58 research outputs found
Enhancing the student experience through effective collaboration: a case study
No full textIn the United Kingdom (UK), closer integration of public services is challenging professionals to work more collaboratively within and across their organizational and professional boundaries (Great Britain DOH 2000; Great Britain DFES 2003). Reflecting a move to more significantly include librarians in educational collaboration (Schulte and Sherwill-Navarro 2009), this paper provides insight into the development of an innovative health curriculum in which academic staff, together with library staff, have engaged in successful collaborative working on a range of health and social care professional programs. This successful partnership has, to date, enabled the theme of lifelong learning to be embedded into a complex, year one, interprofessional module entitled “Foundations of Learning and Collaborative Working” (Northumbria University 2007). Using the Symbolic Interactionist Framework for Collaboration (SIFC) (Machin 2009), a case study of the collaborative working process undertaken is presented and factors influencing the success of the venture are highlighted. Sharing our experience may help others seeking to collaborate in their own work setting
Conducting a good ward round: How do leaders do it?
No full textRationale, Aims and Objectives: Ward rounds (WRs) are complex social processes. Done well, WR discussions and decisions contribute to timely, safe, effective pro-gression of care. However, literature highlights medical dominance; marginalisation or absence of other perspectives, safety risks and suboptimal resource use. This study examined leadership behaviours and what supported good interprofessional WRs, defined as enabling interprofessional collaboration and decision making which progresses patient care in a safe and timely manner. Deepening appreciation of this art should support learning and improvements. Method: Mixed‐method appreciative inquiry (AI) into how WRs go well and could go well more often. Context: daily interprofessional consultant‐led WRs in a large adult critical care unit. Data: ethnographic and structured observations (73 h, 348 patient reviews); AI conversations and interviews (71 participants). Inductive iterative analysis shaped by Activity Theory. Participants: 256 qualified healthcare professionals working in the unit. Results: Leadership of good WRs supported (and minimized contradictions to): making good use of expertise and time, and effective communication. These three key activities required careful and skilled orchestration of contributions to each patient review, which was achieved through four distinct phases (a broadly pre-dictable script), ensuring opportunity to contribute while maintaining focus and a productive pace. This expertise is largely tacit knowledge, learnt informally, which is difficult to analyse and articulate oneself, or explain to others. To make this easier, and thus support learning, we developed the metaphor of a conductor leading musicians.
Conclusions: Whilst everyone contributes to the joint effort of delivering a good WR, WR leadership is key. It ensures effective use of time and diverse expertise, and coordinates contributions rather like a conductor working with musicians. Although WR needs and approaches vary across contexts, the key leadership activities we identified are likely to transfer to other settings
SIN-BARRSS – Developing a mnemonic to support nurses’ participation in interprofessional ward rounds in intensive care: An appreciative inquiry for quality improvement
No full textObjectives.
To develop and pilot a mnemonic to increase the willingness and ability of bedside nurses to contribute to patient reviews in the daily interprofessional ward round.
Research methodology/design.
Appreciative inquiry quality improvement study, using ethnographic observations and appreciative inquiry discussions, augmented by quantitative data collection of basic facts.
Setting.
Large (44 beds) critical care unit in the United Kingdom.
Main outcome measures.
Interprofessional development and acceptance of mnemonic; successful preparation for pilot; use and usability of mnemonic; improvements in bedside nurses’ contributions to ward round discussions (frequency and focus).
Result/findings.
Interprofessional development of a usable and useful mnemonic was successful, pilot implementation showed promising levels of take up and acceptance. Compared to before the quality improvement project bedside nurses were more willing and able to participate in ward round discussions, did so more often, and used the mnemonic script with insight and flexibility.
Conclusions.
The implementation of a mnemonic supported bedside nurses’ contributions to the ward round. This could provide a framework for introducing similar programmes to other intensive care units. Appreciative inquiry methodology could be replicated in other settings to aid the improvement of interprofessional ward rounds, or to address other quality improvement priorities.
Implications for clinical practice.
A mnemonic can provide a structure which supports bedside nurses’ contributions in ways that make good use of bedside nurses’ professional expertise and most up to date knowledge of patients’ clinical state. Furthermore, a well-designed mnemonic can be used flexibly and provides an outline script that supports less experienced and less confident nurses to make well-focused and well received contributions to rapid interprofessional discussions. In turn, this can increase these nurses’ confidence and capability. More experienced and confident nurses, and ward round leaders, can use the same mnemonic flexibly as an aide memoir that guards against missing information and insights that could affect the quality and safety of patient care
Actuarial examinations: what can be learnt from the students' perspective?
No full textThis thesis presents a detailed analysis of the student experience of qualifying as an actuary,\ud
and reflects upon what might be learnt from this. The actuarial profession is small and,\ud
outside the financial sector, little known. However, within the financial sector, actuaries are\ud
influential. Their professional examinations are seen as very demanding and the qualification\ud
is coveted. This exploration of the students' perspective, breaks new ground in research on\ud
the profession by: adopting principles of 'illuminative evaluation' (Parlett & Hamilton,\ud
1972) and later developments in qualitative research; and using adult learning theory as the\ud
conceptual framework.\ud
Themes which emerged from the study coalesce around three dominant concerns: adjusting\ud
to the learning milieu, the disjuncture between expectation and experience and, finding and\ud
decoding clues. These are elaborated separately, then integrated in a series of case studies\ud
which demonstrate the diversity of student experience. Dynamic Concept Analysis\ud
(Kontiainen, 1973, 1989) is employed to structure the case studies, and highlight the\ud
relational nature of influences upon the learning experience.\ud
Kontiainen's model of adult learning (1991) is modified to improve its interpretive power\ud
in the context of distance learning, and to incorporate the findings of research into student\ud
approaches to learning.\ud
Contributions are made to the discourses of actuarial education, professional education,\ud
distance education and adult learning. Attention is drawn to the pivotal role of the\ud
correspondence course tutor in supporting: adjustment to the learning milieu; and high\ud
quality learning. Overload is a recurrent theme, and is associated with perceptions of\ud
control and validity. Questioning of the validity of several aspects of the education and\ud
assessment processes by members of the profession, is discussed. A possible general model\ud
for the student experience of actuarial examinations is presented
Interprofessional ward rounds in an adult intensive care unit: an appreciative inquiry into the central collaboration between the consultant and the bedside nurse
No full textDone well, ward rounds (WRs) promote effective, safe care and collaboration; but WR quality varies. An improvement-focused appreciative inquiry (AI) into a large intensive care unit’s WR practices identified a pivotal axis of collaboration between the most senior medical role (the consultant) and the bedside nurse (BSN). This paper examines that axis of interprofessional collaboration (IPC) to deepen understanding of its implications. Data included ethnographic observations, interviews, and co-constructed AI with groups of staff. Four key concepts emerged from cyclical interpretive analysis: “need,” “presence,” “ability” and “willingness.” BSNs and consultants needed the interprofessional WR to enable their work; WR effectiveness was affected by whether they were both present, then able and willing to participate in IPC. BSN presence was necessary for effective and efficient IPC between these key roles. Indirect contributions, based on prior exchanges with colleagues or through written notes, reduced the joint problem-solving through discussion and negotiation that characterizes IPC to less efficient asynchronous interprofessional coordination. Factors affecting “presence,” “ability” and “willingness” are discussed alongside potential mitigations and acknowledgment of asymmetric power. Appreciative examination of interprofessional WRs identified mechanisms supporting and undermining effective WR IPC and the centrality of consultants’ and BSNs’ collaboration
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