Desperately seeking consistency: student nurses' experiences and expectations of academic supervision

© 2016 Elsevier Ltd Background Academic supervision - the support available to students when writing assignments - is a fundamental element in the provision of support within nurse education. Not only can it underpin high levels of academic achievement, but it also has a role in enhancing the retention of students. Despite its importance, there is little investigation of undergraduate academic supervision within the nursing literature. Objectives To explore students' experiences and expectations of academic supervision as part of an undergraduate programme of nurse education. Design A qualitative approach to explore student perceptions. Setting The research was undertaken at a Higher Education Institution in the United Kingdom. The institution offers undergraduate nurse education programmes to approximately 800 students. Participants Eight pre-registration nursing students from a Bachelor of Science programme participated in a focus group interview. All were in the first semester of their final year. Methods Data were collected using focus group interviewing, based around a semistructured question framework. The focus groups explored students' expectations and previous experiences of academic supervision. The focus group was recorded, responses were transcribed and thematic analysis was undertaken to identify key findings. Results Three themes were identified from the data: relationship with supervisor, variation between supervisors, and the link between supervision and marking. Overall, students identified frustration with variability in the provision of academic supervision. Conclusions Effective academic supervision depends on a strong relationship between student and supervisor - something that can be difficult to achieve if supervision is only for a short period of time. Equally, students crave a consistent approach to supervision, in terms of both the amount and content of feedback. Students are able to identify and articulate a clear link between effective supervision and academic achievement

Developing the Future Academic Workforce: The Experiences of Early Career Academics from Health and Social Care Registered Professions - A survey of academic staff

Aim: To explore the experiences of new academics transitioning from clinical practice into academia. Background: Previous research has focused on support offered to practitioners after taking up new academic posts, but support prior to this transition to help set realistic expectations about the nature and demands of the role is lacking. Design: A cross-sectional survey. Methods: An electronic survey (March-June 2022) using two validated measures were used; an amended version of the Career Transition Inventory (CTI), and the HEXACO personality trait measure. The survey included open questions (analysed thematically) to elicit further detail. Ethical approval was granted by the University of Lincoln. Results: The CTI showed strong agreement with a range of statements such as “I felt overwhelmed in my first year of academia”, “my line manager supported me during my probationary period”, and “I felt as though I had made the right decision to move from a clinical/professional role to an academic role”, suggesting the transition to academia was a difficult process but that help was received when required. Despite the challenges faced in transitioning, most participants felt it was a good decision. The HEXACO personality trait measure suggested that higher levels of extraversion seemed to be associated with a more positive transition from a clinical role to an academic role. The qualitative data resulted in four themes: (1) a need to do something different (2) expectations not reflecting reality (3) importance of support, (4) transformative experience. Conclusion: Feelings like a novice again highlighted the importance of support and preparation for role transition. Data from this study suggest training or exposure prior to applying for an academic post may help to align people’s expectations and reduce the pressure felt when entering a world which is unknown to them. Higher Education Institutes are ideally placed to offer pre-transition preparation programmes

Developing the Future Academic Workforce: The Experiences of Early Career Academics from Health and Social Care Registered Professions – Factors influencing transition: development of an academic transition measure

Aim: Development and initial testing of a Transition to Academia from Practice (TAP) measure.    Background: Previous research has explored the psychological resources employed by a person when deciding to transition in their career, resulting in the development of the Career Transition Inventory (CTI). The transition to academia has been explored in studies, however, there appears to be no specific measure for this career change. Design: A cross-sectional survey.  Methods: A survey was designed centred on the five factors measured in the CTI with the questions amended to reflect transitioning from clinical practice to academia, based on findings from qualitative research in this area. Responses from 122 participants, across a range of countries and clinical professions, provided the data for developing the TAP. Reliability testing and factor analysis was conducted using JASP to test and refine the TAP. Ethical approval was granted by the University of Lincoln.  Results: The initial 72-item survey resulted in a Cronbach’s alpha of α=0.812. Principal component factor analysis revealed support for the five factors, with the addition of subfactors and identification of an outcome variable. (1) Readiness with subfactors “understanding the role” and “motivations and desires”, (2) Confidence with subfactors “confidence in expertise”, “confidence in role”, and “confidence in transition”, (3) Control with subfactors “in control” and “adaptation”, (4) Internal support, and (5) External factors. Factor 5 revealed a further factor relating to “intention to stay” which on reflection, was the outcome for a successful transition rather than a prerequisite for undertaking a change. The final measure resulted in 50 items and 3 questions to measure a successful transition. Conclusion: The TAP helps to understand the factors that result in a successful transition to academia which may help to develop support for professionals who are contemplating the transition

Developing the Future Academic Workforce: Early Career Academics: A systematic review

The aims of this review were to: (a) identify the experiences of clinical practitioners following the transition from clinical practice to academia (b) identify the barriers and facilitators to successful transition into academia as a novice academic (c) identify strategies to support the transition from expert healthcare practitioner to novice academic. Design A systematic review of published, peer-reviewed, original research exploring the experiences of novice academics following a career as a healthcare practitioner. Data Sources Six electronic databases were searched: CINAHL Complete (EBSCO),  Medline (EBSCO), Scopus (Elsevier), Web of Science (all databases) (Clarivate), British Education Index (EBSCO) and ERIC – Education Resources Information Center (EBSCO). Review Methods Three authors independently screened the literature using agreed inclusion and exclusion criteria. Themes were extracted from each selected study and synthesised to address the aims of the review. Results 20 studies were retrieved and included in the review. Themes identified included: lack of mentorship or the person to ask; lack of preparedness for the role; balancing workload with teaching requirements and maintaining a work-life balance; building relationships and career progression. Conclusion Novice healthcare practitioners that have transitioned from a role as an expert practitioner to novice academic need to be supported with robust mentorship, time to learn and develop as an academic and to receive the practical and theoretical skills to become a confident and accomplished teacher, scholar and academic. Impact This review addresses the problems faced by expert clinical practitioners transitioning to the role of novice academic. Understanding the challenges faced by new healthcare academics allows education providers to consider how to support, nurture and retain aspiring academics of the future when navigating the challenges of returning to novice status. This review provides healthcare education providers with recommendations of strategies to consider when identifying how to prepare and support new academics

Developing the Future Academic Workforce: Preceptorship and Mentorship for Early Career Academics from Health and Social Care

Introduction There needs to be more research exploring the experiences of new academics transitioning from clinical practice into academia to help set realistic expectations about the nature and demands of the role. Method A systematic review and a cross-sectional survey exploring novice academics' experiences following a healthcare practitioner career. We used two validated measures; the Career Transition Inventory (CTI), the HEXACO personality trait measure and open questions (analysed thematically). A link to the questionnaire was sent to international networks of registered health and social care professional. Results We identified challenges around: lack of mentorship; lack of preparedness; balancing workload with teaching requirements and maintaining a work-life balance; building relationships, and career progression. Participants felt overwhelmed in the first year of academia but also reported positive findings around line manager support and validation of having made the right decision to move to an academic role, suggesting the transition to academia was a complex process, but that help was received when required. Discussion and conclusion A key limitation was that the majority of responses were from the UK. There is the potential to replicate more widely in the future. Novice practitioners that have transitioned from expert practitioners to novice academics need to be supported with robust mentorship, time to learn and develop as academics and to receive the practical and theoretical skills to become confident and accomplished teachers, scholars and academics. This study provides healthcare education providers with recommendations of strategies to consider when identifying how to prepare and support new academics

The state of mixed methods research in nursing: A focused mapping review and synthesis.

AIMS To consider the scope and quality of mixed methods research in nursing. DESIGN Focused mapping review and synthesis (FMRS). DATA SOURCES Five purposively selected journals: International Journal of Nursing Studies, Journal of Nursing Scholarship, Journal of Advanced Nursing, Worldviews on Evidence-Based Nursing, and Journal of Mixed Methods Research. REVIEW METHODS In the target journals, titles and abstracts from papers published between 2015-2018 were searched for the words or derivative words 'mixed methods'. Additional keyword searches were undertaken using each journal's search tool. We included studies that investigated nursing and reported to use a mixed methods approach. Articles that met the inclusion criteria were read in full and information was extracted onto a predetermined pro forma. Findings across journals were then synthesized to illustrate the current state of mixed methods research in nursing. RESULTS We located 34 articles that reported on mixed methods research, conducted across 18 countries. Articles differed significantly both within and across journals in terms of conformity to a mixed methods approach. We assessed the studies for the quality of their reporting as regard the use of mixed methods. Nineteen studies were rated as satisfactory or good, with 15 rated as poorly described. Primarily, a poor rating was due to the absence of stating an underpinning methodological approach to the study and/or limited detail of a crucial integration phase. CONCLUSIONS Our FMRS revealed a paucity of published mixed methods research in the journals selected. When they are published, there are limitations in the detail given to the underpinning methodological approach and theoretical explanation

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine