What should we assess in practice?

Aim: This article reports on a PhD study and follow up work undertaken to review and develop a tool for assessment of practice. Background: The assessment of practice in nursing and midwifery education and, other health professions has been the source of concern, criticism and research for a number of years with the conclusion that it might not be possible to develop an assessment tool that could encompass all aspects of professional practice. Methods: A qualitative evaluation study was undertaken using the naturalistic method of inquiry. A combination of tools was used in order to collect the data and enable progressive focusing and cross checking of the findings. These included documentary analysis, a questionnaire and focus group and individual interviews. The data was collected from documents analysis, focus group interviews, individual interviews and questionnaires. Results: The results showed that the assessment tool in use at the time did not encompass all criteria assessors used and six areas were identified as those to include in any future tool. Conclusion: The six areas identified by subjects as those to include in any assessment tool were further developed with specific statements so that they could be used within a tool. Implications for nursing management and education: Within the changing nature of health care there is a need to review whether the tool used for assessing pre-registration education of nursing and midwifery students practice is ‘fit for purpose’

Plugging a hole and lightening the burden: A process evaluation of a practice education team

Aim: To investigate the perceptions of clinical and senior managers about the role of Practice Educators employed in one acute hospital in the UK. Background: Producing nurses who are fit for practice, purpose and academic award is a key issue for nurse education partnership providers in the UK. Various new models for practice learning support structures and new roles within health care institutions have been established. To sustain funding and policy support for these models, there is a need for evaluation research. Design: A process evaluation methodology was employed to determine the current value of a practice education team and to provide information to guide future direction. Methods: Data were collected through semi-structured telephone interviews using a previously designed schedule. All senior nurse managers (N=5) and a purposive sample of clinical managers (n=13) who had personal experience of and perceptions about the role of practice educators provided the data. Interview notes were transcribed, coded and a thematic framework devised to present the results. Results: A number of key themes emerged including: qualities needed for being a successful practice educator; visibility and presence of practice educators; providing a link with the university; ‘plugging a hole’ in supporting learning needs; providing relief to practitioners in dealing with ‘the burden of students’; alleviating the ‘plight of students’; and effects on student attrition. Conclusions: Findings provided evidence for the continued funding of the practice educator role with improvements to be made in dealing with stakeholder expectations and outcomes. Relevance to clinical practice: In the UK, there still remain concerns about the fitness for practice of newly registered nurses, prompting a recent national consultation by the professional regulating body. Despite fiscal pressures, recommendations for further strengthening of all systems that will support the quality of practice learning may continue to sustain practice learning support roles

Measuring health-related quality of life for child maltreatment: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Child maltreatment causes substantial morbidity and mortality in the U.S. Morbidity associated with child maltreatment can reduce health-related quality of life. Accurately measuring the reduction in quality of life associated with child maltreatment is essential to the economic evaluation of educational programs and interventions to reduce the incidence of child maltreatment. The objective of this study was to review the literature for existing approaches and instruments for measuring quality-of-life for child maltreatment outcomes.</p> <p>Methods</p> <p>We reviewed the current literature to identify current approaches to valuing child maltreatment outcomes for economic evaluations. We also reviewed available preference-based generic QOL instruments (EQ-5D, HUI, QWB, SF-6D) for appropriateness in measuring change in quality of life due to child maltreatment.</p> <p>Results</p> <p>We did not identify any studies that directly evaluated quality-of-life in maltreated children. We identified 4 studies that evaluated quality of life for adult survivors of child maltreatment and 8 studies that measured quality-of-life for pediatric injury not related to child maltreatment. No study reported quality-of-life values for children younger than age 3.</p> <p>Currently available preference-based QOL instruments (EQ-5D, HUI, QWB, SF-6D) have been developed primarily for adults with the exception of the Health Utilities Index. These instruments do not include many of the domains identified as being important in capturing changes in quality of life for child maltreatment, such as potential for growth and development or psychological sequelae specific to maltreatment.</p> <p>Conclusion</p> <p>Recommendations for valuing preference-based quality-of-life for child maltreatment will vary by developmental level and type of maltreatment. In the short-term, available multi-attribute utility instruments should be considered in the context of the type of child maltreatment being measured. However, if relevant domains are not included in existing instruments or if valuing health for children less than 6 years of age, direct valuation with a proxy respondent is recommended. The choice of a proxy respondent is not clear in the case of child maltreatment since the parent may not be a suitable proxy. Adult survivors should be considered as appropriate proxies. Longer-term research should focus on identifying the key domains for measuring child health and the development of preference-based quality-of-life instruments that are appropriate for valuing child maltreatment outcomes.</p

Toward a Multifaceted Heuristic of Digital Reading to Inform Assessment, Research, Practice, and Policy

In this commentary, the author explores the tension between almost 30 years of work that has embraced increasingly complex conceptions of digital reading and recent studies that risk oversimplifying digital reading as a singular entity analogous with reading text on a screen. The author begins by tracing a line of theoretical and empirical work that both informs and complicates our understanding of digital literacy and, more specifically, digital reading. Then, a heuristic is proposed to systematically organize, label, and define a multifaceted set of increasingly complex terms, concepts, and practices that characterize the spectrum of digital reading experiences. Research that informs this heuristic is used to illustrate how more precision in defining digital reading can promote greater clarity across research methods and advance a more systematic study of promising digital reading practices. Finally, the author discusses implications for assessment, research, practice, and policy

The effects of custodial vs. non-custodial sentences on re-offending: A systematic review of the state of knowledge

As part of a broad initiative of systematic reviews of experimental or quasiexperimental evaluations of interventions in the field of crime prevention and the treatment of offenders, our work consisted in searching through all available databases for evidence concerning the effects of custodial and non-custodial sanctions on reoffending. For this purpose, we examined more than 3,000 abstracts, and finally 23 studies that met the minimal conditions of the Campbell Review, with only 5 studies based on a controlled or a natural experimental design. These studies allowed, all in all, 27 comparisons. Relatively few studies compare recidivism rates for offenders sentenced to jail or prison with those of offenders given some alternative to incarceration (typically probation). According to the findings, the rate of re-offending after a non-custodial sanction is lower than after a custodial sanction in 11 out of 13 significant comparisons. However, in 14 out of 27 comparisons, no significant difference on re-offending between both sanctions is noted. Two out of 27 comparisons are in favour of custodial sanctions. Finally, experimental evaluations and natural experiments yield results that are less favourable to non-custodial sanctions, than are quasi-experimental studies using softer designs. This is confirmed by the meta-analysis including four controlled and one natural experiment. According to the results, non-custodial sanctions are not beneficial in terms of lower rates of re-offending beyond random effects. Contradictory results reported in the literature are likely due to insufficient control of pre-intervention differences between prisoners and those serving “alternative” sanctions