Use of Action Research in Nursing Education

Impact of a clinical care pathway developed through the action research method on the psychological well-being and quality of life in male patients with urethral stricture

BACKGROUND

The objective of this study is to examine the development of a clinical care pathway utilizing an action research methodology for male patients with urethral stricture, and to assess the psychological and quality of life outcomes following the implementation of this pathway.

METHODS

Ninety patients diagnosed with urethral stricture, admitted to our hospital between May 2021 and May 2022, were selected as the study cohort. Employing a random number method, these patients were allocated into an observation group and a control group, each comprising 45 individuals. The control cohort employs standard care protocols for individuals with urethral stenosis, while the experimental group employs an action research methodology to develop a clinical care pathway specific to the management of patients with urethral stenosis, with an intervention cycle of 3 months. The investigation evaluated the impact of the intervention by scrutinizing pre- and post-intervention data through the utilization of the WHO Quality of Life Scale (WHOQOL-BREF), in addition to the Anxiety Rating Scale and the Depression Rating Scale.

RESULTS

Prior to the intervention, no significant differences were observed in WHOQOL-BREF scores across dimensions, as well as anxiety and depression scores between the 2 groups (P > .05). Subsequent to the intervention, the patients in the observation group exhibited significantly higher scores across all WHOQOL-BREF dimensions and total scores compared to the control group, with statistical significance (P < .05). Moreover, anxiety and depression scores in the observation group were markedly lower than those in the control group, demonstrating statistical significance (P < .05).

CONCLUSION

The implementation of a clinical nursing pathway rooted in action research methodology proves to be an effective strategy for enhancing clinical nursing practices, elevating patient quality of life, and diminishing the prevalence of anxiety and depression.

Facilitators and barriers to implementing a specialized care unit for persons with cognitive impairment in an acute geriatric hospital: a process evaluation

BACKGROUND

Implementing dementia care interventions in an acute hospital poses multiple challenges. To understand factors influencing the implementation, in-depth knowledge about specific facilitators and barriers is necessary. The aim of this study was to identify facilitators and barriers to implementing an interprofessional, multicomponent intervention of a specialized unit for persons with cognitive impairment in an acute geriatric hospital.

METHODS

We conducted a process evaluation as part of a participatory action research study. For data collection, semi-structured individual interviews with fifteen professionals involved in the implementation of the specialized unit. We further conducted two focus groups with twelve professionals working on other units of the geriatric hospital. We performed a qualitative content analysis following Kuckartz's content-structuring analysis scheme.

RESULTS

We identified the following barriers to implementing the specialized unit: uncontrollable contextual changes (e.g., COVID-19 pandemic), staff turnover in key functions, high fluctuation in the nursing team, traditional work culture, entrenched structures, inflexible and efficiency-oriented processes, monoprofessional attitude, neglect of project-related communication, and fragmentation of interprofessional cooperation. An established culture of interprofessionalism, an interprofessionally composed project group, cooperation with a research partner, as well as the project groups' motivation and competence of managing change facilitated the implementation.

CONCLUSIONS

The implementation faced numerous barriers that can be described using the key constructs of the i-PARIHS framework: context, recipients, innovation, and facilitation. Overcoming these barriers requires an organizational development approach, extended project duration and increased process orientation. Furthermore, strategically planned, precise and ongoing communication towards all persons involved seems crucial. Differences between the work cultures of the professions involved deserve particular attention with regard to project-related roles and processes.

A scoping review protocol to map the evidence on the use of action research methodology by healthcare professionals and in healthcare team settings

Background: Action research (AR) starts with an existing practical situation with which there is a concern or potential for improvement. It seeks transformative change through the simultaneous process of doing research and undertaking actions, both of which are linked together by a critical reflective process. It simultaneously allows one to systematically investigate a given social situation while promoting democratic change and collaborative participation. AR approaches have been used for many years in business management and education. More recently, AR has become an increasingly popular method of inquiry in healthcare, particularly in nursing, to investigate professional practice while simultaneously; introducing innovations; planning and undertaking action; and evaluating new ideas. The overall goal is to augment collaboration whilst improving the patient experience and outcomes. Methods: The Arksey and O'Malley methodology framework will be used to guide this scoping review process: stage 1 will identify the research questions; the eligibility criteria and search strategy will be defined in stage 2; studies will then be selected in stage 3; data will be extracted and charted from these included studies in stage 4; stage 5 involves aggregating and summarising these results along with criteria relevant for health professionals and policy-makers. An optional consultation (stage 6) exercise may potentially be included. Conclusion: This scoping review will comprehensively map the evidence on the use of AR methodology by healthcare professionals and in healthcare team settings. It is predicted that the findings will inform researchers in carrying out future AR and highlight gaps in the literature. An article reporting the results of the completed scoping review will be submitted for publication to a scientific journal and presented at relevant national and international conferences.

Using action research to evaluate a nursing orientation program in a multicultural acute healthcare setting

Objectives

Competence motivates newly employed nurses to provide high-quality care, which leads to appropriate patient care and satisfaction. A nursing orientation program can have a positive impact on new nurses who are joining healthcare organizations. The research examined the orientation program for new nurses in a multicultural setting to redesign the program.

Methods

The study was carried out in a multicultural tertiary setting. Action research was used as a research strategy with qualitative content analysis and quantitative evaluation. Seventy nurses were part of the orientation program. The competence of the nurses was assessed using the Nurse Competence Scale. Focus-group discussions were also conducted to find the views of the beneficiaries about the program.

Results

The study revealed that the overall competence was high, and there was an overall gain in the competence score (5.48%) among the nurses. Among their competence in different dimensions, new nurses had a maximum gain in competence for the dimension of ensuring quality. However, they showed low competence gain in teaching coaching. The results show that the difference in the overall pre- and post-test scores was statistically significant (P < 0.05) in all dimensions except teaching coaching and managing situations, and the program was effective. However, a few challenges were identified in the program.

Conclusions

New nurses were found to be competent, and the orientation program had a significant impact on the competence of the nurses. The findings emphasized the need for modification of some content and strategy for future programs. The strategies developed from the findings were presented. This helps hospitals to consider examining specific aspects of the orientation program and redesigning it so it can enrich the experiences of new nurses.

An Innovative Civility Intervention Created by a Faculty and Student Action Research Team

BACKGROUND

Incivility is a significant issue in nursing education and practice, contributing to ineffective learning, unprofessional nursing practice, and negative patient outcomes.

METHOD

A team of nursing faculty and students used Action Research to develop a quality improvement project targeting civility. A two-part, evidence-based training was offered to prelicensure nursing students, faculty, and staff. Part one was designed to increase incivility awareness, and part two was intended to enhance communication skills.

RESULTS

Program evaluation data were collected through an anonymous survey and analyzed descriptively for themes. Results indicated students, faculty, and staff perceived the educational innovation as valuable and useful.

CONCLUSION

By using free resources, a college of nursing was able to implement a cost-effective program to begin a conversation and offer a communication strategy to address incivility for students, faculty, and staff. This program design can be adopted by others for use in their organization. [J Nurs Educ. 2020;59(4):214-217.].

Empowerment through Accessibility: Community Needs Assessment Data for LGBTQ Communities

LGBTQ individuals disproportionally experience a variety of adverse health outcomes as compared to heterosexual individuals with similar backgrounds. New Orleans has the fourth-highest concentration of LGBTQ individuals in American metropolitan areas. This research defined, measured, and prioritized LGBTQ community needs based on reports from professionals currently involved in healthcare and social service provision. A total of 22 interviews were completed with service providers located in the Greater New Orleans area. The project outlines the greatest programming needs to reduce health and quality of life disparities currently observed in LGBTQ populations. Major service barriers and considerations for research with minority populations are also discussed. Affordable housing, mental health service accessibility, service provider cultural competence, and transportation management were found to play major roles in LGBTQ focused program efficacy. Researchers include suggestions for implementing participatory research methodology into future studies.

Examining the Efficacy of Online Self-Paced Interactive Video-Recordings in Nursing Skill Competency Learning: Seeking Preliminary Evidence Through an Action Research

A key challenge in nursing education is how to teach the students clinical competencies effectively and to provide opportunities for practicing the fundamental nursing skills safely. The purpose of this study was to examine the competency scores of practicing a clinical skill and the satisfaction level of nursing students on three instructional methods using an action research: the online self-paced interactive video learning, demonstration-only method, and a video demonstration in class. Participants were both male and female nursing students enrolled in the Foundations of Nursing Course (N = 26, 6 males and 20 females; mean age = 19.42 ± 0.50) and were evaluated at precycle, postcycle 1, and postcycle 2. Each cycle of inquiry was planned to address the problems quickly and efficiently through four steps: planning, acting, observing, and reflecting. A triangulation technique was employed for data collection using a competency skill evaluation checklist, a satisfaction questionnaire, and a focus group feedback questionnaire. A video was developed in the researcher's college pertaining to the practical skills. Each research cycle was successively built up on one another using the reflections and feedback from the students based on the previous cycle. The competency skills at various cycles did not demonstrate significant differences between three instructional methods, whereas satisfaction score was the highest with the online self-paced interactive video demonstration. Online video learning use as a supplement in nursing instruction is well supported and offers a promising alternative in teaching clinical skill compared with other teaching strategies. However, more rigorous studies are required to get further empirical evidence in replacing the demonstration method, for teaching nursing practical skill and in improving students' learning ability and competence.

Training improved the note taking skill of nursing students in Aksum University; northern Ethiopia: a classroom-based action research

OBJECTIVE

Note taking is an effective strategy to improve students' learning. It is considered that very few learners are fit enough for basic note taking skill. Thus, this study was aimed to assess note taking skill and motivation for learning of nursing students and to take action on the identified gaps.

RESULTS

The mean note taking skill score is 22.95 ± 4.766. The study demonstrates 9.1% of students had good note taking skill but 54.5 and 36.4% had moderate and poor note taking skills respectively. Regarding learning motivation, 13.6% had motivation and the rest 68.2 and 18.2% had moderate and poor motivation for learning to be a nurse respectively. On the items used to examine motivation, 54.1% of students were less motivated to ask questions in classroom though clarification is needed. Reasons for poor note taking showed 68.2 and 27.3% responded due to "most faculties are simply reading from the slides" and "students are confident that instructors will give slide copies later" respectively were the two main cited reasons respectively. Training nursing students about note taking techniques has made considerable impact on student's learning behavior.