Promoting a Culture of Civility Among Oncology Nurses in the Ambulatory Care Setting to Improve Patient Safety and Nurse Retention

INTRODUCTION: Nurse incivility is a well-documented phenomenon discussed in the literature and woven into the nursing lexicon. Nurse incivility results in negative consequences for nurses, patients and organizations. Adding to its complexity is the fact that nurses may be unable to identify and address covert uncivil behaviors and lack an effective tactic to mitigate situations. AVAILABLE KNOWLEDGE: The nursing literature describes the existence of nurse-to-nurse incivility and its correlation with negative outcomes. Regulatory bodies such as The Joint Commission (TJC) also recognize the adverse outcomes resulting from civility and issued two alerts addressing workplace behavior. Additionally, the American Nurses Association (ANA) (2015) added their weight to the issue and clearly described expectations of professional behavior. METHODS: Ambulatory oncology nurses were invited to participate in the study. The Qualtrics software platform supported the pre-test, Short Negative Acts Survey (S-NAQ), educational module and post-test. T-tests compared pre-test and post-test results and responses from Magnet/Pathway to Excellence versus non-Magnet/Pathway to Excellence employed nurses. INTERVENTION: Participants accessed Qualtrics via an electronic device. Following completion of the initial elements, participants read two clinical vignettes illustrating the evidence-based cognitive rehearsal technique known as “I” message and completed a post-test. RESULTS: Twenty-one ambulatory oncology nurses completed the Qualtrics module and the data demonstrate that nurses gained an understanding of incivility. The module length was modeled after Qualtrics metrics that facilitate maximum participation and completion. CONCLUSIONS: For approximately half of the participants, cognitive rehearsal was new information. Pre-test and post-test results indicate that participants acquired new understanding of this evidence-based practice. According the S-NAQ results, participants reported a lower frequency of negative acts as compared to the literature

US foreign policy and national development in the Caribbean, 1960-1976

The Caribbean has long been an area of intense US interest and activity. Yet at the same time, the United States has failed to articulate a distinctive Caribbean policy, separate from its policy towards Latin America. In part, this failure has resulted from the practical difficulty of determining a definition of "the Caribbean" - US policies towards the different countries within the Caribbean region have varied according to time and perspective.This thesis attempts to determine the exact nature of United States foreign policy towards the Caribbean during the period 1960 to 1976. It starts from the assumption that the Caribbean has been included within US-Latin American policy in the articulation of policy statements and objectives, but that US policy has differed in terms of both its implementation and impact on Caribbean countries. US foreign policy is, therefore, examined from a liberal-democratic perspective in terms of the distinction between national interest and development objectives and policy actions, looking at their impact on the Caribbean national development process - in particular, on economic and political development. In attempting to assess the coherence of US policy, the differences within US policy are examined with respect to two sub-groups in the Caribbean - the English speaking and the Spanish speaking countries.Three specific areas of US policy are examined: first, security policy - looking at both hemispheric defence and internal security policy, military and police assistance programmes; second, economic policy - looking at development assistance, regional integration, private investment, trade and migration; and third, diplomatic policy - looking at US policy towards dependent countries, trades unions, political parties, human rights and different forms of government. The continuity of US policy is assessed by comparing the Democratic presidencies of Kennedy and Johnson with the Republican administrations of Nixon and Ford, and the key feature of US-Caribbean policy - the primacy of security interests - is finally distinguished

Work of the NHS England Youth Forum and its effect on health services.

©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.AIM: To examine the role of members of the NHS England Youth Forum (NHSEYF) and the strategies used to influence health service provision for children and young people. METHOD: An evaluative mixed-methods study was commissioned by NHS England and undertaken by the University of Hertfordshire between July 2015 and September 2016. Data collection comprised activity logs, a form of questionnaire, and semi-structured interviews. FINDINGS: The analysis of the activity logs revealed that the young people were undertaking a wide range of activities across England. Seven themes emerged from the interviews: the young people; motivation; commitment; community (the local area as well as a community spirit); knowledge experts; youth workers; and funding. In summary, the members of the NHSEYF were committed to their role and their work was having a positive effect on health service provision. CONCLUSION: The NHSEYF has developed rapidly and successfully. It is enabling the voice of young people to be heard.Peer reviewedFinal Published versio

Developing student questioning when problem solving: the role of sample student responses

This paper describes intervention resources designed to provide opportunities for student self-regulation, with a particular focus on setting subgoals when problem solving. Each task includes a range of pre-written interrelated “sample student responses” that expose students to multiple perspectives on an unstructured non-routine problem. After students attempt the problem they are given the responses to collaboratively complete, critique and compare. We explore students’ capacity to adopt another person’s (the sample student’s) goals in order to complete a solution, and their capacity, through the use of comparison, to identify worthy criteria when critiquing the completed solutions. We then reflect on how we can make subsequent improvements to the resources

Can designed student responses support teachers to interact with students in a productive way?

This paper introduces the use of pre-designed student responses to unstructured mathematics problems as a possible resource for teachers to develop their capacity of acting contingently in the mathematics classroom in a productive way, whilst teaching. We frame our argument around the notion that contingent moments can be regarded as problem-situations that are, at times, too demanding for the teacher to effectively solve. We provide an unstructured mathematics problem and accompanying designed student responses to illustrate and explain our thinking, considering how this approach has the potential to help teachers flexibly and productively engage with students’ reasoning in-the-moment of instruction. We end the paper with a call for empirical studies to explore these ideas further

Developing students’ strategies for problem solving in mathematics: the role of pre-designed “sample student work”

This paper describes a design strategy that is intended to foster self and peer assessment and develop students’ ability to compare alternative problem solving strategies in mathematics lessons. This involves giving students, after they themselves have tackled a problem, simulated “sample student work” to discuss and critique. We describe the potential uses of this strategy and the issues that have arisen during trials in both US and UK classrooms. We consider how this approach has the potential to develop metacognitive acts in which students reflect on their own decisions and planning actions during mathematical problem solving

Orchestrating productive whole class discussions: the role of designed student responses

The value of students publicly sharing and discussing their solutions to unstructured problems is widely recognized. This can, however, be pedagogically challenging. The solutions may be partial, unclear and unpredictable. For many teachers, particularly those new to working with such problems with their students, the improvisation needed to orchestrate productive discussions can be unmanageably high. In this paper we present a pedagogical tool to help teachers. Specifically, teachers orchestrate discussions of designed, worked-out solutions to unstructured problems. The worked-out solutions have been carefully pre-designed for teachers to use in lessons. Knowing the range of distinct solutions students are to work with supports teachers’ planning. The reduced need for improvisation means they are better placed to learn and practice new ways of probing students’ reasoning. These acquired practices may then be applied to discussions of students’ own responses to a problem. In the study we explore the question: for a teacher new to working with unstructured problems, how do discussions of worked-out solutions (called in this paper designed student responses) differ from discussions of students’ own solutions? Our findings indicate that discussions of authentic student solutions tend to focus on procedural descriptions, whereas the discussions of designed solutions stimulated student explanation and evaluation. The work reported here represents the initial part of an on-going study

Developing students’ strategies for problem solving in mathematics: the role of pre-designed “Sample Student Work”

This paper describes a design strategy that is intended to foster self and peer assessment and develop students’ ability to compare alternative problem solving strategies in mathematics lessons. This involves giving students, after they themselves have tackled a problem, simulated “sample student work” to discuss and critique. We describe the potential uses of this strategy and the issues that have arisen during trials in both US and UK classrooms. We consider how this approach has the potential to develop metacognitive acts in which students reflect on their own decisions and planning actions during mathematical problem solving

Developing student questioning when problem solving: the role of sample student responses

This paper describes intervention resources designed to provide opportunities for student self-regulation, with a particular focus on setting subgoals when problem solving. Each task includes a range of pre-written interrelated “sample student responses” that expose students to multiple perspectives on an unstructured non-routine problem. After students attempt the problem they are given the responses to collaboratively complete, critique and compare. We explore students’ capacity to adopt another person’s (the sample student’s) goals in order to complete a solution, and their capacity, through the use of comparison, to identify worthy criteria when critiquing the completed solutions. We then reflect on how we can make subsequent improvements to the resources