The development of simulated learning environments involving coroner’s court attendance in mental health nursing education

Simulated learning environments (SLEs) provide students with the opportunity to experience complex practice elements with minimal professional risks. This article explores the development of an SLE in undergraduate mental health nursing education. The SLE focuses on events surrounding a client death and follows attendance at a coroner’s court. Student learning outcomes are focused on evaluating essential components of nursing care including communication, record-keeping, risk-taking and ethical decision-making. The SLE, which is now in its fourth iteration, allows educators to review and adapt the teaching practices to achieve the curriculum learning outcomes and encapsulate the Nursing and Midwifery Council’s Code. This article proposes future possibilities for the use of complex simulation dramas to enhance nursing student preparedness for registration

Realistic evaluation as both a science and as a methodology

This paper examines an increasingly used methodology developed by Pawson and Tilley (1997) that they termed, ‘Realistic Evaluation’. The paper provides an overview of methodology as well as exploring its underpinning philosophy, that of critical realism. The paper suggests that Realistic Evaluation provides a useful means of exploring the health and social sciences through the use of mixed methods and concludes with how a researcher might go about constructing a Realist Evaluation study

Conscientious objection – does it also apply to nursing students?

The conscientious clause in nursing can be defined as a kind of special ethical and legal regulation which gives nurses right to object to actively perform certain medical procedures which are against their personal system of values. Usually these values are associated with nurses’ religious beliefs, but not always. Scope of this regulation differs throughout the world. However, it is emphasized that right to the conscientious objection is not absolute and this regulation can not be used in cases of danger to life or serious damage to the health of the patient. Medical procedures to which nurses hold conscientious objection are often within reproductive health services. However, we can also find reports on the use of this right i.e. in end-of-life care and in the process of the implementation of medical experiments. The main issue underlined in the discussion regarding practising conscientious objection in the clinical setting is the collision of two human rights: the right to conscientious objection of medical personnel and the right of patients to specific medical procedures which are legal in their country. If a procedure is legally available in a country it means that patients can expect to receive it, on the other hand, all citizens, including health care workers, have the right to protect their moral identity and the right to object to the implementation of a procedure to which they have a specific objection. It is very difficult to find good ethical and legal balance between these two perspectives

Academic careers: the value of individual mentorship on research career progression

The paper discusses how individual mentoring may impact positively on career pathway development for potential and future clinical academic researchers in nursing and allied health professions. Methods: The paper draws on a number of data sources and methodologies in order to fulfil the aims. Firstly, international literature provides an insight into mentoring processes and impact on career development. This is followed by a review of the mentoring experiences based on a UK study on the professorial populations in nursing and allied health professions. The final section reports on results of interviews with early and advanced researchers on their experiences of mentoring. Results: Individual mentoring is valued highly by health care professionals at all stages of career development. It is considered particularly useful when people are in transition towards a more challenging career role.Individuals in receipt of mentoring both formal and informal, report improved confidence in their cability to achieve their career goals. Mentees report improved levels of competence achieved through knowledge aquisition, networking and ability to probelm solve. Conclusions/Summary: Mentoring is considered an important process for health care professionals at all stages of their career. Opportunities to access and receive mentoring support for health care staff in the UK remain limited and sporadic in nature. There are examples of excellent mentoring schemes in place within some institutons and organisations but a national strategy to support mentoring has yet to be developed Key words: Clinical academic careers, mentoring, nursing, allied health profession

The use of information and communication technologies in mental health nursing

Information and communication technologies (ICTs) are part of everyday nursing practice. They are routinely used to store patient data and provide the foundation by which teams and health professionals communicate (e.g. mental health nurses use email as part of their daily practice). This paper discusses the use of ICTs by mental health nurses and their impact on mental health nursing practice. While some benefits of ICTs—information management, access to health services, quality improvement and cost containment—are well documented, others have yet to be fully realised. The paper looks at the possible reasons for this and examines why mental health nurses should concern themselves with this technological revolution

'Their story is a hard road to hoe': how art-making tackles stigma and builds well-being in young people living regionally

Purpose Remote and regional Australia have comparatively fewer mental health services than their urban counterparts, what is more, mental health remains profoundly stigmatised. This study aims to understand how, if at all, the process of group art-making then publicly displaying the artworks can contribute to stigma reduction for young people (YP) experiencing mental health challenges in regional Australia. Design/methodology/approach Interviews were conducted with six young artists who use regional mental health services and 25 people who viewed their displayed art using a thematic analysis of the coded interview data. Findings Findings of this study demonstrated how art-making as a process increased self-esteem, social interaction and artistic expression; while the viewers experienced an emotional connection to the art. The viewer’s response enhanced YP’s confidence in their abilities. Originality/value Incorporating art-making and exhibiting the art in public spaces could be incorporated into YP’s mental health services to support well-being and inform the perception the general public hold of mental health, thus reducing stigma

A realistic evaluation of two aggression management training programmes

Whilst the training of healthcare staff is seen as a key element to the prevention and management of violence and aggression, questions remain as to the effectiveness of these programmes in preparing staff to apply this to clinical practice. To date there is a relative paucity of well-designed studies into the effectiveness of the training to prevent and manage violence and aggression in healthcare settings. Within this context a study was conceived to examine the effectiveness of two aggression management training programmes in preparing staff for clinical practice. In order to provide a meaningful and evidence-based evaluation of the two programmes, Pawson and Tilley's Realistic Evaluation model was adopted for use in this study. In keeping with the chosen methodology, data was collected using a combination of methods including surveys, semi-structured interviews, and participant observation of training. A total of 64 participants were eligible for inclusion in the study; which ran over the course of a calendar year. The research highlighted that training should have relevance to the staff group undergoing instruction. That training should be conducted wherever possible in staff groups, tackling real problems, with participants reflecting and learning from their experience and from each other. It should also provide measures of competency that describe both workplace and organisational outcomes and describe the requirements of assessment. That training should be engaging and integrate decision-making, planning, organization and skill building and cover a range of interventions. Most importantly, was the need to help staff transfer what they had learnt as part of training to clinical practice. These factors are brought together in a model of training devised as part of this study called the PROMPTS Aggression Management Training Model ©. As the first study to apply realistic evaluation in aggression management research, it was a good fit, particularly given the growing emphasis on understanding how context influences evidence-based practice. The strengths and limitations of the approach are considered, including how to operationalize it. This approach provided a useful interpretive framework with which to make sense of the multiple factors that were simultaneously at play and being observed through various data sources, and for developing explanatory theory about aggression management training and its implementation in practice

A realistic evaluation of two aggression management training programmes

Whilst the training of healthcare staff is seen as a key element to the prevention and management of violence and aggression, questions remain as to the effectiveness of these programmes in preparing staff to apply this to clinical practice. To date there is a relative paucity of well-designed studies into the effectiveness of the training to prevent and manage violence and aggression in healthcare settings. Within this context a study was conceived to examine the effectiveness of two aggression management training programmes in preparing staff for clinical practice. In order to provide a meaningful and evidence-based evaluation of the two programmes, Pawson and Tilley's Realistic Evaluation model was adopted for use in this study. In keeping with the chosen methodology, data was collected using a combination of methods including surveys, semi-structured interviews, and participant observation of training. A total of 64 participants were eligible for inclusion in the study; which ran over the course of a calendar year. The research highlighted that training should have relevance to the staff group undergoing instruction. That training should be conducted wherever possible in staff groups, tackling real problems, with participants reflecting and learning from their experience and from each other. It should also provide measures of competency that describe both workplace and organisational outcomes and describe the requirements of assessment. That training should be engaging and integrate decision-making, planning, organization and skill building and cover a range of interventions. Most importantly, was the need to help staff transfer what they had learnt as part of training to clinical practice. These factors are brought together in a model of training devised as part of this study called the PROMPTS Aggression Management Training Model ©. As the first study to apply realistic evaluation in aggression management research, it was a good fit, particularly given the growing emphasis on understanding how context influences evidence-based practice. The strengths and limitations of the approach are considered, including how to operationalize it. This approach provided a useful interpretive framework with which to make sense of the multiple factors that were simultaneously at play and being observed through various data sources, and for developing explanatory theory about aggression management training and its implementation in practice

Constructing a middle-range theory to explain the uptake of hepatitis C tests in prison

BACKGROUND: Realist evaluation is increasingly used in healthcare research, and theories can provide plausible explanations of why interventions work or do not work in certain circumstances such as the effect of the opt-out hepatitis C virus (HCV) testing policy in English prisons. AIM: To present the process of constructing the middle-range theories (MRTs) developed as part of an evaluation of hepatitis C test uptake in an English prison as a resource for researchers using realist evaluation. DISCUSSION: MRTs are propositions that can explain a particular behaviour or outcome. In this evaluation, the MRTs emerged from a realist evaluation, a theory-driven approach for understanding what interventions work, in what circumstances and how. The mixed-methods data collected during the realist evaluation and the sociological theory of prisonisation were used to create the MRTs. Combining prisonisation with the qualitative data illustrates how healthcare interventions may be viewed by people in prison who may have adopted either the 'deprivation' or 'importation' processes of adaptation to cope with their incarceration. Their views may affect the acceptance of HCV tests. CONCLUSION: The development of MRTs is a creative and iterative process, requiring an in-depth understanding of the data collected and the subject area. MRTs permit us to see relationships among phenomena that might otherwise seem disconnected, thereby aiding the development of more efficacious interventions. IMPLICATIONS FOR PRACTICE: The MRT developed presents an evidence base for selecting interventions to increase the uptake of HCV tests in prisons. This paper explains how a MRT was developed and how HCV test uptake in prisons can be explained using a sociological theory