The influence of portfolio aims and structure on student attitudes towards portfolios as a learning tool: A Scoping Review

Background: Portfolios are widely used in undergraduate health professional education, however the majority of literature suggests that these are poorly received by students, in terms of being an effective learning tool. Objectives: to evaluate whether the aims/purpose or structure/level of standardisation/content of student portfolios influences their attitudes to and perceptions of its use as a learning tool. Major Findings: Aims/purpose and structure/level of standardisation/content of portfolios were analysed in relation to student responses in order to determine any relationship between these. The level of information provided in the studies was variable, making analysis difficult, however there appeared to be no clear link between any of these factors and student responses. The interplay of level of support and guidance, the time required for completion of the portfolio, and the role of assessment appear to have the greatest influence on student views. Conclusions: Considering the wide use of portfolios in health professional education, student support for these is limited, and further research is required to determine if alternative approaches to portfolio learning can positively influence student attitudes and perceptions

Obtaining information from family caregivers to inform hospital care for people with dementia: A pilot study

Aim: We aimed to implement a systematic nurse–caregiver conversation, examining fidelity, dose and reach of implementation; how implementation strategies worked; and feasibility and mechanisms of the practice change. Background: Appropriate hospital care for people living with dementia may draw upon: information from the patient and family caregiver about the patient's perspective, preferences and usual support needs; nursing expertise; and opportunities the nurse has to share information with the care team. Within this context, planned nurse–caregiver communication merits further investigation. Methods: In Phase I, we established the ward staff's knowledge of dementia and Alzheimer's disease, prepared seven nurse change leaders, finalised the planned practice change and developed implementation plans. In Phase II, we prepared the ward staff during education sessions and leaders supported implementation. In Phase III, evaluations were informed by interviews with change leaders, follow-up measures of staff knowledge and a nurse focus group. Qualitative data were thematically analysed. Statistical analyses compared nurses’ knowledge over time. Results: Planned practice change included nurses providing information packs to caregivers, then engaging in, and documenting, a systematic conversation. From 32 caregivers, 15 received information packs, five conversations were initiated, and one was completed. Knowledge of dementia and Alzheimer's disease improved significantly in change leaders (n = 7) and other nurses (n = 17). Three change leaders were interviewed, and six other nurses contributed focus group data. These leaders reported feeling motivated and suitably prepared. Both nurses and leaders recognised potential benefits from the planned conversation but viewed it as too time-consuming to be feasible. Conclusions: The communication initiative and implementation strategies require further tailoring to the clinical setting. A caregiver communication tool may be a helpful adjunct to the conversation. Implementation may be enhanced by more robust stakeholder engagement, change leader inclusion in the reference group and an overarching supportive framework within which change leaders can operate more effectively. Implications for Practice: Nurse-caregiver communication in this context requires inititatives tailored to the clinical setting with input from all stakeholders

Exposure to traumatic perinatal experiences and posttraumatic stress symptoms in midwives: Prevalence and association with burnout

Background: Midwives provide care in a context where life threatening or stressful events can occur. Little is known about their experiences of traumatic events or the implications for psychological health of this workforce. Objectives: To investigate midwives’ experiences of traumatic perinatal events encountered whilst providing care to women, and to consider potential implications. Design: A national postal survey of UK midwives was conducted. Participants: 421 midwives with experience of a perinatal event involving a perceived risk to the mother or baby which elicited feelings of fear, helplessness or horror (in the midwife) completed scales assessing posttraumatic stress symptoms, worldview beliefs and burnout. Results: 33% of midwives within this sample were experiencing symptoms commensurate with clinical posttraumatic stress disorder. Empathy and previous trauma exposure (personal and whilst providing care to women) were associated with more severe posttraumatic stress responses. However, predictive utility was limited, indicating a need to consider additional aspects increasing vulnerability. Symptoms of posttraumatic stress were associated with negative worldview beliefs and two domains of burnout. Conclusions: Midwives may experience aspects of their work as traumatic and, as a consequence, experience posttraumatic stress symptomatology at clinical levels. This holds important implications for both midwives’ personal and professional wellbeing and the wellbeing of the workforce, in addition to other maternity professionals with similar roles and responsibilities. Organisational strategies are required to prepare midwives for such exposure, support midwives following traumatic perinatal events and provide effective intervention for those with significant symptoms