Vocation, friendship and resilience: a study exploring nursing student and staff views on retention and attrition.

INTRODUCTION: There is international concern about retention of student nurses on undergraduate programmes. United Kingdom Higher Education Institutions are monitored on their attrition statistics and can be penalised financially, so they have an incentive to help students remain on their programmes beyond their moral duty to ensure students receive the best possible educational experience. AIMS: to understand students' and staff concerns about programmes and placements as part of developing our retention strategies. DESIGN: This study reports qualitative data on retention and attrition collected as part of an action research study. SETTING: One University School of Nursing and Midwifery in the South West of England. PARTICIPANTS: Staff, current third year and ex-student nurses from the adult field. METHODS: Data were collected in focus groups, both face-to face and virtual, and individual telephone interviews. These were transcribed and subjected to qualitative content analysis. RESULTS: FOUR THEMES EMERGED: Academic support, Placements and mentors, Stresses and the reality of nursing life, and Dreams for a better programme. CONCLUSIONS: The themes Academic support, Placements and mentors and Stresses and the reality of nursing life, resonate with international literature. Dreams for a better programme included smaller group learning. Vocation, friendship and resilience seem instrumental in retaining students, and Higher Education Institutions should work to facilitate these. 'Vocation' has been overlooked in the retention discussions, and working more actively to foster vocation and belongingness could be important

A Blended Approach to Evidence Learning in Professional Practice

Research and e-learning both need to have real-life usability in order to be of benefit. This paper analyses the journey followed as an electronic portfolio was introduced into the midwifery programme at a University in the United Kingdom. Underpinning this innovation were key findings from the literature and an ongoing study exploring "Assessment of Practice". Due to a number of curricular changes required by the authors' institution and the professional body, the decision was made to incorporate these - together with current evidence - into a blended portfolio for use by undergraduate midwifery students. The part-electronic, part-paper portfolio enables students to demonstrate the individual range of their practice learning activities and professional development, resulting in them being able to provide evidence of their competence prior to professional registration. The flexibility offered by the e-portfolio system empowers the learner and promotes autonomy in the gathering of their evidence, which they demonstrate through a system of hyperlinks. Clarity and consistency of multimedia guidance and facilities for regular feedback on progress are key features of the new electronic portfolio. The results of a set of longitudinal case-studies which are currently nearing an end at the Centre for Excellence in Professional Placement Learning had a major influence on the development of the blended portfolio. Student perceptions of the validity and reliability of the various practice assessment methods used in Midwifery, Social Work and Post-registration Health Studies in the University as well as the impact of the practice assessment process on their learning have been explored. Significant findings have emerged from this research with regard to the strengths and weaknesses of portfolios. The importance of students understanding the purpose of practice assessment as well as recognising its contribution to their learning and development has also been highlighted. In line with the authors' focus on producing an evidence-based innovation, a pilot was undertaken of the blended portfolio, in which students with a range of IT (information technology) and learning styles were invited to experiment with the new format. Following the successful outcome of the pilot, the portfolio has recently been rolled out to midwifery students and the mentors who support them in their practice placements. The e-portfolio has been show-cased in the wider University, and a number of health and social work colleagues are keen to incorporate a similar assessment method into their programmes. It is considered that the principles of the blended portfolio and other findings from the research will be of interest to a range of other professions which have a practice component, and would be transferable across international boundaries

Effectiveness of manual therapies: the UK evidence report

<p>Abstract</p> <p>Background</p> <p>The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.</p> <p>Methods</p> <p>The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.</p> <p>Results</p> <p>By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.</p> <p>Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments.</p> <p>Conclusions</p> <p>Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.</p> <p>Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.</p

Developing student nurse retention using action research

Aims of project: to understand students’ and staff concerns about this pre-registration nurse education programme and placements as part of developing our retention strategies. There is international concern about retention of student nurses on undergraduate programmes. United Kingdom Higher Education Institutions are monitored on their attrition statistics and can be penalised financially, so they have an incentive to help students remain on their programmes. Moreover, it is incumbent on healthcare education providers to ensure that students receive the best possible educational experience whilst they are studying for their professional qualifications. It is in this context that we designed our study to investigate the issues facing our students, how we could better foster a sense of belonging and suggest what we could do to alleviate their concerns and help them to stay.TFA

Learning and performing care management: experiences of a newly formed interdisciplinary, assessment and rehabilitation team

Developments in primary and intermediate care services have enhanced interest in the notion of care management, the processes that it encompasses and the challenges that it poses to practitioners who are more used to working in a uni- or multidisciplinary manner. This article explores the way that a set of practitioners, new to care management, coped with the challenges of working within a newly created care-managed assessment and rehabilitation service for older people in one UK county. Data were gathered via non-participant observation, and group and individual interviews, as part of a wider action-research evaluation study. Three themes emerged from the data: the processes of ‘learning’ to become a care manager; ‘doing’ care management; and ‘experiences’ of the role. In order to ‘learn’ care management, staff needed to develop a range of new skills, establish supportive care-management processes, develop a new identity and work in an interdisciplinary way. ‘Doing’ care management involved working with a small group of patients with complex needs and precarious levels of homeostasis. Problem solving and crisis management were key activities and often required a creative approach to practice. Although care managers derived great satisfaction from their role, their ‘experiences’ were characterized by stress and anxiety. The practitioners from healthcare backgrounds needed more preparation to adapt to their new levels of responsibility and client risk. Successful management of the transition to care manager requires support from the key stakeholders and strong leadership within care manager teams. In-house competency-based training and induction programmes, and mentorship, can also play an important role, together with innovative forms of postqualifying education and training, for example, via job exchanges or an apprenticeship model