What are the patterns of personal learning environments (PLE) for undergraduate students undertaking degrees in nursing.

This is the Core Paper Abstract submitted for the NET conference September 201

Understanding the ecology of the Personally Significant Learning Environment (PSLE): one year on

Background: Personal learning environments (PLE) have been shown to be critical in how students negotiate, manage and experience their learning. Understandings of PLEs are largely restricted by narrow definitions that focus on technology alone. The idea of a PLE is often conflated with virtual learning environments (VLEs). In this presentation, we draw on empirical findings from an international study that spanned four countries. Our findings will be of interest to students, educators, researchers and institutions and will facilitate a more in depth understanding of how to support students to create appropriate PLEs for effectively managing their own learning. Aims: The study aim was to provide in-depth insights into how undergraduate students of nursing manage and experience learning through a range of formal and informal components that comprise the PLE. It is a longitudinal mixed-method study that incorporates two key phases. The first phase will be the focus of this presentation. Research design: The first phase comprised a series of focus groups held at each of four institutions in Australia, England, Scotland, Hong Kong and Canada. Ethical approval was obtained at each individual study site. Recruitment at each site was through student emails, flyers and invitations on eLearning sites. Inclusion criteria were that students needed to be enrolled in an undergraduate degree leading to a nurse registration. An important ethical consideration was that students understood that participation or non-participation would not impact relationships with their academic institutions or study outcomes. Nominal group techniques were used in the focus groups together with providing visual representations of their PLE in the form of a sketch or conceptual map. The themed sticky notes and visual representations were photographed and stored for subsequent analysis. Data were analyzed independently by researchers at each site. This initial analysis was at the broadest level of abstraction in order to identify main emerging categories. Via a series of meetings through voice over IP (VoIP) technologies, investigators were able to employ a process of triangulation to provide and reach a consensus regarding commonalities that appeared from focus groups. Key Findings: Eight groups comprising a total of 46 students took part in focus groups across the four sites. The findings from the focus groups generated a range of different types of data that were organized into three major themes; technologies, learning modalities and influencing factors. Technologies included physical items such as; devices; computers; books; journals; newspapers; and furniture; and virtual technology such as; software; applications; and internet resources. PLEs are influenced by individual learning preferences and the learning contexts that students find themselves in. Participants described how the ways they were expected to learn at university, did not always suit their personal learning preferences. Understanding their own learning style was important to enable an effective PLE and customising learning to suit personal preferences was seen as important. An individual’s PLE is impacted by external, interpersonal and intrapersonal factors. A PLE is influenced by these factors both individually, and by the interplay between the factors. External factors included the physical, built aspects of the environment and the learner’s ambient environment. Intrapersonal factors included attitudes, beliefs, preferences and emotions. Interpersonal factors such as how, when and where participants engaged with others also played a significant role in their PLE. Findings suggest a broader understanding of the term personal learning environment than currently exists. Their PLE was relational and comprised a space with personal meaning and significance to the learner - in support of their educational goals. Current definitions of PLE do not capture the broader understanding identified by this study, we therefore propose a new term: personally significant learning environment

Perceived barriers and facilitators to accessing and utilising sexual and reproductive healthcare for people who experience homelessness: a systematic review

No embargo required.IntroductionPeople who experience homelessness face disproportionately poor reproductive health and adverse pregnancy outcomes, including but not limited to unintended pregnancy, abortion, low birth weight and preterm birth, as well as a higher risk of sexually transmitted infections (STIs). Precarious living conditions are known to contribute to poor uptake and engagement with sexual and reproductive healthcare (SRH) for this population.AimTo identify and understand the perceived barriers and facilitators for accessing and utilising SRH for people who experience homelessness from their perspective, and the perspective of support staff/volunteers and healthcare professionals.MethodsElectronic databases and online sources were searched. Two reviewers independently carried out the screening, data extraction, critical appraisal, data synthesis and thematic analysis of findings.ResultsFollowing deduplication and screening, 23 papers/reports were considered eligible for the review. Barriers for people experiencing homelessness to accessing and utilising SRH were identified within the themes of complexity, feelings and knowledge (ie, individual-level factors), as well as patient/provider interaction and healthcare system (ie, organisational factors). Facilitators were identified within all of the above themes except for complexity.ConclusionsBoth population characteristics and attributes of the healthcare system influence access and utilisation of SRH by people experiencing homelessness. Given the complexity of living conditions associated with homelessness, greater efforts to improve access should be placed on healthcare systems and aspects of care delivery. This systematic review highlights current gaps in the literature and provides recommendations for enhancing future research and practice to meet the needs of this vulnerable group more effectively.</jats:sec

Dramatic Shifts in Benthic Microbial Eukaryote Communities following the Deepwater Horizon Oil Spill

Benthic habitats harbour a significant (yet unexplored) diversity of microscopic eukaryote taxa, including metazoan phyla, protists, algae and fungi. These groups are thought to underpin ecosystem functioning across diverse marine environments. Coastal marine habitats in the Gulf of Mexico experienced visible, heavy impacts following the Deepwater Horizon oil spill in 2010, yet our scant knowledge of prior eukaryotic biodiversity has precluded a thorough assessment of this disturbance. Using a marker gene and morphological approach, we present an intensive evaluation of microbial eukaryote communities prior to and following oiling around heavily impacted shorelines. Our results show significant changes in community structure, with pre-spill assemblages of diverse Metazoa giving way to dominant fungal communities in post-spill sediments. Post-spill fungal taxa exhibit low richness and are characterized by an abundance of known hydrocarbon-degrading genera, compared to prior communities that contained smaller and more diverse fungal assemblages. Comparative taxonomic data from nematodes further suggests drastic impacts; while pre-spill samples exhibit high richness and evenness of genera, post-spill communities contain mainly predatory and scavenger taxa alongside an abundance of juveniles. Based on this community analysis, our data suggest considerable (hidden) initial impacts across Gulf beaches may be ongoing, despite the disappearance of visible surface oil in the region

Realist synthesis : illustrating the method for implementation research

BackgroundRealist synthesis is an increasingly popular approach to the review and synthesis of evidence, which focuses on understanding the mechanisms by which an intervention works (or not). There are few published examples of realist synthesis. This paper therefore fills a gap by describing, in detail, the process used for a realist review and synthesis to answer the question \u27what interventions and strategies are effective in enabling evidence-informed healthcare?\u27 The strengths and challenges of conducting realist review are also considered. MethodsThe realist approach involves identifying underlying causal mechanisms and exploring how they work under what conditions. The stages of this review included: defining the scope of the review (concept mining and framework formulation); searching for and scrutinising the evidence; extracting and synthesising the evidence; and developing the narrative, including hypotheses. ResultsBased on key terms and concepts related to various interventions to promote evidenceinformed healthcare, we developed an outcome-focused theoretical framework. Questions were tailored for each of four theory/intervention areas within the theoretical framework and were used to guide development of a review and data extraction process. The search for literature within our first theory area, change agency, was executed and the screening procedure resulted in inclusion of 52 papers. Using the questions relevant to this theory area, data were extracted by one reviewer and validated by a second reviewer. Synthesis involved organisation of extracted data into evidence tables, theming and formulation of chains of inference, linking between the chains of inference, and hypothesis formulation. The narrative was developed around the hypotheses generated within the change agency theory area. ConclusionsRealist synthesis lends itself to the review of complex interventions because it accounts for context as well as outcomes in the process of systematically and transparently synthesising relevant literature. While realist synthesis demands flexible thinking and the ability to deal with complexity, the rewards include the potential for more pragmatic conclusions than alternative approaches to systematic reviewing. A separate publication will report the findings of the review. <br /

Intermittent auscultation versus continuous fetal monitoring: Exploring factors that influence birthing unit nurses' fetal surveillance practice using theoretical domains framework

Background: Intermittent Auscultation (IA) is the recommended method of fetal surveillance for healthy women in labour. However, the majority of women receive continuous electronic monitoring. We used the Theoretical Domains Framework (TDF) to explore the views of Birthing Unit nurses about using IA as their primary method of fetal surveillance for healthy women in labour. Methods: Using a semi-structured interview guide, we interviewed a convenience sample of birthing unit nurses throughout Ontario, Canada to elicit their views about fetal surveillance. Interviews were recorded and transcribed verbatim. Transcripts were content analysed using the TDF and themes were framed as belief statements. Domains potentially key to changing fetal surveillance behaviour and informing intervention design were identified by noting the frequencies of beliefs, content, and their reported influence on the use of IA Results: We interviewed 12 birthing unit nurses. Seven of the 12 TDF domains were perceived to be key to changing birthing unit nurses' behaviour The nurses reported that competing tasks, time constraints and the necessity to multitask often limit their ability to perform IA (domains Beliefs about capabilities; Environmental context and resources). Some nurses noted the decision to use IA was something that they consciously thought about with every patient while others stated it their default decision as long as there were no risk factors (Memory, attention and decision processes, Nature of behaviour). They identified positive consequences (e.g. avoid unnecessary interventions, mother-centered care) and negative consequences of using IA (e.g. legal concerns) and reported that the negative consequences can often outweigh positive consequences (Beliefs about consequences). Some reported that hospital policies and varying support from care teams inhibited their use of IA (Social influences), and that support from the entire team and hospital management would likely increase their use (Social influences; Behavioural regulation). Conclusion: We identified potential influences on birthing unit nurses' use of IA as their primary method of fetal surveillance. These beliefs suggest potential targets for behaviour change interventions to promote IA use

Deep-Sea Nematodes Actively Colonise Sediments, Irrespective of the Presence of a Pulse of Organic Matter: Results from an In-Situ Experiment

A colonisation experiment was performed in situ at 2500 m water depth at the Arctic deep-sea long-term observatory HAUSGARTEN to determine the response of deep-sea nematodes to disturbed, newly available patches, enriched with organic matter. Cylindrical tubes,laterally covered with a 500 µm mesh, were filled with azoic deep-sea sediment and 13C-labelled food sources (diatoms and bacteria). After 10 days of incubation the tubes were analysed for nematode response in terms of colonisation and uptake. Nematodes actively colonised the tubes,however with densities that only accounted for a maximum of 2.13% (51 ind.10 cm−2) of the ambient nematode assemblages. Densities did not differ according to the presence or absence of organic matter, nor according to the type of organic matter added. The fact that the organic matter did not function as an attractant to nematodes was confirmed by the absence of notable 13C assimilation by the colonising nematodes. Overall, colonisationappears to be a process that yields reproducible abundance and diversity patterns, with certain taxa showing more efficiency. Together with the high variability between the colonising nematode assemblages, this lends experimental support to the existence of a spatio-temporal mosaic that emerges from highly localised, partially stochastic community dynamics

The effects of action learning on nurses' use of a fetal health surveillance guideline with low-risk labouring women

Strategies for implementing evidence in clinical practice are often applied with an aim to change provider behaviour and improve patient outcomes. In Canada, many health professionals in birthing units use continuous electronic fetal monitoring rather than intermittent auscultation, despite the fact that continuous electronic fetal monitoring is associated with increased caesarean section and obstetrical intervention rates without benefit to the fetus. Based on a synthesis of credible research, there are national and international guidelines recommending intermittent auscultation for low-risk labouring women. The purpose of this study was to evaluate two interventions, interactive education and Action Learning, that aimed to increase nurses' use of intermittent auscultation in low-risk labouring women as per the Society of Obstetricians and Gynecologists of Canada Fetal Health Surveillance Clinical Practice Guideline (Liston & Crane, 2002). Guided by Roger's (2003) theory of diffusion of innovation and the promoting action on research implementation in health services (PARiHS) framework (Kitson et al., 2008), I conducted a two-phase study. In the first phase, I used a pre-post design with staff nurses (N = 93) to evaluate the effectiveness of an educational intervention. In the second phase, I used a randomized controlled trial design to evaluate the effectiveness of the Action Learning strategy with staff nurses (N = 62) and randomized the nurses to either Action Learning or Usual Care. During labour, 270 consecutively admitted women who met the low-risk inclusion criteria received their care from either an Action Learning or a Usual Care nurse. Neither the interactive education intervention nor the Action Learning intervention had a significant effect on the nurses' use of guideline appropriate care, during episodes of care for low-risk labouring women. Various types of data were explored to determine their influence on the nurses' guideline adherenceLes stratégies de mise en œuvre des données probantes dans la pratique clinique sont souvent appliquées dans le but de modifier le comportement des fournisseurs de soins et d'améliorer les résultats des patients. Au Canada, de nombreux professionnels de la santé travaillant dans des unités d'accouchement surveillent constamment le rythme cardiaque du fœtus plutôt que de manière intermittente. Des directives nationales et internationales, recommandent l'auscultation intermittente pour les femmes en travail à faible risque. L'objectif de cette étude était d'évaluer deux types d'intervention : la formation interactive et l'apprentissage actif, destinées à augmenter l'usage de l'auscultation intermittente par le personnel infirmier pour les femmes en travail à faible risque, conformément à la directive de pratique clinique pour la surveillance de la santé du fœtus, directive fournie par la SOGC (Liston & Crane, 2002). En m'appuyant sur la théorie de la diffusion des innovations de Rogers (2003) et sur le modèle PARiHS – promoting action on research implementation in health services (Kitson et al., 2008), j'ai mené une étude en deux phases. Dans la première phase, j'ai utilisé un modèle avant-après avec des infirmières soignantes (N = 93) pour évaluer l'efficacité d'une intervention éducative. Dans la seconde phase, j'ai utilisé une méthodologie d'essai comparatif aléatoire pour évaluer l'efficacité de la stratégie d'apprentissage actif et j'ai assigné de manière aléatoire les infirmières (N = 62) au groupe bénéficiant de l'apprentissage actif ou au groupe dispensant les soins habituels. Durant le travail, 270 femmes admises consécutivement et répondant au critère de faible risque, ont reçu les soins d'une infirmière ayant suivi un apprentissage actif ou d'une infirmière dispensant les soins habituels. Ni l'intervention éducative interactive ni la stratégie d'apprentissage actif n'ont eu d'effet significatif s

The significance of Personal Learning Environments (PLEs) in nursing education: extending current conceptualizations’

Background: Personal learning environments (PLE) have been shown to be a critical part of how students negotiate and manage their own learning. Understandings of PLEs appear to be constrained by narrow definitions that focus primarily on technological engagement with a range of web tools and associated applications. This paper addresses a gap in the literature around PLEs for students currently enrolled in undergraduate nursing degrees. Purpose: To provide in-depth insights into how undergraduate students of nursing manage and experience their learning. Methods: This was an international multi-site qualitative study, utilizing focus groups. A schedule of 10 questions and nominal group techniques were used. Findings: Whilst the focus groups took place in very different geographical locations, there were strong similarities in student understandings of effective PLEs. These went well beyond current technological definitions. Findings were organized into three major themes; technologies, learning modalities and influencing factors. Discussion: We propose a broader understanding of PLEs that acknowledges individual personal and cultural contexts which we call the personally significant learning environment (PSLE). There is a need for greater investigation of how students understand and systematize their PSLE. Conclusions: This paper and our findings will be of interest to educators, researchers and institutions for developing appropriate frameworks that may maximize learning outcomes, encourage cultural sensitivities and facilitate greater understandings of how to support students to create appropriate PSLEs