Why We Became Nurse Educators (Journal Club)

Journal Club Article: Evans, J. D. (2018). Why We Became Nurse Educators: Findings From a Nationwide Survey of Current Nurse Educators. Nursing Education Perspectives39(2), 61-65. [abstract]

Background: The need to build the nurse faculty workforce and resolve the persistent shortage of educators led to a study of nurse educator recruitment and retention. The shortage of nurse educators is a barrier to building the nursing workforce.

Aim: The study was designed to ask teaching nurse faculty what they believed would be effective strategies in the attraction, recruitment, and retention of nurse educators through a sample of national nurse faculty.

Method: This descriptive study used an online survey questionnaire. Participants were recruited through email requests to the deans and directors of 841 accredited associate (ADN), baccalaureate (BSN), master’s, and doctoral degree programs at schools and colleges of nursing across the United States. 940 nurse educators teaching at all levels were asked to rate the effectiveness of attraction, recruitment, and retention strategies.

The survey consisted of demographic questions and three Likert type scales that asked respondents to rate the effectiveness of attraction, recruitment, and retention strategies. Open-ended questions in each section allowed participants to expand on their answers.

This article reports on responses to one of the survey’s open-ended question; a content analysis was conducted to develop a narrative description about why respondents chose nursing education.

Results: Nurse educator’s chose education roles to:

  • teach in a stimulating yet flexible work environment,
  • hoped to influence the profession,
  • had been influenced by educators, and
  • sought change and challenge in their careers.

Conclusion: “Faculty find nursing academia satisfying and rewarding, but noncompetitive compensation and unsatisfactory work environments can eclipse satisfiers.”

Keywords: Healthy Workplace; Nurse Faculty Recruitment; Nurse Faculty Retention; Nurse Faculty Shortage; Nursing Education; Workforce.

FORTH Innovation Method

Methodology of  innovation process to introduce and develop changes in ideas, business and products. 5 steps are taken in a stage-gated process.

  1. Full Steam Ahead
  2. Observe & Learn
  3. Raise Ideas
  4. Test Ideas
  5. Homecoming

Alleged success of the FORTH method are that out of 100 ideas, 78 are taken into development and 51 are introduced, compared to 21 in an average stage-gated process.

Resources

Forth Innovation Method.

Forth Innovation [Free downloads]

Van Wulfen, G. (2013). The Innovation Expedition: A visual toolkit to start innovation. Bis.

Follow Gijs van Wulfen @gijsvanwulfen

Playlists: Multimedia Production Part 4

Create a Video Playlist

You may be uploading and creating your own video playlist, or collating a playlist of useful resources to suit a particular topic. Here are some resources to consider using. Please post in the comments section any other resources that are available.

  • Viewer playlists – organise your favourite videos and share. No creation of videos is required, you are just grouping together useful resources to share.
  • Creator playlists – if you create videos it provides a way to organise videos into topics and for viewers to find them.
  • Organised into subject content, theme or whatever you choose.
  • Videos are organised in a legal format for yourself and others to view.
  • Can embed into a website or resource.
  • Can provide analytics.

Example: Nursing Education Network Playlist

How To Make A YouTube Playlist

Why To Make a YouTube Playlist

Some Persuasive Data from YouTube Statistics:

  • YouTube has over a billion users — almost one-third of all people on the Internet — and every day people watch hundreds of millions of hours on YouTube and generate billions of views.
  • YouTube overall, and even YouTube on mobile alone, reaches more 18-34 and 18-49 year-olds than any cable network in the U.S.
  • Growth in watch time on YouTube has accelerated and is up at least 50% year over year for three straight years.

Data from YouTube Statistics

Other video player resources: Vimeo or Apple.

Teaching And Learning Through Video 

Multimedia Posts

Recording: Multimedia Production Part 3

Use you mobile phone, laptop or tablet for quality video recordings. Just check your device to see what video recording and editing software you already have. There are lots of options available for editing but as a beginner using your devices editing software or using YouTube may be the easier and less frustrating approach until you build up your recording skills.

Some considerations:

  • Lighting
  • Stability (use two hands or a selfie stick)
  • Audio and background noise
  • Point of view: where is the camera focused on
  • Framing: orientation of the camera
  • Clean your lens

Inclusivity

Don’t forget to add captions and subtitles [more info here].

Multimedia Posts

Storyboard: Multimedia Production Part 2

Storyboarding

 “A storyboard is a graphic organizer in the form of illustrations or images displayed in sequence for the purpose of pre-visualizing a motion picture, animation, motion graphic or interactive media sequence” (Wikipedia, 2019).

Example of a Storyboard

Storyboard for The Radio Adventures of Dr. Floyd

Storyboard Resources

ACMI. (2019). Storyboarding for the beginner.

ACMI. (2019). Storyboard Template.

Classic Disney Animation

Editing Resources

IT skills and budget are likely key factors in finding suitable editing resources. Here are a few, but a quick internet search will show many available resources. 

Inclusivity 

Don’t forget to review accessibility during the creation of resources for neurodiversity inclusiveness.

Multimedia Posts

 

 

Multimedia Production: Part 1

This is the first post in the journey for development in multimedia production. I have minimal experience in photography or video production and so this is also a personal learning project. Any useful resources will be shared to enable nurse educators to give it a try themselves (anyone with multimedia experience please add resources in the comments section below). A ‘traditional’ nurse educator approach will be used (i.e. no budget), so whatever resources we already have or can borrow will be used.

  1. First step will be the process of multimedia production.
  2. Step two will be the production side of things.
  3. Step three the equipment, likely using a mobile phone and any free developing apps and potentially a borrowed GoPro.
  4. Step 4 creating and collating playlists

Video 101: Shooting Basics from Vimeo Video School

Rule of Thirds

“The guideline proposes that an image should be imagined as divided into nine equal parts by two equally spaced horizontal lines and two equally spaced vertical lines, and that important compositional elements should be placed along these lines or their intersections (Wikipedia, 2019).

Rivertree thirds md
Image by Moondigger [CC BY-SA 2.5] from Wikimedia Commons

Dialogue: The Art of Thinking Together

Book Club: Isaacs, W. (2008). Dialogue: The art of thinking together. Crown Business. [GoodReads review]

This book was suggested as part of preparation for participating in an Unconference. The purpose for this resource was to maximise the limited time, within a group of people with an interest in education but who were not known to each other, so to enable conversation and dialogue to occur in the one day timeframe. 

Dialogue is about “shared inquiry, a way of thinking and reflecting together”(pg. 9). 

This inquiry can involve telling stories and the ability to think and talk together. How we think does affect how we talk, with relation to our held memory and emotions.

“Dialogue is a practice for deliberately and consciously evoking powerful conversations like these” (pg 70).

The aim is to create mutual respect, coordination and connection within a group of people.  

  1. Listening
  2. Respecting
  3. Suspending
  4. Voicing 

Why is this important, well dialogue occurs in all walks of life. This approach can be used to work together, resolve conflicts (be warned this is not an easy process, the book provides many examples of dialogic discussion) and solve problems. The aim is to empower and create new ways of thinking and working together.

3 Levels of action in a dialogue (pg. 29-30):

  1. Produce coherent actions: do what we say,
  2. Create fluid structures of interaction,
  3. Provide an environment for dialogue to occur.

Path to Dialogue

Purpose of Dialogue

  • determine what is the problem?
  • In the world of information overload, dialogue can determine what truly matters to us?
  • Build capacity for new behaviour.
  • Learn to inquire together.

4 Principles of Dialogue

  1. Participation
  2. Unfolding
  3. Awareness
  4. Coherence

Learn to Listen

  • Prepare to listen
  • Learn to be present
  • What are you thinking?
  • Use reflective listening, see how others are experiencing the situation
  • Listen together

Listening Together

  • Respecting boundaries, but not being passive
  • Wholeness of the conversation
  • Awareness, the ability to suspend directions/opinions using reflection in action
  • Foster enquiry
  • Voice

The Environment

  • The container: for a rich field of interaction
  • Psychological safety

Keywords: Dialogue; Dialogic: Listening; Respect; Voice; Change Management

References

Argyris, C. (1977). Double loop learning in organizationsHarvard business review55(5), 115-125.

Argyris, C., & Schon, D. A. (1974). Theory in practice: Increasing professional effectiveness. Jossey-Bass.

Bohm, D., & Peat, F. D. (2010). Science, order and creativity. Routledge.

Isaacs, W. (2008). Dialogue: The art of thinking together. Crown Business. [GoodReads review]

Isaacs, W. N. (1993). Taking flight: Dialogue, collective thinking, and organizational learningOrganizational dynamics22(2), 24-39.

Yacavone, M. (2010). A Summary of… David Kantor’s Four-Player Model of Communication.

Clinical Supervision in Nursing

Instructional

Across nursing and healthcare, the supervision of students is an important component of training and learning. Clinical placements and the experiential learning experience are essential for developing and applying learned theoretical knowledge in the clinical environment. Undergraduate, graduate, postgraduate and new staff are all some of the unique supervision opportunities for nurses to support. Not every nurse will be interested in formal education, but it is likely they will be a preceptor or supervisor. Therefore it is important nurses understand the skills required for effective supervision. Skills such as reflective practice, assessment and feedback are part of this supervision. Being made to feel welcome and recognised as an important part of the team, just basic socialisation aspects to the nursing team.

Supervision

Supervision is defined “as a formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, and is acknowledged to be a life-long process” (Martin, Copley, & Tyack, 2014, p. 201).

“Clinical Supervision is regular, protected time for facilitated, in-depth reflection on clinical practice” (Bond and Holland,1998 p. 12)

Models of Supervision

Proctor’s model of supervision is perhaps the most commonly used within health care. “Supervision towards reflective practice” (Proctor, 2010). Proctor’s framework focuses on 3 areas of supervision:

  1. Normative: managerial aspect of practice and learning, such as professional CPD and core mandatory training.
  2. Formative: educative aspect of developing knowledge and skills in professional development and use self reflection for self awareness development. The aim is “to become increasingly reflective upon practice” within the supervision process (Proctor 2001, p.31).
  3. Restorative: supportive aspect for personal development, improving stress management and burnout prevention.

Clinical Supervision Skills Review Tool 

This Clinical Supervision Skills Review Tool is a helpful resource to review your supervision skills. More about this resource in the video below.

Other resources:

Note: This blog post resources and notes were taken from attending an education session ran by Monash University on supervision.

References

Boud, D., & Molloy, E. (2013). Rethinking models of feedback for learning: the challenge of designAssessment & Evaluation in Higher Education38(6), 698-712.

Carrucan-Wood, L. (2015). Preceptorship: Grounding and growing the next generation. Nursing Review.

Department of Health and Human Services. (2015) Clinical Supervision Skills Review Tool.  Victorian Government, Melbourne.

Hattie, J., & Timperley, H. (2007). The power of feedbackReview of educational research77(1), 81-112.

Martin, P., Copley, J., & Tyack, Z. (2014). Twelve tips for effective clinical supervision based on a narrative literature review and expert opinionMedical teacher36(3), 201-207.

Proctor, B. (2010). Training for the supervision alliance: Attitude, Skills and Intention. In Routledge handbook of clinical supervision (pp. 51-62). Routledge.

Sloan, G., & Watson, H. (2002). Clinical supervision models for nursing: structure, research and limitationsNursing Standard (through 2013)17(4), 41.

Winstanley, J. (2000). Manchester clinical supervision scale. Nursing Standard (through 2013)14(19), 31.

‘Do not interrupt’ Bundled Intervention to Reduce Medication Interruptions.

Journal Club Article: Westbrook, J. I., Li, L., Hooper, T. D., Raban, M. Z., Middleton, S., & Lehnbom, E. C. (2017). Effectiveness of a ‘Do not interrupt’ bundled intervention to reduce interruptions during medication administration: a cluster randomised controlled feasibility studyBMJ Qual Saf, bmjqs-2016.

Aim: Evaluate the effectiveness of a ‘Do not interrupt’ bundled intervention to reduce non-medication-related interruptions to nurses during medication administration.

Method:parallel eight cluster randomised controlled study. Nurses were informed that the study was a direct observational study of medication administration and preparation tasks. Nursing staff were blinded to the study aim focused on interruptions and at baseline were blinded to the intervention. Only intervention ward staff were informed of the intervention subsequently.

Use of real time collected data using the Work Observational Method by Activity Timing Software (WOMBAT).

Setting: 4 wards in 1 hospital. Over 8 weeks and 364.7 hours, 227 nurses were observed administering 4781 medications.

Intervention: Wearing a vest when administering medications; strategies for diverting interruptions; clinician and patient education; and reminders.

Outcome Measures: 

  1. Primary outcome was non-medication-related interruptions during individual medication dose administrations.
  2. Secondary outcomes were total interruption and multitasking rates. A survey of nurses’ experiences was administered.

Intervention: The ‘Do not interrupt’ intervention comprised five ‘bundled’ elements:

  1. Wearing of a ‘Do not interrupt’ medication vest by nurses when preparing and administering medications,
  2. Interactive workshops with nurses regarding the purpose of the intervention to reduce non-medication-related interruptions and to identify local barriers and enablers to intervention use (eg, where to store vests),
  3. Brief standardised education sessions with clinical staff (eg, doctors, allied health),
  4. Patient information, which included why nurses were wearing a vest, and a request not to interrupt nurses during medication administration unless their concern was serious and urgent, or related to their medication. Patients were informed of other nurses and staff from whom to seek help if required,
  5. The use of reminders such as posters and stickers to inform health professionals, patients and visitors not to interrupt nurses during medication rounds for safety reasons.

Results: Baseline characteristics for control and interventions wards were similar.  Due to the observational approach of the study, the impact on influencing behaviours must be considered.

  • At baseline, nurses experienced 57 interruptions/100 administrations, 87.9% were unrelated to the medication task being observed.
  • A significant reduction of 15 non-medication-related interruptions/100 administrations compared with control wards.
  • Medication
  • The intervention more effective reducing interruptions from other nurses, no substantial impact from patient interruptions.
  • Intervention ward nurses reported that vests were time consuming, cumbersome and hot.
  • Only 48% of nurses indicated that they would support the intervention becoming hospital policy.
  •  There was reduction in multitasking rates in the intervention wards compared to control wards.

Discussion: The main aspect was the reduction of interruptions (30%) which potentially (as reduction in medication errors was not measured) translates to a reduction in medication administered errors (MAEs) of 1.8%.

This study was conducted in a paper system, so the impact of electronic medication administration records (eMARs) on reducing medication errors needs to be considered.

If visual aids such as vests are not a preference for nurses, also the infection control issue moving around the ward then educating nurses to deal with interruptions is advocated.

Resources

Hayes, C., Jackson, D., Davidson, P. M., & Power, T. (2015). Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administrationJournal of Clinical Nursing24(21-22), 3063-3076.

Westbrook, J. I., Woods, A., Rob, M. I., Dunsmuir, W. T., & Day, R. O. (2010). Association of interruptions with an increased risk and severity of medication administration errorsArchives of Internal medicine170(8), 683-690.

Westbrook, J. I., & Ampt, A. (2009). Design, application and testing of the Work Observation Method by Activity Timing (WOMBAT) to measure clinicians’ patterns of work and communication. International Journal of Medical Informatics78, S25-S33.

Flowing Data Simulations

Take a look at this great visual data on the simulations of a day in the life of Americans. Put it to fast and it becomes mesmerising to watch the activities over a 24 hour period of a sample of 1000 people.

Yau, N. (2015). A Day in the Life of an American.

Other time use data:

This shows the amazing visual presentations using technology that can replace reams of words or the same old slide presentation format. Remember, it is the message within the storytelling that is essential as part of a presentation to resonate with the listener.