A cooperative inquiry into action learning and praxis development in a community nursing module

Use of Action Research in Nursing Education

Purpose. The purpose of this article is to describe action research in nursing education and to propose a definition of action research for providing guidelines for research proposals and criteria for assessing potential publications for nursing higher education. Methods. The first part of this project involved a search of the literature on action research in nursing higher education from 1994 to 2013. Searches were conducted in the CINAHL and MEDLINE databases. Applying the criteria identified, 80 publications were reviewed. The second part of the project involved a literature review of action research methodology from several disciplines to assist in assessing articles in this review. Results. This article summarizes the nursing higher education literature reviewed and provides processes and content related to four topic areas in nursing higher education. The descriptions assist researchers in learning more about the complexity of both the action research process and the varied outcomes. The literature review of action research in many disciplines along with the review of action research in higher education provided a framework for developing a nursing-education-centric definition of action research. Conclusions. Although guidelines for developing action research and criteria for publication are suggested, continued development of methods for synthesizing action research is recommended.

Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry

Background

Facilitators are known to be influential in the implementation of evidence-based health care (EBHC). However, little evidence exists on what it is that they do to support the implementation process. This research reports on how knowledge transfer associates (KTAs) working as part of the UK National Institute for Health Research ‘Collaboration for Leadership in Applied Health Research and Care’ for Greater Manchester (GM CLAHRC) facilitated the implementation of EBHC across several commissioning and provider health care agencies.

Methods

A prospective co-operative inquiry with eight KTAs was carried out comprising of 11 regular group meetings where they reflected critically on their experiences. Twenty interviews were also conducted with other members of the GM CLAHRC Implementation Team to gain their perspectives of the KTAs facilitation role and process.

Results

There were four phases to the facilitation of EBHC on a large scale: (1) Assisting with the decision on what EBHC to implement, in this phase, KTAs pulled together people and disparate strands of information to facilitate a decision on which EBHC should be implemented; (2) Planning of the implementation of EBHC, in which KTAs spent time gathering additional information and going between key people to plan the implementation; (3) Coordinating and implementing EBHC when KTAs recruited general practices and people for the implementation of EBHC; and (4) Evaluating the EBHC which required the KTAs to set up (new) systems to gather data for analysis. Over time, the KTAs demonstrated growing confidence and skills in aspects of facilitation: research, interpersonal communication, project management and change management skills.

Conclusion

The findings provide prospective empirical data on the large scale implementation of EBHC in primary care and community based organisations focusing on resources and processes involved. Detailed evidence shows facilitation is context dependent and that ‘one size does not fits all’. Co-operative inquiry was a useful method to enhance KTAs learning. The evidence shows that facilitators need tailored support and education, during the process of implementation to provide them with a well-rounded skill-set. Our study was not designed to demonstrate how facilitators contribute to patient health outcomes thus further prospective research is required.

A Different Drum

The authors in this article describe the background and development of a drama-based educational initiative for student nurses in the United Kingdom (UK) Forty-five student nurses from Adult and Mental-Health fields of study took part in a one-day experience where they worked alongside individuals with learning disabilities to produce art, dance, and drama sketches. The workshop was evaluated using a validated questionnaire to explore the experience from the students’ perspectives. Students felt challenged as they were pushed beyond the comfort zone of a regular classroom environment. Moreover, a greater understanding of core concepts such as empathy, dignity, stigma, and social exclusion were identified as key outcomes of the experience. The focus for future work in this field is to explore the ways in which arts-based learning and teaching initiatives can be developed within mainstream curricula.

Patchwork text: a praxis oriented means of assessment in district nurse education

A patchwork text was used to assess summatively B.Sc. and M.Sc. district nurse students' learning and how this was informed critically, during a module on a one year fulltime community programme. Assessment was embedded within an action learning process that adopted an extended epistemology so students demonstrated connections between practice, theory and their reflections. Five lecturers undertook first-person and co-operative inquiry into their experiences, including post-course reflexive discussions with 16 students and their practice mentors. Maintaining reflective diaries functioned to enhance writing as learning, with students presenting in non-linear terms, their regress, progress and self-evaluative skills. Marking was challenging for lecturers. Elements of criteria based upon portfolio assessment and qualitative research were supplemented by action research quality indicators, in terms of students explicating their choices and rationale. Summative judgements were enhanced and validated by markers engaging in critical dialogue with second markers and moderators and not through exclusive use of ever-increasingly sophisticated criteria. Crucially, assessment requires mentor verification of students' accounts. In summary, a relational, tripartite approach to learning and assessment (students, teachers and practice mentors collective contributions) enhances quality of both learning and its assessment, including competency assessment. Errors and weaknesses are also identified, no panaceas are claimed.