Nursing care behaviour in interprofessional learning explained by critical discourse analysis

Aim: to demonstrate Fairclough’s critical discourse analysis as a way to understand nurse caring behaviour in asynchronous text-based interprofessional online learning within higher education. Background: asynchronous text-based learning experience of homogeneous nursing groups indicated nurse caring behaviour in a small number of studies. However, positive findings were not found in studies about interprofessional learning undertaken by nurses. Instead, nurses’ dominance which might be a result of professional boundaries was frequently reported as a barrier to interprofessional education, yet little is understood about the phenomenon. Design: a study which employed Fairclough’s critical discourse analysis was used to understand the translation of nurse caring behaviour in text-based online interprofessional learning within higher education. Data Source: the asynchronous online discussions produced by thirteen students undertaking an online interprofessional learning module at master’s level in a University in the North of England were the discourse data for analysis. Findings: By using Fairclough’s critical discourse analysis, understanding of the semiotic categories corresponding to genres, discourses and styles yielded information on nurses’ discourse in online learning. Through appreciating the subliminal way in which these three categories relate to social practices and social events, the dialectical relations between semiosis of the online text and its other elements were made explicit. In doing so, the way nurse caring behaviour in interprofessional learning were translated in an asynchronous text-based learning environment was explained. Conclusions: Fairclough’s critical discourse analysis was useful in explaining how nurse caring attributes when displayed online could result in the interprofessional learning space being used as a platform for nurses and allied healthcare professionals to co-construct power-relations. The analysis required researchers’ tacit knowledge, based on an emic (insider) position in healthcare practice and education, which is closely linked to the power-relations that is entangled in the social order and practices in healthcare. This explains why researchers outside of critical discourse analytic work would hold a strong view for an etic (outsider) perspective in discourse analysis. In this regard, one should consider triangulating critical discourse methodology with other qualitative theoretical frameworks

Critical discourse analysis : an alternative but vital route to understanding how nurses' caring behaviour is translated in text-based interprofessional online learning in higher education

Paper presented at ProPEL international conference 2014, 24-27 June, Stirling, Scotland. ABSTRACT Aim: to demonstrate Fairclough’s critical discourse analysis as an alternative but vital route to the understanding of translation of nursing caring behaviour in asynchronous text-based interprofessional online learning within higher education. Background: Positive asynchronous text-based online learning experience indicating nursing caring behaviours were reported in only a small number of studies about homogeneous nursing groups. In addition, these positive findings seemed to be eroded by nurses’ dominance in interprofessional learning situations. The dominance which might be a result of professional boundaries is a critical barrier to interprofessional education, where little is yet understood about the phenomenon. Design: A study which employed Fairclough’s critical discourse analysis was used to seek understanding of the translation of nursing caring behaviour in text-based interprofessional online learning within higher education. Data Source: The main findings based on Fairclough’s critical discourse analysis of a text-based discussion is used to demonstrate the usefulness of the methodology. The asynchronous online discussions for analysis was produced by 9 students who were undertaking an interprofessional online learning module at master’s level in a University in North England Findings: By using Fairclough’s critical discourse analysis, understanding of the semiotic categories corresponding to genres, discourses and styles is gained. However, it is through appreciating on how these 3 categories relate to social practices and social events has helped in making explicit the dialectical relations between semiosis and its other elements. In doing so, how nurses’ caring behaviours in interprofessional learning were translated in an asynchronous text-based learning environment can be explained. Conclusions: Fairclough’s critical discourse analysis was useful in explaining how nursing caring attributes could result in the interprofessional learning space being used as an alternate platform for nurses and allied healthcare professionals to co-construct the power-relations. It is critical to appreciate that the analysis was based on the researcher’s emic position. Owing to the fact that tacit knowledge of the research in the power-relations which entangled in the social order and practices in healthcare is required in the analysis, the strength of an emic position could become a limitation. This is particularly perceived amongst researchers who hold a strong view for an etic perspective in discourse analytic work. In this regard, research exploring issues of interprofessional education should consider triangulating the critical discourse methodology with other qualitative theoretical frameworks

A Foucauldian analysis on the professionalisation effort of nursing in Singapore

Aim: A discussion using Foucault’s genealogical analysis to explain the professionalisation effort of nursing in Singapore. Background: Nursing in Singapore is strongly influenced by Western civilisation, however, the discipline may not have adopted similar responses to the world’s nursing professionalisation agenda as led by the West. An explanation on the ways nursing is spoken of and practiced in Singapore provides insights to the effects on nursing development in the country. Design: The discussion uses Foucault’s genealogy of power to draw on the practices of clinical nursing and nursing education in Singapore in an attempt to uncover the unorthodox professionalisation effort. Data Sources: The discussion is an outcome of a critical reflective observation made by the authors between 1993 and 2014. It is supported by related literature, critical debates amongst Singapore healthcare professionals, nurse lecturers and the Singapore locals. Implications for Nursing: Time and effort vested in overcoming medico-political dominance, should be used in the pursuit of high quality nursing clinical knowledge and acumen. Specialised nursing knowledge and autonomous practice should adopt an explicit focus in its mission to achieve the common good which is in favour of the public interest. Conclusions: While the hierarchical nursing structure was the foundation for professionalising nursing, nursing subservience was the gateway for advancing nursing in Singapore. Without generalising the positive effects of the power-relations in Singapore, nursing practice which reflected the ‘subservience in females’ and demonstrated respect for authority within a hierarchical system had evidently led to good quality nursing practices which serve as a strong foundation for nursing to secure professional recognition

A glimpse into nursing discursive behaviour in interprofessional online learning

Background: The importance of interprofessional learning to provide quality patient care has resulted in the increasing use of asynchronous computer mediated conferencing in healthcare programmes within universities. The asynchronicity based on typed-written discussions in a virtual learning environment which provided flexibility in learning was used to increase opportunities for nurses and other allied healthcare professionals to participate in interprofessional learning in higher education. However, successful online learning relies on discursive practices in the virtual learning environment, embedded within discursive exchanges in practice are power relations in nursing language use; which had a negative impact on interprofessional learning and working relationships amongst nurses, between nurses and other allied healthcare professionals. This paper presents an analysis of the discursive practices of registered nurses in interprofessional learning based on asynchronous computer mediated conferencing. It aimed to ascertain if power relations were implicit in nursing language. Methods: Fairclough’s critical discourse analysis was used to analyse eight hundred and ninety typewritten online messages created in a 100% text-based online learning module at Master’s level in a University in North England between September 2004 and September 2009. Although the messages were created by 9 registered nurses and 4 other allied healthcare professionals undertaking interprofessional learning to learn about the issues surrounding e-learning in healthcare settings, this paper is part of a larger study focused on the messages by the nurses. Results: Nurses’ messages tended to appear as the first few responses in the discussion threads and their language was formal and objectifying. The genres resembled those found either in written assignment within higher education or in nursing documentation within practice. The virtual learning environment was an alternative social space for clinical practice where dominance of nurses was created, maintained and reinforced. Conclusions: Existing literature highlighted the incidents of problematic issues of interprofessional learning. In contrast, this paper explains the way nurses, through discursive practices, construct themselves in relation to their nursing and allied healthcare colleagues. Nurses need to be aware of the power-relations embedded in their language use and future research could usefully focus on the discursive aspect of interprofessional learning

Caring behaviours of student nurses: Effects of pre-registration nursing education

In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice. The findings based on student surveys indicated a statistically significant reduction in the overall level of caring behaviour in first to final year students. When compared with the findings of lecturers and nurses, less variance to lecturers than to nurses was found amongst the first years' score, and the lowest variance to nurses was demonstrated amongst the final year. A greater reduction was evidenced amongst Singaporean students, which was exaggerated with exposure to pre-enrolled nursing education and magnified with caring job experience. This study indicates more effort is necessary to harness student caring attributes in students' entire educational journey so that expressive caring is not subsumed in the teaching of students to meet demands of complicated contemporary care

Study on Ferum (Fe) and Zinc (Zn) removal by using rice bran at Sungai Pelepah, Kota Tinggi, Johor

Water pollution due to heavy metals is currently occurring at Sungai Pelepah, Kota Tinggi. Adsorption method is one of the most low cost effective methods to overcome this pollution problem compared to the other available methods for example, duckweed, orange peels, tea leaves, coconut shell and many more in heavy metals removal. In this study, rice bran was used as a low cost adsorbent. Rice bran is the outer layer of a grain of rice. Rice bran is an agricultural waste material generated in rice producing during milling process. It is an economical product and could easily to be obtained. Therefore, three objectives were selected for this study which is to determine the possibility of using rice bran as an adsorbent in heavy metals removal, to determine the characteristics of rice bran as an adsorbent and to identi@ the water quality of Sungai Pelepah after the treatment. The water samples were collected at Sungai Pelepah and the rice bran was collected at rice-milling factory. Three batch reactors consist of Reactor A (water sample with common activated carbon as adsorbent), Reactor B (water sample with rice bran as adsorbent) and Reactor C (conk01 reactor). The batch reactors were conducted in the environmental laboratory, UTHM. As expected that rice bran could remove the heavy metals fiom the water sample as well as other adsorbents. The largest removal of Zinc (Zn) is 91.1% at 90 minutes and the largest Iron re) removal is 73.0% with duration 90 minutes. As a conclusion, rice bran could be one of the low cost and effective adsorbent to be used in large amount operation of water treatment

Embracing a culture in conducting research requires more than nurses' enthusiasm

Aims This study explored the perceptions of clinical nurses about their research knowledge and experiences to highlight any gaps in nurse education in supporting research activities in healthcare organisations. Background Nurses' research activities have been encouraged by moving hospital-based nurse education into higher education institutions whereby there is a stronger emphasis on teaching and developing nursing research at both undergraduate and post graduate levels. They were further encouraged by the introduction of advanced nurse practitioner roles, in the hope to increase opportunities for research participation. Whilst nurses' research activities have been explored in many countries, nurses in Singapore where there is a strong emphasis on evidence-based practice have not been investigated. Methods A mixed-methods exploratory descriptive design, using a questionnaire based on open and closed questions was employed to obtain the views of clinical nurses about their capacity and organisational support in conducting research. The questionnaires were distributed to convenient samples who attended one of the 4 research seminars held on separate occasions between July and August 2011 in Singapore. Results A total of 146 nurses were recruited. Whilst nurses demonstrated strong enthusiasm in conducting research, this characteristic feature was not adequate for them to embrace a research culture in organisations. Active participation as co-investigators was not possible in healthcare organisations where skewed distribution of resources towards medical and nurse researchers was perceived. Conclusions The results suggest a need for a significant shift in focus on educational training from imparting research contents to providing opportunities to experience the research process. Organisational support in terms of protected time and financial support ought to be in place for nursing research experience. The findings also demonstrated that in places where organisational support was available, awareness of research opportunities such as educational and organisational support needed to be strengthened. This in turn would enable more nurses particularly those who provide direct patient care to conduct research within the context of the competing nursing practice demands

Adaptive circular enclosure colour distribution geometrical model utilizing point-in-polygon for segregation between lips and skin pixels

This paper is inspired from various boundary determination techniques which are used for segregating colours between background, skin and lips. Basic concept for this technique is based on colour segmentation with CIELAB colourspace utilized for justifiable reasons. Using LAB colour-space, lips colours were compiled into a colour-map and processed accordingly to our proposed algorithm of adaptive circular enclosure. Algorithm output was determined as a series of coordinates symbolizing boundary values surrounding colourmap. Separation of colours is based on these boundaries by creating a freeform polygon that defines if colour-value either belongs within colour-boundary polygon or not. This technique is famously known as the point in-polygon technique. Proposed technique evaluation uses XM2VTS database based on false positive and false-negative to compute segmentation error. Simulation shows proposed algorithm yields segmented error of 5.55% with accuracy of 94.45%

Analysis of Automated Emergency Braking System to Investigate Forward Collision Condition Using Scenario-Based Virtual Assessment

In the recent trend of automotive technologies, active safety systems for vehicles have become one ofthe key elements to reduce road traffic conditions. Automated vehicles are known as one of the active safetysystems to minimize road traffic congestion and unwanted road hazardous situations. Generally, automatedvehicles are designed using advanced driving assistance system (ADAS) technology to enhance the safetycapability of the vehicles. Moreover, automated vehicles are designed to adopt multiple scenarios with differenttypes of traffic situations. Generally, the performance of automated vehicles is evaluated to adapt with various roadconditions and different type of traffic conditions, autonomously. Nonetheless, most of the safety testing wasconducted in a controlled environment and with less traffic conditions. Moreover, this technology is tested indeveloped countries and mostly evaluated for highway driving scenarios, with less pedestrians and motorist’s roadusers. On the other hand, in developing countries such as Malaysia, most of the automotive researchers haveinitiated research related to automated vehicle based on controlled environment only. One of the primary focusesfor the current automotive researchers is to reduce road accidents due to frontal collision. Thus, automatedemergency braking systems have been heavily investigated by most developers to minimize road accidents. Mostof the researchers analyze the system in terms of theoretical based simulation and tested using actual vehicle forphysical testing. However, this type of testing is not sufficient to optimize the performance of automatedemergency braking systems for developing countries. Therefore, this study focuses on scenario-based virtualassessment to evaluate the capability of autonomous vehicles using automated emergency braking system withoutcausing road casualties with the distance range is 4.5m to 0.5m depending on vehicle speed. &nbsp

Analysis of Automated Emergency Braking System to Investigate Forward Collision Condition Using Scenario-Based Virtual Assessment

In the recent trend of automotive technologies, active safety systems for vehicles have become one ofthe key elements to reduce road traffic conditions. Automated vehicles are known as one of the active safetysystems to minimize road traffic congestion and unwanted road hazardous situations. Generally, automatedvehicles are designed using advanced driving assistance system (ADAS) technology to enhance the safetycapability of the vehicles. Moreover, automated vehicles are designed to adopt multiple scenarios with differenttypes of traffic situations. Generally, the performance of automated vehicles is evaluated to adapt with various roadconditions and different type of traffic conditions, autonomously. Nonetheless, most of the safety testing wasconducted in a controlled environment and with less traffic conditions. Moreover, this technology is tested indeveloped countries and mostly evaluated for highway driving scenarios, with less pedestrians and motorist’s roadusers. On the other hand, in developing countries such as Malaysia, most of the automotive researchers haveinitiated research related to automated vehicle based on controlled environment only. One of the primary focusesfor the current automotive researchers is to reduce road accidents due to frontal collision. Thus, automatedemergency braking systems have been heavily investigated by most developers to minimize road accidents. Mostof the researchers analyze the system in terms of theoretical based simulation and tested using actual vehicle forphysical testing. However, this type of testing is not sufficient to optimize the performance of automatedemergency braking systems for developing countries. Therefore, this study focuses on scenario-based virtualassessment to evaluate the capability of autonomous vehicles using automated emergency braking system withoutcausing road casualties with the distance range is 4.5m to 0.5m depending on vehicle speed. &nbsp