207 research outputs found

    Clinical Nurse Instructor Competencies: An Exploratory Study of Role Requirements

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    Background: Baccalaureate nursing education consists of theoretical and practical training that prepares students for the role of competent nursing care providers. The practical application of knowledge and skills is vital in nursing curricula worldwide. Nursing programs have changed over the last few decades and have become increasingly dependent on part-time Clinical Instructors (CIs) to teach the clinical components of the curricula. However, CIs receive minimal instruction to prepare for this complex role. It has been acknowledged in Canada that there is limited research to inform CI specific competencies. Purpose: The purpose of this research was to conduct an exploratory study to identify the CIs perceptions of the importance of the World Health Organization’s (WHO) nurse educator core competencies and their importance to the clinical teaching role. Methodology: This was an exploratory quantitative study. A self-report survey was developed guided by the WHOs Nurse Educator Core Competencies (NECC). Donabedian’s structure-process-outcome conceptual framework guided this study. Sample and setting: Convenience sampling of participants employed as CIs in a baccalaureate in nursing program in an Ontario university. CIs who taught theory courses were excluded. The survey response rate was 23.9% (n=27). Results: The study results confirm that all the NECC have merit but need to be adapted to a CI-specific role. This is a multi-phased research project and the findings of the study have implications for all stakeholders, including schools of nursing and CIs. Ongoing research is required to inform the policy direction as it pertains to the CI-specific role and competencies in Canada. Implications for nursing programs, research and policy will be shared. Conclusions: Clinical Instruction is an area of nursing which deserves to be acknowledged as a specialty. National standardized CI-specific competencies will provide a strong foundation for CI preparation in Canada. Contexte : Le baccalaurĂ©at en sciences infirmiĂšres comprend des cours thĂ©oriques et pratiques prĂ©parant les Ă©tudiantes au rĂŽle de professionnelles compĂ©tentes en soins de santĂ©. Dans les programmes d’études en sciences infirmiĂšres partout dans le monde, l’application pratique des connaissances et habiletĂ©s est essentielle. Les programmes de sciences infirmiĂšres se sont transformĂ©s au cours des derniĂšres dĂ©cennies, dĂ©pendant de plus en plus des enseignantes de clinique (Clinical Instructors; CI), Ă  temps partiel, pour le volet pratique du programme d’études. Ces enseignantes reçoivent toutefois trĂšs peu de soutien pour les prĂ©parer Ă  jouer ce rĂŽle complexe. Au Canada, il a Ă©tĂ© reconnu que peu de recherches renseignent sur les compĂ©tences spĂ©cifiques des enseignantes de cliniques. Objectif : Cette Ă©tude exploratoire avait pour but d’identifier les perceptions des enseignantes de clinique quant Ă  l’importance des CompĂ©tences essentielles des infirmiĂšres enseignantes (Nurse Educator Core Competencies; NECC) dĂ©crites par l’Organisation mondiale de la SantĂ© (OMS) ainsi qu’à leur importance pour le rĂŽle d’enseignante de clinique. MĂ©thode : Il s’agissait d’une Ă©tude quantitative exploratoire. Un sondage a Ă©tĂ© Ă©laborĂ© en s’appuyant sur les compĂ©tences essentielles des infirmiĂšres enseignantes de l’OMS. Le cadre conceptuel « structure-processus-rĂ©sultats » de Donabedian a guidĂ© cette Ă©tude. Échantillon et milieu : Un Ă©chantillonnage de convenance a Ă©tĂ© constituĂ© de participantes volontaires employĂ©es comme enseignantes de clinique dans un programme de baccalaurĂ©at en sciences infirmiĂšres d’une universitĂ© en Ontario. Les enseignantes qui donnaient des cours thĂ©oriques Ă©taient exclues. Le taux de rĂ©ponse au sondage a Ă©tĂ© de 23,9 % (n=27). RĂ©sultats : Les rĂ©sultats de l’étude confirment que toutes les compĂ©tences sont pertinentes, mais qu’elles doivent ĂȘtre adaptĂ©es au rĂŽle spĂ©cifique propre aux enseignantes de clinique. Ce projet de recherche comporte plusieurs Ă©tapes, et les rĂ©sultats de cette Ă©tude ont des retombĂ©es pour toutes les parties prenantes, y compris les Ă©coles de sciences infirmiĂšres et les enseignantes de clinique. Les travaux devront se poursuivre afin d’orienter la politique en ce qui concerne le rĂŽle et les compĂ©tences spĂ©cifiques des enseignantes de clinique au Canada. Les retombĂ©es pour les programmes de sciences infirmiĂšres, la recherche et les politique seront prĂ©sentĂ©es. Conclusions : L’enseignement clinique constitue un domaine des sciences infirmiĂšres mĂ©ritant d’ĂȘtre reconnu comme une spĂ©cialitĂ©. Des normes nationales de compĂ©tences spĂ©cifiques aux enseignantes de clinique serviront de base solide pour la prĂ©paration de ces enseignantes au Canada

    e-Delphi Technique in Postgraduate Registered Nursing Education and Competency Development: A Scoping Review

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    Background: It is common for nursing programs in Canada to hire part-time clinical instructors (CIs) to teach the practical components of curricula. Although experts in their field, these Registered Nurses (RNs) don’t have any formal preparation in education. Additionally, there are no current established competencies for CIs in Canada. This void in the Canadian literature warrants a search of competency development using the e-Delphi technique. The e-Delphi technique is a commonly used surveying technique for competency development in healthcare. Objective: To understand the extent, range, and nature of evidence of the use of the e-Delphi technique and critically appraise its use in postgraduate nursing education and nursing competency development to establish the feasibility of application to clinical nurse educator competency (CNEC) development in Canada. Methods: Two independent researchers conducted a scoping review to determine the extent, range, and nature of evidence of the use of the e-Delphi technique and critically appraise its use in postgraduate nursing education and nursing competency development. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute Reviewers’ Manual were used to guide the review. Results: The main components of e-Delphi that were extracted from the literature for review included the purposes of the studies, background of expert panel members, methods of e-Delphi used, reported level of consensus, number of rounds to meet consensus, time between rounds of questions, number of participants and changing participants. The purposes of the reviewed studies demonstrated that e-Delphi is a preferred method for developing or revising competencies for post baccalaureate programs. However, the other key components that were extracted revealed much variation in the use of e-Delphi by researchers. Most importantly, researchers need to ensure they report on the backgrounds of the expert panel members, decrease the time between the survey rounds and avoid introducing new participants in later rounds of the surveys to ensure consistency and methodological rigour of e-Delphi. Conclusion: There are variations in how e-Delphi is used in the literature for competency development, but if the authors are transparent with all phases of the method used, it is evident that it can significantly contribute to the advancement of future CNEC development in Canada. RĂ©sumĂ© Contexte : Il est courant pour les programmes de formation en sciences infirmiĂšres au Canada d’embaucher des formatrices et formateurs cliniques Ă  temps partiel pour enseigner les composantes pratiques des programmes d’études. Bien que spĂ©cialistes dans leur domaine, ces infirmiĂšres et infirmiers ne dĂ©tiennent aucune formation formelle en enseignement. De plus, il n’existe actuellement aucun rĂ©fĂ©rentiel de compĂ©tences Ă©tabli pour les formatrices et formateurs cliniques au Canada. Ce vide dans les Ă©crits canadiens justifie une recherche sur l’élaboration des compĂ©tences liĂ©es Ă  la formation clinique Ă  l’aide de la mĂ©thode e-Delphi, une technique de sondage en ligne frĂ©quemment utilisĂ©e pour nommer et clarifier les compĂ©tences dans le domaine de la santĂ©. Objectif : Comprendre l’étendue, la portĂ©e et la nature des donnĂ©es probantes de l’utilisation de la mĂ©thode e-Delphi et Ă©valuer de maniĂšre critique son utilisation dans la formation aprĂšs l’obtention du grade en sciences infirmiĂšres ainsi que le dĂ©veloppement des compĂ©tences infirmiĂšres afin d’établir la faisabilitĂ© de l’application pour l’élaboration des compĂ©tences des formatrices et formateurs cliniques au Canada. MĂ©thodes : Deux chercheuses indĂ©pendantes ont menĂ© une revue de la portĂ©e pour dĂ©terminer l’étendue, l’éventail et la nature des donnĂ©es probantes de l’utilisation de la mĂ©thode e-Delphi et Ă©valuer de maniĂšre critique son utilisation dans la formation aprĂšs l’obtention du grade en sciences infirmiĂšres et le dĂ©veloppement des compĂ©tences infirmiĂšres. Le Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR]) et le Joanna Briggs Institute Reviewers’ Manual ont Ă©tĂ© utilisĂ©s pour guider cette revue. RĂ©sultats : Les principales composantes de la mĂ©thode e-Delphi qui ont Ă©tĂ© extraites de la littĂ©rature pour la revue comprenaient les objectifs des Ă©tudes, les antĂ©cĂ©dents des membres du groupe d’experts, les mĂ©thodes e-Delphi utilisĂ©es, le niveau de consensus rapportĂ©, le nombre de tours pour atteindre le consensus, le temps entre les tours de questions, ainsi que le nombre et les changements de participants. Les objectifs des Ă©tudes examinĂ©es ont dĂ©montrĂ© que la mĂ©thode e-Delphi est privilĂ©giĂ©e pour dĂ©velopper ou rĂ©viser des compĂ©tences pour les programmes post-baccalaurĂ©at. Cependant, les autres composantes clĂ©s extraites ont rĂ©vĂ©lĂ© une grande variation dans l’utilisation de la mĂ©thode e-Delphi par les groupes de recherche. Plus important encore, ces derniers doivent s’assurer de rapporter les antĂ©cĂ©dents des membres du panel d’experts, de rĂ©duire le temps entre les cycles de sondage et d’éviter d’introduire de nouveaux participants dans les cycles ultĂ©rieurs des sondages afin d’assurer la cohĂ©rence et la rigueur mĂ©thodologique de la mĂ©thode e-Delphi. Conclusion : Il existe des variations dans la façon dont la mĂ©thode e-Delphi est utilisĂ©e et rapportĂ©e dans la littĂ©rature pour le dĂ©veloppement des compĂ©tences, mais si il y a transparence Ă  toutes les phases de l’utilisation de la mĂ©thode, il est Ă©vident qu’elle peut contribuer de maniĂšre significative Ă  l’élaboration du futur rĂ©fĂ©rentiel des compĂ©tences des formatrices et formateurs cliniques au Canada

    Real-time in vivo dosimetry in high dose rate prostate brachytherapy

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    Background and purpose: Single fraction treatments of 15 Gy or 19 Gy are common in HDR prostate brachytherapy. In vivo dosimetry (IVD) is therefore important to ensure patient safety. This study assesses clinical IVD and investigates error detection thresholds for real-time treatment monitoring. Materials and methods: IVD was performed for 40 treatments planned using intra-operative trans-rectal ultrasound (TRUS) with a MOSFET inserted into an additional needle. Post-treatment TRUS images were acquired for 20 patients to assess needle movement. Monte Carlo simulations of treatment plans were performed for 10 patients to assess impact of heterogeneities. Per-needle and total plan uncertainties were estimated and retrospectively applied to the measured data as error detection thresholds. Results: The mean measured dose was −6.4% compared to prediction (range + 5.1% to −15.2%). Needle movement and heterogeneities accounted for −1.8% and −1.6% of this difference respectively (mean values for the patients analysed). Total plan uncertainty (k = 2) ranged from 11% to 17% and per needle uncertainty (k = 2) ranged from 18% to 110% (mean 31%). One out of 40 plans and 5% of needles were outside k = 2 error detection threshold. Conclusions: IVD showed good agreement with predicted dose within measurement uncertainties, providing reassurance in the accuracy of dose delivery. Thresholds for real-time error detection should be calculated on an individual plan/needle basis

    Importance of dynamic contrast enhanced magnetic resonance imaging for targeting biopsy and salvage treatments after prostate cancer recurrence

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    Purpose: Evaluate T2 weighted MRI (T2W), diffusion weighted imaging (DWI), and dynamic contrast enhanced MRI (DCE-MRI) for determining areas of prostate cancer recurrence to target biopsy or salvage treatment in patients previously treated with I-125 seed brachytherapy. Material and methods: MRI data from 15 patients, whose primary treatment was I-125 seed brachytherapy and who were subsequently treated with partial gland salvage high-dose-rate brachytherapy were retrospectively analyzed. Two radiologists independently reviewed imaging on two occasions blinded to clinical and biopsy information. At first review, the T2W and DWI sequences were assessed for likely presence of tumor and at second review, the additional DCE-MRI sequence was assessed. Results were recorded and compared on a prostate diagram divided into 12 sectors (quadrants at each of base, mid-gland, and apex) plus seminal vesicles (SV). Results: Number of patients for whom recurrence was visible was 7/15 for T2W, 6.5/15 for DWI, and 15/15 for DCE-MRI (average of results for the two radiologists). Approximately, half of the sectors identified as showing recurrence were at the anterior base of the prostate. Conclusions: In prostate cancer patients previously treated with I-125 permanent seed implants, DCE-MRI is superior to T2W and DWI in defining areas of recurrence, and should be used to target biopsy and for treatment planning of focal salvage therapies

    Patchiness and Co-Existence of Indigenous and Invasive Mussels at Small Spatial Scales: The Interaction of Facilitation and Competition

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    Ecological theory predicts that two species with similar requirements will fail to show long-term co-existence in situations where shared resources are limiting, especially at spatial scales that are small relative to the size of the organisms. Two species of intertidal mussels, the indigenous Perna perna and the invasive Mytilus galloprovincialis, form mixed beds on the south coast of South Africa in a situation that has been stable for several generations of these species, even though these populations are often limited by the availability of space. We examined the spatial structure of these species where they co-exist at small spatial scales in the absence of apparent environmental heterogeneity at two sites, testing: whether conspecific aggregation of mussels can occur (using spatial Monte-Carlo tests); the degree of patchiness (using Korcak B patchiness exponent), and whether there was a relationship between percent cover and patchiness. We found that under certain circumstances there is non-random conspecific aggregation, but that in other circumstances there may be random distribution (i.e. the two species are mixed), so that spatial patterns are context-dependent. The relative cover of the species differed between sites, and within each site, the species with higher cover showed low Korcak B values (indicating low patchiness, i.e. the existence of fewer, larger patches), while the less abundant species showed the reverse, i.e. high patchiness. This relationship did not hold for either species within sites. We conclude that co-existence between these mussels is possible, even at small spatial scales because each species is an ecological engineer and, while they have been shown to compete for space, this is preceded by initial facilitation. We suggest that a patchy pattern of co-existence is possible because of a balance between direct (competitive) and indirect (facilitative) interactions

    Review of progress in implementing the recommendations of Sir Gareth Roberts, regarding employability and career development of PhD students and research staff

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    The need for improvement in the development of research careers and researchers’ training in transferable skills was highlighted in two particular recommendations (numbers 4.2 and 5.3) in the 2002 report ‘SET for success: the report of Sir Gareth Roberts’ Review - the supply of people with science, technology, engineering and mathematics skills’ (Roberts, 2002). As a consequence of that review, Research Councils UK (RCUK)1 have invested about £120 million, usually referred to as ’Roberts’ Money’, in research organisations to address this concern in all research disciplines. The last ‘Roberts’ Money’ payment will be for the period up to March 2011; it was therefore proposed to assess the progress made with taking forward these specific recommendations. An independent panel was formed by RCUK to undertake this review in 2010. The terms of reference for the panel are in Annex A. In summary, the panel was asked to review progress made and to advise RCUK and the higher education (HE) sector about future requirements for the development and training of researchers. In the course of their review, the panel considered a wide range of existing reports, interviewed key stakeholders in the HE sector and elsewhere, as well as drawing on their own knowledge and expertise. This report presents the findings of the panel’s review

    Stress related epigenetic changes may explain opportunistic success in biological invasions in Antipode mussels

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    Different environmental factors could induce epigenetic changes, which are likely involved in the biological invasion process. Some of these factors are driven by humans as, for example, the pollution and deliberate or accidental introductions and others are due to natural conditions such as salinity. In this study, we have analysed the relationship between different stress factors: time in the new location, pollution and salinity with the methylation changes that could be involved in the invasive species tolerance to new environments. For this purpose, we have analysed two different mussels’ species, reciprocally introduced in antipode areas: the Mediterranean blue mussel Mytilus galloprovincialis and the New Zealand pygmy mussel Xenostrobus securis, widely recognized invaders outside their native distribution ranges. The demetylathion was higher in more stressed population, supporting the idea of epigenetic is involved in plasticity process. These results can open a new management protocols, using the epigenetic signals as potential pollution monitoring tool. We could use these epigenetic marks to recognise the invasive status in a population and determine potential biopollutants

    A review of the biocontrol programmes against aquatic weeds in South Africa

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    Biological control (biocontrol) against invasive macrophytes is one of the longest standing programmes in South Africa, initiated in the 1970s against water hyacinth, Pontederia crassipes Mart. (Pontederiaceae). Since then, 15 agent species (13 insects, one mite and one pathogen) have been released against six weeds, most of which are floating macrophytes, with excellent levels of success. The release of the water hyacinth planthopper Megamelus scutellaris Berg (Hemiptera: Delphacidae) in particular, has improved biocontrol prospects for water hyacinth since 2018. In the last decade, however, a new suite of submerged and rooted emergent invasive macrophytes has been targeted. The first release against a submerged macrophyte in South Africa, and the first release against Brazilian waterweed, Egeria densa Planch. (Hydrocharitaceae), anywhere in the world, was achieved with the release of a leafmining fly, Hydrellia egeriae Rodrigues-JĂșnior, Mathis and Hauser (Diptera: Ephydridae). Yellow flag, Iris pseudacorus L. (Iridaceae) and Mexican waterlily, Nymphaea mexicana Zucc. (Nymphaeaceae), have also been targeted for biocontrol for the first time worldwide, and are in the early stages of agent development. Post-release evaluations, long term monitoring and controlled experiments have highlighted the need for a more holistic approach to managing aquatic invasive plants in South Africa, whose presence is largely driven by eutrophication, resulting in regime shifts between floating and submerged invaded states

    Differences in stress tolerance and brood size between a non-indigenous and an indigenous gammarid in the northern Baltic Sea

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    Differences in stress tolerance and reproductive traits may drive the competitive hierarchy between nonindigenous and indigenous species and turn the former ones into successful invaders. In the northern Baltic Sea, the non-indigenous Gammarus tigrinus is a recent invader of littoral ecosystems and now occupies comparable ecological niches as the indigenous G. zaddachi. In laboratory experiments on specimens collected between June and August 2009 around Tvašrminne in southern Finland (59°500N/23°150E), the tolerances towards heat stress and hypoxia were determined for the two species using lethal time, LT50, as response variable. The brood size of the two species was also studied and some observations were made on maturation of juveniles. Gammarus tigrinus was more resistant to hypoxia and survived at higher temperatures than G. zaddachi. Brood size was also greater in G. tigrinus than in G. zaddachi and G. tigrinus matured at a smaller size and earlier than G. zaddachi. Hence, there are clear competitive advantages for the non-indigenous G. tigrinus compared to the indigenous G. zaddachi, and these may be further strengthened through ongoing environmental changes related to increased eutrophication and a warming climate in the Baltic Sea region
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