Implementing simulation in a nursing education programme: a case report from Tanzania

This paper presents a description of, and some reflections around, the experience of implementing simulation-based education within a nursing education programme in a low-income context. The students in the nursing education programme found the simulation sessions to be useful, motivating and a realistic learning method. Our experience may provide useful insight for other nursing education programmes in low-income contexts. It looks like a deeper knowledge about the feasibility of simulation-based education from both the teacher and student perspective is necessary.publishedVersio

Lessons learned through developing and implementing simulation-based education in nursing education programmes in sub-Saharan Africa

Based on the authors’ experiences, this paper aims to describe and reflect on the project of developing and implementing simulation-based education in two nursing education programmes in Tanzania and Madagascar. The project lasted from August 2017 to December 2019. The essential aspects that contributed to the project’s achievements were the school’s interest in developing and implementing simulation-based education and the many opportunities for sharing theoretical knowledge and practicing simulation. Notably, the teachers adapted simulation-based education as a pedagogical method to their own context, developing scenarios related to their local culture and national curriculum. In the debriefing session, the teachers asked open-ended questions to promote reflection, however, they mostly used directive feedback to highlight performance issues and correct performance gaps. The students also expected directives to learn from their mistakes. Overall, the reflection on the experience may provide new insights into developing and implementing simulation-based education in low-resource settings.publishedVersio

Developing and testing the EPICC Spiritual Care Competency Self‐Assessment Tool for student nurses and midwives

Aims and objectives To develop and psychometrically test a self-assessment tool that measures undergraduate nursing and midwifery students’ perceptions of spiritual care competence in health care practice. Background Spiritual care is part of nurses/midwives’ responsibility. There is a need to better benchmark students’ competency development in spiritual care through their education. The EPICC Spiritual Care Education Standard served as groundwork for the development of the EPICC Spiritual Care Competency Self-Assessment Tool. Design Cross sectional, mixed methods design. A STROBE checklist was used. Methods The Tool (available in English, Dutch and Norwegian) was developed by an international group. It was tested between July–October 2020 with a convenience sample of 323 nursing/midwifery students at eight universities in five countries. The Tool was tested for validity using Kaiser–Meyer–Olkin (KMO) test, exploratory and confirmatory factor analysis, one-way ANOVA and independent samples t test. The reliability was tested by Cronbach's alpha coefficient. Qualitative data were analysed using thematic analysis. Results The KMO test for sampling adequacy was 0.90. All, but two, items were related to the same factor. Cronbach's alpha coefficient for the Tool was 0.91. Students found the Tool easy to use, and they gained new insights by completing it. However, students felt that some questions were repetitive and took time to complete. Conclusions The Tool has construct and discriminant validity, and high internal consistency (is reliable). In addition, students found the Tool useful, especially in early stages of education. Relevance to clinical practice The Tool affords student nurses and midwives the opportunity to self-evaluate their knowledge, skills and attitudes about spirituality and spiritual care. The Tool offers students, educators and preceptors in clinical practice a tangible way of discussing and evaluating spiritual care competency

Vessel-based brain-shift compensation using elastic registration driven by a patient-specific finite element model

International audienceDuring brain tumor surgery, planning and guidance are based on pre-operative images which do not account for brain-shift.However, this shift is a major source of error in neuro-navigation systems and affects the accuracy of the procedure. The vascular tree is extracted from pre-operative Magnetic Resonance Angiography and from intra-operative Doppler ultrasound images, which provides sparse information on brain deformations.The pre-operative images are then updated based on an elastic registration of the blood vessels, driven by a patient-specific biomechanical model.This biomechanical model is used to extrapolate the deformation to the surrounding soft tissues.Quantitative results on a single surgical case are provided, with an evaluation of the execution time for each processing step.Our method is proved to be efficient to compensate for brain deformation while being compatible with a surgical process

Rethinking Nursing Care: An Ethnographic Approach to Nurse-Patient Interaction in the Context of a HIV Prevention Programme in Rural Tanzania.

While care has been described as the essence of nursing, it is generally agreed that care is a complex phenomenon that remains elusive. Literature reviews highlight the centrality of nurse-patient interactions in shaping care. In sub-Saharan Africa, where there is a critical shortage of health workers, nurses remain the core of the health workforce, but the quality of the patient care they provide has been questioned. OBJECTIVE: The study explored how care is shaped, expressed and experienced in nurses' everyday communication among HIV positive women in Tanzania. STUDY CONTEXT: Data were collected through a prevention of mother-to-child transmission of HIV programme with a comprehensive community component conducted by a church-run hospital in rural Tanzania. The population is largely agro-pastoral, the formal educational level is low and poverty is rampant. METHODS: An ethnographic approach was employed. Nurses and women enrolled in the prevention of mother-to-child transmission of HIV programme were followed closely over a period of nine months in order to explore their encounters and interactions. FINDINGS AND DISCUSSION: The way care is shaped, expressed and experienced is not globally uniform, and the expectations of what quality care involves differ between settings. In this study the expectations of nurses' instructions and authority, combined with nurses' personal engagement were experienced as caring interactions. The findings from this study demonstrate that the quality of nursing care needs to be explored within the specific historical, socio-cultural context in which it is practised

Nursing students’ experiences with simulation-based education as a pedagogic method in low-resource settings: A mixed-method study

Abstract Aims and Objectives This study introduced simulation-based education in nurse education programs in Tanzania and Madagascar and explored nursing students’ experiences with this pedagogic method as a mode of learning. Background Simulation-based education has barely been introduced to education programs in resource-constrained settings. The study was conducted in two nurse education programs: one in rural Tanzania and the other in the mid-land of Madagascar. Both institutions offer diploma programs in nursing. Simulation-based education has not been included in the teaching methods used in these nursing programs. Design A descriptive and convergent mixed method design was employed. Methods Ninety-nine nursing students were included in the study. Simulation sessions followed by data collection took place once in 2017 and twice in 2018. Data were collected by means of several questionnaires and six focus groups. The data were analyzed using descriptive statistics and qualitative content analysis. The Standards for Reporting Qualitative Research (SRQR) was used to report the results. Results The quantitative data revealed that the students rated all the questions related to the simulation design elements, educational practices, and students’ satisfaction and self-confidence in learning with scores of above four on a 5-point Likert scale. The qualitative data from the first theme, building competence and confidence, further emphasized and outlined the quantitative results. Additionally, the qualitative data revealed a second theme, improving through encouragement and corrections. The students clearly expressed that they wanted to be aware of their weaknesses to be able to improve; however, the provision of feedback should be carried out in an encouraging way. Conclusion The findings indicated that the nursing students were satisfied with simulation as a pedagogic method, as it improved their competence and prepared them for professional practice. Further research is necessary to explore whether the students are able to transfer their knowledge into clinical practice.publishedVersio

Challenges of disseminating clinical practice guidelines in a weak health system: the case of HIV and infant feeding recommendations in Tanzania

© 2015 Shayo et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License and originally published in the International Breastfeeding Journal. See DOI 10.1186/s13006-014-0024-Background: Clinical guidelines aim to improve patient outcomes by providing recommendations on appropriate healthcare for specific clinical conditions. Scientific evidence produced over time leads to change in clinical guidelines, and a serious challenge may emerge in the process of communicating the changes to healthcare practitioners and getting new practices adopted. There is very little information on the major barriers to implementing clinical guidelines in low-income settings. Looking at how continual updates to clinical guidelines within a particular health intervention are communicated may shed light on the processes at work. The aim of this paper is to explore how the content of a series of diverging infant feeding guidelines have been communicated to managers in the Prevention of Mother to Child Transmission of HIV Programme (PMTCT) with the aim of generating knowledge about both barriers and facilitating factors in the dissemination of new and updated knowledge in clinical guidelines in the context of weak healthcare systems. Methods: A total of 22 in-depth interviews and two focus group discussions were conducted in 2011. All informants were linked to the PMTCT programme in Tanzania. The informants included managers at regional and district levels and health workers at health facility level. Results: The informants demonstrated partial and incomplete knowledge about the recommendations. There was lack of scientific reasoning behind various infant feeding recommendations. The greatest challenges to the successful communication of the infant feeding guidelines were related to slowness of communication, inaccessible jargon-ridden English language in the manuals, lack of summaries, lack of supportive supervision to make the guidelines comprehensible, and the absence of a reading culture. Conclusion: The study encountered substantial gaps in knowledge about the diverse HIV and infant feeding policies. These gaps were partly related to the challenges of communicating the clinical guidelines. There is a need for caution in assuming that important changes in guidelines for clinical practice can easily be translated to and implemented in local programme settings, not least in the context of weak healthcare systems

Immigrants in Norway: Resilience, challenges and vulnerabilities in times of COVID-19

Immigrants have been found to be disproportionately impacted during the COVID-19 pandemic across the world. Our study, exploring the experiences of immigrants in Norway during the pandemic, is based on interviews and focus group discussions with 10 and 21 immigrants, respectively. Our analysis showed that participants perceived the circumstances induced by the pandemic to be difficult and voiced the challenges experienced. Their experiences encompassed social, economic, and the public sphere, where immigrants felt themselves to be in more vulnerable positions than before the pandemic. Our analysis identified four main themes: 1) Feeling stagnated, 2) Perceptions towards government and health authorities, 3) Boundaries of us vs them, and 4) Coping. We conclude our paper by stating that government and health authorities should consider both short-term and long-term consequence of the pandemic to mitigate impact on communities at risk.publishedVersio

Vessel-based brain-shift compensation using elastic registration driven by a patient-specific finite element model

International audienceDuring brain tumor surgery, planning and guidance are based on pre-operative images which do not account for brain-shift.However, this shift is a major source of error in neuro-navigation systems and affects the accuracy of the procedure. The vascular tree is extracted from pre-operative Magnetic Resonance Angiography and from intra-operative Doppler ultrasound images, which provides sparse information on brain deformations.The pre-operative images are then updated based on an elastic registration of the blood vessels, driven by a patient-specific biomechanical model.This biomechanical model is used to extrapolate the deformation to the surrounding soft tissues.Quantitative results on a single surgical case are provided, with an evaluation of the execution time for each processing step.Our method is proved to be efficient to compensate for brain deformation while being compatible with a surgical process