Service user involvement: Inspiring student nurses to make a difference to patient care

What Is the State of Compassion Education? A Systematic Review of Compassion Training in Health Care

PURPOSE

To investigate the current state and quality of compassion education interventions offered to health care providers during training or practice, determine how the components of each education intervention map onto the domains of an empirically based clinical model of compassion, and identify the most common approaches to compassion education.

METHOD

The MEDLINE, Embase, CINAHL Plus with Full Text, Sociological Abstracts, Web of Science, ERIC, and Education Research Complete databases were searched from inception to March 2020 in this systematic review. Studies that evaluated a compassion education intervention for health care providers or those in training to enhance compassion toward patients and/or families were included. A narrative synthesis of the included studies was performed. The components of each intervention were mapped onto the domains of compassion described in the Patient Compassion Model.

RESULTS

One hundred eight peer-reviewed publications describing 103 interventions were included. Modalities ranged from establishing curricula and interventions in clinical settings to programs that used humanities-based reflective practices, clinical simulation, role modeling, and contemplative practices, with many education interventions adopting a multimodal approach. Most interventions mapped to the virtuous response domain of the Patient Compassion Model; very few mapped to the other domains of this model.

CONCLUSIONS

Most interventions were limited as they focused on a single domain of compassion; did not adequately define compassion; were assessed exclusively by self-report; were devoid of a comparator/control group; and did not evaluate retention, sustainability, and translation to clinical practice over time. The authors suggest that compassion education interventions be grounded in an empirically based definition of compassion; use a competency-based approach; employ multimodal teaching methods that address the requisite attitudes, skills, behaviors, and knowledge within the multiple domains of compassion; evaluate learning over time; and incorporate patient, preceptor, and peer evaluations.

Interaction with an ostomy patient in a laboratory setting: Expectations and experiences of first-year nursing students

BACKGROUND

Interacting with real patients is an important component of nursing education in all learning settings.

OBJECTIVES

This study aimed to determine the expectations and experiences of first-year nursing students' interaction with a real patient with an ostomy in the clinical skill laboratory.

METHOD

The phenomenological qualitative study was carried out with 17 first-year undergraduate nursing students. Data was collected via focus group interviews during pre- and post-nursing students and real patient with an ostomy interaction. Semi-structured questions were used during the focus group interviews. The data were analyzed by inductive content analysis method.

RESULTS

The findings are presented under two contexts: expectations of first-year nursing students related to interaction with an ostomy patient and experiences of first-year nursing students related to interaction with an ostomy patient. The two contexts were divided into five main themes: Emotions regarding interaction with a real patient with an ostomy, providing ostomy care to a real patient with an ostomy, predictions for living with an ostomy, effects of interaction with a real patient with an ostomy, and real patient engagement in nursing education.

CONCLUSIONS

In consequence of the research, the first-year nursing students were enthusiastic about the interaction with the real patient. The most important contribution to interaction with a patient was breaking down the prejudices of students concerning being a patient and having an illness. Real patients should engage in varied learning environments in nursing education, particularly via patients with different illnesses and health conditions.

Consumer involvement in university education programs in the nursing, midwifery, and allied health professions: a systematic scoping review

BACKGROUND

Incorporating consumers' voices in tertiary education curricula is an ongoing initiative of educators of health professions in order to facilitate students' readiness for consumer-based practice and to meet accreditation standards. Consequently, educators within these professions use a range of different strategies to involve, recruit and retain consumers. To date, no study has attempted to consolidate the different strategies used by nursing, midwifery and allied health educators to involve, recruit and retain consumers. Consolidating these strategies will lead to a sharing of ideas, which would be of benefit to educators looking for ways to involve consumers in their programs.

OBJECTIVES

This scoping review aimed to identify how consumers are involved, recruited and retained in nursing, midwifery and allied health curricula, as reported within research from these professions.

DESIGN

The scoping review was carried out and reported according to the PRISMA Extension for Scoping Reviews.

DATA SOURCES

Eight electronic databases were searched on 8^th January 2019 for English, peer-reviewed primary literature without limiting publication date. The databases were: Cochrane Library, Embase, Emcare, ERIC: Educational Resources Information Center database, Joanna Briggs Institute EBP database, Medline, Scopus, and Web of Science.

REVIEW METHODS

The screening of studies was based on selection criteria and involved a two-stage process conducted by two independent reviewers. Once the studies were identified, two reviewers were involved in the charting process of each study. A form was developed to extract information regarding types of consumer involvement and strategies to recruit and retain consumers. Key concepts were then identified across the charted data and categorised and synthesised based on common characteristics or keywords.

RESULTS

From 2334 studies, a total of 58 articles were included. Four main areas for consumer involvement types and eight strategies for recruitment and retention were identified and mapped across the studies.

CONCLUSION

The collated findings allow idea sharing among educators from these professions on the various types of consumer involvement, recruitment and retention strategies. Enriching tertiary education programs with consumer input enhances student learning and assists these professions to meet accreditation standards.

Older people’s views and experiences of engagement in standardised patient simulation

Background

The last two decades have witnessed initiatives aimed at improving the care of older people, including educating nurses so that they are equipped with the skills to care for older people with frailty and complex multimorbidities. It has been suggested that involvement of older service users in nurse education can facilitate the development of nurses’ caring skills by promoting understanding of the reality of older people’s situations. One method of involving older service users is standardised patient simulation (SPS). While some recent studies have acknowledged the importance of considering standardised patients’ experiences and perceptions of simulation, to date few have focused specifically on the experiences of older people.

Methods

In this qualitative study, data were collected via focus groups, whereby older people were invited to discuss their views and experiences of involvement in SPS. Data were analysed using open coding.

Findings

Four themes emerged from the data, demonstrating that involving older people in SPS may be beneficial for their well-being. The four themes were: ‘using personal experiences to improve care’, ‘having a sense of purpose’, ‘preparation and support for SPS’ and ‘feeling appreciated’.

Discussion

While most participants reported that they enjoyed the SPS activities, engagement appeared to have had a much deeper significance for them. Many participants’ responses suggested that involvement assisted them to ‘make sense’ of their experiences of illness and healthcare, and also gave a sense of purpose, of belonging and of being valued.

Conclusion

Findings support the need for nurse educators to consider developing SPS programmes that involve older people.

Expert patient perspectives on radiotherapy: a phenomenological comparison

Background

Patient involvement in health profession student training is becoming more common and includes clinical case studies, informing curriculum development and active teaching in dedicated patient experience sessions. Despite a growing evidence base supporting patient involvement, there is little published data concerning motivation for involvement. A qualitative study was performed to provide narrative relating to patient experiences in expert patient sessions on an undergraduate radiation therapy course.

Methods

A phenomenological approach utilised semi-structured interviews with two expert patients from different backgrounds. A common set of questions were used for each participant. Interviews were digitally recorded and transcribed before thematic coding.

Results

Both participants identified areas of similarity as well as key difference in their experiences. Both had different levels of public speaking experience as well as different levels of knowledge relating to radiation therapy treatment. Both found the initial session emotional but ultimately enjoyed the process and found it cathartic.

Conclusion

The patients enjoyed this experience and identified clear value of the teaching for themselves and the students. Previous public speaking or clinical experience seemed to have limited impact on patient experience and suggested the vulnerability of the situation. Both had different perspectives of their fellow patients and their role in the healthcare partnership. These findings indicate the value of ensuring students have access to a range of perspectives from different patients.

The caring concept, its behaviours and obstacles: perceptions from a qualitative study of undergraduate nursing students

Developing caring competences is considered to be one of the most important aims of undergraduate nursing education and the role of clinical placement is recognised as special in this regard. Students' reflection on caring, their experience and obstacles in being caring is recommended as a key strategy in the process of teaching and studying the nursing discipline. Therefore, the aim of this study was to describe the concept of caring, its manifestations and possible obstacles while caring, as perceived by first-year nursing students before and after their first clinical placement. Qualitative content analysis of 15 Polish students' narratives written before and after their clinical experience in the form of text-diaries was undertaken. The findings revealed that students entered their nursing education with a deep humanistic vision of caring both on theoretical and practical levels and the first clinical placement has enriched this vision. Expressive caring was more appreciated by students than the instrumental one and their concept of caring was coherent with the caring behaviours as described in their narratives. Several internal and external obstacles for caring have been reported by students, indicating a specific tension between their ideal of caring and their practical experience of caring in the clinical reality.

The role of service-user feedback in undergraduate nursing courses

There is an increasing expectation that service users should contribute in a meaningful way to student nurse education courses. This article describes how service-user feedback on undergraduate student nurses' performance during practice learning opportunities (PLOs) gives an insight into the qualities service users value in student nurses. At Cardiff University, the new Bachelor of Nursing course, launched in September 2012, took into account the Nursing and Midwifery (NMC) standards for preregistration, implementing a mechanism for service users to feed back on students' clinical performance. To facilitate this service, user/carer feedback pages were inserted into the students' bound clinical practice portfolio. A large sample of the clinical portfolios (n=100) from one cohort across adult, child and mental health nursing fields were examined at the end of year 1, year 2 and again at the end of year 3, and service users' comments collated. In considering the words used by service users, the authors propose that they reflected the six fundamental values-or 6Cs-of care, compassion, competence, communication, courage and commitment that underpin the delivery of excellent care. Conclusions drawn from the feedback were that students exhibited the caring and professional qualities that service users value, and indeed showed the dignity and respect for patients and people that the profession demands.