Absent bystanders and cognitive dissonance: a comment on Timmins & de Vries

Just participation or just participation? A participatory justice model for more successful theory of change design, implementation, and solution uptake

While a wide consensus acknowledges that participation is critical for the successful implementation of change that improves the livelihoods of people and communities around the world, justly securing that participation from stakeholders (at both the design and implementation stages) remains a demanding problem. This paper proposes a heuristic model for increasing participation that not only helps to investigate instances of nonparticipation but also opens up alternative intervention strategies and pathways for designers and implementers to consider toward more justly increasing participation and overcoming nonparticipation. Applied to a successful case of participation in Gurúè District, Mozambique—where an 89% solution adoption of an improved postharvest seed storage method was measured two years after initial training—this paper demonstrates the key importance of designing opportunities and motivations for participation into any solutions or innovations but especially justice as a factor for successful realization of theory of change efforts (all the more so in developing nation contexts). Applied to a second case study, this paper also explores participation despite little to no motivation to do so. Aiming to afford designers and implementers of theory of change interventions a tool for more successfully and exactly matching innovation goals with innovation outcomes, the paper also addresses broader implications for the model within theory of change approaches generally.

Nursing students' evolving professional values: Capturing their journey through co-operative inquiry

AIM/OBJECTIVE AND BACKGROUND

Despite a worldwide emphasis in nursing codes of practice that state nurses must uphold professional values to be caring and compassionate, evidence continues to emerge of poor-quality care standards. Existing literature attests to a tendency to deteriorating caring values as students' progress through their nursing programme. In response, one university in England exposed pre-registration nursing students to a values-based curriculum which embedded Todres et al.'s (2009) Humanising Values Framework.

DESIGN AND METHODS

This paper describes the later stages of a co-operative inquiry, where students as participants explore their evolving values around person-centred approaches to care as they engaged with clinical practice. Data were collected between 2013 and 2016.

RESULTS AND CONCLUSION

Findings reveal how students developed their confidence and resilience in the face of situations that challenged their value base by internalising a humanised approach to care. They demonstrated this in practice by using problem-based coping strategies, peer and mentor support. Engagement with a curriculum based on humanistic philosophy encouraged students as participants to feel confident in the practice of person-centred care.

Teaching psychology to nursing students-a discussion of the potential contribution of psychology towards building resilience to lapses in compassionate caring

Psychology is a required element in nursing education in many countries. It is particularly aimed at teaching nursing students to get a better understanding of patients, colleagues, health care organizations and themselves, and moreover to apply what they learn about psychology to optimise their care. A meaningful integration of psychology within nursing education requires an emphasis on its application in understanding aspects of care and skills development. However, its ultimate value is demonstrated when addressing problem areas in nursing and health care. In this paper the authors outline an approach to psychology education in nursing which emphasises its development as a problem solving support. An example is presented which focuses on the application of psychology to the challenge of care erosion and deficient critical nursing reflection. The discussion includes the organisational context, social pressure, social cognition, reflection and the role of inner conflict (cognitive dissonance). Nursing educators can contribute to the prevention of care erosion by a combined effort to teach awareness of psychological mechanisms, 'critical' reflection, mastery in practice, strong values and standards, and 'inoculation' against justifications of substandard care.

Exploring the compassion deficit debate

Several recent high profile failures in the UK health care system have promoted strong debate on compassion and care in nursing. A number of papers articulating a range of positions within this debate have been published in this journal over the past two and a half years. These articulate a diverse range of theoretical perspectives and have been drawn together here in an attempt to bring some coherence to the debate and provide an overview of the key arguments and positions taken by those involved. In doing this we invite the reader to consider their own position in relation to the issues raised and to consider the impact of this for their own practice. Finally the paper offers some sense of how individual practitioners might use their understanding of the debates to ensure delivery of good nursing care.