Are women nursing academics represented in university leadership positions?

The nursing workforce constitutes the largest professional health workforce in Australia. Nursing is traditionally a female dominated profession. This study reviewed Australian universities that provide entry to practice nursing education. The study identified the distribution of females and males in leadership in nursing education, the positioning of the discipline in the university, and where nurses occupy leadership roles above the nursing discipline (faculty/college). Of the 37 universities that offered entry to practice nursing, more females were evident. However, more men were evident in academia than the proportion of men in nursing outside of the academic setting. Leadership nomenclature varied within each nursing discipline group reviewed. This study demonstrated that the number of nursing academics has decreased since the late 1990’s. The nursing workforce is still a significant contributor to the academic workforce and yet numbers of nurse academics working in roles senior to their discipline were few. This paper discusses how the nursing workforce as predominantly female, has implications to both females and males, and may impact opportunities for leadership and promotion to senior roles

Do commencing nursing and paramedicine students differ in interprofessional learning and practice attitudes: evaluating course, socio-demographic and individual personality effects

Background Interprofessional education (IPE) requires health students to learn with, from and about each other in order to develop a modern workforce with client-centred care at its core. Despite the client centred focus of IPE, training programs often utilize standard approaches across student cohorts without consideration of discipline, sociodemographic and personality variability that attract students to different health disciplines. Knowing the students who engage in IPE to tailor training may prove as beneficial as knowing the client to delivered individualized client centred care in interprofessional practice (IPP). This research investigates whether students commencing undergraduate nursing and paramedicine degrees ener training with existing demographic and personality differences and, if these are associated with different attitudes towards health care teams and interprofessional education. Method This online study recruited 160 nursing and 50 paramedicine students in their first week of their undergraduate course. Students completed questionnaires regarding their background, personality (General Perceived Self Esteem Scale, International Mini Markers) and the attitudes towards health care teams scale (ATHCTS) and interprofessional education perception scale (IEPS). Results Results show that commencing nursing and paramedicine students are demographically different on education, gender, speaking a language other than English at home (LOTE) and their own experience with healthcare. The results further demonstrate that LOTE, discipline being studied and personality factors play a role in perceptions regarding interprofessional training whilst discipline being studied impacted on attitudes towards health care teams in the workforce. Conclusion These results highlight a number of existing personal and psychological differences between individuals who choose to train in these selected professions. This suggests a need for tertiary education IPE programs to move towards tailoring their education to value this student diversity in the same client centred manner that students are asked to develop clinically

Cultural respect encompassing simulation training: being heard about health through broadband

BACKGROUND: Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity - defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire - of the streamed simulations. DESIGN AND METHODS: In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. RESULTS: Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P<0.05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. CONCLUSIONS: Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals\u27 learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training. Significance for public healthThere are significant health inequalities for migrant populations. They commonly have poorer access to health services and poorer health outcomes than the Australian-born population. The factors are multiple, complex and include language and cultural barriers. To address these disparities, culturally competent patient-centred care is increasingly recognised to be critical to improving care quality, patient satisfaction, patient compliance and patient outcomes. Yet there is a lack of quality in the teaching and learning of cultural competence in healthcare education curricula, particularly in rural settings where qualified trainers and resources can be limited. The Cultural Respect Encompassing Simulation Training (CREST) program offers opportunities to health professional students and practitioners to learn and develop communication skills with professionally trained culturally and linguistically diverse simulated patients who contribute their experiences and health perspectives. It has already been shown to contribute to health professionals\u27 learning and is effective in improving cultural competency in urban settings. This study demonstrates that CREST when delivered via live video-streaming and simulation can achieve similar results in rural settings

Cultural respect encompassing simulation training: being heard about health through broadband

Background. Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity – defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire – of the streamed simulations. Design and Methods. In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. Results. Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P<0.05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. Conclusions. Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals’ learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training

Culturally and Linguistically Diverse Simulated Patients: Otherness and Intersectional Identity Transformations Revealed Through Narrative

Simulation aims to replicate the important aspects of a situation to aid learning. Simulated patients (SPs) should ideally represent the diversity of patients encountered in clinical practice. Culturally and Linguistically Diverse (CALD) people are underrepresented in simulated patient groups in comparison to population demographics. Little is known about CALD SPs. The research aim was to explore the experience of CALD people who have worked as simulated patients. The methodology is narrative. In accordance with the intention to reveal values, beliefs and actions embedded in a particular context, participant stories were explored to reveal rich and meaning-making content. This approach offered motivations, rationales and driving emotions rather than outcomes. Participant stories were developed preserving the coherence of their account using a modified version of Emden’s (1998b) process. The theoretical framework of intersectionality was used as this supported the complexity of individual identities whilst reflecting contexts and cultures. Using an interpretive scheme of significance, value and intention a thematic analysis was undertaken. This analysis was intensified through intersectional analysis. Five themes and four intersectional identity groups emerged. The five themes: The SP experience, The SP imperative, Otherness, Learning and Identity emerged. These themes encapsulate the changing selves of the SP through their life journeys and more poignantly their simulated journeys. The four intersectional identity groups: shielding emotion, taming stigma, influencing image and overcoming ignorance represented the dynamic way the SPs identities were represented to themselves as well as to others through simulation. A CALD SP model named “BLOSSOM” was developed that demonstrates the movement of identity through simulation akin to the liminal processes described by van Gennep and modified by Turner (1987). The model is crosscut by intersectionality and the pluralism of otherness. The outcomes of this model have implications for the recruitment, retention and simulation scenario development incorporating CALD SPs and form the basis for the recommendations

Making the most of simulated learning: Understanding and managing perceptions

AbstractIncreased emphasis on the use of simulation by nursing education providers is evident world-wide. It is unclear what the implications of this initiative are for academic staff within nursing programs. Programs report a range of responses to simulation pedagogy amongst faculty ranging from enthusiasm to avoidance. This study identified a wide range of concerns encapsulating the staff themselves, their concern for students as well as organisational considerations that impact staff perceptions.</jats:p

The Culturally and Linguistically Diverse SPs' Evaluation of Simulation Experience

Background: Increasing diversity of populations worldwide emphasizes the need for culturally appropriate communication that addresses the needs of health care consumer and provider. While cultural competency training using simulation is reported, the prevalence is low and only a few studies include simulated patients. Often these studies report small-scale interventions involving one or two simulated patients. The Cultural Respect Encompassing Simulation Training (CREST) program aimed to develop cultural communication education using simulation with simulated patients. The program funded by the Commonwealth Government of Australia recruited and trained 30 culturally and linguistically diverse simulated patients. Aim: This research, part of a larger study, aimed to evaluate the learning, training and teaching experience of the culturally and linguistically diverse (CALD) simulated patients in the CREST project. Methods: Thirty simulated patients differentiated by age, gender, ethnicity, religion, sexual orientation, and arrival mechanism to Australia were recruited and trained. Through a co-construction process simulation scenarios were developed with the SP. Simulations were undertaken with entry to practice students across the disciplines of nursing, medicine, paramedicine, physiotherapy and social work as well as with practitioners from a range of health disciplines. Results: Evaluation data included a 14-item survey completed after simulation experiences assessing aspects of pre-simulation, simulation and post-simulation experience using a 5-point Likert scale. A focus group discussion centered on the SP experience and was thematically analyzed. Conclusion: SPs felt well prepared for simulation experience and were grateful for the opportunity to participate. The rehearsal held prior to each SPs portrayal was identified as particularly important and useful. SPs were surprised and pleased to find the simulation participants interested and engaged with them focusing on issues of their culture and ethnicity. This was contrary to many of the real experiences SPs had encountered and these earlier experiences influenced both their desire to participate as SPs and their expectations. Portraying safe but authentic content was positive and empowering for CALD SPs