Knowledge translation in everyday nursing: from evidence-based to inquiry-based practice

A Psychometric Study of the Student Evidence-Based Practice Scale S-EBPQ-Arabic Version for Use among Undergraduate Nursing Students

Background

Previous studies have demonstrated the significance of evidence-based practice in improving patient care and outcomes. Therefore, integrating evidence-based practice into the health professions' education curriculum has become a pedagogical priority. However, there is a lack of reliable and valid scales to measure students' evidence-based practice usage, attitudes, knowledge, and skills in Arab countries.

Aim

This study aims to examine the adapted Student Evidence-Based Practice Scale Questionnaire (S-EBPQ) validity at logical statistical level and reliability for use among students in Arabic context.

Methods

This cross-sectional study included 233 undergraduate nursing students from a university in Saudi Arabia, who were recruited after translating and pilot testing the S-EBPQ. Three distinctive types of validity including conceptual, content, and face validity were assessed to determine the quality of the questionnaire items logically. Exploratory factor analyses were performed to examine the tool's structural validity. Additionally, internal consistency was assessed to evaluate reliability. Findings. All items were considered relevant to Arab culture, and no changes were made to any items. The content validity indices for all items were above 0.80 as this was considered an acceptable value. The exploratory factor analysis identified the same four factors (practice, attitude, retrieving and reviewing evidence, and sharing and applying evidence-based practice). All KMO values for the individual items ≥0.876 were also well above the acceptable 0.6 limit. The four-factor structure explained a total variance of 64%, with factor load score λ ≥ 0.455. The total and subscale S-EBPQ scores showed evidence of reliability, with Cronbach's alpha ≥0.8.

Conclusions

This study demonstrated the reliability and validity of the Arabic S-EBPQ version. The study has the potential to advance Arab countries' understanding of evidence-based practice. S-EBPQ is a validated tool that can be used to assess nursing students' knowledge of EBP practices. Since educators need to continually evaluate instructional and curricular design in order to meet contemporary nursing needs, this scale can enhance the educational process and enhance students' competencies.

How care holds humanity: the myth of Cura and theories of care

Modern medicine has often struggled to grasp the cultural aspects of interpersonal care. The medical humanities, on the other hand, have struggled to grasp the embodied, intimate character of care. In a recent appeal to the medical humanities, Julia Kristeva et al argue that care can be a point of crossing between these two 'ontological domains'. They evoke the myth of Cura, referring to previous utilisations by such diverse thinkers as Heidegger and Kleinman, as well as Kristeva's previous work. This study adds to these bodies of work by using the original text from Hyginus in much greater detail. Textual analysis, theoretical discussions and autotheoretical work unpack care as (1) a fundamental aspect of the human condition, (2) a holding-together of different domains of knowledge, (3) a withholding from these domains and (4) the site of intimate knowledge that both 'ontological domains' struggle to grasp.

A philosophical analysis of anti-intellectualism in nursing: Newman's view of a university education

Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti-intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti-intellectualism in nursing education. We use John Henry Newman's view of the purpose of a university education as a heuristic perspective to examine anti-intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency-based curricula and business models rooted in neoliberal financial policies reinforce anti-intellectualism in nursing. Anti-intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti-intellectualism. Counteracting anti-intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti-intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized.

Being and becoming a nurse: Toward an ontological and reflexive turn in first-year nursing education

In this paper, we call for an ontological and reflexive turn in first-year nursing education. An ontological turn focuses on formation, the 'being' and 'becoming' of a nurse, and emphasizes the value of nursing knowledge. First-year nursing students often possess romanticized ideals about being a nurse that devalues the knowledge and expertise of nurses. We posit a thoughtful ontological orientation within nursing education that shifts the emphasis toward becoming skillful nurses, with expertise grounded in nursing perspectives. A focus on formation includes discussions regarding ideologies, dominant perspectives, and reflexive explorations of students' views of nursing juxtaposed with the realities of nursing practice. We propose ontologic reflexivity as an approach to consider what perspectives are prioritized (or not) within the nursing classroom. Within pedagogical dialogic spaces, ontologic reflexivity calls on educators to create opportunities for students to learn the value of nursing knowledge along with other forms of knowledge. We consider ways in which an ontological and reflexive turn within the first year of nursing education may contribute to the formation of nursing students who value nursing knowledge, are open-minded to various forms of knowledge, and possess an intentional reflexive way of being.

Striving to be in close proximity to the patient: An interpretive descriptive study of nursing practice from the perspectives of clinically experienced registered nurses

This paper explores essential characteristics of current nursing practice from the perspectives of clinically experienced registered nurses in various fields of health care in Sweden. Nursing practice has been the subject of much debate in the past and because of its complexity as well as continuous changes in society it is important to continue the debate. A qualitative study, including 16 group interviews with altogether 74 participants, was conducted. Nursing practice was viewed as a multifaceted field. The participants struggled to define nursing but were able to describe it using concrete examples. The analysis, using interpretive description, identified current practice as essentially consisting of: 'A practice pervaded by comprehensive responsibility', 'A practice that recognises a patient's unique needs', 'A practice based on multifaceted knowledge' and 'A practice that mediates between traditional values and changing demands'. Current nursing practice can be understood as striving to be in close proximity to the patient, but in tension with pervasive requirements and societal changes. Going forward, it is necessary to continue to reflect on and discuss the nature of nursing practice in an interprofessional context. Studies from primary and home care are also needed to broaden the understanding of nursing practice.

Self-care while undertaking qualitative nursing research

BACKGROUND

Nursing research is usually carried out by registered nurses with some experience of practice. However, nurses may find that the role of the nurse researcher is very different from that of the practising clinical nurse and has its own challenges.

AIM

To explore the differences between the two roles and offer some guidance to nurses carrying out qualitative research, particularly research into sensitive topics.

DISCUSSION

Nurses need to be aware of various issues that could affect their ability to carry out nursing research and be emotionally traumatic.

CONCLUSION

There is a general need for greater awareness about the potential risks of carrying out qualitative research into sensitive topics.

IMPLICATIONS FOR PRACTICE

Nurse researchers must consider self-care when planning a research project, assessing their role, personality, background, personal experiences and stress triggers, and ensuring peer and supervisory support, reflection and a healthy lifestyle.

Toward Relational Practices for Enabling Knowledge-to-Action in Health Systems: The Example of Deliberative Dialogue

Despite widespread emphasis on evidence-informed decision making in health care, there remain persistent challenges in actualizing this ideal. An integrated strategy to knowledge translation can help bridge perspectives across sectors, communities, and organizations, and bridge the "knowledge-to-action" gap. One such strategy is a deliberative dialogue method. Deliberative dialogue has unique potential to mobilize partnered changes and improvements across health care, and we believe, is most salient when enacted relationally through practices of relational engagement and relational accountability. Drawing from our own scholarship, we reflect on how these practices can help establish both processes and outcomes that can affect meaningful change.

Philosophical and theoretical content of the nursing discipline in academic education: A critical interpretive synthesis

BACKGROUND

Nursing as clinical practice, management and research are based on nursing philosophy and theory. Thus, the philosophical and theoretical content is required to be incorporated in academic education in order to enable nurses' skills for reflection, analysis, and thinking about the profession.

OBJECTIVE

The aim of this review was to describe what is known of the philosophical and theoretical content of the nursing discipline within academic education.

DESIGN

A critical interpretive synthesis (CIS).

METHODS

Electronic searches were performed across four databases, CINAHL, Scopus, Medline, and Web of Science, for papers published in English from 1980 to 2016. The selection of original articles was based on stages, and inclusion and exclusion criteria were used. Quality of the selected papers were evaluated by method sensitive appraisal criteria. The five phases of CIS were used to combine the selected data.

RESULTS

The searches resulted 9148 titles, whereas 13 were selected. Nurses need philosophical and theoretical education in order to be aware of human health and explain the complexity of the human experience of illness. The philosophy of science, the philosophy of care, and theory development were highlighted as the key contents in nursing academic education as these subjects are central to the discipline that ensures that nurses acquire advanced skills. A model was developed that linked disciplinary issues the progression nursing science through the influence of advanced skills.

CONCLUSIONS

Based on the findings in this study the philosophical and theoretical content of nursing discipline crates a basis for the academic education and enables a professional and exclusive vision for nurses. It provides an overall understanding of people's lives and support nurses to achieve deeper awareness of the meaning of illness and health in a person lifespan what is needed on the evidence-based decision making.

A Qualitative Study of Challenges and Opportunities in Mobilizing Research Knowledge on Violence Against Women

Background Effective delivery of interventions by health and social services requires research-based knowledge which identifies the causes and consequences of violence against women. Methods to effectively share new knowledge with violence against women decision-makers remain under studied. Purpose This paper examines how new research-based knowledge-namely, the lack of efficacy of health-care screening for exposure to intimate partner violence against women-is received by stakeholders in the violence against women field. Methods Data from 10 stakeholder group discussions ( N = 86) conducted during a knowledge-sharing forum were analyzed to assess how stakeholders responded to the new knowledge. Results Participant reactions ranged from full acceptance to significant resistance to the research findings. We suggest themes that help explain these reactions, including the context and content of our findings and their epistemological match to participants' experiences and beliefs, and the perceived value of research evidence, compared to other forms of knowledge. Conclusions Violence against women is a complex psycho-social phenomenon, and people with an interest in this field bring diverse and even conflicting perspectives regarding its causes, consequences, and potential solutions.

Pediatric nurse practitioners' clinical competencies and knowing patterns in nursing: Focus group interviews

BACKGROUND

The generic competency domains of advanced nursing practice have been reported on in numerous countries, but rather few studies have examined competencies specific to pediatric nurse practitioners (PNPs).

OBJECTIVES

We identified the core clinical competencies of PNPs in South Korea and related these identified competencies to the five patterns of knowing in nursing.

DESIGN

Focus group interviews were conducted with five PNP students and four PNPs using two thematic questions, one on clinical competencies required for PNPs and the other on competencies specific to Korean PNPs. A purposive sampling method was used to choose nurses with varying work experience and age from different hospital units. The inclusion criterion for PNP students was having at least two years of clinical experience and that for PNPs was having at least two years of clinical experience as a PNP in pediatric units in tertiary hospitals. The verbatim transcriptions of these interviews were analysed by two researchers using inductive content analysis.

RESULTS

Six clinical competency domains were identified including advanced pediatric-specific knowledge and clinical skills, education and counseling, utilization and engagement in research, professional identity development, clinical and professional leadership, and holistic care. Some competencies identified were related to empirical and ethical knowledge that could be taught in nursing, whereas others were based on esthetic and personal knowledge, which can be mastered through professional experience.

CONCLUSIONS

To provide holistic care for children and families, PNPs must acquire all necessary patterns of knowing through continuing education and individual reflection on personal practice.

Expert Nurses' Perceptions of the Relevance of Carper's Patterns of Knowing to Junior Nurses

This study explored with expert nurses in the UK how nursing wisdom can be developed in new and junior nurses. Carper's patterns of knowing and Benner's novice-to-expert continuum formed the theoretical framework. Employing a constructionist research methodology with participant engagement in co-construction of findings, data were collected via 2 separate cycles comprising 4 consecutive sessions followed by a nationally advertised miniconference. Empirical, ethical, personal, and esthetic knowing was considered evident in junior nurses. Junior nurses in the UK seem to lack a previously unrecognized domain of organizational knowing without which they cannot overcome hegemonic barriers to the successful development of nursing praxis.

The consequences of using advanced physical assessment skills in medical and surgical nursing: A hermeneutic pragmatic study

Aims and objectives

The aim of this study was to explore the consequences of the nurse's use of advanced assessment skills on medical and surgical wards.

Background

Appropriate, accurate, and timely assessment by nurses is the cornerstone of maintaining patient safety in hospitals. The inclusion of “advanced” physical assessment skills such as auscultation, palpation, and percussion is thought to better prepare nurses for complex patient presentations within a wide range of clinical situations.

Design

This qualitative study used a hermeneutic pragmatic approach.

Method

Unstructured interviews were conducted with five experienced medical and surgical nurses to obtain 13 detailed narratives of assessment practice. Narratives were analyzed using Van Manen's six-step approach to identify the consequences of the nurse's use of advanced assessment skills.

Results

The consequences of using advanced assessment skills include looking for more, challenging interpretations, and perseverance. The use of advanced assessment skills directs what the nurse looks for, what she sees, interpretation of the findings, and her response. It is the interpretation of what is seen, heard, or felt within the full context of the patient situation, which is the advanced skill.

Conclusion

Advanced assessment skill is the means to an accurate interpretation of the clinical situation and contributes to appropriate diagnosis and medical management in complex patient situations.

Relevance to clinical practice

The nurse's use of advanced assessment skills enables her to contribute to diagnostic reasoning within the acute medical and surgical setting.

Evidence based nursing and midwifery practice in a regional Australian healthcare setting: Behaviours, skills and barriers

AIM

To establish self-reported skill levels, behaviours and barriers in relation to evidence-based practice (EBP) among a representative sample of regional Australian nurses and midwives in senior roles.

BACKGROUND

It has been widely established that nurses and midwives continue to face challenges in relation to putting evidence into practice on the clinical floor. Prior to conducting an EBP capacity building activity in a regional Australian Local Health District, a survey assessing needs and skill and barrier areas was conducted.

METHODS

A quantitative descriptive survey which utilised the 'Developing Evidence Based Practice Questionnaire' (DEBPQ) was conducted in early 2012 among senior nurses and midwives of a regional New South Wales Local Health District (LHD). The survey results were contrasted with reported DEBPQ results from a sample of UK metropolitan nurses and a sample of Australian general practice nurses (GPNs).

RESULTS

One hundred and sixty nine nurses completed the survey (response rate 42%). Survey respondents' reliance on accepted evidentiary knowledge sources was found to be low. Research literature-related knowledge sources were ranked outside of the top 10 sources, compared with numerous personalised and subjective sources, which ranked within the top 10. Access to and understanding of research material was a primary barrier to reviewing evidence in the study sample. Time-related barriers to changing practice on the basis of evidence figured prominently in the study sample and the UK and Australian GPN samples. The study sample rated their EBP skill levels significantly higher than both their UK counterparts and the Australian GPN sample (P < 0.0001).

CONCLUSION

Capacity building interventions are needed among senior nurses and midwives in Australian regional LHDs, as the most prominent knowledge sources reported are non-evidentiary in nature and barriers to finding and reviewing evidence, along with barriers to making practice change, remain significant.

Pragmatism and integrated knowledge translation: exploring the compatabilities and tensions

Aim

This paper presents a discussion of the role of the philosophy of pragmatism in the integrated knowledge translation approach to research.

Design

Critical inquiry is used to discuss bringing pragmatic philosophy and the integrated knowledge translation approach to research together to advance nursing knowledge.

Methods

This paper draws from the literature written on the philosophy of pragmatism and from the current literature on knowledge translation. The possibilities, tensions and limitations for underpinning an integrated knowledge translation research approach with pragmatic philosophy are discussed while highlighting the implications this has for creating knowledge aimed at advancing the practice of nursing.

Results

The implications for how nursing knowledge is created in using an integrated knowledge translation approach that is underpinned by pragmatic philosophy are important. Creating nursing knowledge that address the complex problems found in nursing practice is needed. In acknowledging the inseparability of knowledge and practice, researchers, practitioners, policy makers and the public can come together to co‐create knowledge that is useful for the practice of nursing. It is these implications of underpinning an integrated knowledge translation research approach with pragmatic philosophy that are significant in creating nursing knowledge that advances the practice of nursing.

Translational Scholarship and a Palliative Approach: Enlisting the Knowledge-As-Action Framework

Based on a retheorized epistemology for knowledge translation (KT) that problematizes the "know-do gap" and conceptualizes the knower, knowledge, and action as inseparable, this paper describes the application of the Knowledge-As-Action Framework. When applied as a heuristic device to support an inquiry process, the framework with the metaphor of a kite facilitates a responsiveness to the complexities that characterize KT. Examples from a KT demonstration project on the integration of a palliative approach at 3 clinical sites illustrate the interrelatedness of 6 dimensions-the local context, processes, people, knowledge, fluctuating realities, and values.

Crosstalk: public cafés as places for knowledge translation concerning health care research

This article explores the use of public cafés as a model for knowledge translation and community engagement. We base our discussion on a public café series organized around the theme of access to health care and held in three neighborhoods in the Lower Mainland of British Columbia, Canada. The cafés were part of the Canadian Institutes of Health Research Café Scientifique program. Our purposes for this series of cafés were threefold: (a) to provide a site of communication to connect research with members of the public, (b) to build a network among participants based on common connections to the local community, and (c) to explore through discussion how gendered and raced perspectives concerning access to health care may influence the lived experiences of Canadians today. We intended to promote an intergroup conversation, based on the assumption that people of First Nations descent, newcomers to Canada (whether through immigration or resettlement), and settlers (such as Euro-Canadians) would all benefit from hearing each other's perspectives on access to health care, as well as presentations by invited academics about their research on access to health care. A form of "crosstalk" emerged in the cafés, mediated by gender and ethnicity, where social differences and geographical distances between various groups were not easily bridged, and yet where opportunity was created for inclusive dialogic spaces. We conclude that knowledge translation is not easily accomplished with the café format, at least not with the type of critical knowledge we were aiming to translate and the depth of engagement we were hoping for. Our experiences highlighted three strategies that facilitate knowledge translation: relationships and shared goals; involvement of policymakers and decision makers; and tending to social relations of power.

Perceived outcomes of web-based modules designed to enhance athletic trainers' knowledge of evidence-based practice

CONTEXT

The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial.

OBJECTIVE

To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians.

DESIGN

Qualitative study.

SETTING

Individual telephone interviews.

PATIENTS OR OTHER PARTICIPANTS

A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed.

DATA COLLECTION AND ANALYSIS

We conducted 1 individual telephone interview with each participant. After transcription, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data.

RESULTS

Participants perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice.

CONCLUSIONS

Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice.

A narrative review of recent developments in knowledge translation and implications for mental health care providers

OBJECTIVE

Attention to knowledge translation (KT) has increased in the health care field in an effort to improve uptake and implementation of potentially beneficial knowledge. We provide an overview of the current state of KT literature and discuss the relevance of KT for health care professionals working in mental health.

METHOD

A systematic search was conducted using MEDLINE, PsycINFO, and CINAHL databases to identify review articles published in journals from 2007 to 2012. We selected articles on the basis of eligibility criteria and then added further articles deemed pertinent to the focus of ourpaper.

RESULTS

After removing duplicates, we scanned 214 review articles for relevance and, subsequently, we added 46 articles identified through hand searches of reference lists or from other sources. A total of 61 papers were retained for full review. Qualitative synthesis identified 5 main themes: defining KT and development of KT science; effective KT strategies; factors influencing the effectiveness of KT; KT frameworks and guides; and relevance of KT to health care providers.

CONCLUSIONS

Despite limitations in existing evidence, the concept and practice of KT holds potential value for mental health care providers. Understanding of, and familiarity with, effective approaches to KT holds the potential to enhance providers' treatment approaches and to promote the use of new knowledge in practice to enhance outcomes.

Social-Interaction Knowledge Translation for In-Home Management of Urinary Incontinence and Chronic Care

Although urinary incontinence (UI) can be managed conservatively, it is a principal reason for the breakdown of in-home family care. This study explored the social interaction processes of knowledge translation (KT) related to how UI management knowledge might be translated within in-home care. In-depth interview data were collected from a theoretical sample of 23 family caregivers, older home care recipients, and home care providers. Constant comparison and Glaser’s analysis criteria were used to create translating knowledge through relating , a substantive theory with 10 subthemes: living with the problem; building experiential knowledge; developing comfort; easing into a working relationship; nurturing mutuality; facilitating knowledge exchange; building confidence; fi ne-tuning knowledge; putting it all together; and managing in-home care. Findings inform both theory and practice of in-home UI KT, illuminating how intersubjectivity and bi-directional relational interactions are essential to translating in-home chronic care knowledge, which is largely tacit and experiential in nature.

Science and practice aligned within nursing: structure and process for evidence-based practice

Science and Practice Aligned Within Nursing (SPAWN) is an innovative method developed to guide the implementation of evidence-based practice (EBP) by oncology nurses in direct patient care settings. Science and Practice Aligned Within Nursing actualizes and addresses the important and essential practice component of EBP in oncology nursing. This article describes the development of SPAWN infrastructure, phases of the process, implementation, outcome evaluation, key insights, and lessons learned.

Living in the in-between: families caring for a child with a progressive neurodegenerative illness

Medical advances in recent years have led to an increased life span for children with progressive, neurodegenerative illnesses. The purpose of this hermeneutic inquiry was to explore the experience of families caring for their child at home. In-depth, audiorecorded interviews with six families (13 interviews) living in western Canada were transcribed and analyzed. The illness journey was revealed to be complex and unpredictable. We discovered many metaphors that spoke to the child's/family's life and explored the paradox of duality, such as holding both joy and sorrow, and containing both suffering and love. We outline implications for policy development within the area of respite care and coordination of services for families. The voices of families must be a vital component to influence and guide education and service development within the emerging specialty of pediatric palliative care.

Narratives of Neonatal Intensive Care Unit Nurses: Experience with End-of-Life Care

The purpose of this interpretive narrative research is to explore the experiences of Neonatal Intensive Care Unit (NICU) nurses with end-of-life care of infants and their families. Guided by Newman's Research-as-Praxis, we met with nurse participants from a tertiary care NICU twice in small groups and once on the telephone to share their stories. Patterns of relationship were discerned and shared with our participants for their affirmation, challenge, and elaboration. NICU nurses' end-of-life experiences include relationship patterns, knowledge construction, and tensions of temporal and spatial proximity of suffering and death. Arts-based forms of dissemination of our findings have been developed to invite readers into reconstruction of their experiences and to demonstrate the transferability of the method.

Knowing nursing through inquiry: engaging students in knowledge creation

Two nurse educators share a nursing knowledge course, which was created as a forum for questioning and discovery, thereby revealing a process of knowing nursing through inquiry. The process of inquiry in nursing praxis is emphasized, facilitating students' understanding that they are knowledge-users and creators. With students, we explore the construction of praxis, which includes being/becoming (ontology), knowing (epistemology), and doing (actions with consequences). Nursing knowledge is understood to arise from philosophy, world views, nursing theories, patterns of knowing, evidence-based research, and standards of practice. Students are encouraged to critically reflect on and use what is congruent with their praxis and to construct new knowledge. Exemplars from nurse educators and students are presented as evidence of our claim for furthering the science of nursing education.

Praxis

Praxis is grounded as an essential underpinning construct of nursing. Praxis is advocated to be the route to allow nurses to be emancipated from ‘regimes of truth’ and reified bureaucratic structures. Praxis is also described as the vehicle to take nurses on the journey of continued professional and profession growth.

Clinical learning environment, supervision and nurse teacher evaluation scale: psychometric evaluation of the Swedish version

AIM

This article is a report of the development and psychometric testing of the Swedish version of the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale.

BACKGROUND

To achieve quality assurance, collaboration between the healthcare and nursing systems is a pre-requisite. Therefore, it is important to develop a tool that can measure the quality of clinical education. The Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale is a previously validated instrument, currently used in several universities across Europe. The instrument has been suggested for use as part of quality assessment and evaluation of nursing education.

METHODS

The scale was translated into Swedish from the English version. Data were collected between March 2008 and May 2009 among nursing students from three university colleges, with 324 students completing the questionnaire. Exploratory factor analysis was performed on the 34-item scale to determine construct validity and Cronbach's alpha was used to measure the internal consistency.

RESULTS

The five sub-dimensions identified in the original scale were replicated in the exploratory factor analysis. The five factors had explanation percentages of 60.2%, which is deemed sufficient. Cronbach's alpha coefficient for the total scale was 0.95, and varied between 0.96 and 0.75 within the five sub-dimensions.

CONCLUSION

The Swedish version of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale has satisfactory psychometric properties and could be a useful quality instrument in nursing education. However, further investigation is required to develop and evaluate the questionnaire.

Public health nursing practice with 'high priority' families: the significance of contextualizing 'risk'

Public health nurses (PHNs) play a vital role in supporting families at risk; few studies, however, have focused on how PHNs actually work with families to provide support, build trust, and use their clinical judgment to make decisions in complex, at-risk situations. In this study, we report on findings from research that illustrate how PHNs use relational approaches in their work with 'high priority' families. Drawing on data collected from interviews and focus groups with 32 PHNs, we discuss three central features inherent to working relationally with families at risk: (i) contextualizing the complexities of families' lives; (ii) responding to shifting contexts of risk and capacity; and (iii) working relationally with families under surveillance. These findings show that the ability to recognize risk and capacity as intersecting aspects of families' lives, and to practice from a stance that recognizes risk as contextualized is foundational to effective working relationships with high-priority families.

Boundaries and the culture of theorizing in nursing

In this dialogue we direct attention to the way in which each of us (including you the reader) is a knowing practitioner, examining how our ontologies and the cultures we live and create are (and are not) shaping theorizing and ultimately family nursing practice. Questions we explore include: How might closer attention to ontology enhance theorizing in family nursing and healthcare? How might we enlist boundaries and differences as potential lines of joining? How might we engage in theorizing as a unitary act--living the values and ideals we espouse and aspire toward?

Othering: difference understood??: a 10-year analysis and critique of the nursing literature

It has been 10 years since Advances in Nursing Science (ANS) published the first article that articulated othering within a nursing framework. This issue's topic, Critique and Replication, provided an opportunity for analysis of the influence of the original ANS article on the visibility and application of othering within nursing literature. Comprehensive searches of major health databases identified 32 publications citing the original ANS article. The analysis focused on exclusionary and inclusionary othering, role taking, and constructions of the other. Results indicate that although othering has become more visible within nursing literature, exclusionary othering dominates. The article concludes with thoughts for moving beyond othering and toward engagement.

Critical inquiry and knowledge translation: exploring compatibilities and tensions

Knowledge translation has been widely taken up as an innovative process to facilitate the uptake of research-derived knowledge into health care services. Drawing on a recent research project, we engage in a philosophic examination of how knowledge translation might serve as vehicle for the transfer of critically oriented knowledge regarding social justice, health inequities, and cultural safety into clinical practice. Through an explication of what might be considered disparate traditions (those of critical inquiry and knowledge translation), we identify compatibilities and discrepancies both within the critical tradition, and between critical inquiry and knowledge translation. The ontological and epistemological origins of the knowledge to be translated carry implications for the synthesis and translation phases of knowledge translation. In our case, the studies we synthesized were informed by various critical perspectives and hence we needed to reconcile differences that exist within the critical tradition. A review of the history of critical inquiry served to articulate the nature of these differences while identifying common purposes around which to strategically coalesce. Other challenges arise when knowledge translation and critical inquiry are brought together. Critique is one of the hallmark methods of critical inquiry and, yet, the engagement required for knowledge translation between researchers and health care administrators, practitioners, and other stakeholders makes an antagonistic stance of critique problematic. While knowledge translation offers expanded views of evidence and the complex processes of knowledge exchange, we have been alerted to the continual pull toward epistemologies and methods reminiscent of the positivist paradigm by their instrumental views of knowledge and assumptions of objectivity and political neutrality. These types of tensions have been productive for us as a research team in prompting a critical reconceptualization of knowledge translation.

Fostering nurses' political knowledges and practices: education and political activation in relation to lesbian health

This article describes findings from a qualitative policy study focused on female nurses' activism in relation to lesbian health. Critical feminist analysis and comparative life history methodology were applied to career histories obtained from 10 diversely situated female nurses across Ontario, Canada. The findings show that nursing activist practices are informed by advocacy experiences that foster inclusive professional and community education plus formal education processes that shape their political socialization. Implications for nursing theory include the development of political knowledges and practices that support caring science, sociopolitical knowing, and primary healthcare nursing practice in a community context.