The Irish Carnegie Community Engagement Classification Pilot: A critical analysis on culture and context from a community of practice approach

This article provides a reflective critique of the process undertaken to pilot the Carnegie Community Engagement Framework in Ireland between 2015 and 2016. Of particular interest to the authors is the cultural specificity of employing a US-centric self-assessment data capturing tool in a heterogeneous Irish context. Taking the reader through from conception of the idea to its execution and post-pilot reflections, we examine the cultural appropriateness and translatability of the tool to Irish higher education. To frame the discussion of the process, we employ the concept of a community of practice, as defined by Wenger (1998). This was adopted to promote a culture of collaboration in an ever-growing neoliberal system that promotes competition between institutions, rather than facilitating their co-construction of knowledge. In the analysis, we demonstrate how forming this community of practice allowed for a cohesive assessment of the challenges and opportunities that arose through the pilot process. This was particularly important since each participating institution had different motivations for engaging with the pilot. Reflecting with some distance, we consider the value that comes from operating as a community of practice, as well as some shortcomings that we identified as specific to this pilot

Experiences of undergraduate nursing students who worked clinically during the COVID‐19 pandemic

Abstract Aim This study explored the experiences of undergraduate nursing students who worked clinically during the COVID‐19 pandemic in Irish healthcare settings. Design A qualitative descriptive approach was employed. Methods Online focus group interviews were used to collect data from general nursing students (N = 47) between February and April 2021. Data were analysed using thematic analysis. Results Descriptive thematic analysis of the data revealed five themes; changes in care delivery, changes in communication and relationships with the patient, an emotionally charged work atmosphere, coping strategies during the pandemic and student learning specific to COVID‐19. Challenges such as an increased workload, fear of contracting the virus and taking on novel and additional roles were revealed. Students remained undeterred, and despite the many challenges faced, they largely viewed their experiences as a source of personal and professional growth, and benefitted from the learning opportunities afforded to them

Prospective in-patient cohort study of moves between levels of therapeutic security: the DUNDRUM-1 triage security, DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales and the HCR-20

<p>Abstract</p> <p>Background</p> <p>We examined whether new structured professional judgment instruments for assessing need for therapeutic security, treatment completion and recovery in forensic settings were related to moves from higher to lower levels of therapeutic security and added anything to assessment of risk.</p> <p>Methods</p> <p>This was a prospective naturalistic twelve month observational study of a cohort of patients in a forensic hospital placed according to their need for therapeutic security along a pathway of moves from high to progressively less secure units in preparation for discharge. Patients were assessed using the DUNDRUM-1 triage security scale, the DUNDRUM-3 programme completion scale and the DUNDRUM-4 recovery scale and assessments of risk of violence, self harm and suicide, symptom severity and global function. Patients were subsequently observed for positive moves to less secure units and negative moves to more secure units.</p> <p>Results</p> <p>There were 86 male patients at baseline with mean follow-up 0.9 years, 11 positive and 9 negative moves. For positive moves, logistic regression indicated that along with location at baseline, the DUNDRUM-1, HCR-20 dynamic and PANSS general symptom scores were associated with subsequent positive moves. The receiver operating characteristic was significant for the DUNDRUM-1 while ANOVA co-varying for both location at baseline and HCR-20 dynamic score was significant for DUNDRUM-1. For negative moves, logistic regression showed DUNDRUM-1 and HCR-20 dynamic scores were associated with subsequent negative moves, along with DUNDRUM-3 and PANSS negative symptoms in some models. The receiver operating characteristic was significant for the DUNDRUM-4 recovery and HCR-20 dynamic scores with DUNDRUM-1, DUNDRUM-3, PANSS general and GAF marginal. ANOVA co-varying for both location at baseline and HCR-20 dynamic scores showed only DUNDRUM-1 and PANSS negative symptoms associated with subsequent negative moves.</p> <p>Conclusions</p> <p>Clinicians appear to decide moves based on combinations of current and imminent (dynamic) risk measured by HCR-20 dynamic score and historical seriousness of risk as measured by need for therapeutic security (DUNDRUM-1) in keeping with Scott's formulation of risk and seriousness. The DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales have utility as dynamic measures that can off-set perceived 'dangerousness'.</p