Using psychodynamic small group work in nurse education: closing the theory-practice gap?

An auto-ethnographic reflection on the nature of nursing in the UK during the Covid-19 pandemic

In this article I discuss the effects on the patient experience of isolation nursing during the CoronaVirus Disease (COVID)-19 pandemic. An unintended consequence of isolation nursing has been to distance patients from nurses and emphasise the technical side of nursing while at the same time reducing the relational or affective potential of nursing. Such distanced forms of nursing normalise the distal patient in hospital. I consider ways in which this new form of distanced nursing has unwittingly contributed to the continued commodification of nursing care in the British NHS. Autoethnography is used to describe and reflect on the illness experience, the experiences of caregivers and the sociocultural organisation of health care. The findings discuss three areas of the illness experience: intimate nursing care; communication; the 'distanced' patient experience.

The 'values journey' of nursing and midwifery students selected using multiple mini interviews: Evaluations from a longitudinal study

Values-based practice is deemed essential for healthcare provision worldwide. In England, values-based recruitment methods, such as multiple mini interviews (MMIs), are employed to ensure that healthcare students' personal values align with the values of the National Health Service (NHS), which focus on compassion and patient-centeredness. However, values cannot be seen as static constructs. They can be positively and negatively influenced by learning and socialisation. We have conceptualised students' perceptions of their values over the duration of their education programme as a 'values journey'. The aim of this hermeneutic longitudinal focus group study was to explore the 'values journey' of student nurses and midwives, recruited through MMIs, across the 3 years of their education programme. The study commenced in 2016, with 42 nursing and midwifery students, originally recruited onto their programmes through multiple mini interviews. At the third and final point of data collection, 25 participants remained. Findings indicate that students' confidence, courage and sense of accountability increased over the 3 years. However, their values were also shaped by time constraints, emotional experiences and racial discrimination. We argue that adequate psychological support is necessary as healthcare students embark on and progress through their values journey, and propose a framework for this.

Involving patients and carers in developing the radiotherapy curriculum: enhancing compassion

Background:

This article describes a collaborative project that aimed to develop a patient-centred curriculum in radiotherapy. In the wake of the Francis report in 2013 and a call for compassion to be a central tenet of health programmes, the project was a timely opportunity to enhance the radiotherapy curriculum.

Methods:

Collaboration between university staff and patients and carers using the service improvement model Plan-Do-Study-Act was the method employed for the curriculum project. Two key discussion forums helped shape the curriculum plan, with module and course evaluation continuing to inform developments.

Results:

The key outcome of the project is that it has shaped the 'care' theme evident in the current undergraduate programme. Co-production methods resulted in the development of a range of shared classroom activities that focus on experiences, care values and communication strategies. The new curriculum has evaluated positively and the impact of learning is demonstrated both in the classroom and clinical setting. The project team have also influenced recruitment processes and patient and carer involvement in programme approval is embedded.

Conclusion:

Working together, with patients and carers is an ideal method to enhance the curriculum and reflect the requirements in practice of current health and social care professions. Further developments in student assessment are planned.

The interrelationships between student approaches to learning and group work

BACKGROUND AND AIM

As part of the process of nursing students becoming 'work ready' within future health care teams, students need the skills to work collaboratively. In higher education, establishing group work assignments is a teaching method to develop group work skills. Not only is group work an important teaching method to develop effective group work skills but it is also used to activate deep learning. However, to date, there has been a lack of research on the impact of group work on student approaches to learning. This study aimed to examine the interrelationships between students, group work characteristics, and their approaches to learning.

DESIGN AND PARTICIPANTS

A survey design was used, before and after a targeted academic skills development intervention, which had a specific focus on the development of group work skills. The sample involved first year undergraduate nursing students undertaking a Bachelor of Nursing programme at a regional university in Australia. A total of 92 students completed the pre-survey, and 102 students completed the post-survey.

METHOD

Data were collected using quantitative surveys.

RESULTS

Metacognitive awareness was found to best predict a deep approach to learning. Young age and experiencing discomfort in group work were two predictors of a surface approach to learning.

CONCLUSION

Findings indicate that nurse educators should develop strategies that support students' metacognitive awareness in relation to group work, and also support those students who feel less comfortable in working with others.

Student nurses' views on respect towards service users - an interpretative phenomenological study

AIM

To explore student nurses' understanding and behaviours of respect towards patients in order to inform educational strategies to optimise respectful care.

BACKGROUND

There is a causal relationship between the perception of being treated with respect and patient satisfaction. Concerns over standards of care prompted a commissioned report into the quality of nurse education in the United Kingdom.

DESIGN

A hermeneutic phenomenological interview study was used to identify and interpret student nurses' behaviours and understanding of respect towards patients.

SETTING

University health and social care faculty in the north-west of England, United Kingdom.

PARTICIPANTS

Eight third-year student nurses (adult branch), on different university sites, with practice placements across different healthcare trusts.

METHODS

Interviews about their understanding of respect and their behavioural intentions of respect towards patients were recorded and transcribed, then analysed using interpretative phenomenological analysis (IPA) to produce themes from the data.

FINDINGS

Three themes of relevance to nurse education were identified. Respect is a complex concept that is difficult to apply in practice. Students are not always aware of incongruence between their feelings of respect towards patients and their behaviours towards them. Role-modelling of respectful care is variable, and essential care is often learned from healthcare assistants.

DISCUSSION

Awareness of emotional responses and their relationship to patient perceptions of respect should be facilitated in theory and practice. Rehearsal of the application of respect involving emotional labour, and reflection in and on the practice of respectful care, are needed to address student learning needs. The theory-practice gap in relation to respect, variation in professional practice and the under-recognised importance of healthcare assistants in student nurse education, are barriers to the learning of respect to patients.

CONCLUSIONS

Interactive education experiences are important to develop self-awareness and insight into respectful care. Mentorship in practice should encourage reflection in and on the practice of respect towards patients.