quantitative research that evaluated (a) any type of independent assertiveness communication training program; and (b) programs with assertiveness training included as a core component of team skills or communication training for healthcare professionals and students, regardless of healthcare setting and level of qualification of participants.Studies selected based on eligibility criteria were assessed for methodological quality and the data were extracted by two independent researchers using the Joanna Briggs Institute critical appraisal and data extraction tools.Eleven papers were critically appraised using the Joanna Briggs Institute critical appraisal checklists. Eight papers...
Johnson, M, Sanchez, P, Langdon, R, Manias, E, Levett-Jones, T, Weidemann, G, Aguilar, V & Everett, B 2017, 'The impact of interruptions on medication errors in hospitals: an observational study of nurses.', Journal of Nursing Management, vol. 25, no. 7, pp. 498-507.View/Download from: UTS OPUS or Publisher's site
To explore interruptions during medication preparation and administration and their consequences.Although not all interruptions in nursing have a negative impact, interruptions during medication rounds have been associated with medication errors.A non-participant observational study was undertaken of nurses conducting medication rounds.Fifty-six medication events (including 101 interruptions) were observed. Most medication events (99%) were interrupted, resulting in nurses stopping medication preparation or administration to address the interruption (mean 2.5 minutes). The mean number of interruptions was 1.79 (SD 1.04). Thirty-four percent of medication events had at least one procedural failure, while 3.6% resulted in a clinical error.Our study confirmed that interruptions occur frequently during medication preparation and administration, and these interruptions were associated with procedural failures and clinical errors. Nurses were the primary source of interruptions with interruptions often being unrelated to patient care.This study has confirmed that interruptions are frequent and result in clinical errors and procedural failures, compromising patient safety. These interruptions contribute a substantial additional workload to medication tasks. Various interventions should be implemented to reduce non-patient-related interruptions. Medication systems and procedures are advocated, that reduce the need for joint double-checking of medications, indirectly avoiding interruptions.
Levett-Jones, T & Guinea, S 2017, 'The Evolution of a Mnemonic for Quality Simulation Practices', Clinical Simulation in Nursing, vol. 13, no. 11, pp. 552-561.View/Download from: UTS OPUS or Publisher's site
© 2017 International Nursing Association for Clinical Simulation and Learning As health care simulation continues to mature, the literature has shifted from descriptive narratives about 'doing' simulation towards a greater focus on the scholarship of simulation practice. In essence, there has been a shift from viewing simulation as a technology to a pedagogy. At the same time, there has been increasing attention to what defines excellence, quality, and sustainability of simulation practice. This article presents a comprehensive overview of educational principles and practices for simulation derived from contemporary health care and education literature, framed using the mnemonic simulation. This article complements existing work into quality indicators and standards and will be relevant to a range of health care disciplines.
Dean, S, Williams, C, Donnelly, S & Levett-Jones, T 2017, 'Designing a Women's Refuge: An Interdisciplinary Health, Architectureand Landscape Collaboration', International Journal of Higher Education, vol. 6, no. 6, pp. 139-148.View/Download from: UTS OPUS or Publisher's site
University programs are currently faced with a number of challenges: how to engage students as active learners, how to ensure graduates are 'work ready' with broad and relevant professional skills, and how to support students to see their potential as agents of social change and contributors to social good. This paper presents the findings from a
study that explored the impact of an authentic, interdisciplinary project with health, architecture and landscape students. This project facilitated students' entrée into the lived experience of women and children requiring refuge services as a result of homelessness and/or domestic violence. Students collaborated with stakeholders from the refuge sector, visiting sites, undertaking individual research, exchanging ideas and problem-solving, to develop a design guide for a women's refuge. Focus groups were conducted at the conclusion of the activity to gauge students' perceptions of the value of the activity. Results indicated that the 'hands-on' and collaborative nature of the learning experience in a real-world context was valued, primarily due to its direct relevance to professional practice. Architecture and landscape participants reported an increase in their understanding and knowledge of refuge clients, and many expressed a commitment to further learning and contribution to the sector. Nursing students felt that the authentic learning experience helped prepare them for the 'real world' of practice and that it aided the development of their professional identities and capacity to effect real-world change. The learning activity had a positive impact on knowledge acquisition and students' confidence to act as agents of social change.
Croft, H, Nesbitt, K, Rasiah, R, Levett-Jones, T & Gilligan, C 2017, 'Safe dispensing in community pharmacies: Applying the software, hardware, environment and liveware (SHELL) model', Clinical Pharmacist, vol. 9, no. 7.View/Download from: Publisher's site
© 2018 Royal Pharmaceutical Society.All Rights Reserved. The human aspects of the community pharmacy work system are vulnerable to medication-related errors. Established models of human error can identify actual or potential hazards, and are important in our understanding the interaction between human and system factors that influence performance. The software, hardware, environment and liveware (SHELL) model, a traditional human factors framework, is used in this article to classify potential sources of error in community pharmacies. A thorough review of the literature identified 50 risk factors which were categorised according to the dimensions of the SHELL model, which focuses on the system in which the pharmacist works, rather than individual performance. This model uses a systematic approach to examine mismatches at the interface between the human and the components of the system that are potential sources of error. The application of this model to hazard identification and error reduction in community pharmacy is explored.
Hills, C, Levett-Jones, T, Warren-Forward, H & Lapkin, S 2016, 'Generation Y occupational therapy students' views and preferences about the provision of feedback during clinical practice education', Focus on Health Professional Education: A Multi-disciplinary Journal, vol. 17, no. 2, pp. 32-47.View/Download from: UTS OPUS or Publisher's site
Introduction: Feedback is central to students' learning whilst on practice education and has been identified by students as one aspect of quality placements. Generation Y students have been reported as preferring praise during feedback, and in occupational therapy, students classified as Generation Y have been reported as having difficulty accepting critical feedback in practice education. This study aimed to seek one group of Generation Y students' views and preferences in regards to quality feedback during practice education.
Method: After ethical approval, students from one occupational therapy program in an Australian university were invited to participate in a semi-structured interview to explore their learning preferences regarding feedback during practice education.
Results: Twenty-two student interviews were completed. After thematic analysis, four themes were generated: "feedback is important for student learning", "student preferences on the provision of feedback", "when to provide feedback" and "the role of the team in providing feedback".
Conclusion: Participants reported that feedback should be regular and consistent as it is important for insight into their level of proficiency. Immediate explicit feedback was highly valued when it identified areas for improvement and was preferred to praise, this being contrary to the purported preference of Generation Y students. Participants also valued protected supervision time for feedback, feedback from the multidisciplinary team and an opportunity to self-evaluate prior to receiving feedback. Recommendations are made for methods and approaches to feedback that would be informative to clinical practice educators and those who deliver preparatory courses for clinical educators in universities.
Hills, C, Ryan, S, Smith, DR, Warren-Forward, H, Levett-Jones, T & Lapkin, S 2016, 'Occupational therapy students' technological skills: Are 'generation Y' ready for 21st century practice?', Australian Occupational Therapy Journal, vol. 63, pp. 391-398.View/Download from: UTS OPUS or Publisher's site
© 2016 Occupational Therapy Australia.Background/aim: Technology is becoming increasingly integral to the practice of occupational therapists and part of the everyday lives of clients. 'Generation Y' are purported to be naturally technologically skilled as they have grown up in the digital age. The aim of this study was to explore one cohort of 'Generation Y' occupational therapy students' skills and confidence in the use of technologies relevant to contemporary practice. Methods: A cross-sectional survey design was used to collect data from a cohort of 274 students enrolled in an Australian undergraduate occupational therapy programme. Results: A total of 173 (63%) students returned the survey. Those born prior to 1982 were removed from the data. This left 155 (56%) 'Generation Y' participants. Not all participants reported to be skilled in everyday technologies although most reported to be skilled in word, Internet and mobile technologies. Many reported a lack of skills in Web 2.0 (collaboration and sharing) technologies, creating and using media and gaming, as well as a lack of confidence in technologies relevant to practice, including assistive technology, specialist devices, specialist software and gaming. Conclusions: Overall, the results suggested that this group of 'Generation Y' students were not universally skilled in all areas of technology relevant to practice but appear to be skilled in technologies they use regularly. Recommendations are therefore made with view to integrating social networking, gaming, media sharing and assistive technology into undergraduate programmes to ensure that graduates have the requisite skills and confidence required for current and future practice.
Honda, K, Levett-Jones, T, Stone, T & Maguire, J 2016, 'Japanese nursing students' sense of belonging: A story of Uchi (insider) and Soto (outsider).', Nurse Education in Practice, vol. 20, pp. 85-92.View/Download from: UTS OPUS or Publisher's site
Clinical placement experiences are the cornerstone of nursing education and a body of literature indicates that belongingness is fundamental to students' learning when undertaking placements. However, little is known about Japanese nursing students' sense of belonging and how it is influenced by their cultural values. The aim of this paper is to profile a study that: measured the extent to which Japanese nursing students' experience a sense of belonging in clinical placements, and explored the factors that impact on and are consequences of that experience. A mixed methods design was used with quantitative data collected using the Belongingness Scale-Clinical Placement Experience and qualitative data collected using semi-structured interviews. Ninety-two third and fourth year students from a large regional university in Japan completed the questionnaire; of these six also participated in interviews. The results identified similarities and differences between this and other studies of belongingness. Supportive and welcoming clinical environments facilitated participants' belongingness and motivation to learn. However, the belongingness scores of this sample were lower than those in all other studies. This may be explained, in part, by the Japanese cultural values of "Uchi (insider) and Soto" (outsider), which pervaded the participants' placement experiences and led to feelings of exclusion and alienation.
Wilson, AJ, Palmer, L, Levett-Jones, T, Gilligan, C & Outram, S 2016, 'Interprofessional collaborative practice for medication safety: Nursing, pharmacy, and medical graduates' experiences and perspectives.', Journal of Interprofessional Care, vol. 30, no. 5, pp. 649-654.View/Download from: UTS OPUS or Publisher's site
Medication errors are the second most prevalent cause of adverse patient incidents in Australian hospital settings. Although numerous strategies to address this patient safety issue have been implemented, the impact of interprofessional collaborative practice (IPCP) on medication safety has received limited attention. The aim of this article is to report the perspectives and experiences of recently graduated, currently practicing Australian nurses, pharmacists, and doctors in relation to IPCP and medication safety. Sixty-eight graduates from three Australian states participated in focus groups. Thematic analysis of transcripts was conducted using an iterative process. The findings from this study illustrate how knowing about and valuing the skills and responsibilities of other team members and respecting each person's unique contribution to the work of the team can lead to more effective communication and collaboration in the context of medication safety. Although collaborative practice is critical to safe medication prescribing, dispensing, and administration, there are recurring and pervasive challenges to its achievement. This study indicated the need for improved preparation of graduates to equip them with the knowledge and skills needed to participate in an interprofessional team; and we advocate that deliberate, structured, and meaningful interprofessional clinical education initiatives are required.
Borrott, N, Day, GE, Sedgwick, M & Levett-Jones, T 2016, 'Nursing students' belongingness and workplace satisfaction: Quantitative findings of a mixed methods study.', Nurse Education Today, vol. 45, pp. 29-34.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The relationship between nursing students' belongingness and workplace satisfaction has received limited attention in the literature to date. AIM: The aim of this study was to explore the relationship between, and factors that may influence final semester nursing students' need to belong, sense of belonging and workplace satisfaction while on clinical placements. METHODS: A cross-national longitudinal multiphase explanatory sequential mixed methods study underpinned by a pragmatic theoretical framework was used for this study. A convenience sample of third-year nursing students from two Australian and one Canadian university (n=468) were recruited. Participants were asked to complete a 62 item survey which was a composite of three previously validated surveys: the 10 item 'Need to Belong Scale', the 34 item 'Belongingness Scale: Clinical Placement Experience (BES:CPE)' and the 18 item 'Nursing Workplace Satisfaction Questionnaire'. Data were analysed using descriptive and inferential statistics. RESULTS: Key results indicated that participants wanted to have someone to turn to, and to be accepted; they found nursing work interesting and considered it worthwhile to make an effort in this meaningful job. Participants were usually comfortable to ask for and accept help but many felt discriminated against during clinical placements. Only belongingness was strongly correlated with workplace satisfaction. CONCLUSIONS: Irrespective of site, nursing students' satisfied sense of belonging influenced their workplace satisfaction while on clinical placements. Workplace satisfaction is a key determinant of career decisions and the results from this study have the potential to inform clinical placement practices and policies and to influence beginning nurses' decisions to continue in the profession.
Bickhoff, L, Levett-Jones, T & Sinclair, PM 2016, 'Rocking the boat - nursing students' stories of moral courage: A qualitative descriptive study.', Nurse education today, vol. 42, pp. 35-40.View/Download from: UTS OPUS or Publisher's site
This paper profiles a qualitative study that examined how undergraduate nursing students demonstrate moral courage when confronted with clinical situations that negatively impact the quality of patient care and/or patient experience and the factors that encouraged or inhibited their willingness to speak up when they identified poor practice.Clinical placements are an essential component of nursing programmes. However, placements are a reported source of stress for students, with many witnessing, or feeling compelled to participate in, poor practice. In these instances, nursing students require the moral courage to raise concerns in order to protect patient safety and dignity.This was a qualitative descriptive study. Nine nursing students and one nursing graduate from one semi-metropolitan university in Australia were interviewed and the data were thematically analysed.Four key themes emerged: (1) patient advocate identity, which had two sub-themes of knowing one's own moral code and previous life experiences; (2) consequences to the patient and to the participant; (3) the impact of key individuals; and (4) picking your battles.This study demonstrates the importance of undergraduate nursing students identifying as patient advocates, the multitude of consequences students face when questioning the practice of a registered nurse, and the influence supervising nurses and clinical facilitators have on a student's decisions to intervene to protect patient safety. Further research is required to examine the factors, both intrinsic and extrinsic, that influence nursing students' moral courage and their decisions to intervene when poor practice is witnessed.
Lyneham, J & Levett-Jones, T 2016, 'Insights into Registered Nurses' professional values through the eyes of graduating students.', Nurse Education in Practice, vol. 17, pp. 86-90.View/Download from: UTS OPUS or Publisher's site
Professional values are integrated into undergraduate nursing curricula and taught in various ways. A significant influence on students' developing values and their definition of a 'good nurse' are the nurses they interact with in practice. The aim of this paper is to present the findings from a study that explored the professional values that graduating students viewed as important and how these values were illustrated in the behaviours of the nurses whose clinical practice they admired and wished to emulate. Fourteen students from one Australian university were interviewed on the last day of their final clinical placement. An interpretive qualitative design employing semi-structured interviews framed the study. Data were audio recorded, transcribed and thematically analysed. The participants' descriptions illustrated a range of professional values and behaviours. Four main professional values were identified, these included: being person-centred; kindness and caring; being in control; and commitment to learning. Findings demonstrated that the participants understood the meaning and relevance of professional nursing values, from a theoretical, moral and practical stance. Their responses also illustrated an appreciation of how these values influence patient care and the organisational culture as a whole.
Sinclair, PM, Kable, A, Levett-Jones, T & Booth, D 2016, 'The effectiveness of Internet-based e-learning on clinician behaviour and patient outcomes: A systematic review.', International Journal of Nursing Studies, vol. 57, pp. 70-81.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The contemporary health workforce has a professional responsibility to maintain competency in practice. However, some difficulties exist with access to ongoing professional development opportunities, particularly for staff in rural and remote areas and those not enrolled in a formal programme of study. E-learning is at the nexus of overcoming these challenges. The benefits of e-learning have been reported in terms of increased accessibility to education, improved self-efficacy, knowledge generation, cost effectiveness, learner flexibility and interactivity. What is less clear, is whether improved self-efficacy or knowledge gained through e-learning influences healthcare professional behaviour or skill development, whether these changes are sustained, and whether these changes improve patient outcomes. OBJECTIVE: To identify, appraise and synthesise the best available evidence for the effectiveness of e-learning programmes on health care professional behaviour and patient outcomes. DESIGN: A systematic review of randomised controlled trials was conducted to assess the effectiveness of e-learning programmes on clinician behaviour and patient outcomes. Electronic databases including CINAHL, Embase, ERIC, MEDLINE, Mosby's Index, Scopus and Cochrane - CENTRAL were searched in July 2014 and again in July 2015. QUALITY ASSESSMENT AND DATA EXTRACTION: Studies were reviewed and data extracted by two independent reviewers using the Joanna Briggs Institute standardised critical appraisal and data extraction instruments. DATA SYNTHESIS: Seven trials met the inclusion criteria for the analysis. Due to substantial instructional design, subject matter, study population, and methodological variation between the identified studies, statistical pooling was not possible and a meta-analysis could not be performed. Consequently, the findings of this systematic review are presented as a narrative review. RESULTS: The results suggest that e-learning was at least as effectiv...
McAllister, M, Levett-Jones, T, Petrini, MA & Lasater, K 2016, 'The viewing room: A lens for developing ethical comportment.', Nurse Education in Practice, vol. 16, no. 1, pp. 119-124.View/Download from: UTS OPUS or Publisher's site
Healthcare is dynamic and complex, and against this background, nursing students must negotiate the transition from lay person to healthcare professional. Diverse life experiences and learning styles can further complicate this journey of transformation. The contemporary role of the nurse includes caring for and making clinical decisions about patients based on ethical principles. Learning about and integrating ethical comportment as part of the transformative journey requires nurse educators to create and implement learning experiences that challenge nursing students to think deeply and broadly about the experiences they encounter, to question their previous assumptions and prejudices, to consider the world of healthcare through a new lens, and to reflect on and learn from the process. The judicious use of film has the potential to assist students to recognize and develop ethical comportment as they prepare for real-world clinical practice experiences. In this paper, we present three film exemplars and related teaching strategies designed to facilitate transformative learning and development of ethical comportment.
MacLellan, L, Levett-Jones, T & Higgins, I 2016, 'The enemy within: Power and politics in the transition to nurse practitioner', NursingPlus Open, vol. 2, pp. 1-7.View/Download from: UTS OPUS or Publisher's site
© 2016 The Authors. Background: The period of transition from registered nurse to nurse practitioner is often challenging. While adjusting to their autonomous role, nurse practitioners need to create and define a distinct role for themselves within practice contexts that may be unfamiliar, sometimes unwelcoming and inhospitable. During this time of transition, nurses need well developed negotiation skills and personal attributes including resilience, tenacity, fortitude and determination. Purpose of the research: The purpose of the research reported in this paper was to explore the transition experiences of 10 newly endorsed nurse practitioners in Australia during their first year of practice. This paper focuses on power, control and political manoeuvring that negatively impacted the [U+05F3]nurse practitioners[U+05F3] transition. A qualitative approach using a modified version of Carspecken[U+05F3]s five stage critical ethnography, informed by focused ethnography, was the methodology selected for this study. Methods included observations of practice, journaling, face to face and phone interviews which were recorded, transcribed and analysed thematically. Results: "The enemy within" emerged as a dominant theme highlighting issues of power, powerlessness and politics dominating the participant[U+05F3] s experiences. Power struggles amongst nurses, both overt and covert, and the deliberate misuse of power were frequently encountered. Many of the participants felt powerless and ill-prepared to negotiate the challenging situations in which they found themselves. Many lacked the skills needed to address the negative behaviours they experienced. Conclusions: This paper reports on the experiences of 10 newly endorsed nurse practitioners during their transition to the nurse practitioner role. The impact of the political climate at the time of this study had an undeniable influence on many of the participants[U+05F3] transition experiences. Competition for the limited nu...
Hills, C, Levett-Jones, T, Warren-Forward, H & Lapkin, S 2016, 'Teaching and learning preferences of 'Generation Y' occupational therapy students in practice education', International Journal of Therapy and Rehabilitation, vol. 23, no. 8, pp. 371-379.View/Download from: UTS OPUS or Publisher's site
© 2016 MA Healthcare Ltd. Background/Aims: Practice education is integral to health professional curricula. There is emerging evidence that student generational attributes may be impacting on practice education. Students born between 1982 and 2000, termed 'Generation Y', are said to have a different outlook on learning to those students from other generational groups. However, there is little research from student perspectives to investigate these claims. This study aimed to identify 'Generation Y' occupational therapy students' preferred teaching and learning approaches in practice education. Methods: Using a qualitative descriptive approach and purposive sampling, 22 semi-structured interviews were undertaken with third and fourth year 'Generation Y' occupational therapy students from one Australian university. Interview transcripts were analysed thematically. Findings: Four themes emerged from the data: developing practice skills and confidence; essential communication; valued educational approaches; and the supervisory relationship and the team. Conclusion: Findings relate to 'Generation Y' characteristics. Practice educators may need to consider that these students have unique learning preferences. Students prefer 'doing' to observing, they want to be given clear expectations and responsibility for their own work tasks, they want to work in a team, they prefer to self-evaluate prior to feedback and access to the internet is essential for their learning.
Williams, B, Abel, C, Khasawneh, E, Ross, L & Levett-Jones, T 2016, 'Simulation experiences of paramedic students: a cross-cultural examination', Advances in Medical Education and Practice, vol. 7, pp. 181-186.View/Download from: UTS OPUS or Publisher's site
Background: Simulation-based education is an important part of paramedic education and
training. While accessing clinical placements that are adequate in quality and quantity continues to
be challenging, simulation is being recognized by paramedic academics as a potential alternative.
Examining students' satisfaction of simulation, particularly cross-culturally is therefore important
in providing feedback to academic teaching staff and the international paramedic community.
Objective: This study aimed to compare simulation satisfaction among paramedic students
from universities in Australia and Jordan.
Methods: A cross-sectional study using a paper-based English version of the Satisfaction
with Simulation Experience Scale was administered to paramedic students from all year levels.
Results: A total of 511 students participated in this study; 306 students (60%) from Australia
(Monash University) and 205 students (40%) from Jordan (Jordan University of Science and
Technology). There were statistically significant differences with large effect size noted in all three
original factors between Australian and Jordanian students: debrief and feedback (mean =38.66 vs
mean =34.15; P<0.001; d=0.86), clinical reasoning (mean =21.32 vs mean =18.28; P<0.001;
d=0.90), and clinical learning (mean =17.59 vs mean =15.47; P<0.001; d=1.12).
Conclusion: This study has demonstrated that simulation education is generally well received by
students in Australia and Jordan although Australian students reported having higher satisfaction
levels then their Jordanian counterparts. These results provide important data for paramedic
educators involved in simulation-based education and training in Australia and Jordan and pave
the way for other cross-cultural examinations to be explored.
Omura, M, Maguire, J, Levett-Jones, T & Stone, TE 2016, 'Effectiveness of assertive communication training programs for health professionals and students: a systematic review protocol.', JBI database of systematic reviews and implementation reports, vol. 14, no. 10, pp. 64-71.View/Download from: UTS OPUS or Publisher's site
REVIEW QUESTION/OBJECTIVE:The objective of this systematic review is to identify, appraise and synthesize the best available evidence related to the effectiveness of assertive communication training programs in healthcare.More specifically, the objective of this systematic review is to determine the effectiveness of assertive communication interventions for health professionals and students on levels of assertiveness, communication competence and impact on clinician behaviors compared to alternative or no interventions.
Lapkin, S, Levett-Jones, T, Chenoweth, L & Johnson, M 2016, 'The effectiveness of interventions designed to reduce medication administration errors: A synthesis of findings from nine systematic reviews', Journal of Nursing Management, vol. 24, no. 7, pp. 845-858.View/Download from: Publisher's site
The aim of this overview was to examine the effectiveness of interventions designed to improve patient safety by reducing medication administration errors using data from systematic reviews.
Medication administration errors remain unacceptably high despite the introduction of a range of interventions aimed at enhancing patient safety. Systematic reviews of strategies designed to improve medication safety report contradictory findings. A critical appraisal and synthesis of these findings are, therefore, warranted.
A comprehensive three-step search strategy was employed to search across 10 electronic databases. Two reviewers independently examined the methodological rigour and scientific quality of included systematic reviews using the Assessment of Multiple Systematic Reviews protocol.
Sixteen systematic reviews were eligible for inclusion. Evidence suggest that multifaceted approaches involving a combination education and risk management strategies and the use of bar code technology are effective in reducing medication errors.
More research is needed to determine the benefits of routine double-checking of medications during administration by nurses, outcomes of self-administration of medications by capable patients, and associations between interruptions and medications errors.
Implications for nursing management
Medication-related incidents must be captured in a way that facilitates meaningful categorisation including contributing factors, potential and actual/risk of harm and contextual information on the incident.
Dalton, D.L., Gee, T. & Levett-Jones, P.T. 2015, 'Using clinical reasoning and simulation-based education to 'flip' the enrolled nurse curriculum', Australian Journal of Advanced Nursing, vol. 33, no. 2, pp. 28-34.
© 2015 Australian Nursing Federation. All rights reserved. Objective This paper describes the development and implementation of an innovative Diploma of Nursing curriculum for preparing Enrolled Nursing students for acute care nursing practice. Setting Vocational Education and Training at the Health Education and Research Centre in Hobart, Tasmania. Subjects Vocational Education and Training students enrolled in the Diploma of Nursing (Enrolled-Division 2 Nursing) (HLT51612). Primary Argument The increasing complexity and acuity of contemporary practice environments requires a nursing workforce that is flexible and competent. In 2013 nurse educators developed an innovative approach to offering the national standardized Diploma of Nursing course that integrates three key pedagogical approaches: the 'flipped classroom', simulation-based learning and the Clinical Reasoning Cycle. Conclusion By 'flipping the curriculum' students are provided with opportunities to develop and extend their clinical reasoning skills as they respond to both routine and unpredictable 'patient' scenarios in the safety of a simulation environment. These simulated clinical learning experiences are designed to challenge students to 'think like a nurse' while actively engaging in the provision of safe and effective 'patient' care.
MacLellan, L, Higgins, I & Levett-Jones, T 2015, 'A game of snakes and ladders: negotiating the 'ups and downs' of endorsement as a nurse practitioner in Australia.', Journal of Contemporary Nursing, vol. 50, no. 2-3, pp. 139-148.View/Download from: UTS OPUS or Publisher's site
Australian legislation supporting the nurse practitioner (NP) role was enacted in 1998. Since then, NPs have played an important advanced practice role within the interdisciplinary healthcare team. However, the literature suggests that transition to the NP role can be challenging.This paper highlights the complex transition experiences of ten recently endorsed Australian NPs. The convoluted legislative and regulatory requirements that were negotiated by the NPs are presented as narratives.Informed by an ethnographic approach, participants were interviewed several times during their first year. Interview transcripts were thematically analysed and aggregated into three narratives representative of key findings.The findings exemplify the complexity of navigating through a labyrinth of bureaucracy and the extensive negotiations required to appease those who yielded power over their future practice.This study raises awareness of the transition experiences of Australian NPs and their challenges and barriers during this time.
Thomson, K, Outram, S, Gilligan, C & Levett-Jones, T 2015, 'Interprofessional experiences of recent healthcare graduates: A social psychology perspective on the barriers to effective communication, teamwork, and patient-centred care.', Journal of Interprofessional Care, vol. 29, no. 6, pp. 634-640.View/Download from: UTS OPUS or Publisher's site
Achieving safe, quality health care is highly dependent on effective communication between all members of the healthcare team. This study explored the attitudes and experiences of recent healthcare graduates regarding interprofessional teamwork and communication within a clinical setting. A total of 68 pharmacy, nursing, and medicine graduates participated in 12 semi-structured focus group discussions in clinical workplaces across three Australian states. Discussion focussed on graduates' experiences of interprofessional education and its impact on their capacity for interprofessional teamwork and communication. The Social Identity and Realistic Conflict theories were used as a framework for qualitative data analysis. A consistent pattern of profession-focussed, rather than patient- or team-focussed goals was revealed along with reports of negative stereotyping, hierarchical communication, and competition for time with the patient. Graduates acknowledged the importance of communication, teamwork, and patient-centred care and felt a better understanding of the roles of other health professionals would assist them to work together for patients' wellbeing. Identifying workplace identities and differential goals has uncovered possible motivations underlying health professionals' behaviour. These insights may help improve interprofessional collaboration by focusing attention on common team goals, increasing feelings of worth and being valued among different professionals, and decreasing the need for competition.
McAllister, M, Lasater, K, Stone, TE & Levett-Jones, T 2015, 'The reading room: Exploring the use of literature as a strategy for integrating threshold concepts into nursing curricula.', Nurse Education in Practice, vol. 15, no. 6, pp. 549-555.View/Download from: UTS OPUS or Publisher's site
In addition to acquiring a solid foundation of clinical knowledge and skills, nursing students making the transition from lay person to health professional must adopt new conceptual understandings and values, while at the same time reflecting on and relinquishing ill-fitting attitudes and biases. This paper presents creative teaching ideas that utilise published narratives and explores the place of these narratives in teaching threshold concepts to nursing students. Appreciating nuance, symbolism and deeper layers of meaning in a well-drawn story can promote emotional engagement and cause learners to care deeply about an issue. Moreover, aesthetic learning, through the use of novels, memoirs and picture books, invites learners to enter into imagined worlds and can stimulate creative and critical thinking. This approach can also be a vehicle for transformative learning and for enhancing students' understanding and internalisation of threshold concepts that are integral to nursing. Guided engagement with the story by an effective educator can help learners to examine taken-for-granted assumptions, differentiate personal from professional values, remember the link between the story and the threshold concept and re-examine their own perspectives; this can result in transformative learning. In this paper, we show how threshold concepts can be introduced and discussed with nursing students via guided engagement with specific literature, so as to prompt meaningful internalised learning.
Levett-Jones, T, Pitt, V, Courtney-Pratt, H, Harbrow, G & Rossiter, R 2015, 'What are the primary concerns of nursing students as they prepare for and contemplate their first clinical placement experience?', Nurse Education in Practice, vol. 15, no. 4, pp. 304-309.View/Download from: UTS OPUS or Publisher's site
Nursing students' first clinical placement experience can be a critical turning point -reinforcing professional aspirations for some, and for others, a time of emotional turbulence. There is a paucity of research focusing on students' perceptions and concerns prior to their first placement experience. Thus, the aim of this study was to explore the concerns of first year bachelor of nursing students from one Australian university as they prepared for their first clinical placement. Participants completed an online 'readiness for practice' survey consisting of 22 items. This paper focuses on participants' responses to the one open ended question: 'Please comment on any concerns that you have in relation to being prepared for your first clinical placement'. Summative qualitative content analysis was used for analysis. 144 students (55%) responded to the open ended question. Responses were categorised into six themes including: Not prepared for placement; feeling nervous, anxious and worried; bullying and belonging; practicalities; patient safety and making mistakes; and working outside of my scope of practice. It appears that activities designed to equip students with the capacity to manage the inherent challenges of undertaking a clinical placement may sometimes have a paradoxical effect by increasing students' level of stress and anxiety. An enhanced understanding of students' concerns may help educators implement appropriate support strategies.
MacLellan, L, Levett-Jones, T & Higgins, I 2015, 'Nurse practitioner role transition: a concept analysis.', Journal of the American Association of Nurse Practitioners, vol. 27, no. 7, pp. 389-397.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Transitioning from registered nurse to nurse practitioner (NP) can be challenging personally and professionally. Insight into transition experiences may help validate the experiences of new NPs and provide greater understanding of the challenges faced during their professional journey. PURPOSE: The purpose of this article is to report a concept analysis of transition from registered nurse to NP. The article provides new knowledge, understanding, and clarity about the concept of transition. DATA SOURCES: Walker and Avants' framework for concept analysis was used to identify the attributes, antecedents, and consequences of the concept. A literature review of refereed journals was undertaken. Model cases from an ethnographic study conducted in Australia provide real life examples of the attributes of transition. CONCLUSIONS: Transitioning to the role of NP is complex and dependent on the individual and the attitudes of healthcare colleagues. Change and adaptation are required of both the NP and members of the healthcare team. Failure to adapt by either party undermines the potential for NPs to deliver improved health care. IMPLICATIONS FOR PRACTICE: Mentorship along with a nurturing environment may be effective strategies for increasing the NP's self-confidence and ensuring a smooth and successful transition period.
Levett-Jones, T, Bowen, L & Morris, A 2015, 'Enhancing nursing students' understanding of threshold concepts through the use of digital stories and a virtual community called 'Wiimali'.', Nurse Education in Practice, vol. 15, no. 2, pp. 91-96.View/Download from: UTS OPUS or Publisher's site
Wiimali is a dynamic virtual community developed in 2010 and first implemented into our Bachelor of Nursing (BN) program in 2011. The word Wiimali comes from the Gumiluraai Aboriginal language. Wiimali and the digital stories it comprises were designed to engage nursing students and enhance their understanding of the threshold concepts integral to safe and effective nursing practice. In this paper we illustrate some of the key features of Wiimali with web links to a virtual tour of the community and a selection of digital stories. We explain how this innovative educational approach has the potential to lead to transformative learning about concepts such as social justice, person-centred care and patient safety. Consistent feedback about Wiimali attests to the positive impact of this educational approach. Students have commented on how Wiimali caused them to think differently about the concepts of community and social justice; how it brings the health-related problems of community members to life; and how the digital stories enhance their learning about person-centred care and patient safety.
MacLellan, L, Higgins, I & Levett-Jones, T 2015, 'Medical acceptance of the nurse practitioner role in Australia: a decade on.', Journal of the American Association of Nurse Practitioners, vol. 27, no. 3, pp. 152-159.View/Download from: UTS OPUS or Publisher's site
PURPOSE: In Australia, nurse practitioners (NPs) were first endorsed in 2000. After more than a decade, the number of NPs remains relatively small with previous research suggesting medical resistance as a key reason for this. This article presents a selection of narratives from a study that explored the transition experiences of newly endorsed NPs with particular attention to relationships with their medical colleagues. DATA SOURCES: A critical ethnographic approach was undertaken to explore the experiences of 10 Australian NPs who were interviewed three to four times for up to an hour throughout their first year of practice. CONCLUSIONS: Participants' narratives provide insight into their transition to practice and the barriers and facilitators to their new role. In contrast to previous research, medical colleagues were generally supportive and collegial while resistance was demonstrated most often by senior nurses yielding positions of power. IMPLICATIONS FOR PRACTICE: This study provides insight into the influences that key health professionals have over the transition of NPs. Despite the fact there are still negative attitudes being expressed by some medical associations, in this study medical colleagues were largely supportive of the NP role and that integral to the development of these interprofessional relationships was mutual respect and effective communication.
Ashktorab, T, Hasanvand, S, Seyedfatemi, N, Zayeri, F, Levett-Jones, T & Pournia, Y 2015, 'Psychometric testing of the Persian version of the Belongingness Scale-Clinical Placement Experience.', Nurse Education Today, vol. 35, no. 3, pp. 439-443.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Belongingness has been identified both as a fundamental human need and as a prerequisite for nursing students' clinical learning. Belongingness has also been associated with students' academic achievement, retention, self-esteem, self-directed learning, and self-efficacy. The Belongingness Scale-Clinical Placement Experience is a valid and reliable measure of nursing students' belongingness scores; however, a Persian version of this scale is not currently available. AIM: This study aimed to translate the Belongingness Scale-Clinical Placement Experience into Persian, to evaluate its psychometric properties, and to measure the belongingness experiences of Iranian nursing students. METHODS: Following translation and initial validity and reliability testing of the scale, 300 nursing students from three universities in Iran completed the survey. Further psychometric testing was undertaken followed by analysis of descriptive statistics. RESULTS: Based on the results of confirmatory factor analysis two items were removed from the scale. The mean score of Persian version of the Belongingness Scale-Clinical Placement Experience was 3.21 (0.57). The whole scale had a high internal consistency (Cronbach's alpha=0.92). The alpha coefficients of the subscales of "self-esteem", "connectedness", and "efficacy" were 0.85, 0.86, and 0.80 respectively. CONCLUSION: Similar to previous versions of the Belongingness Scale-Clinical Placement Experience, the Persian version demonstrated strong psychometric properties with strong validity and reliability, indicating its utility and appropriateness when measuring Iranian nursing students' belongingness experiences. Further testing with other cohorts would strengthen these results.
Pitt, V, Powis, D, Levett-Jones, T & Hunter, S 2015, 'The influence of critical thinking skills on performance and progression in a pre-registration nursing program.', Nurse Education Today, vol. 35, no. 1, pp. 125-131.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The importance of developing critical thinking skills in preregistration nursing students is recognized worldwide. Yet, there has been limited exploration of how students' critical thinking skill scores on entry to pre-registration nursing education influence their academic and clinical performance and progression. AIM: The aim of this study was to: i) describe entry and exit critical thinking scores of nursing students enrolled in a three year bachelor of nursing program in Australia in comparison to norm scores; ii) explore entry critical thinking scores in relation to demographic characteristics, students' performance and progression. METHOD: This longitudinal correlational study used the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills in a sample (n=134) of students, at entry and exit (three years later). A one sample t-test was used to determine if differences existed between matched student critical thinking scores between entry and exit points. Academic performance, clinical performance and progression data were collected and correlations with entry critical thinking scores were examined. RESULTS: There was a significant relationship between critical thinking scores, academic performance and students' risk of failing, especially in the first semester of study. Critical thinking scores were predictive of program completion within three years. The increase in critical thinking scores from entry to exit was significant for the 28 students measured. In comparison to norm scores, entry level critical thinking scores were significantly lower, but exit scores were comparable. Critical thinking scores had no significant relationship to clinical performance. CONCLUSION: Entry critical thinking scores significantly correlate to academic performance and predict students risk of course failure and ability to complete a nursing degree in three years. Students' critical thinking scores are an important determinant of their success a...
Dalton, L, Gee, T & Levett-Jones, T 2015, 'Using clinical reasoning and simulation-based education to 'flip' the Enrolled Nurse curriculum', Australian Journal of Advanced Nursing, vol. 33, no. 2, pp. 29-35.View/Download from: UTS OPUS
Sinclair, P, Kable, A & Levett-Jones, T 2015, 'The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: a systematic review protocol.', JBI database of systematic reviews and implementation reports, vol. 13, no. 1, pp. 52-64.View/Download from: Publisher's site
The objective of this systematic review is to identify, appraise and synthesize the best available evidence for the effectiveness of internet-based e-learning programs on health care professional behavior and patient outcomes.Technological innovation has not only impacted social change in recent years but has been the prime driver of educational transformation.The newest consumers of post-secondary education, the so-called 'digital natives', have come to expect education to be delivered in a way that offers increased usability and convenience. Health care professionals (HCPs) in the clinical setting, particularly those in rural and remote communities, are no different. Today's health workforce has a professional responsibility to maintain competency in practice through achieving a minimum number of hours of continuing professional development. Consequently, HCPs seeking professional development opportunities are reliant on sourcing these independently according to individual learning needs. However, difficulties exist in some health professionals' access to ongoing professional development opportunities, particularly those with limited access face-to-face educationdue to geographical isolation or for those not enrolled in a formal program of study.These issues challenge traditional methods of teaching delivery; electronic learning (e-learning) is at the nexus of overcoming these challenges.The term e-learning originated in the mid-1990s as the internet began to gather momentum.Electronic learning can be broadly defined as any type of educational media that is delivered in an electronic form.Terms such as computer-assisted learning, online learning, web-based learning and e-learning are often used synonymously but all reflect knowledge transfer via an electronic device. This broad definition allows for a gamut of multimedia to be used for the purpose of constructing and assessing knowledge. Multimedia typically used in e-learning range from the now archaic Compact...
Levett-Jones, T, Andersen, P, Reid-Searl, K, Guinea, S, McAllister, M, Lapkin, S, Palmer, L & Niddrie, M 2015, 'Tag team simulation: An innovative approach for promoting active engagement of participants and observers during group simulations', Nurse Education in Practice, vol. 15, no. 5, pp. 345-352.View/Download from: Publisher's site
Active participation in immersive simulation experiences can result in technical and non-technical skill enhancement. However, when simulations are conducted in large groups, maintaining the interest of observers so that they do not disengage from the learning experience can be challenging.We implemented Tag Team Simulation with the aim of ensuring that both participants and observers had active and integral roles in the simulation. In this paper we outline the features of this innovative approach and provide an example of its application to a pain simulation.Evaluation was conducted using the Satisfaction with Simulation Experience Scale. A total of 444year nursing students participated from a population of 536 (response rate 83%). Cronbach's alpha for the Scale was .94 indicating high internal consistency. The mean satisfaction score for participants was 4.63 compared to 4.56 for observers. An independent sample t test revealed no significant difference between these scores (t (300)=-1.414, p=0.16).Tag team simulation is an effective approach for ensuring observers' and participants' active involvement during group-based simulations and one that is highly regarded by students. It has the potential for broad applicability across a range of leaning domains both within and beyond nursing.
Lapkin, S, Levett-Jones, T & Gilligan, C 2015, 'Using the Theory of Planned Behaviour to examine health professional students' behavioural intentions in relation to medication safety and collaborative practice.', Nurse Education Today, vol. 35, no. 8, pp. 935-940.View/Download from: Publisher's site
BACKGROUND: Safe medication practices depend upon, not only on individual responsibilities, but also effective communication and collaboration between members of the medication team. However, measurement of these skills is fraught with conceptual and practical difficulties. AIMS: The aims of this study were to explore the utility of a Theory of Planned Behaviour-based questionnaire to predict health professional students' behavioural intentions in relation to medication safety and collaborative practice; and to determine the contribution of attitudes, subjective norms, and perceived control to behavioural intentions. DESIGN: A descriptive cross-sectional survey based upon the Theory of Planned Behaviour was designed and tested. PARTICIPANTS: A convenience sample of 65 undergraduate pharmacy, nursing and medicine students from one semi-metropolitan Australian university were recruited for the study. METHODS: Participants' behavioural intentions, attitudes, subjective norms, and perceived control to behavioural intentions in relation to medication safety were measured using an online version of the Theory of Planned Behaviour Medication Safety Questionnaire. RESULTS: The Questionnaire had good internal consistency with a Cronbach's alpha of 0.844. The three predictor variables of attitudes, subjective norms, and perceived control accounted for between 30 and 46% of the variance in behavioural intention; this is a strong prediction in comparison to previous studies using the Theory of Planned Behaviour. Data analysis also indicated that attitude was the most significant predictor of participants' intention to collaborate with other team members to improve medication safety. CONCLUSION: The results from this study provide preliminary support for the Theory of Planned Behaviour-Medication Safety Questionnaire as a valid instrument for examining health professional students' behavioural intentions in relation to medication safety and collaborative practice.
Everson, N, Levett-Jones, T, Lapkin, S, Pitt, V, van der Riet, P, Rossiter, R, Jones, D, Gilligan, C & Courtney-Pratt, H 2015, 'Measuring the impact of a 3D simulation experience on nursing students' cultural empathy using a modified version of the Kiersma-Chen Empathy Scale', Journal of Clinical Nursing, vol. 24, no. 19-20, pp. 2849-2858.View/Download from: Publisher's site
Omura, M, Levett-Jones, T, Stone, TE, Maguire, J & Lapkin, S 2015, 'Measuring the impact of an interprofessional multimedia learning resource on Japanese nurses and nursing students using the Theory of Planned Behavior Medication Safety Questionnaire', Nursing & Health Sciences, vol. 17, no. 4, pp. 500-506.View/Download from: Publisher's site
Interprofessional communication and teamwork are essential for medication safety; however, limited educational opportunities for health professionals and students to develop these skills exist in Japan. This study evaluated the impact of an interprofessional multimedia learning resource on registered nurses' and nursing students' intention to practice in a manner promoting medication safety.
Using a quasi-experimental design, Japanese registered nurses and nursing students (n=203) were allocated to an experimental (n=109) or control group (n=94). Behavioral intentions of medication safety and the predictor variables of attitudes, perceived behavioral control, and subjective norms were measured using a Japanese version of the Theory of Planned Behavior Medication Safety Questionnaire.
Registered nurses in the experimental group demonstrated a greater intention to collaborate and practice in a manner that enhanced medication safety, evidenced by higher scores than the control group on all predictor variables.
The results demonstrate the potential for interprofessional multimedia learning resources to positively impact the behaviors of Japanese registered nurses in relation to safe medication practices. Further research in other contexts and with other cohorts is warranted.
Courtney-Pratt, H, Levett-Jones, T, Lapkin, S, Pitt, V, Gilligan, C, Van der Riet, P, Rossiter, R, Jones, D & Everson, N 2015, 'Development and psychometric testing of the satisfaction with Cultural Simulation Experience Scale', Nurse Education in Practice, vol. 15, no. 6, pp. 530-536.View/Download from: UTS OPUS or Publisher's site
Ebert, L, Hoffman, K, Levett-Jones, T & Gilligan, C 2014, '"They have no idea of what we do or what we know": Australian graduates' perceptions of working in a health care team.', Nurse Education in Practice, vol. 14, no. 5, pp. 544-550.View/Download from: UTS OPUS or Publisher's site
Globally it has been suggested that interprofessional education can lead to improvements in patient safety as well as increased job satisfaction and understanding of professional roles and responsibilities. In many health care facilities staff report being committed to working collaboratively, however their practice does not always reflect their voiced ideologies. The inability to work effectively together can, in some measure, be attributed to a lack of knowledge and respect for others' professional roles, status and boundaries. In this paper, we will report on the findings of an interpretative study undertaken in Australia, focussing specifically on the experiences of new graduate nurses, doctors and pharmacists in relation to 'knowing about' and 'working with' other health care professionals. Findings indicated there was little understanding of the roles of other health professionals and this impacted negatively on communication and collaboration between and within disciplines. Furthermore, most new graduates recall interprofessional education as intermittent, largely optional, non-assessable, and of little value in relation to their roles, responsibilities and practice as graduate health professionals. Interprofessional education needs to be integrated into undergraduate health programs with an underlying philosophy of reciprocity, respect and role valuing, in order to achieve the proposed benefits for staff and patients.
Reid-Searl, K, Levett-Jones, T, Cooper, S & Happell, B 2014, 'The implementation of Mask-Ed: reflections of academic participants.', Nurse Education in Practice, vol. 14, no. 5, pp. 485-490.View/Download from: UTS OPUS or Publisher's site
This paper profiles the findings from a study that explored the perspectives and experiences of nurse educators who implemented a novel simulation approach termed Mask-Ed. The technique involves the educator wearing a silicone mask and or body parts and transforming into a character. The premise of this approach is that the masked educator has domain specific knowledge related to the simulation scenario and can transmit this to learners in a way that is engaging, realistic, spontaneous and humanistic. Nurse educators charged with the responsibility of implementing Mask-Ed in three universities were invited to participate in the study by attending an introductory workshop, implementing the technique and then journaling their experiences, insights and perspectives over a 12 month period. The journal entries were then thematically analysed. Key themes were categorised under the headings of Preparation, Implementation and Impact; Reflexivity and Responsiveness; Student Engagement and Ownership; and Teaching and Learning. Mask-Ed is a simulation approach which allows students to interact with the 'characters' in humanistic ways that promote person-centred care and therapeutic communication. This simulation approach holds previously untapped potential for a range of learning experiences, however, to be effective, adequate resourcing, training, preparation and practice is required.
Pitt, V, Powis, D, Levett-Jones, T & Hunter, S 2014, 'Nursing students' personal qualities: a descriptive study.', Nurse Education Today, vol. 34, no. 9, pp. 1196-1200.View/Download from: UTS OPUS or Publisher's site
Reports of a lack of compassionate care from nurses have resulted in calls to integrate the assessment of personal qualities into nursing student selection, with the intent to recruit individuals whose attributes reflect those desired in the practising nurse. Whilst nursing programmes are able to determine students' academic abilities on enrolment limited attention has been given to other qualities. Although there is an understanding of the qualities desired in the practising nurse, to date there has been limited exploration of nursing students' personal qualities as they enter nursing programmes and whether these change over time.To describe the personal qualities of newly enrolled Bachelor of Nursing students, and to determine if these qualities are age and gender specific and whether they change over time.The Personal Qualities Assessment (PQA; www.pqa.net.au) was completed by 138 nursing students on enrolment and repeated after three years.Twenty four percent of students had PQA scores at the extreme ends (±2 SD) of the continuum of one or more sub-scale distributions. Significant positive correlations were found between age and the PQA measured traits: self-control, resilience, narcissism, empathy and moral orientation. Females were significantly more conscientious, community orientated and involved; males had significantly higher narcissism and aloofness scores and lower empathy. For those students (n=28) who completed the follow-up PQA, their personal qualities scores did not change.Most of the study sample possessed mid-range personal quality trait scores, but approximately a quarter of the nursing students recorded extreme scores. Older students were found to have a higher measure of self-control, resilience, empathy and narcissism and more communitarian in attitude. Significant differences were found between males' and females' scores. That personal qualities were unchanged after three years suggests the importance of incorporating the assessment of the...
O'Donnell, JM, Decker, S, Howard, V, Levett-Jones, T & Miller, CW 2014, 'NLN/Jeffries Simulation Framework state of the science project: Simulation learning outcomes', Clinical Simulation in Nursing, vol. 10, no. 7, pp. 373-382.View/Download from: UTS OPUS or Publisher's site
Background: Jeffries presented "A Framework for Designing, Implementing, and Evaluating Simulation Used as Teaching Strategies in Nursing", which described specific constructs as core to the framework design, in 2005. In 2010, the National League of Nursing/Jeffries Simulation Framework (NLN/JSF) project reviewed the current state of the science in support of the framework. A panel of education and simulation experts was gathered to review the literature for each of the framework constructs. Within the construct of learning outcomes, five key subcomponents emerged from the literature: skills performance, learner satisfaction, knowledge/learning, critical thinking/clinical judgment, and self-confidence/self-efficacy. Method: Literature citations and publications were abstracted into a shared database to summarize findings. Preliminary findings were presented during the 2012 Annual International Nursing Association Simulation/Learning Resources Center conference. During the conference, feedback received help guide further exploration of constructs. The project team summarized findings from the literature review and identified gaps in the knowledge for future research. Results: We discovered challenges in the volume and strength of evidence supporting the construct. Constructs were found within the literature using a variety of terms. Supportive evidence was strongest in knowledge acquisition, satisfaction and clinical skill attainment, weakest for critical thinking/clinical judgment, and confidence/self-efficacy. Conclusion: Many of the concepts of the Learning Outcomes appear to be widely discussed within simulation arenas. There is a need to standardized terms and provide descriptions of constructs and outcomes reported in the simulation literature. Based on our discovered limitations and gaps in the literature, there are multiple opportunities for future research to validate how learning outcomes are effected by using the NLN/JSF framework as a modality for educ...
Day, J, Levett-Jones, T & Taylor, ACT 2014, 'Using a virtual community to enhance nursing student's understanding of primary health care.', Collegian (Royal College of Nursing, Australia), vol. 21, no. 2, pp. 143-150.View/Download from: UTS OPUS or Publisher's site
Gilligan, C, Outram, S & Levett-Jones, T 2014, 'Recommendations from recent graduates in medicine, nursing and pharmacy on improving interprofessional education in university programs: a qualitative study.', BMC Medical Education, vol. 14, pp. 52-52.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Interprofessional education (IPE) has been recognized as an innovative approach for the development of a collaborative, practice-ready health workforce, but is not used consistently in undergraduate health professional programs. We sought to explore the reflections of graduates on the IPE experiences they had during their undergraduate education and training. It was anticipated that having completed their pre-vocational education and spent up to two years working in a clinical environment, recent graduates would be well-placed to provide insights into the value of the IPE opportunities they had, and to suggest approaches for improving these opportunities in undergraduate programs. METHODS: This study was part of a larger research project (Interprofessional Education for the Quality use of Medicines; IPE for QuM) which used focus groups as part of an interpretive research design to inform other aspects of the research. Here, we report on focus groups with recent graduates recruited from area health services across Australia. RESULTS: Sixty-eight recent graduates working in New South Wales, Western Australia, and Tasmania participated in 12 focus group sessions. In this paper, we report on new graduates' reflections on their experiences of IPE as part of their university degree, as well as their recommendations to improve interprofessional education before graduation. The new graduates were unanimous in valuing IPE from their current perspective of being in the health workforce. Most IPE experiences recalled were regarded as positive, but those valued most highly were experiences that involved genuine engagement and opportunities to interact with students in other professions working on a relevant problem. Clinical placement was a missed opportunity with few structured meaningful interprofessional learning experiences. Surprisingly there was little social contact between professions in universities even when programs were co-located, thus reinforcing pr...
Pitt, V, Powis, D, Levett-Jones, T & Hunter, S 2014, 'The influence of personal qualities on performance and progression in a pre-registration nursing programme.', Nurse Education Today, vol. 34, no. 5, pp. 866-871.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Research conducted primarily with psychology and medical students has highlighted that personal qualities play an important role in students' academic performance. In nursing there has been limited investigation of the relationship between personal qualities and performance. Yet, reports of student incivility and a lack of compassion have prompted appeals to integrate the assessment of personal qualities into pre-registration nursing student selection. Before this can be done research is needed to explore the influence of students' personal qualities on programme performance and progression. AIM: This study explores the relationships between students' personal qualities and their academic and clinical performance, behaviours and progression through a pre-registration nursing programme in Australia. METHOD: This longitudinal descriptive correlational study was undertaken with a sample of Australian pre-registration nursing students (n=138). Students' personal qualities were assessed using three personal qualities assessment (PQA) instruments. Outcome measures included grades in nursing theory and clinical courses, yearly grade point average, final clinical competency, progression (completion), class attendance and levels of life event stress. RESULTS: Significant correlations were found between academic performance and PQA scores for self-control, resilience and traits of aloofness, confidence and involvement. Final clinical competence was predicted by confidence and self-control scores. Students with higher empathy had higher levels of life event stress in their first year and class attendance had a positive correlation with self-control. Completing the programme in three years was weakly predicted by the measure of resilience. No difference was noted between extreme or non-extreme scorers on the PQA scales with respect to performance or progression. CONCLUSION: This sample of students' personal qualities was found to influence their academic and clin...
Stone, TE & Levett-Jones, T 2014, 'A comparison of three types of stimulus material in undergraduate mental health nursing education.', Nurse Education Today, vol. 34, no. 4, pp. 586-591.View/Download from: UTS OPUS or Publisher's site
The paper discusses an innovative educational approach that compared the use of different textual forms as stimulus materials in the teaching of an introductory mental health course.Practitioners in many disciplines, including nursing, appreciate the value of narratives in making sense of experiences, challenging assumptions and enhancing learning: they enable exploration of reality from different perspectives and create an emotional resonance. Narratives help nursing students to uncover embedded meanings, values and beliefs; they can include written texts, illustrated texts or picture books.180 students enrolled in an elective undergraduate nursing course.This project afforded students the choice of critically analysing (a) a chapter from one of two autobiographies, (b) an illustrated text, or (c) an illustration from a picture book. Each text was a narrative account from a personal or carer's perspective of the experience of mental illness. Their written submissions were then analysed by means of a qualitative descriptive approach.In analysis of the autobiographies students tended to paraphrase the authors' words and summarise their experiences. Those choosing the illustrated text were able to link the images and text, and provide a deeper and more insightful level of interpretation, albeit influenced by the author's personal account and expressed emotions; however, those analysing a picture book illustration demonstrated a surprising level of critical and creative thinking, and their interpretations were empathetic, insightful and thoughtful.The use of picture books, although not a common approach in nursing education, appears to engage students, challenge them to think more deeply, and stimulate their imagination.
Palmer, L, Levett-Jones, T, Smith, R & McMillan, M 2014, 'Academic literacy diagnostic assessment in the first semester of first year at university', International Journal of the First Year in Higher Education, vol. 5, no. 1, pp. 67-78.View/Download from: UTS OPUS or Publisher's site
One vital aspect of the first semester of the first year at university is how academic literacy expectations are made explicit though teaching and assessment practices at the disciplinary level. This paper describes how an academic literacy diagnostic process, and the MASUS tool, was used to ascertain the academic literacy profile of a cohort of undergraduate nursing students [N=569] at the beginning and end of their first semester. Key findings of this quantitative descriptive case study were that only just over half of commencing students possessed appropriate academic literacy skills in all four aspects of the diagnostic and nearly 20% scored in the lowest band—suggesting difficulty with multiple aspects of academic literacy. By the end of semester, 77% of the students who had scored in the lowest band of the MASUS at the beginning of the semester had improved their scores to the middle or highest band, and 73% of them eventually attained a pass or higher grade for the course. The findings of this study suggest that large-scale academic literacy diagnostic assessment, when embedded and contextualized within a course of study, is an effective means of providing the early feedback and targeted support that many commencing university students need.
Levett-Jones, T & Lapkin, S 2014, 'A systematic review of the effectiveness of simulation debriefing in health professional education.', Nurse Education Today, vol. 34, no. 6, pp. e58-e63.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE: The objective of this review was to identify, appraise and synthesise the best available evidence for the effectiveness of debriefing as it relates to simulation-based learning for health professionals. BACKGROUND: Simulation is defined as a technique used to replace or amplify real experiences with guided experiences that evoke or replace substantial aspects of the real world in a fully interactive manner. The use of simulation for health professional education began decades ago with the use of low-fidelity simulations and has evolved at an unprecedented pace. Debriefing is considered by many to be an integral and critical part of the simulation process. However, different debriefing approaches have developed with little objective evidence of their effectiveness. INCLUSION CRITERIA: Studies that evaluated the use of debriefing for the purpose of simulation-based learning for health professionals were included. Simulation studies not involving health professionals and those conducted in other settings such as such as military or aviation were excluded. REVIEW METHODS: A review protocol outlining the inclusion and exclusion criteria was submitted, peer reviewed by the Joanna Briggs Institute (JBI) for Evidence Based Practice, and approved prior to undertaking the review. A comprehensive search of studies published between January 2000 and September 2011 was conducted across ten electronic databases. Two independent reviewers assessed each paper prior to inclusion or exclusion using the standardised critical appraisal instruments for evidence of effectiveness developed by the Joanna Briggs Institute. RESULTS: Ten randomised controlled trials involving various debriefing methods were included in the review. Meta-analysis was not possible because of the different outcomes, control groups and interventions in the selected studies. The methods of debriefing included: post simulation debriefing, in-simulation debriefing, instructor facilitated debriefing and ...
Lapkin, L, Levett-Jones, T & Gilligan, C 2014, 'The effectiveness of web-based interprofessional learning modules on health professional students' behavioural intentions in relation to medication safety: A quasi- experimental study', Focus on Health Professional Education, vol. 16, no. 1, pp. 46-58.View/Download from: UTS OPUS or Publisher's site
Background: Safe medication practices are a key focus of the global strategy to improve patient safety. Emerging evidence demonstrates that learning experiences focusing on developing collaborative skills such as mutual understanding of others' roles, teamwork and interprofessional communication can enhance medication safety. However, interprofessional education for undergraduate students is limited by factors such timetabling restrictions and curricular constraints. Web-based approaches provide the opportunity to overcome these barriers. However, currently there is little empirical evidence of the effectiveness of web-based approaches in changing the behaviour of health professional students in relation to medication safety and collaborative practice.
Aim: To examine the impact of web-based interprofessional learning modules on health professional students' behavioural intentions in relation to medication safety and team work.
Methods: A quasi-experimental approach was employed to evaluate the effectiveness of the learning modules and 320 undergraduate health professions students were recruited. Students were allocated to either an experimental (n= 155) or control group (n= 165). Participants in the experimental group completed a multimedia web-based learning module. The purpose-designed Theory of Planned Behaviour Medication Safety Questionnaire was used to compare behavioural intentions, attitudes, subjective norms and perceived behavioural control in relation to medication safety between the control and experimental groups.
Results: Participants in the experimental group demonstrated significantly greater intention to practice in a way that enhances medication safety and collaborative practice than those in the control group, as evidenced by higher scores on all outcomes: behavioural intention (p < 0.001); attitude (p < 0.001); perceived behavioural control (p= 0.107); and subjective norm (p = 0.115).
Conclusion: The web-based interprofessional learni...
McAllister, M, Levett-Jones, T, Downer, T, Harrison, P, Harvey, T, Reid-Searl, K, Lynch, K, Arthur, C, Layh, J & Calleja, P 2013, 'Snapshots of simulation: creative strategies used by Australian educators to enhance simulation learning experiences for nursing students.', Nurse Education in Practice, vol. 13, no. 6, pp. 567-572.View/Download from: UTS OPUS or Publisher's site
Simulation in nursing is a flourishing area for nurse educators' practice. Defined as learning that amplifies, mimics or replaces real-life clinical situations, simulation aims to give students opportunity to reason through a clinical problem and make decisions, without the potential for harming actual patients. Educators in nursing are contributing to simulation learning in diverse and creative ways. Yet much of their craft is not being widely disseminated because educators are not always confident in publishing their work. This paper aims to stimulate creative development in simulation by providing short summaries, or snapshots, of diverse approaches that nurse educators are using. The objective is to inspire others to share other ideas in development or in practice that are improving learning for nursing students and practitioners, so that simulation scholarship is advanced. The snapshots presented range from approaches that: better support educators to attend to the whole process of simulation education, give students quick access to short skill-based videos, orientate students to the laboratory environment, harness the power of the group to develop documentation skills, use simulation to enrich lectures, develop multidisciplinary knowledge, and finally, which teach therapeutic communication with children in a fun and imaginative way.
Arthur, C, Levett-Jones, T & Kable, A 2013, 'Quality indicators for the design and implementation of simulation experiences: a Delphi study.', Nurse Education Today, vol. 33, no. 11, pp. 1357-1361.View/Download from: UTS OPUS or Publisher's site
Simulation is widely used in nursing education. Previous studies have examined the impact of simulation on the acquisition of psychomotor skills, knowledge, critical thinking and non-technical skills such as teamwork. Challenges associated with the integration of simulation into nursing curricula have also been examined, however only limited research addresses the most effective simulation design and teaching strategies for quality educational outcomes. This paper reports a Delphi study that synthesises expert opinion on the pedagogical principles and teaching strategies that are indicative of quality in simulation based learning activities. The resultant set of Quality Indicator Statements is presented and opportunities for application and further research are discussed.
Kable, AK, Arthur, C, Levett-Jones, T & Reid-Searl, K 2013, 'Student evaluation of simulation in undergraduate nursing programs in Australia using quality indicators.', Nursing and Health Sciences, vol. 15, no. 2, pp. 235-243.View/Download from: UTS OPUS or Publisher's site
Student evaluation of the implementation of evidence-based quality indicators for simulation experiences in undergraduate nursing programs in 2012 was explored in this study. The evaluation instrument used five specific measures derived from quality indicators. Students evaluated 10 simulation learning experiences in the first and second years of undergraduate nursing programs at two universities in Australia. Overall, students (n=85) reported that simulation contributed to their achievement of objectives, but they did not always feel supported in these sessions. Student preparation and orientation was scored lower than other components of the simulation experience. Students reported very good scores for perceived realism and fidelity of simulation sessions, particularly the silicone mask and high-fidelity sessions, which implies that learning from simulation is transferable into the clinical practice setting. However, patient charts and other clinical documents were not always considered to be realistic. Debriefing was scored very highly overall and for both approaches used for debriefing. The student-evaluation instrument was an effective means of measuring student-related quality indicators across a range of simulation sessions. It identified areas for the improved delivery of simulation sessions.
McCoy, MA, Levett-Jones, T & Pitt, V 2013, 'Development and psychometric testing of the Ascent to Competence Scale.', Nurse Education Today, vol. 33, no. 1, pp. 15-23.View/Download from: UTS OPUS or Publisher's site
AIM: This paper reports the development and psychometric testing of the Ascent to Competence Scale, an instrument designed to measure nursing students' perceptions of the quality of their clinical placement experience. BACKGROUND: The key purpose of clinical placements is to facilitate students' learning and progress toward the attainment of competence. The attainment of competence requires personal commitment and active involvement of students; support and guidance of clinical and academic staff; and clinical environments that are welcoming and inclusive of students. METHOD: The items for the Ascent to Competence Scale were identified following a critical review of the literature. Content and face validity were established by an expert panel. During 2010 the instrument was tested with third year nursing students (n=88) from one Australian university. Exploratory factor analysis with promax oblique rotation was used to determine construct validity and Cronbach's coefficient alpha determined the scale's internal consistency reliability. RESULTS: The final scale demonstrated satisfactory internal consistency (alpha 0.98). Exploratory factor analysis yielded a three-component structure termed "Being welcomed"; "Belongingness" and "Learning and competence". Each subscale demonstrated high internal consistency: 0.89; 0.96; and 0.95 respectively. CONCLUSION: The Ascent to Competence Scale provides a fresh perspective on clinical placements as it allows for the relationship between belongingness, learning and competence to be explored. The scale was reliable and valid for this cohort. Further research in different contexts would be valuable in extending upon this work. RELEVANCE TO CLINICAL PRACTICE: The Ascent to Competence Scale profiled in this paper will be of benefit to both educational and healthcare institutions. The use of a quantified yardstick, such as the Ascent to Competence Scale, is important in evaluating the efficacy of programs, placements and partnersh...
Pitt, V, Powis, D, Levett-Jones, T & Hunter, S 2013, 'Can existing personal qualities measures be used to examine nursing students' professional and personal attributes?', Focus on Health Professional Education, vol. 15, no. 2, pp. 41-54.View/Download from: UTS OPUS
Background: Schools of nursing
continue to be challenged because
students who display unprofessional
behaviour are being allowed to progress
through pre-registration programs.
The inclusion of a personal qualities
assessment as part of the admissions
process may address this issue;
however, no instrument currently
used for selecting nursing students
measures the range of personal qualities
required in a practising nurse.
Aim: The aim of this study was to
determine whether a test battery
known as the Personal Qualities
Assessment is an appropriate
instrument to measure the personal
qualities of nursing students.
Methods: A literature review identified
studies that explored the personal
qualities of a professional nurse.
Thematic analysis identified recurring
patterns, both in the literature and in
the Australian Nursing and Midwifery
professional codes and standards
statements. The codes and standards
statements were compared and mapped
by an expert panel to the traits measured
by the Personal Qualities Assessment.
Inter-rater agreement analysis was used
to demonstrate the experts' agreement
with each other in the mapping exercise.
Results: The Personal Qualities
Assessment was found to map closely
to the personal qualities desired
in a registered nurse as expressed
in the Australian Nursing and
Midwifery professional codes and
standards statements. There was a
strong level of agreement between
experts (item-IRA=0.5–1) in their
mapping of the Australian Nursing
and Midwifery professional codes
and standards statements and the
Personal Qualities Assessment.
Conclusion: The Personal Qualities
Assessment could make a useful
addition to the admission process
by helping to determine whether
students wishing to enter into nursing
education meet selection criteria.
Lapkin, S, Levett-Jones, T & Gilligan, C 2013, 'A systematic review of the effectiveness of interprofessional education in health professional programs.', Nurse Education Today, vol. 33, no. 2, pp. 90-102.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE: The objective of this systematic review was to identify the best available evidence for the effectiveness of university-based interprofessional education for health students. BACKGROUND: Currently, most health professional education is delivered in a traditional, discipline specific way. This approach is limited in its ability to equip graduates with the necessary knowledge, skills and attitudes for effective interprofessional collaboration and for working as part of a complex health care team. Interprofessional education is widely seen as a way to improve communication between health professionals, ultimately leading to improved patient outcomes. INCLUSION CRITERIA: The review included all randomised controlled trials and quasi-experimental studies in which two or more undergraduate or post-graduate health professional groups are engaged in interprofessional education. REVIEW METHODS: A three-stage comprehensive search of ten electronic databases as well as grey literature was conducted. Two independent reviewers assessed each paper prior to inclusion using the standardised critical appraisal instruments for evidence of effectiveness developed by the Joanna Briggs Institute. RESULTS: Nine published studies consisting of three randomised controlled trials, five controlled before and after studies and one controlled longitudinal study were included in the review. CONCLUSION: Student's attitudes and perceptions towards interprofessional collaboration and clinical decision-making can be potentially enhanced through interprofessional education. However, the evidence for using interprofessional education to teach communication skills and clinical skills is inconclusive and requires further investigation. IMPLICATIONS FOR RESEARCH: Future randomised controlled studies explicitly focused on interprofessional education with rigorous randomisation procedures, allocation concealment, larger sample sizes, and control groups, would improve the evidence base for in...
MacDonald-Wicks, L & Levett-Jones, T 2012, 'Effective teaching of communication to health professional undergraduate and postgraduate students: A systematic review', JBI Database of Systematic Reviews and Implementation Reports, vol. 10, no. 28 Suppl, pp. 1-12.View/Download from: UTS OPUS
© 2012, Joanna Briggs Institute. All rights reserved. Review Question/Objective: The objective is to identify and assess the effectiveness of tools and methods of teaching communication skills to health professional students in undergraduate and postgraduate programs, to facilitate communication in hospitals, nursing homes and mental health institutions.
Pitt, V, Powis, D, Levett-Jones, T & Hunter, S 2012, 'Factors influencing nursing students' academic and clinical performance and attrition: an integrative literature review.', Nurse Education Today, vol. 32, no. 8, pp. 903-913.View/Download from: UTS OPUS or Publisher's site
Predicted workforce shortages have resulted in government initiatives to increase student numbers in preregistration nursing education. In tandem schools of nursing need to ensure students' progress and complete. The aim of this review was to identify factors that influence preregistration nursing students' academic performance, clinical performance and attrition. An integrative review of both quantitative and qualitative literature was conducted using validated appraisal checklists. The review included studies published from 1999 to 2011 in the databases: MEDLINE, CINAHL, Proquest nursing, Proquest Education (via Proquest 5000), ERIC, Journals@Ovid, PsychINFO and ScienceDirect. Studies were categorised according to their impact on academic progression, clinical progression and attrition. Forty four studies were found; most used quantitative methodologies. The review identified that few studies explored factors that impact on students' clinical performance. The four categories that potentially impact on nursing students' academic performance and attrition were: demographic, academic, cognitive and personality/behavioural factors. The challenge for universities committed to students' success is to develop strategies aimed at addressing these factors that are appropriate to specific contexts and student cohorts.
Levett-Jones, T & Lapkin, S 2012, 'The effectiveness of debriefing in simulation-based learning for health professionals: A systematic review', JBI Database of Systematic Reviews and Implementation Reports, vol. 10, no. 51, pp. 3295-3337.View/Download from: UTS OPUS or Publisher's site
© the authors 2012. Background: Simulation is defined as a technique used to replace or amplify real experiences with guided experiences that evoke or replace substantial aspects of the real world in a fully interactive manner. The use of simulation for educational purposes began decades ago with the use of low-fidelity simulations and has evolved at an unprecedented pace. Debriefing is considered by many to be an integral and critical part of the simulation process. However, different debriefing approaches have developed with little objective evidence of their effectiveness. Objectives: The aim of this review was to identify, appraise and synthesise the best available evidence for the effectiveness of debriefing as it relates to simulation-based learning for health professionals.
Levett-Jones, T, Gilligan, C, Lapkin, S & Hoffman, K 2012, 'Interprofessional education for the quality use of medicines: designing authentic multimedia learning resources.', Nurse Education Today, vol. 32, no. 8, pp. 934-938.View/Download from: UTS OPUS
It is claimed that health care students who learn together will be better prepared for contemporary practice and more able to work collaboratively and communicate effectively. In Australia, although recognised as important for preparing nursing, pharmacy and medical students for their roles in the medication team, interprofessional education is seldom used for teaching medication safety. This is despite evidence indicating that inadequate communication between health care professionals is the primary issue in the majority of medication errors. It is suggested that the pragmatic constraints inherent in university timetables, curricula and contexts limit opportunities for health professional students to learn collaboratively. Thus, there is a need for innovative approaches that will allow nursing, medical and pharmacy students to learn about and from other disciplines even when they do not have the opportunity to learn with them. This paper describes the development of authentic multimedia resources that allow for participative, interactive and engaging learning experiences based upon sound pedagogical principles. These resources provide opportunities for students to critically examine clinical scenarios where medication safety is, or has the potential to be compromised and to develop skills in interprofessional communication that will prepare them to manage these types of situations in clinical practice.
Lapkin, S, Levett-Jones, T & Gilligan, C 2012, 'A cross-sectional survey examining the extent to which interprofessional education is used to teach nursing, pharmacy and medical students in Australian and New Zealand universities.', Journal of Interprofessional Care, vol. 26, no. 5, pp. 390-396.View/Download from: UTS OPUS or Publisher's site
The current status of interprofessional education (IPE) in Australian and New Zealand universities is largely unexamined despite its generally acknowledged benefit. Data are also limited about the use of IPE in teaching medication safety to nursing, pharmacy and medical students. For this reason a web-based cross-sectional survey was used to gather information from Australian and New Zealand universities offering nursing, pharmacy or medical programs. Responses were received from 31 of the 43 (72%) target universities. Eighty percent of the participants indicated that they currently offer IPE experiences, but only 24% of these experiences met the accepted definition of IPE. Of the participants who offer IPE as defined by Center for the Advancement of Interprofessional Education, only 50% use it to teach medication safety. Timetabling restrictions and lack of appropriate teaching and learning resources were identified as the main barriers to implementation of IPE. All participants reported that staff development, multi-media and e-learning resources would be beneficial to IPE initiatives and the teaching of medication safety. Innovative approaches will be needed to overcome the barriers and facilitate the uptake of quality IPE more broadly. Web-based and e-learning options promise a possible way forward, particularly in the teaching of medication safety to nursing, pharmacy and medical students.
Brown, R, Guinea, S, Crookes, P, McAllister, M, Levett-Jones, T, Kelly, MA, Reid-Searl, K, Churchouse, C, Andersen, P, Chong, N & Smith, A 2012, 'Clinical simulation in Australia and New Zealand: Through the lens of an advisory group', Collegian, vol. 19, no. 3, pp. 177-186.View/Download from: Publisher's site
Summary: Across Australia, innovations in simulation to enhance learning in nursing have been occurring for three decades and nursing is, and needs to be, a leading player in simulation knowledge diffusion. However, expertise is unevenly distributed across health services and education providers. Rather than build on the expertise and achievements of others, there is a tendency for resource duplication and for trial and error problem solving, in part related to a failure to communicate achievements for the beneï¬ts of the professional collective. For nursing to become a leader in the use of simulation and drive ongoing development, as well as conducting high quality research and evaluation, academics need to collaborate, aggregate best practice in simulation learning, and disseminate that knowledge to educators working in health services and higher education sectors across the whole of Australia and New Zealand. To achieve this strategic intent, capacity development principles and committed action are necessary. In mid 2010 the opportunity to bring together nurse educators with simulation learning expertise within Australia and New Zealand became a reality. The Council of Deans of Nursing and Midwifery (CDNM) Australia and New Zealand decided to establish an expert reference group to re-ect on the state of Australian nursing simulation, to pool expertise and to plan ways to share best practice knowledge on simulation more widely. This paper re-ects on the achievements of the ï¬rst 18 months since the groups establishment and considers future directions for the enhancement of simulation learning practice, research and development in Australian nursing.
Bembridge, E, Levett-Jones, T & Jeong, SY-S 2011, 'The transferability of information and communication technology skills from university to the workplace: a qualitative descriptive study.', Nurse Education Today, vol. 31, no. 3, pp. 245-252.View/Download from: UTS OPUS or Publisher's site
AIM: This paper presents the findings from a study that explored whether the information and communication technology (ICT) skills nurses acquired at university are relevant and transferable to contemporary practice environments. BACKGROUND: Whilst universities have attempted to integrate information and communication technology into nursing curricula it is not known whether the skills developed for educational purposes are relevant or transferable to clinical contexts. METHODS: A qualitative descriptive study was used to explore the perspectives of a small group of new graduate nurses working in a regional/semi-metropolitan healthcare facility in New South Wales, Australia. Semi-structured interviews were used and the data thematically analysed. FINDINGS: The themes that emerged from the study are presented in accordance with the conceptual framework and structured under the three headings of pre-transfer, transition and post-transfer. The transferability of information and communication technology skills from university to the workplace is impacted by a range of educational, individual, organisational and contextual factors. CONCLUSION: Access to adequate ICT and the necessary training opportunities influences new graduates' work satisfaction and their future employment decisions. The ability to effectively use information and communication technology was viewed as essential to the provision of quality patient care.
Arthur, C, Kable, A & Levett-Jones, T 2011, 'Human patient simulation manikins and information communication technology use in Australian schools of nursing: A cross-sectional survey', Clinical Simulation in Nursing, vol. 7, no. 6.View/Download from: UTS OPUS or Publisher's site
Background: Shortage of suitable quality placements for undergraduate nursing students' clinical experience has motivated Australian schools of nursing to consider alternatives to traditional clinical placements. Human patient simulation manikins and information communication technologies may have the potential to facilitate the development of nursing students' clinical competence within a laboratory environment. Method: A cross-sectional survey of Australian schools of nursing was undertaken to explore the use and types of simulation and information communication technologies and the pedagogical principles underpinning their use. Results: This report profiles the facilities, staffing, teaching strategies, and underpinning pedagogical principles currently employed. Survey results show substantial variations in simulation and information communication technology resources and teaching strategies in current use. Conclusion: Additional funding and staff training opportunities will be required to ensure adequate facilities and staffing are available to support quality use of these technologies. © 2011 International Nursing Association for Clinical Simulation and Learning.
Jeong, SY-S, Hickey, N, Levett-Jones, T, Pitt, V, Hoffman, K, Norton, CA & Ohr, SO 2011, 'Understanding and enhancing the learning experiences of culturally and linguistically diverse nursing students in an Australian bachelor of nursing program.', Nurse Education Today, vol. 31, no. 3, pp. 238-244.View/Download from: UTS OPUS or Publisher's site
The growth in numbers of culturally and linguistically diverse students entering nursing programs in Australia presents challenges for academic and clinical staff, and most importantly the students themselves. In this paper we present the findings from a pilot study designed to explore these issues and to develop strategies to address them. This study used a qualitative explorative approach to gain rich in-depth data. Eleven culturally and linguistically diverse students, three clinical facilitators, and four academic staff participated in focus group interviews. Four major themes emerged: level of English language competence, feelings of isolation, limited opportunities for learning, and inadequate university support. The issues we identified led to a meaningful discussion of the political, financial, social and intercultural context that they are entrapped in. This paper provides educators, clinicians, policy makers and researchers with an insight where and how they commence to break the trap and highlights, the need for further research into the perspectives of Australian students' who study and socialise with their international peers.
Nephrology nurse educators face many challenges related to professional development and resource sharing. In Australia and New Zealand, as well as other countries where the 'tyranny of distance' is a feature, access, equity and lack of educational support due to the geographical isolation of many nephrology units, present particular challenges. This paper reports the findings from a case study of 51 nephrology nurse educators in Australia. Using an exploratory descriptive approach, the study aimed to identify current issues facing nephrology nurse educators and determine the feasibility of developing an online community of practice to support them in their role. An outcome of the study was the establishment of The Nephrology Educators' Network. This network seeks to enhance peer support, collegiality, critical companionship, collaboration, knowledge sharing and the benchmarking of practices for those involved in nephrology nurse education. In this paper, we describe and reflect on some of the outcomes and challenges faced in developing this network.
van der Riet, P, Francis, L & Levett-Jones, T 2011, 'Complementary therapies in healthcare: design, implementation and evaluation of an elective course for undergraduate students.', Nurse Education in Practice, vol. 11, no. 2, pp. 146-152.View/Download from: UTS OPUS or Publisher's site
Complementary therapies are making a significant and cost effective contribution to the health of the community, especially in relation to chronic disease management and prevention of disease. Because of the increased use of complementary therapies, nurses, and other health professionals need to be familiar with specific practices so that they can assist clients to make informed decisions in the use of these therapies. Importantly, with the increased interest in complementary therapies, there is a need to ensure these practices are safe, cause no harm and are used to enhance the well-being of patients. This paper reports on the design, implementation and evaluation of a complementary therapies course and a linked Thai cultural studies tour. The course was implemented at The University of Newcastle for the first time in 2009 with an enrollment of 200 students. It is an elective course for both nursing students and those from other disciplines. In this paper we describe the reasons for the introduction of this course and its value in nursing education. We then provide an overview of the course and report on evaluation results from both the course and the Thai cultural studies tour.
Levett-Jones, T, Gersbach, J, Arthur, C & Roche, J 2011, 'Implementing a clinical competency assessment model that promotes critical reflection and ensures nursing graduates' readiness for professional practice.', Nurse Education in Practice, vol. 11, no. 1, pp. 64-69.View/Download from: UTS OPUS or Publisher's site
AIM: This paper describes the design, implementation and evaluation of the Structured Observation and Assessment of Practice (SOAP), a model used to assess third year undergraduate nursing students' clinical competence. BACKGROUND: Competence is a complex concept that is difficult to define and measure. The assessment of nursing students' clinical competence has confronted universities with problems of validity, reliability, subjectivity and bias for many years. This presents particular problems in nursing as patient outcomes may be compromised by incompetent practice. Too often assessments of nursing students' competence comprise brief assessments of psychomotor skills, vague global assessment of generic skills/attributes or assessments undertaken in simulated laboratory settings rather than the real world of practice. METHODS: The Structured Observation and Assessment of Practice (SOAP), is a full day holistic practice-driven clinical competence assessment approach that motivates nursing students' learning, promotes critical reflection and confirms graduates' readiness for professional practice. This model was introduced in 2004 and since then 1031 students have been assessed. Quantitative and qualitative data has been collected via an anonymous online evaluation. RESULTS: Survey results have been statistically analysed using The Statistical Package for the Social Sciences (SPSS) (Version 13) with exploratory factor analysis employed to ascertain construct validity. This paper will report on the four components that showed acceptable factor loadings and that together accounted for 77.65 per cent of the variance: perceived learning outcomes, consistency with general clinical performance, quality of assessors, and anxiety/stress impact. CONCLUSION: The results of the SOAP approach supports the premise that quality clinical assessment requires nursing students' exposure to complex challenges undertaken in authentic clinical contexts, observed by registered nurses ...
Levett-Jones, T & Lapkin, S 2011, 'The effectiveness of debriefing in simulation-based learning for health professionals: A systematic review', JBI Database of Systematic Reviews and Implementation Reports, vol. 9, no. 64, pp. 1-16.View/Download from: UTS OPUS or Publisher's site
Lapkin, S, Levett-Jones, T & Gilligan, C 2011, 'The effectiveness of interprofessional education in university-based health professional programs: A systematic review.', JBI library of systematic reviews, vol. 9, no. 46, pp. 1917-1970.View/Download from: UTS OPUS
Background: A key responsibility of universities is to prepare health professional graduates for their roles as effective members of the health care team. Currently, most university-based health professional education is delivered in a traditional, discipline specific way. This approach is limited in its ability to equip graduates with the necessary knowledge, skills and attitudes for effective interprofessional collaboration and for working as part of a complex health care team. Interprofessional education occurs when learners from two or more professional groups learn about, from and with each other. The fundamental premise of interprofessional education is that if health professional students learn together they will be better prepared for interprofessional collaboration ultimately leading to improved patient outcomes.Objective -The objective of this systematic review was to identify the best available evidence for the effectiveness of university-based interprofessional education.Inclusion criteria -The review included all randomised controlled trials and quasi-experimental studies that assessed the effectiveness of interprofessional education in university-based health professional programs. All studies that included two or more undergraduate or post-graduate health professional groups engaged in interprofessional education were considered. Outcome measures included objectively measured or self-reported educational outcomes and/or professional competencies related to interprofessional education as assessed by validated instruments such as the Readiness for Interprofessional Learning Scale and the Interdisciplinary Education Perception Scale.A three-stage comprehensive search strategy was utilised to search across ten electronic databases. English language studies published between January 2000 and February 2011 were considered for inclusion.Methodological quality: Two independent reviewers assessed the methodological quality of each study selected for retriev...
Gidding, HF, Law, MG, Amin, J, Macdonald, GA, Sasadeusz, JJ, Jones, TL, Strasser, SI, George, J, Dore, GJ & ACHOS investigator team 2011, 'Predictors of deferral of treatment for hepatitis C infection in Australian clinics.', The Medical journal of Australia, vol. 194, no. 8, pp. 398-402.View/Download from: UTS OPUS
OBJECTIVE: To determine uptake of treatment for hepatitis C virus (HCV) infection and predictors of deferral of treatment for HCV by using prospectively collected data from the Australian Chronic Hepatitis C Observational Study (ACHOS). DESIGN, PATIENTS AND SETTING: Cohort study involving interview and medical record review at enrolment and routine follow-up clinic visits of patients with chronic HCV and compensated liver disease attending a national network of 24 HCV clinics between April 2008 and December 2009. Eligible patients were those who had not been previously treated, were enrolled within 6 months of their first clinic visit, were eligible for treatment and had been enrolled for at least 6 months. MAIN OUTCOME MEASURE: Predictors of patients undergoing HCV treatment within the first 6 months of assessment. RESULTS: 1239 patients were enrolled in ACHOS, of whom 406 met the criteria for inclusion in the subcohort for this study. Among this subcohort, 171 (42%) received treatment within 6 months of their first clinic visit. Current injecting drug use (odds ratio [OR], 0.26; 95% CI, 0.08-0.77), past and current treatment for drug dependency (OR, 0.34; 95% CI, 0.18-0.67, and OR, 0.42; 95% CI, 0.22-0.81, respectively) and alcohol use above 20 g/day (OR, 0.20; 95% CI, 0.08-0.46) were independent predictors of deferral of treatment. At least one of these factors applied to 41% of the subcohort. Clinical factors, including HCV genotype, HCV RNA level, and stage of liver disease were not associated with deferral of treatment for HCV. CONCLUSION: Factors related to drug and alcohol use, rather than clinical factors, influenced uptake of treatment for HCV. Further support for patients with drug and alcohol dependency is required to optimise treatment uptake.
Lapkin, S & Levett-Jones, T 2011, 'A cost-utility analysis of medium vs. high-fidelity human patient simulation manikins in nursing education.', Journal of Clinical Nursing, vol. 20, no. 23-24, pp. 3543-3552.View/Download from: UTS OPUS or Publisher's site
AIMS AND OBJECTIVES: This study presents a cost-utility analysis that compared medium- vs. high-fidelity human patient simulation manikins in nursing education. The analysis sought to determine whether the extra costs associated with high-fidelity manikins can justify the differences, if any, in the outcomes of clinical reasoning, knowledge acquisition and student satisfaction. BACKGROUND: Investment in simulated learning environments has increased at an unprecedented pace. One of the driving forces is the potential for simulation experiences to improve students' learning and engagement. A cost-effectiveness analysis is needed to inform decisions related to investment in and use of simulation equipment. METHOD: Costs associated with the use of medium- and high-fidelity manikins were calculated to determine the total cost for each. A cost-utility analysis using multiattribute utility function was then conducted to combine costs and three outcomes of clinical reasoning, knowledge acquisition and student satisfaction from a quasi-experimental study to arrive at an overall cost utility. RESULTS: The cost analysis indicated that to obtain equivalent clinical reasoning, knowledge acquisition and student satisfaction scores, it required $AU1·21 (US$ 1·14; €0·85) using medium-fidelity as compared with $AU6·28 (US$6·17; €4·40) for high-fidelity human patient simulation manikins per student. CONCLUSION: Based on the results of the cost-utility analysis, medium-fidelity manikins are more cost effective requiring one-fifth of the cost of high-fidelity manikins to obtain the same effect on clinical reasoning, knowledge acquisition and student satisfaction. RELEVANCE TO CLINICAL PRACTICE: It is important that decision-makers have an economic analysis that considers both the costs and outcomes of simulation to identify the approach that has the lowest cost for any particular outcome measure or the best outcomes for a particular cost.
Levett-Jones, T, Lapkin, S, Hoffman, K, Arthur, C & Roche, J 2011, 'Examining the impact of high and medium fidelity simulation experiences on nursing students' knowledge acquisition.', Nurse Education in Practice, vol. 11, no. 6, pp. 380-383.View/Download from: UTS OPUS or Publisher's site
AIM: This paper describes a study that measured and compared knowledge acquisition in nursing students exposed to medium or high fidelity human patient simulation manikins. BACKGROUND: In Australia and internationally the use of simulated learning environments has escalated. Simulation requires a significant investment of time and money and in a period of economic rationalisation this investment must be justified. Assessment of knowledge acquisition with multiple choice questions is the most common approach used to determine the effectiveness of simulation experiences. METHOD: This study was conducted in an Australian school of nursing; 84 third year nursing students participated. A quasi-experimental design was used to evaluate the effect of the level of manikin fidelity on knowledge acquisition. Data were collected at three points in time: prior to the simulation, immediately following and two weeks later. RESULTS: Differences in mean scores between the control (medium fidelity) and experimental (high fidelity) groups for Tests 1, 2 and 3 were calculated using independent t tests and were not statistically significant. Analysis of covariance (ANCOVA) was conducted to determine whether changes in knowledge scores occurred over time and, while an improvement in scores was observed, it was not statistically significant. CONCLUSION: The results of this study raise questions about the value of investing in expensive simulation modalities when the increased costs associated with high fidelity manikins may not be justified by a concomitant increase learning outcomes. This study also suggests that multiple choice questions may not be the most appropriate measure of simulation effectiveness.
Levett-Jones, T, McCoy, M, Lapkin, S, Noble, D, Hoffman, K, Dempsey, J, Arthur, C & Roche, J 2011, 'The development and psychometric testing of the Satisfaction with Simulation Experience Scale.', Nurse Education Today, vol. 31, no. 7, pp. 705-710.View/Download from: UTS OPUS or Publisher's site
AIM: This paper reports the development and psychometric testing of the Satisfaction with Simulation Experience Scale, an instrument designed to measure and compare differences in satisfaction levels between nursing students exposed to medium and high fidelity human patient simulation manikins. BACKGROUND: Student satisfaction is important to engaged and meaningful learning and it facilitates active and purposeful participation in simulation experiences. There are suggestions that student satisfaction may have some correlation with performance. Few studies have explored in a rigorous way the impact of manikin fidelity on nursing students' satisfaction with simulation experiences. METHOD: The items for the Satisfaction with Simulation Experience Scale were identified following a critical review of the literature. Content validly was established by use of an expert panel. During 2009 and 2010 the instrument was tested with second year (n=268) and third year nursing students (n=76) from one Australian university. Exploratory factor analysis with varimax rotation was used to determine construct validity and Cronbach's coefficient alpha determined the scale's internal consistency reliability. Differences in satisfaction levels between groups were analysed using an independent t test. Responses to an open ended question were categorised using thematic content analysis. RESULTS: The scale demonstrated satisfactory internal consistency (alpha 0.77). Exploratory factor analysis yielded a three-component structure termed Debriefing and Reflection, Clinical Reasoning, and Clinical Learning; each subscale demonstrated high internal consistency: 0.94; 0.86; 0.85 respectively. Mean satisfaction scores were high for each group. However, statistically significant differences were not apparent between second or third year students exposed to medium and high fidelity manikins. Content analysis identified 13 main categories including supplementing versus replacing clinical placemen...
Hoffman, K, Dempsey, J, Levett-Jones, T, Noble, D, Hickey, N, Jeong, S, Hunter, S & Norton, C 2011, 'The design and implementation of an Interactive Computerised Decision Support Framework (ICDSF) as a strategy to improve nursing students' clinical reasoning skills.', Nurse Education Today, vol. 31, no. 6, pp. 587-594.View/Download from: UTS OPUS or Publisher's site
This paper describes the conceptual design and testing of an Interactive Computerised Decision Support Framework (ICDSF) which was constructed to enable student nurses to "think like a nurse." The ICDSF was based on a model of clinical reasoning. Teaching student nurses to reason clinically is important as poor clinical reasoning skills can lead to "failure-to rescue" of deteriorating patients. The framework of the ICDSF was based on nursing concepts to encourage deep learning and transferability of knowledge. The principles of active student participation, situated cognition to solve problems, authenticity, and cognitive rehearsal were used to develop the ICDSF. The ICDSF was designed in such a way that students moved through it in a step-wise fashion and were required to achieve competency at each step before proceeding to the next. The quality of the ICDSF was evaluated using a questionairre survey, students' written comments and student assessment measures on a pilot and the ICDSF. Overall students were highly satisfied with the clinical scenarios of the ICDSF and believed they were an interesting and useful way to engage in authentic clinical learning. They also believed the ICDSF was useful in developing cognitive skills such as clinical reasoning, problem-solving and decision-making. Some reported issues were the need for good technical support and the lack of face to face contact when using e-learning. Some students also believed the ICDSF was less useful than actual clinical placements.
Stone, T, Levett-Jones, T, Harris, M & Sinclair, PM 2010, 'The genesis of 'the Neophytes': a writing support group for clinical nurses.', Nurse Education Today, vol. 30, no. 7, pp. 657-661.View/Download from: Publisher's site
This paper profiles the establishment and evaluation of the Neophyte Writers' Group, run by nurse academics in collaboration with clinical nurses. The growing demand for nurses to write, publish and present their work had inspired the introduction of a series of workshops designed to develop and improve writing and presentation skills, which eventuated in formation of the Neophytes. The group was founded on the basis of Bandura's theory of self-efficacy (1997), a concept which has been discussed extensively in social psychology literature to explain motivation and learning theory. People with high assurance in their capabilities regard difficult tasks as challenges to be mastered rather than as threats to be avoided (Bandura, 1994). The Neophytes' group employs a collaborative approach intended to increase and reinforce members' self-confidence; the underlying philosophy is to promote and enhance writers' motivation, capacity and self-efficacy in order to achieve future publication goals confidently and independently. Support which engenders these strengths through a program relevant to participants' needs is likely, as this group found, to increase publication productivity. Additional unexpected outcomes resulted, such as engagement by clinical nurses' in academic work, and an increase in research higher degree enrolments.
Bembridge, E, Levett-Jones, T & Jeong, SY-S 2010, 'The preparation of technologically literate graduates for professional practice.', Contemporary Nurse, vol. 35, no. 1, pp. 18-25.View/Download from: Publisher's site
The impact of information and communication technology has been felt globally and the healthcare sector is not immune to the changes brought about by the introduction of new technologies. In contemporary clinical practice environments, information and communication technology skills are advantageous, not only to nurses, but also to the patients for whom they care. There is good evidence that these skills, appropriately utilised, can have a significant impact on patient outcomes. This scholarly paper presents the background to a project that explores graduate nurses' experiences of using information and communication technology in clinical contexts. A broad historical overview of the implementation of information and communication technology in higher education and healthcare in Australia is provided before discussing the extent to which the technology skills learnt at university are relevant or transferable to contemporary practice environments. The current levels and use of information and communication technology among new graduate nurses, the apparent dichotomy between technological versus humanised healthcare, and the need for national information and communication technology competency standards are discussed.
Hunter, S & Levett-Jones, T 2010, 'The practice of nurses working with older people in long term care: an Australian perspective.', Journal of Clinical Nursing, vol. 19, no. 3-4, pp. 527-536.View/Download from: Publisher's site
AIMS AND OBJECTIVES: To provide a contemporary description of the practice of nurses caring for older people in long term care. BACKGROUND: The increasing size and morbidity of the population of older persons is driving the requirement for nurses who work in long term care to have appropriate educational qualifications and expertise. DESIGN: A mixed method research design was used in this study. METHOD: The perceptions from clinical registered nurses (n = 48) and nurse managers (n = 16), working in six long term aged care facilities were elicited. Data were collected via purposive questionnaires, document analysis and semi-structured interviews. RESULTS: There was considerable agreement among the data and from the two groups of nurses about registered nurses' practice. The most frequently performed nursing activities revealed in the questionnaire were 'Organising their own workload' and 'Devising an individualised plan of care' whilst the lowest were 'Developing policies in response to changes in legislation or clinical practice' and 'Introducing appropriate research findings into practice'. Categories from the interviews included, 'It is a team effort', 'We manage' and 'Clinical skills and responsibilities'. Overall the data revealed a picture of nurses managing the care of older persons in a specialised context. CONCLUSION: The findings confirm that the practice of nurses working with older persons in long term care has expanded to the role of specialised care facilitator. Registered nurses' practice in this study is consistent with current descriptions of gerontological nursing. However, some elements of practice require further development: person-centred care and evidence-based practice. RELEVANCE TO CLINICAL PRACTICE. It remains a challenge for registered nurses working with older people to deliver person-centred care and to engage with evidence and integrate evidence into policy and practice. Strategies are required for registered nurses to develop these e...
Bembridge, E, Levett-Jones, T & Jeong, SY-S 2010, 'The preparation of technologically literate graduates for professional practice', CONTEMPORARY NURSE, vol. 35, no. 1, pp. 18-25.View/Download from: Publisher's site
Lapkin, S, Levett-Jones, T, Bellchambers, H & Gilligan, C 2010, 'The effectiveness of interprofessional education in university based health professional programs: A systematic review', JBI Database of Systematic Reviews and Implementation Reports, vol. 8, no. Supplement, pp. 1-19.View/Download from: Publisher's site
Levett-Jones, T, Sundin, D, Bagnall, M, Hague, K, Schumann, W, Taylor, C & Wink, J 2010, 'Learning to think like a nurse', Hunter New England Nursing Journal, vol. 3, no. 1, pp. 15-20.
Lapkin, S, Fernandez, R, Levett-Jones, T & Bellchambers, H 2010, 'The effectiveness of using human patient simulation manikins in the teaching of clinical reasoning skills to undergraduate nursing students: a systematic review.', JBI library of systematic reviews, vol. 8, no. 16, pp. 661-694.
Human patient simulation manikins are being used extensively both nationally (in Australia) and internationally in the education of health professionals. There is evidence suggesting that these types of technologies are effective in teaching psychomotor skills. Furthermore student satisfaction with simulation approaches is generally high. However, the extent to which human patient simulation manikins are effective in the teaching of clinical reasoning skills to undergraduate nursing students is less clear.The aim of this systematic review was to identify the best available evidence for the effectiveness of using whole-body high-fidelity human patient simulation manikins to teach clinical reasoning skills to undergraduate nursing students.The review included all randomised controlled trials that assessed the effectiveness of high fidelity human patient manikins in educating undergraduate nursing students. Studies that included health professionals were excluded unless data for nursing students were analysed separately. The primary outcome measure was clinical reasoning. Other outcome measures included critical thinking, student satisfaction, knowledge acquisition, confidence levels, and skill performance as assessed by methods such as objective structured clinical examinations, and questionnaires.Using a systematic search strategy designed for each database, the following electronic sources were searched for the period 1999 -2009: AMED, CINAHL, Cochrane Database, Dissertation and Theses, EMBASE, ERIC, Journals@Ovid, MEDLINE, Proquest Nursing Journals, PsycINFO. Hand searching of the reference lists of included studies and conference proceedings was undertaken to identify further studies.Two independent reviewers assessed the methodological quality of each study selected for retrieval prior to inclusion using a critical appraisal tool from the Joanna Briggs Institute.Data were extracted from studies using the standardised data extraction tool from the Joanna Briggs...
Lapkin, S, Levett-Jones, T & Bellchambers, H 2010, 'The meaningfulness and appropriateness of using human patient simulation manikins as a teaching and learning strategy in undergraduate nursing education: a systematic review.', JBI library of systematic reviews, vol. 8, no. 8 Suppl, pp. 1-16.
Lapkin, S, Levett-Jones, T, Bellchambers, H & Fernandez, R 2010, 'The effectiveness of using patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: A systematic review', Clinical Simulation in Nursing, vol. 6, no. 6.View/Download from: Publisher's site
Human patient simulation manikins (HPSMs) are being used extensively in the education of health professionals, but their effectiveness in the teaching of clinical reasoning skills to undergraduate nursing students is not clear. The aim of this systematic review is to identify the best available evidence for their effectiveness in this regard. The review included all English-language randomized controlled trials from 1999 to 2009 that assessed the effectiveness of high-fidelity HPSMs in educating undergraduate nursing students. The results indicate that the use of HPSMs improves knowledge acquisition and critical thinking and enhances students' satisfaction with the learning. There is a lack of unequivocal evidence of the effectiveness of using high-fidelity HPSMs in the teaching of clinical reasoning skills to undergraduate nursing students. Further research is required to ascertain the effectiveness of the use of HPSMs as an educational strategy to improve the clinical reasoning skills of undergraduate nursing students. © 2010 International Nursing Association for Clinical Simulation and Learning.
Lapkin, S, Levett-Jones, T, Bellchambers, H & Gilligan, C 2010, 'The effectiveness of interprofessional education in university based health professional programs: A systematic review', The JBI Database of Systematic Reviews and Implementation Reports, vol. 8, pp. 104-122.
Levett-Jones, T, Hoffman, K, Dempsey, J, Jeong, SY, Noble, D, Norton, CA, Roche, J & Hickey, N 2010, 'The 'five rights' of clinical reasoning: an educational model to enhance nursing students' ability to identify and manage clinically 'at risk' patients.', Nurse Education Today, vol. 30, no. 6, pp. 515-520.
Acute care settings are characterised by patients with complex health problems who are more likely to be or become seriously ill during their hospital stay. Although warning signs often precede serious adverse events there is consistent evidence that 'at risk' patients are not always identified or managed appropriately. 'Failure to rescue', with rescue being the ability to recognise deteriorating patients and to intervene appropriately, is related to poor clinical reasoning skills. These factors provided the impetus for the development of an educational model that has the potential to enhance nursing students' clinical reasoning skills and consequently their ability to manage 'at risk' patients. Clinical reasoning is the process by which nurses collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process. Effective clinical reasoning depends upon the nurse's ability to collect the right cues and to take the right action for the right patient at the right time and for the right reason. This paper provides an overview of a clinical reasoning model and the literature underpinning the 'five rights' of clinical reasoning.
Levett-Jones, T, Kenny, R, Van der Riet, P, Hazelton, M, Kable, A, Bourgeois, S & Luxford, Y 2009, 'Exploring the information and communication technology competence and confidence of nursing students and their perception of its relevance to clinical practice.', Nurse Education Today, vol. 29, no. 6, pp. 612-616.View/Download from: Publisher's site
AIM: This paper profiles a study that explored nursing students' information and communication technology competence and confidence. It presents selected findings that focus on students' attitudes towards information and communication technology as an educational methodology and their perceptions of its relevance to clinical practice. BACKGROUND: Information and communication technology is integral to contemporary nursing practice. Development of these skills is important to ensure that graduates are 'work ready' and adequately prepared to practice in increasingly technological healthcare environments. METHODS: This was a mixed methods study. Students (n=971) from three Australian universities were surveyed using an instrument designed specifically for the study, and 24 students participated in focus groups. FINDINGS: The focus group data revealed that a number of students were resistant to the use of information and communication technology as an educational methodology and lacked the requisite skills and confidence to engage successfully with this educational approach. Survey results indicated that 26 per cent of students were unsure about the relevance of information and communication technology to clinical practice and only 50 per cent felt 'very confident' using a computer. CONCLUSION: While the importance of information and communication technology to student's learning and to their preparedness for practice has been established, it is evident that students' motivation is influenced by their level of confidence and competence, and their understanding of the relevance of information and communication technology to their future careers.
Levett-Jones, T & Lathlean, J 2009, ''Don't rock the boat': Nursing students' experiences of conformity and compliance.', Nurse Education Today, vol. 29, no. 3, pp. 342-349.
AIM: This paper profiles a cross national case study that examined nursing students' experience of belongingness when undertaking clinical placements. The aim of the paper is to present selected findings that focus on the relationship between belongingness, conformity and compliance. BACKGROUND: Literature from the disciplines of psychology, social science and nursing is presented as a background to the study. METHODS: This was a mixed methods case study; in this paper the qualitative phase is described. Eighteen third year nursing students from two universities in Australia and one in the United Kingdom were interviewed and the data thematically analysed. FINDINGS: Three sub themes emerged within the category of conformity and compliance. These included: Don't rock the boat; getting the RNs offside; and speaking up. Students described how and why they adopted or adapted to the teams' and institution's values and norms, rather than challenging them, believing that this would improve their likelihood of acceptance and inclusion by the nursing staff. CONCLUSION: Further research is required to examine the subtle interplay of factors that influence nursing students' attitudes and behaviours in relation to their need to belong, how conformity and compliance are acculturated in practice, and how students can be empowered to speak out against poor practice to become assertive and confident practitioners.
Levett-Jones, T & Lathlean, J 2009, 'Response to Roger Watson's (Editor-in-Chief) commentary on: The 'Ascent to Competence' conceptual framework: An outcome of a study of belongingness.', Journal of Clinical Nursing, vol. 18, no. 20, pp. 2920-2921.View/Download from: Publisher's site
Levett-Jones, T & Lathlean, J 2009, 'The ascent to competence conceptual framework: an outcome of a study of belongingness.', Journal of Clinical Nursing, vol. 18, no. 20, pp. 2870-2879.
AIM: This paper presents qualitative findings from a study that explored nursing students' experience of belongingness when undertaking clinical placements. The aim is to locate the professional and practical implications of the research within an Ascent to Competence conceptual framework. BACKGROUND: The need to belong exerts a powerful influence on cognitive processes, emotional patterns, behavioural responses, health and well-being and failure to satisfy this need can have devastating consequences. The literature suggests that diminished belongingness may impede students' motivation for learning and influence the degree to which they are willing to conform rather than adopt a questioning approach to clinical practice. DESIGN: A mixed methods, cross national, multi-site case study approach was adopted with third-year preregistration nursing students from three universities (two in Australia and one in England) participating; 362 in the quantitative phase and 18 in the qualitative phase. FINDINGS: Qualitative findings demonstrated that, although the primary purpose of clinical education is to facilitate students' progress towards the attainment of competence, the realisation of this goal is impacted by a wide range of individual, interpersonal, contextual and organisational factors which can be conceptualised hierarchically. By this structuring it is possible to see how belongingness is a crucial precursor to students' learning and success. CONCLUSION: The framework demonstrates that students progress to a stage where attainment of competence is possible only after their previous needs for safety and security, belongingness, healthy self-concept and learning have been met. RELEVANCE TO CLINICAL PRACTICE: The future of the nursing profession depends upon the development of confident, competent professionals with a healthy self-concept and a commitment to patient-centred care and self-directed learning. This paper demonstrates that the realisation of this goal is ...
Levett-Jones, T, Lathlean, J, Higgins, I & McMillan, M 2009, 'Development and psychometric testing of the Belongingness Scale-Clinical Placement Experience: an international comparative study.', Collegian, vol. 16, no. 3, pp. 153-162.
AIM: This paper reports the development and psychometric testing of the Belongingness Scale-Clinical Placement Experience, an instrument designed to measure the extent to which nursing students experience belongingness related to their clinical placements. BACKGROUND: The need to belong is a global concept that exerts a powerful influence on cognitive processes, emotional patterns, behavioural responses, health and well-being. Diminished belongingness impedes students' motivation to learn. Measuring belongingness specific to the clinical environment and comparing different cohorts requires valid and reliable instruments. METHOD: Scales for measuring belongingness were identified following a critical review of the literature. From these a new 34-item instrument was developed. During 2006 the instrument was tested with students (n = 362) from two Australian universities and one university in the south of England. Principal component analysis with varimax rotation was used to determine construct validity and Cronbach's coefficient alpha determined the scale's internal consistency reliability. RESULTS: Differences in belongingness scores were statistically significant, with the British cohort scoring higher than either of the Australian sites. The scale demonstrated high internal consistency (alpha 0.92). Principal component analysis yielded a three-component structure termed Esteem, Connectedness and Efficacy and each subscale demonstrated high internal consistency: 0.9; 0.82; 0.8 respectively. CONCLUSION: The scale was reliable and valid for the three cohorts. Results indicated that the instrument is capable of differentiating between respondents and cohorts. Further research in different contexts would be valuable in taking this work forward.
Levett-Jones, T, Lathlean, J, Higgins, I & McMillan, M 2009, 'Staff-student relationships and their impact on nursing students' belongingness and learning.', Journal of Advanced Nursing, vol. 65, no. 2, pp. 316-324.
AIM: This paper is a report of selected findings from a study exploring the relationship between belongingness and placement experiences of preregistration nursing students. BACKGROUND: Staff-student relationships are an important influence on students' experiences of belongingness and their clinical learning. The need to belong is universal and pervasive, exerting a powerful influence on thought processes, emotions, behaviour, health and happiness. People deprived of belongingness are more likely to experience diminished self-esteem, increased stress and anxiety, depression and a decrease in general well-being. Nursing students' motivation and capacity to learn, self-concept, confidence, the extent to which they are willing to question or conform to poor practice and their future career decisions are influenced by the extent to which they experience belongingness. METHOD: During 2006, 18 third year students from two Australian universities and one United Kingdom university participated in in-depth semi-structured interviews. Data were analysed thematically. FINDINGS: Participants described placement experiences spanning a continuum from those promoting a high degree of belongingness to those provoking intense feelings of alienation. Staff-student relationships (including receptiveness, inclusion/exclusion, legitimization of the student role, recognition and appreciation, challenge and support) were the most important influence on students' sense of belonging and learning. Similarities between sites were remarkable, despite the differences in healthcare and higher education systems. CONCLUSION: Staff-student relationships are key to students' experience of belongingness. Understanding the types of interactions and behaviours that facilitate or impede students' belongingness and learning are essential to the creation of positive clinical experiences.
Levett-Jones, T & Lathlean, J 2008, 'Belongingness: a prerequisite for nursing students' clinical learning.', Nurse Education in Practice, vol. 8, no. 2, pp. 103-111.
The concept of belongingness has intuitive appeal. Human beings are social creatures; the need to belong and be accepted is fundamental, and social exclusion can be devastating. This paper reports on the selected findings from the qualitative phase of mixed-methods study that explored nursing students' experience of belongingness while on clinical placements. The 18 interview participants in this study were from Australia and the United Kingdom. They provided a range of perspectives on belongingness and how it influenced their placement experience. Central to this discussion was their strong belief that belonging is a prerequisite for clinical learning. This theme dominated all of the interviews. Given that the primary purpose of clinical placements is for students to learn to nurse, there needs to be a clear understanding of the relationship between belongingness and learning. With reference to the published literature and excerpts from interview transcripts, this paper proposes that reconceptualising nursing students' clinical learning experiences through a 'lens of belongingness' provides a new perspective and reveals yet unexplored insights.
Levett-Jone, T, Lathlean, J, Higgins, I & McMillan, M 2008, 'The duration of clinical placements: A key influence on nursing students' experience of belongingness', Australian Journal of Advanced Nursing, vol. 26, no. 2, pp. 8-16.
Objective: This paper reports selected findings from a study that investigated nursing students' experience of belongingness. The manner in which this experience is influenced by the duration of students' clinical placements is the focus of the discussion. Design: A mixed method, multi-site case study approach using an anonymous online survey: the Belongingness Scale - Clinical Placement Experience was completed by 362 students, 18 of whom also participated in semi-structured interviews. Setting: The setting for the study was two Australian universities and one university in the United Kingdom offering undergraduate nursing programs. Subjects: Third year undergraduate students (n=362) were recruited into the study. Main outcome measure: Nurses experience of belongingness and the influence of the duration of clinical placement on the experience of belongingness. Results: Students' self-concept, degree of self-efficacy, confidence, resilience, willingness to question or conform to poor practice, career decisions, capacity and motivation to learn were all impacted by the extent to which they experienced belongingness. Differences in belongingness scores between the students from the three sites were statistically significant, with participants from the United Kingdom scoring higher than those from either of the Australian sites, F(2, 355) = 21.70, p = <.001, p2 = 0.11. Although the reasons for these results are multifactorial, this study found the duration and structure of clinical placements to be one of the most important factors affecting students' belongingness. Conclusion: A consolidated period of practice for students to 'settle in' and establish collegial relationships is an important influence on their experience of belonging and a necessary precursor to their active and participative learning. Findings from this study call for a re-examination of the assumptions, educational philosophies, policies and practices that underpin the duration of clinical placem...
Myall, M, Levett-Jones, T & Lathlean, J 2008, 'Mentorship in contemporary practice: the experiences of nursing students and practice mentors.', Journal of Clinical Nursing, vol. 17, no. 14, pp. 1834-1842.
AIM: This paper explores the role of the mentor in contemporary nursing practice in the UK. It presents findings from a recent study which investigated the impact of a locality-based nursing education initiative on students, practice mentors and academic staff and draws on another study, conducted in the same setting and two Australian sites, to examine the perceptions of nursing students and mentors. BACKGROUND: Within nursing, mentorship is integral to students' clinical placement experiences and has attracted increasing interest among researchers. Despite a plethora of studies focussing on mentoring and its nature and application within the practice setting, limited attention has been paid to the extent to which guidelines provided by regulatory bodies for nursing inform and influence the practice of mentoring in contemporary health-care settings. DESIGN: The study used a two-phased design with data on mentorship being focussed on the second phase. METHOD: Data were collected using an online survey questionnaire of pre-qualifying students and a postal questionnaire for practice mentors. FINDINGS: The findings highlight the importance of mentorship for prequalifying students and emphasise the need to provide mentors with adequate preparation and support. They confirm previous research, but also highlight improvements in bridging the gap between rhetoric and reality for mentorship. Results are further strengthened when compared with those of the second study. CONCLUSIONS: Findings provide new evidence of a narrowing of the gap between the theory and practice of mentoring and for the continuing implementation of national standards to clarify the roles and responsibilities of the mentor. They also suggest the benefits of developing such standards in countries with similar systems of support for nursing students. RELEVANCE TO CLINICAL PRACTICE: Mentorship is pivotal to students' clinical experiences and is instrumental in preparing them for their role as confident ...
Levett-Jones, TL 2007, 'Facilitating reflective practice and self-assessment of competence through the use of narratives.', Nurse Education in Practice, vol. 7, no. 2, pp. 112-119.View/Download from: Publisher's site
Reflective practice is a skill that is central to nursing students' professional development. Although there is an abundance of literature on the value of reflective practice there are few concrete methods that facilitate self-assessment of competence through the use of reflective practice. One such method is narrative reflection. A nursing narrative is a brief recount of an actual situation or episode in clinical practice that is significant because it resulted in new learning and/or new understanding. Narratives provide important opportunities for uncovering nursing practices that often go unnoticed and a new appreciation of the knowledge and skills of clinical practice. Nursing narratives reveal the richness of the clinical knowledge embedded in practice and provide a way for knowledge and practice to be linked together in meaningful dialogue, promoting interpretive analysis and reflection. A narrative approach contextualises knowledge and values and builds upon the clinical experiences of the student. Narratives afford opportunities for nursing students to: Learn from practice through reflection. Describe and critically analyse episodes of their clinical practice. Illuminate and assess their own level of competence by applying competency standards as a benchmark. Identify areas of strength and those requiring development. Develop practice-driven clinical learning objectives. Narratives have proven to be a successful means of developing students' ability to reflect upon and assess competence in a clinically relevant and motivating way. This paper will explore the possibilities that narratives hold for developing clinical acumen, promoting reflective practice, and assessing competence. It will provide an overview of narrative writing, and discuss some of the challenges encountered in the implementation of this clinical learning innovation at the author's university in Australia.
Levett-Jones, T 2007, 'Researching the implementation of pioneering roles in nursing and midwifery: Empirical insights about lecturer practitioners, consultant nurses and nurse registrars', Journal of Research in Nursing, vol. 12, no. 1, pp. 41-42.View/Download from: Publisher's site
Levett-Jones, T, Lathlean, J, McMillan, M & Higgins, I 2007, 'Belongingness: a montage of nursing students' stories of their clinical placement experiences.', Contemporary Nurse, vol. 24, no. 2, pp. 162-174.
The psychological and social sciences literature is replete with assertions that human beings are fundamentally and pervasively motivated by the need to belong. This paper reports on some of the findings from the qualitative phase of a mixed-method, multi-site study that explored nursing students' experience of belongingness while on clinical placements. Students from Australia and the United Kingdom were interviewed to identify factors that impact upon and are consequences of belongingness. A montage of participants' stories is used to illustrate some of the key features of clinical workplaces that are conducive to the development of belongingness. Contextual factors and interpersonal dynamics were seen to have a significant bearing on students' experiences. Clinical leaders/managers who were welcoming, accepting and supportive, and nursing staff who were inclusive and encouraging, facilitated students' perception of being valued and respected as members of the nursing team. Additionally, the provision of consistent, quality mentorship was identified as important to students' feelings of connectedness and fit. The experience of belongingness, in turn, enhanced students' potential for learning and influenced their future career decisions. Alternatively, alienation resulted from unreceptive and unwelcoming clinical environments and from the dissonance created when students' personal and professional values did not articulate with those evident in practice environments. Consequently, distress, detachment and disengagement occurred and students' capacity and motivation for learning was negatively impacted.
Clinical experience is recognised as central to nursing education. Quality clinical placements across a range of venues are vital to the development of competent and confident professionals. However there is evidence, both empirical and anecdotal, suggesting that nursing students' clinical placement experiences are often fraught with problems. These problems are long standing and multi-dimensional. For many students clinical placements are typified by feelings of alienation and a lack of belongingness. This paper proposes that the problematic nature of clinical placements may be better understood through the lens of 'belongingness'. A critical review of selected studies drawn from the psychological and social science literature provides insight and useful direction for a more focused review of the nursing literature. The potential relationships between belongingness, nursing students, and their clinical placement experiences are then exemplified by excerpts taken from the nursing literature (including unpublished material). Finally, an ongoing study that seeks to address the paucity of empirical research in this area is highlighted.
Levett-Jones, T, Fahy, K, Parsons, K & Mitchell, A 2006, 'Enhancing nursing students' clinical placement experiences: a quality improvement project.', Contemporary Nurse, vol. 23, no. 1, pp. 58-71.View/Download from: Publisher's site
Clinical experience is recognised as the core of nursing education. Quality clinical placements across a variety of venues are vital to the development of capable and competent professionals. However there is evidence, both anecdotal and empirical, suggesting that students' clinical placement experiences are fraught with problems. The quality improvement project described in this paper aimed to improve the clinical learning experience of nursing students by strengthening communication and partnerships between the university and the two local health services. To achieve this goal, clinicians' perceptions of the problems related to clinical placements and their recommendations for improvement were explored. Focus groups, brainstorming sessions, personal interviews and surveys were used to collect qualitative and quantitative data. Problems and priority issues were identified as more than five hundred clinicians expressed their concerns, claims and issues. Key findings from the project are described under five themes: communication breakdown between the university and clinicians; mentorship; preparation for clinical placements; clinical competence; and graduates' readiness for practice. Utilising a quality improvement framework this project promoted vigorous debate and dialogue between university and health service partners. The nature and extent of the problems surrounding clinical placements were examined, high priority issues targeted for improvement, and the subsequent results measured through feedback from clinicians and students. The success of this project, although impressive in the early stages, will depend upon ongoing communication and evaluation to ensure sustainability of the improvements made.
Lathlean, J, Burgess, A, Coldham, T, Gibson, C, Herbert, L, Levett-Jones, T, Simons, L & Tee, S 2006, 'Experiences of service user and carer participation in health care education.', Nurse education in practice, vol. 6, no. 6, pp. 424-429.View/Download from: Publisher's site
The agenda of involving service users and their carers more meaningfully in the development, delivery and evaluation of professional education in health is gaining in importance. The paper reports on a symposium which presented three diverse initiatives, established within a school of nursing and midwifery in the United Kingdom. These represent different approaches and attempts to engage service users and in some instances carers more fully in professional education aimed at developing mental health practitioners. Each is presented as achieving movement on a continuum of participation from service users as passive recipients to service users as collaborators and co-researchers. The paper concludes with a discussion of the lessons to be learnt which will hopefully stimulate service user involvement on a wider basis.
Lathlean, J, Burgess, A, Coldham, T, Gibson, C, Herbert, L, Levett-Jones, T, Simons, L & Tee, S 2006, 'Experiences of service user and carer participation in health care education.', Nurse Education Today, vol. 26, no. 8, pp. 732-737.
The agenda of involving service users and their carers more meaningfully in the development, delivery and evaluation of professional education in health is gaining in importance. The paper reports on a symposium which presented three diverse initiatives, established within a school of nursing and midwifery in the United Kingdom. These represent different approaches and attempts to engage service users and in some instances carers more fully in professional education aimed at developing mental health practitioners. Each is presented as achieving movement on a continuum of participation from service users as passive recipients to service users as collaborators and co-researchers. The paper concludes with a discussion of the lessons to be learnt which will hopefully stimulate service user involvement on a wider basis.
Levett-Jones, T & FitzGerald, M 2005, 'A review of graduate nurse transition programs in Australia.', The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation, vol. 23, no. 2, pp. 40-45.
BACKGROUND: Despite nearly two decades of experience with graduate transition programs in Australia little evidence exists regarding the effectiveness of these programs as interventions that enhance the transition from nursing student to professional practitioner. There is general acknowledgement that this is a crucial time for people entering the profession and yet there is little agreement on what constitutes best practice for nurses' transition to the workforce. AIM: This paper challenges the status quo through a review of current programs and questions whether primacy should be given to formal transition programs or to the development of educationally supportive clinical learning environments. CONCLUSION: There is sufficient doubt in the efficacy of formal transition programs to at least investigate potential alternatives such as concentration on the development of a supportive practice culture conducive to learning. Indeed, the type of learning environment suitable for graduate nurses is likely to be one that will also facilitate the continued development and enhanced job satisfaction of the rest of the nursing team.
Levett-Jones, TL 2005, 'Self-directed learning: implications and limitations for undergraduate nursing education.', Nurse Education Today, vol. 25, no. 5, pp. 363-368.View/Download from: Publisher's site
Self-directed learning (SDL) is an educational concept that has received increasing attention in recent years, particularly in the context of higher education. Whilst the benefits of SDL have been espoused by a number of adult education theorists (Brookfield, S., 1986. Understanding and Facilitating Adult Learning. Jossey-Bass, San Francisco; Houle, C., 1984. Patterns of Learning: New Perspectives on Life-Span Education. Jossey-Bass, San Francisco; Knowles, M., 1998. The Adult Leaner: A Neglected Species, fifth ed., Gulf, Houston; Tough, A., 1979. The Adults Learning Project: A Fresh Approach to Theory and Practice in Adult Learning. Ontario Institute for Studies in Education, Toronto), its introduction into curricula has not always been successful (Nolan, J., Nolan, M., 1997a. Self-directed and student-centred learning in nurse education: 1. British Journal of Nursing 6 (1), 51-55; Nolan, J., Nolan, M., 1997b. Self-directed and student-centred learning in nurse education: 2. British Journal of Nursing 6 (2), 103-107; Slevin, O., Lavery, M., 1991. Self-directed learning and student supervision. Nurse Education Today 11, 368-377). The indiscriminate application of SDL principles and poorly prepared teachers and/or students has at times meant that the introduction of SDL has been resented rather than welcomed (Iwasiw, C., 1987. The role of the teacher in self-directed learning. Nurse Education Today 7, 222-227; Turunen, H., Taskinen, H., Voutilainen, U., Tossavainen, K., Sinkkonen, S., 1997. Nursing and social work students' initial orientation towards their studies. Nurse Education Today 17, 67-71). This paper clarifies and explores these issues by: (a) examining the origins of SDL; (b) discussing the relevance of self-directed learning to Knowles' theory of adult learning and contemporary educational practices such as enquiry based learning and problem based learning; and (c) highlighting the implications and limitations of SDL with regard to adult education in g...
Levett-Jones, TL 2005, 'Continuing education for nurses: a necessity or a nicety?', Journal of Continuing Education in Nursing, vol. 36, no. 5, pp. 229-233.
The changing health care climate has resulted in escalating financial constraints. One department that is often scrutinized for its cost-benefit relation to the hospital is the nursing education department. These departments are increasingly being reduced in size and investment in the continuing education of nurses is being rationalized. However, reducing financial support of education may be counterproductive in both the short- and long-term. This article does not propose a "recipe" for effectively facilitating continuing education. However, it does provide sound justification for investing in the continuing education of nurses and demonstrates not only that quality education results in enhanced knowledge and skills, but that there is also a positive correlation between professional development and factors such as staff satisfaction, staff retention, and quality patient care.
Palmer, L, Levett-Jones, T & Smith, R, 'First year students' perceptions of academic literacies preparedness and embedded diagnostic assessment', Student Success, vol. 9, no. 2, pp. 49-49.View/Download from: Publisher's site
This paper reports findings from the second stage of a mixed-methods study of embedded academic literacies and diagnostic assessment—specifically first-year nursing students' perceptions of the MASUS procedure. We found overwhelming support from participants (85%) in favour of embedded diagnostic assessment. The main reasons for this were receiving constructive, individualised feedback and insights into expectations and requirements. This was important as over a quarter of participants said they had 'no idea' about the academic literacy requirements of university when they commenced their program and 60% had not formally studied for at least seven years. Those without recent study experience or with prior poor academic performance expressed high levels of anxiety about academic literacy requirements and lacked confidence in their writing abilities. These findings indicate how stressful the process of mastering academic literacies is for many first-year students' and highlight the potential benefits of embedding for retention and engagement.
Levett-Jones, T, Courtney-Pratt, H & Govind, N 2019, 'Implementation and evaluation of the post-practicum oral clinical reasoning exam' in Professional and Practice-based Learning, pp. 57-72.View/Download from: Publisher's site
© Springer Nature Switzerland AG 2019. Nurses with effective clinical reasoning skills have a positive impact on patient outcomes. For this reason it is imperative that students understand and are able to demonstrate application of the clinical reasoning process. While clinical reasoning is often taught and assessed in preparation for clinical placements, a post-practicum assessment can help to identify if and to what extent students' clinical experiences influence their learning. The aim of this chapter is to provide a detailed overview of the development of a post-practicum clinical reasoning exam, guidelines for educators interested in adopting this novel approach, and results from the initial evaluation of the exam. The post-practicum clinical reasoning exam for nursing students was conducted in the following manner: Students were provided with a verbal clinical handover and the healthcare records of four patients. In the individual face-to-face oral exam that followed, students were required to describe how they would prioritise, plan and manage the care of the four patients using the clinical reasoning cycle as their organising framework. The exam was marked by a trained staff member, and immediate summative feedback was provided. On completion of the oral exam students were invited to complete a short evaluation survey with closed and open-ended questions. Quantitative data was statistically analysed and qualitative data was thematically analysed. There were 471 students enrolled in the clinical course; of these, 181 participated giving a response rate of 38%. The mean satisfaction score was 3.03 out of a maximum of 5 indicating a moderate level of satisfaction with the oral exam. Three themes emerged from qualitative analysis: 'Better than written assessment items', 'Authenticity of the approach' and 'The need for better preparation'.
Pich, J, Govind, N & Levett-Jones, T 2017, 'Gastrointestinal nursing skills' in Berman, A, Synder, S, Levett-Jones, T, Burton, T & Harvey, N (eds), Skills in clinical nursing, Pearson Australia, Sydney.
Levett-Jones, T & Arthur, C 2017, 'UNIT 9 Gastrointestinal Nursing Skills' in Berman, A, Synder, S, Levett-Jones, T, Burton, T & Harvey, N (eds), Skills in Clinical Nursing, Pearson Australia, Sydney.
Levett-Jones, T & Palmer, L 2017, 'Medical-surgical nursing' in Medical-surgical nursing: Critical thinking in client care, Pearson Australia, Sydney.
Levett-Jones, T & Wilson, A 2017, 'Health and illness in the adult client' in LeMone, P, Burke, K, Levett-Jones, T, Dwyer, T & Moxham, L (eds), Medical-surgical nursing: Critical thinking in client care, Pearson Australia, Sydney.
Day, J, Levett-Jones, T & Kenny, R 2015, 'Communication' in Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D (eds), Kozier and Erb's Fundamentals of Nursing Pack, Vols 1-3, Australian Edition, Pearson Australia Group, Sydney.
This third Australian edition has once again undergone a rigorous review and writing process.
Levett-Jones, T & Van Der Reit, P 2015, 'Teaching and Learning' in Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D (eds), Kozier and Erb's Fundamentals of Nursing Pack, Vol 1-3, Australian Edition, Pearson Australia Group, Sydney.
This third Australian edition has once again undergone a rigorous review and writing process.
Levett-Jones, T & Fagen, A 2015, 'Diagnosing' in Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D (eds), Kozier and Erb's Fundamentals of Nursing Pack, Vols 1-3, Australian Edition, Pearson Australia Group, Sydney.
This third Australian edition has once again undergone a rigorous review and writing process.
Bellchambers, H & Levett-Jones, T 2015, 'Health and illness in the adult client' in LeMone, P, Burke, K, Levett-Jones, T, Bauldoff, G & Gubrud, P (eds), Medical-surgical nursing: Critical thinking in client care, Pearson Australia, Sydney.
The focus of this product package is to provide students with a strong knowledge base, an understanding of contemporary practice issues in Australia and the capacity for sound clinical reasoning.
Levett-Jones, T 2015, 'Simulation' in Brown, T & Williams, B (eds), Evidence-based education in the health professions: Promoting best practice in the teaching and learning of health professional students, Radcliffe Publishing Ltd, Sydney.
Levett-Jones, T. 2014, 'Person-centred care (in nursing): Seek first to understand and then to be understood ...' in Health Practice Relationships, Springer, pp. 111-118.View/Download from: Publisher's site
Levett-Jones, T 2014, 'Person-centred care (in nursing): Seek first to understand and then to be understood ...' in Health Practice Relationships, Sense, The Netherlands, pp. 111-118.View/Download from: UTS OPUS or Publisher's site
Person-centred care1 (PCC) is a holistic approach to the planning and delivery of
healthcare that is grounded in a philosophy of personhood. While there are many
definitions of PCC in the literature, each promotes self-determination and a
commitment to helping individuals lead the life they want. Health professionals who
practise in a person-centred way acknowledge that each person is unique, has equal
rights and worth, and brings experiences, skills and knowledge about their health and
illness. Person-centred nurses are typically empathic, respectful, ethical, open-minded
and self-aware. They tend to have a profound sense of personal responsibility for
actions (moral agency), they place the 'person' at the centre of healthcare, and consider
the person's needs and wishes as paramount.
In this chapter I explore the rationale for and benefits of practising in a personcentred
way. Narratives highlighting both positive and negative examples of PCC
provide opportunities to reflect on and examine the attributes, meaning and relevance of
PCC to clinical practice. The chapter concludes with a discussion of the relationship
between PCC and patient safety.
Levett-Jones, T, Oates, K & MacDonald-Wicks, L 2014, 'The relationship between communication and patient safety' in Levett-Jones, T (ed), Critical conversations for patient safety: An essential guide for health professionals, Pearson Australia Group, Sydney.
Critical Conversations in Patient Safety bridges that gap.
Levett-Jones, T, Gilligan, C, Outram, S & Horton, G 2014, 'Key attributes of 'patient safe' communication' in Levett-Jones, T (ed), Critical conversations for patient safety: An essential guide for health professionals, Pearson Australia Group, Sydney.
Critical Conversations in Patient Safety bridges that gap.
Levett-Jones, T 2014, 'Medical-surgical nursing' in LeMone, P, Burke, K, Levett-Jones, T, Dwyer, T & Moxham, L (eds), Medical-surgical nursing: Critical thinking in client care, Pearson Australia, Sydney.
Levett-Jones, T & Hoffman, K 2013, 'Clinical reasoning – What it is and why it matters' in Levett-Jones, T (ed), Clinical reasoning: Learning how to think like a nurse, Pearson Australia Group, Sydney.
Levett-Jones, T, Hoffman, K, Dempsey, J & Sinclair, P 2013, 'Caring for a person with fluid and electrolyte imbalance' in Levett-Jones, T (ed), Clinical reasoning: Learning to think like a nurse, Pearson Australia Group, Sydney.
Levett-Jones, T & Newby, D 2013, 'Caring for a person experiencing and adverse drug event' in Levett-Jones, T (ed), Clinical Reasoning: Learning how to think like a nurse, Pearson Australia Group, Sydney.
Smith, M & Levett-Jones, T 2013, 'Providing clinical education: working across sectors' in Loftus, S, Higgs, J, Smith, M, Duffy, E & Gerzina, T (eds), Education health professionals: becoming a university teacher, Springer, Sydney.
This chapter provides a context for understanding the characteristics and
motivations of health professionals who become university teachers and explores
the nature of their experiences. Health professionals who become university
Loftus, S, Smith, M & Levett-Jones, T 2013, 'Teaching clinical reasoning' in Educating health professionals: Becoming a university teacher, Sense Publishers, Sydney.
Levett-Jones, T. 2012, 'Turning the conference paper into publishable work' in Writing for Publication in Nursing and Healthcare Getting it Right, John Wiley & Sons, London.
Writing for Publication in Nursing and Healthcare is an invaluable guide to 'getting it right', focusing on all aspects of writing for publication.
Levett-Jones, T & Stone, T 2012, 'Turning the conference paper into publishable work' in Writing for publication in nursing and healthcare: getting it right, Wiley-Blackwell, London, pp. 145-161.View/Download from: UTS OPUS or Publisher's site
Simmons, C, Williams, W, Sher, W & Levett-Jones, T 2012, 'Work ready: E-portfolios to support professional placements', Office for Learning and Teaching, Sydney.
Levett-Jones, T & Van Der Reit, P 2012, 'Teaching' in Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D (eds), Kozier & Erb's Fundamentals of Nursing (Australian edition), Pearson Australia Group, Sydney.
This third Australian edition has once again undergone a rigorous review and writing process.
Day, J, Levett-Jones, T & Kenny, R 2012, 'Communication' in Berman, A, Kozier, B, Erb, G, Synder, S, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D (eds), Kozier and Erb's Fundamentals of Nursing, Pearson Australia, Sydney.
Bellchambers, H & Levett-Jones, T 2011, 'Medical-surgical nursing' in LeMone, P, Burke, K, Levett-Jones, T, Dwyer, T & Moxham, L (eds), Medical-surgical nursing: Critical thinking in client care, Pearson Australia, Sydney.
Levett-Jones, T & Bellchambers, H 2011, 'Health and illness in the adult client' in LeMone, P, Burke, K, Levett-Jones, T, Dwyer, T & Moxham, L (eds), Medical-surgical nursing: Critical thinking in client care, Pearson Australia, Sydney.
Day, J & Levett-Jones, T 2010, 'Communication' in Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D (eds), Kozier and Erb's fundamentals of nursing, Pearson Australia, Sydney.
Levett-Jones, T & van der Reit, P 2010, 'Teaching and learning' in Berman, A, Synder, S, Kozier, B, Erb, G, Levett-Jones, T, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl, K & Stanley, D (eds), Kozier and Erb's Fundamentals of Nursing, Pearson Australia, Sydney.
Levett-Jones, T 2008, 'Acute pain management' in Paliadelis, P (ed), Developing clinical judgment: A case scenario approach, Cengage Learning, South Melbourne.
Levett-Jones, T 2008, 'Fluid and electrolyte balance' in Paliadelis, P (ed), Developing clinical judgment: A case scenario approach, Cengage Learning, South Melbourne.
Levett-Jones, T & White, W 2008, 'Acute wound management' in Paliadelis, P (ed), Developing clinical judgment: A case scenario approach, Cengage Learning, South Melbourne.
Palesy, D & Levett-Jones, T 2018, 'Advancing the Professional Disposition of Postgraduate Nursing Students: ORaRDAs and CPEGs', National Nurse Education Conference, Melbourne, Victoria, Australia.View/Download from: UTS OPUS
Lucas, C, Power, T, Hayes, C, Williams, KA, Levett-Jones, T & Ferguson, C 2018, 'DEVELOPMENT, IMPLEMENTATION AND EVALUATION OF THE RIPE MODEL FOR INTERPROFESSIONAL COLLABORATION UTILIZING HIGH FIDELITY MANIKINS', RESEARCH IN SOCIAL & ADMINISTRATIVE PHARMACY, ELSEVIER SCIENCE INC, pp. E29-E29.View/Download from: Publisher's site
Hills, C, Levett-Jones, T, Warren-Forward, H & Lapkin, S 2018, 'WHAT STUDENTS THINK IS BEST PRACTICE WHEN TEACHING THEM CLINICAL REASONING IN PRACTICE EDUCATION', BRITISH JOURNAL OF OCCUPATIONAL THERAPY, SAGE PUBLICATIONS LTD, pp. 67-67.
Travaglia, J, Debono, DS, Robertson, H, Levett-Jones, T, Dean, S, Hinchcliff, R, Hor, S, Justin, L & Hughes, C 2018, 'As the left hand of darkness is light, so the left hand of risk is vulnerability: a new perspective on patient safety', ISQua's 35th International Conference - Heads, Hearts and Hands: Weaving the Fabric of Quality and Safety in Healthcare. International Society for Quality in Health Care, Kuala Lumpur.
Dean, S, Levett-Jones, T, Debono, DS, Robertson, H, Hinchcliff, R & Travaglia, JF 2018, 'Intersectionality and harm versus autonomy: findings from international studies examining whether vulnerabilities contribute to differences in patient safety', Conference on Interdisciplinary Social Sciences, Grenada, Spain.
Wyllie, A, Levett-Jones, T, DiGiacomo, M & Davidson, P 2018, 'A REAL orientation: a program designed to give early career academic nurses career confidence', National Nurse Education Conference, Melbourne.
Wyllie, A, Levett-Jones, T, Davidson, P & DiGiacomo, M 2018, 'P-ECAN - Designing a program to maximise career planning for early career academic nurses', 7th International Nurse Education Conference, Banff, Canada.
Govind, N, Levett-Jones, T & Courtney-Pratt, H 2017, 'To teach is to learn twice: Exploring the peer teaching experiences of first and third year nursing and midwifery students', International Clinical Skills Conference, Prato, Italy.
Levett-Jones, T, Govind, N, Pich, J & Hoffman, K 2017, 'The implementation and evaluation of an innovative and immersive disability empathy simulation', International Clinical Skills Conference, Prato, Italy.
Hills, C, Levett-Jones, T, Lapkin, S, Boshoff, K & Jewell, K 2015, ''Generation Y' students' preference for lecture and on-line learning. A systematic review', British Journal of Occupational Therapy, British Association of Occupational Therapists, pp. 73-74.
Arthur, C, Levett-Jones, T & Kable, A 2011, 'Quality Indicators for the Design and Implementation of Simulation Experiences', CLINICAL SIMULATION IN NURSING, ELSEVIER SCIENCE INC, pp. E246-E246.
Rossiter, R, Stone, T & Levett-Jones, T 2010, 'One oar or two? Enhancing mental health undergraduate education', International Journal of Mental Health Nursing, Wiley, pp. A42-A42.
Simmons, C, Williams, A, Levett-Jones, T, Sher, W, Bowen, L & Gu, N 2010, 'Worlds apart? Developing a professional competency assessment framework that links university education with 'real world' practices in the Construction Management and Nursing', Learning Forum London 2010, EIfEL, London, pp. 65-65.View/Download from: UTS OPUS
Harris, M, Stone, T, Levett-Jones, T & Sinclair, P 2009, 'The genesis of 'the neophytes': A writing support group for clinical nurses', International Journal of Mental Health Nursing, Wiley, pp. A10-A10.