Crossing the Threshold: Students' Experiences of the Transition from Student to Staff Nurse

Current policy in the health services emphasises nursing students’ fitness to practice at the point of registration. There has also been some suggestion that pre-registration education has not equipped them with the necessary knowledge and skills. Other research findings have indicated that students can find this transition stressful. Due to the massive investment in nurse education and the need to retain nurses in the workforce, we wanted to understand the factors that might better support this transition. Using telephone interviews with former students of The Open University part-time, distance learning, pre-registration nursing programme, we explored nurses’ experiences of their first 3-6 months of qualified practice. A number of recurring themes emerged which were then exposed to theoretical analysis using Van Gennep’s theory of transition and Bridges’ work on organisational change. In at the deep end Here students talked of their feelings associated with their increased accountability and of their anxiety in those early days following qualification. Changing identities As sponsored Health Care Assistants (HCAs), OU nursing students regularly juggle the transition from HCA to student but then make a further transition to staff nurse. Many talked about the impact of this on former HCA colleagues and the significance of the uniform as a symbol defining their new identity. Coming together In this theme, participants talked of how things started to come together, their growing confidence and their satisfaction of being able to apply their knowledge in practice. Scaffolding This was the name given to the formal and informal support structures participants described as useful during their transition. These included their educational preparation, organisational support and the individual support of mentors and family

Emerging Infectious Diseases

Description of infectious diseases emerging across the globe with explanation of factors contributing to emergence

Working at the coal face: The contribution of Programme Tutors in supporting practice-based learning in nursing

This paper reports the findings of a Centre for Excellence in Teaching and Learning-funded project to explore key features of effective support for pre-registration nursing students in practice settings. Background The cultivation of positive practice learning environments for students of nursing, including high quality learning support, has been long established as a thorny issue for nurse educators and practitioners. Indeed it was a key theme for the very first nursing research series, supported by the Royal College of Nursing, in the early 1980’s. This included Fretwell’s (1982) work on ward teaching and learning, Orton’s (1981) work on the ward learning environment and Ogier’s (1982) work on the role of the ward sister. Since then there has been an explosion of research in this area. As a profession we have a responsibility to ensure high quality learning support for students in practice settings. If we do not, there will be wide-ranging implications for the quality of patient care, work-related stress, role satisfaction, retention and attrition and professional reputation. Given the significant investment in nurse education and the need to retain nurses in the workforce, it is unsurprising therefore that the practice learning environment has emerged as a key policy issue in the United Kingdom and internationally. Previous research indicates that relationships between the learner and staff are crucial in supporting learning in practice (Pearcey and Elliott, 2004) and that ‘learning is maximised when the learner is effectively partnered with a clinician and experiences are shared’ (Henderson et al., 2009, p.178). In this context, The Programme Tutor (PT) – a role unique to the pre-registration nursing programme at The Open University (OU) – is crucial in facilitating learning in the practice setting. The purpose of the PT role is to work longitudinally with both students and their mentors to support learning in practice and monitor student progress. The PT therefore plays a pivotal role in facilitating learning in the practice setting, aspects of which may have potential for transfer to the wider health education sector. Objectives The overall aim of the project was to critically examine the experiences of a sample of PTs supporting students and mentors on the pre-registration nursing programme at the OU in order to identify the key features of effective PT practice. These features would then inform the continuing development of the programme. Two PTs were recruited as co-researchers on the project, the objectives of which were to: • Explore PT’s experiences of supporting students and mentors • Explore PT’s views regarding student progression • Identify how PTs ‘grow’ into their role • Identify enabling and disabling factors contributing to role effectiveness • Examine the boundaries between the role of the PT and mentor • Explore variations in the PT role across the UK. Data collection and analysis A sample of 20 PTs working on the final practice module of the pre-registration nursing programme, and located across the nations and regions of the UK, was identified. Following ethical approval, telephone interviews were conducted using an interview guide informed by both a review of the literature and the experience of the PT co-researchers. Telephone interviews were used in preference to individual face-to-face interviews in order to accommodate the dispersed geographical spread of participants. The interviews were recorded using digital recording equipment and following transcription, conventional approaches to qualitative data analysis were used to identify common themes across the data. The ethical principles of confidentiality, anonymity and informed consent were upheld throughout the study. The sample was assured that confidentiality would be maintained at all times throughout the project. Anonymity was protected by using pseudonyms both for PTs and organisations. Informed consent was gained at the start of the project and participants were able to withdraw from the project at any stage. Findings suggest that PTs find their role both rewarding and vital in the context of creating supportive learning environments and ultimately supporting students’ transition to become registered practitioners. Being an effective communicator and establishing and maintaining relationships with students, mentors and service managers was described as crucial to the success of the role. Understanding the pressures within practice environments and being able to acknowledge the realities of ‘working at the coalface’ enabled PTs to support both students and mentors in such settings. Conclusion This paper will elaborate more fully the findings of the project, illustrated with reference to verbatim quotes from the data. Although a role unique to the OU pre-registration nursing programme, there may be aspects of the role which could be transferable to other practice-based learning settings. This will be interactively debated with conference delegates. (word count 800) References Fretwell, J. E. (1982) Ward teaching and Learning, Royal College of Nursing, London. Henderson, A., Twentyman, M., Eaton, E., Creedy, D., Stapleton, P. and Lloyd, B. (2009) Creating supportive clinical learning environments: an intervention study, Journal of Clinical Nursing, 19, pp.171-182. Ogier, M. E. (1981) An ideal sister, Royal College of Nursing, London Orton, H. D. (1981) Ward learning climate, Royal College of Nursing, London Pearcey, P. A. and Elliott, B. E. (2004) Student impressions of clinical nursing, Nurse Education Today, 18, pp.29-31

Instrumentation and Procedures for Validation of Synthetic Infrared Image Generation Models

Synthetic infrared image generation models are becoming more complex with the incorporation of radiation propagation, thermodynamic, environmental, energy matter interaction, and sensor models linked through ray tracers into CAD models of scenes. As these models evolve, it is becoming increasingly necessary and difficult to design validation experiments to determine how well the models work and where the limitations are. This paper describes an experimental approach to validation of the radiometric integrity of an end-to-end thermal infrared SIG model. The approach attempts to break down the overall SIG model into a set of submodels with measurable input and output parameters. A scene is then instrumented and imaged in a time lapse fashion over an extended period (e.g., 48 hours). This scene is also synthetically produced so that the actual and synthetic scenes can be compared. The experimental approach includes acquisition of meteorological data (air temperature, relative humidity, wind speed, cloud cover, precipitation type and rate, total insolation, diffuse insolation), object data (emissivity, absorptivity, thermal conductivity, specific heat, temperature), atmospheric data (transmission, path radiance) and image data (calibrated longwave infrared and midwave infrared images, as well as visible images). Error propagation models are used in conjunction with the experimental data to determine the source and relative importance of errors in the modeling process

Union Commitment: Is There a Gender Gap?

Au cours des dernières décennies, la composition de la main-d’œuvre au Canada s'est nettement modifiée à cause de la croissance du pourcentage des femmes qui sont entrées et sont restées sur le marché du travail. Parallèlement à l'augmentation du taux de participation de la main-d’œuvre féminine, les femmes en sont venues à former une part de plus en plus grande de l'effectif syndical. La présente étude veut aller au-delà de la question de la propension des femmes à adhérer aux syndicats et comparer leurs comportements et ceux des hommes dans leur engagement respectif envers l'organisation qui les représente. Fondé sur un échantillon de 223 femmes et de 222 hommes, membres d'un syndicat, qui travaillent dans le commerce de gros et de détail de produits alimentaires ainsi que dans le secteur de la santé en Saskatchewan, nous cherchons à découvrir si les syndiquées sont aussi engagées dans les organisations syndicales locales que leurs collègues de sexe masculin.Cette enquête vise aussi à établir dans quelle mesure les facteurs que l'on associe généralement à l'engagement syndical sont les mêmes pour les femmes et pour les hommes. À partir des recherches antérieures touchant l'engagement syndical, nous en étudions ici trois dimensions spécifiques: 'la fidélité au syndicat', 'les obligations envers le syndicat' et 'la volonté de travailler pour le syndicat'. Nous avançons l'hypothèse que les différences entre les hommes et les femmes sont plus prononcées pour les formes d'engagement syndical qui requièrent un degré plus élevé d'action. En particulier, la plus grande divergence susceptible d'exister dans l'engagement syndical entre les sexes devrait se retrouver dans 'la volonté de travailler pour le syndicat' plutôt que dans la forme moins active des 'obligations' ou dans celle plus passive de 'la fidélité'.La comparaison des tests de moyennes révèle que les syndiquées se sont déclarées, de façon significative, plus loyales envers le syndicat que leurs collègues masculins. Cependant, les hommes ont exprimé dans une plus grande proportion leur intention de 'travailler' pour l'association syndicale locale. Aucune différence entre les employés des deux sexes quant aux 'obligations' envers le syndicat n'a été constatée. On a utilisé un modèle de régression multiple pour isoler l'influence de d'autres facteurs identifiés dans les recherches publiées sur l'engagement syndical. Les résultats révèlent que la variable sexe a un effet statistiquement significatif sur l'engagement syndical seulement pour la dimension 'volonté de travailler pour le syndicat'. Et bien que son effet soit significatif, cette variable n'explique qu'un pour cent de la variance totale pour ce qui a trait à cette dimension. Par ailleurs, l'analyse des autres facteurs associés à l'engagement syndical, tant pour les femmes que pour les hommes, n'indique qu'un écart minime. En résumé, les résultats suggèrent que le sexe est tout au plus un facteur mineur dans la détermination de l'une des trois dimensions étudiées de l'engagement syndical. De plus, la plupart des facteurs qui concourent à l'engagement syndical sont partagés tant par les membres masculins que féminins des organisations syndicales locales. Par rapport aux politiques syndicales, ces résultats font particulièrement ressortir l'importance des efforts des syndicats en vue de socialiser les nouveaux membres dès le début de l'adhésion et de se préoccuper de leurs besoins, sans égard à leur sexe. Pour les deux groupes, les expériences de socialisation dès le commencement de la syndicalisation sont très liées au degré d'engagement personnel dans l'organisation syndicale locale.In the context of the growing feminization of membership in Canadian labour unions, this study examines the relationship between gender and multiple dimensions of worker commitment to the union organization. Based upon survey responses from 223 female and 222 male union members in Saskatchewan, the results reveal no gender differences with regard to expressed levels of union "loyalty" and "responsibility to the union". However, a small but significantly lower level of "willingness to work for the union" was expressed by female union members. In comparative analyses of males and females, the results are generally supportive of greater commonality than differences in the correlates of union commitment for men and women

Young Adult Smokers\u27 Neural Response to Graphic Cigarette Warning Labels

Introduction: The study examined young adult smokers\u27 neural response to graphic warning labels (GWLs) on cigarette packs using functional magnetic resonance imaging (fMRI). Methods: Nineteen young adult smokers (M age 22.9, 52.6% male, 68.4% non-white, M 4.3 cigarettes/day) completed pre-scan, self-report measures of demographics, cigarette smoking behavior, and nicotine dependence, and an fMRI scanning session. During the scanning session participants viewed cigarette pack images (total 64 stimuli, viewed 4 s each) that varied based on the warning label (graphic or visually occluded control) and pack branding (branded or plain packaging) in an event-related experimental design. Participants reported motivation to quit (MTQ) in response to each image using a push-button control. Whole-brain blood oxygenation level-dependent (BOLD) functional images were acquired during the task. Results: GWLs produced significantly greater self-reported MTQ than control warnings (p \u3c .001). Imaging data indicate stronger neural activation in response to GWLs than the control warnings at a cluster-corrected threshold p \u3c .001 in medial prefrontal cortex, amygdala, medial temporal lobe, and occipital cortex. There were no significant differences in response to warnings on branded versus plain cigarette packages. Conclusions: In this sample of young adult smokers, GWLs promoted neural activation in brain regions involved in cognitive and affective decision-making and memory formation and the effects of GWLs did not differ on branded or plain cigarette packaging. These findings complement other recent neuroimaging GWL studies conducted with older adult smokers and with adolescents by demonstrating similar patterns of neural activation in response to GWLs among young adult smokers

Magnify is a universal molecular anchoring strategy for expansion microscopy

Expansion microscopy enables nanoimaging with conventional microscopes by physically and isotropically magnifying preserved biological specimens embedded in a crosslinked water-swellable hydrogel. Current expansion microscopy protocols require prior treatment with reactive anchoring chemicals to link specific labels and biomolecule classes to the gel. We describe a strategy called Magnify, which uses a mechanically sturdy gel that retains nucleic acids, proteins and lipids without the need for a separate anchoring step. Magnify expands biological specimens up to 11 times and facilitates imaging of cells and tissues with effectively around 25-nm resolution using a diffraction-limited objective lens of about 280 nm on conventional optical microscopes or with around 15 nm effective resolution if combined with super-resolution optical fluctuation imaging. We demonstrate Magnify on a broad range of biological specimens, providing insight into nanoscopic subcellular structures, including synaptic proteins from mouse brain, podocyte foot processes in formalin-fixed paraffin-embedded human kidney and defects in cilia and basal bodies in drug-treated human lung organoids

Healthy eating and lifestyle in pregnancy (HELP): a cluster randomised trial to evaluate the effectiveness of a weight management intervention for pregnant women with obesity on weight at 12 months postpartum

Objective: To assess whether a weight management intervention for pregnant women with obesity was effective in reducing body mass index (BMI) 12 months after giving birth. Methods: Pragmatic, cluster randomised controlled trial (RCT) with embedded cost-effectiveness analysis. 598 women with a BMI of ≥30 kg/m2 (between 12 and 20 weeks gestation) were recruited from 20 secondary care maternity units in England and Wales. BMI at 12 months postpartum was the primary outcome. A range of clinical and behavioural secondary outcomes were examined. Interventions: Women attending maternity units randomised to intervention were invited to a weekly weight management group, which combined expertise from a commercial weight loss programme with clinical advice from midwives. Both intervention and control participants received usual care and leaflets on diet and physical activity in pregnancy. Results: Mean (SD) BMI at 12 months postpartum was 36.0 kg/m2 (5.2) in the control group, and 37.5 kg/m2 (6.7) in the intervention group. After adjustment for baseline BMI, the intervention effect was −0.02 (95% CI −0.04 to 0.01). The intervention group had an improved healthy eating score (3.08, 95% CI 0.16 to 6.00, p < 0.04), improved fibre score (3.22, 1.07 to 5.37, p < 0.01) and lower levels of risky drinking at 12 months postpartum compared to the control group (OR 0.45, 0.27 to 0.74, p < 0.002). The net incremental monetary benefit was not statistically significantly different between arms, although the probability of the intervention being cost-effective was above 60%, at policy-relevant thresholds. Conclusions: There was no significant difference between groups on the primary outcome of BMI at 12 months. Analyses of secondary outcomes indicated improved healthy eating and lower levels of risky drinking. Trial registration: Current Controlled Trials ISRCTN25260464