The link between patient safety competence and adverse event among master of nursing students: a cross-sectional mixed-methods study

BACKGROUND

Patient safety (PS) is a core competency for registered nurses. However, there is a gap between the PS competence of nursing students and their clinical experience in PS. This study explored the effect of PS competence levels on the occurrence of adverse events (AEs) among nursing master's students in China.

METHODS

A sequential mixed methods design was used, with a purposive sample across seven colleges. A total of 327 graduate nursing students, aged 22 to 38, participated in the survey, and 15 participated in qualitative interviews. The Health Professional Education in Patient Safety Survey (H-PEPSS) assessed the students' competence levels in PS. The respondents also reported any AEs that they had been involved in over the past year.

RESULTS

A total of 78 AEs occurred in the past year, with 17.7% of the participants involved 1 to 3 AEs. The most common AEs were medication administration errors (30.77%) and improper use of medical equipment/supplies (28.20%). Students acquired more competencies from the clinical setting than from the classroom setting. Three competencies learned from classroom settings were associated with clinical AEs: low clinical safety skills [OR = 0.61], inappropriate identify, response to and disclosing AE and close calls [OR = 0.454], and low confidence in working in teams with other health professionals [OR = 2.168]. Qualitative data analysis revealed five themes: recognizing AEs, reducing harm by addressing immediate risks to patients and others involved, promoting safe medication and clinical practice, managing members' authority and team dynamics, and dealing with inter-professional conflict.

CONCLUSIONS

The quantitative and qualitative data align, supporting the enhancement of students' PS competence.

Status of the midwifery workforce and childbirth services and the impact of midwife staffing on birth outcomes in China: a multicentre cross-sectional study

OBJECTIVE

To investigate the status of the midwifery workforce and childbirth services in China and to identify the association between midwife staffing and childbirth outcomes.

DESIGN

A descriptive, multicentre cross-sectional survey.

SETTING

Maternity hospitals from the eastern, central and western regions of China.

PARTICIPANTS

Stratified sampling of maternity hospitals between 1 July and 31 December 2021.The sample hospitals received a package of questionnaires, and the head midwives from the participating hospitals were invited to fill in the questionnaires.

RESULTS

A total of 180 hospitals were selected and investigated, staffed with 4159 midwives, 412 obstetric nurses and 1007 obstetricians at the labour and delivery units. The average efficiency index of annual midwifery services was 272 deliveries per midwife. In the sample hospitals, 44.9% of women had a caesarean delivery and 21.4% had an episiotomy. Improved midwife staffing was associated with reduced rates of instrumental vaginal delivery (adjusted β -0.032, 95% CI -0.115 to -0.012, p<0.05) and episiotomy (adjusted β -0.171, 95% CI -0.190 to -0.056, p<0.001).

CONCLUSION

The rates of childbirth interventions including the overall caesarean section in China and the episiotomy rate, especially in the central region, remain relatively high. Improved midwife staffing was associated with reduced rates of instrumental vaginal delivery and episiotomy, indicating that further investments in the midwifery workforce could produce better childbirth outcomes.

How to design and deliver a small group teaching session

RATIONALE AND KEY POINTS

Small group teaching sessions are commonly used in healthcare to deliver education, provide practice updates and support continuing professional development. Such sessions can provide opportunities for participants to acquire new knowledge, foster peer relationships, consolidate learning and develop skills. This article provides a step-by-step guide for nurses and other healthcare professionals on designing and delivering a small group teaching session. • A small group teaching session requires considered, detailed and methodical preparation. • When designing a small group teaching session, it is important to determine its aims, learning outcomes, group characteristics, location and timeframe. • A well-planned small teaching session includes learning activities that are constructively aligned to the aims and intended learning outcomes. • Assessing participant learning and addressing gaps in their understanding is essential during the delivery of small group teaching. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article could improve your practice when designing and delivering a small group teaching session. • How you could use this information to educate your colleagues on small group teaching methods.

Postgraduate nurse education in Indonesia and Australia: A comparative analysis

BACKGROUND

Indonesia and Australia are neighbouring countries; however, their nursing systems are very different and there is limited migration between countries.

AIM

As part of a larger study, the aim was to undertake a comparative analysis of postgraduate nurse education in Indonesia and Australia.

DESIGN

Detailed literature review across academic and grey literature and semi-structured interviews with key stakeholders in Indonesia (n = 52) and Australia (n = 13) representing education, governments, professional nursing organisations, and rural, remote and urban health care providers.

FINDINGS

Three key categories of comparison were identified: Higher Education System, Education Offerings, and Specialist practice and education standards. Regulation of higher education was found to generally be comparable. Postgraduate nursing specialisations are available in both countries, but there are currently more offerings in Australia. Furthermore, nurse practitioner education and graduate entry pathways into nursing are only currently available in Australia. Journal publications are required for graduation from masters and doctoral programmes in Indonesia, but not Australia.

CONCLUSIONS

While there are many areas of similarity, postgraduate nurse education is more diverse in Australia, while there are growing opportunities for new developments in Indonesia. This analysis identifies areas for future consideration around postgraduate education development in both countries, along with possibilities for future collaboration. Furthermore, comparative analysis provided a useful foundation on mapping key elements.

Mental health status and stressful life events among postgraduate nursing students in Cyprus: a cross-sectional descriptive correlational study

BACKGROUND

Despite prior evidence supporting the association between stressful life events and mental health status, there are limited data on the number and severity of stressful life events and their effects on university students' mental health status. Therefore, the present study aimed to: (a) examine mental health status and subsequent predictors of clinically significant mental distress symptoms, (b) estimate the number and severity of stressful life events, and (c) explore the associations between mental health status, stressful life events (number and severity) and sociodemographic characteristics.

METHODS

This study was descriptive, cross-sectional, and correlational with internal comparisons. A convenience sample of 90 Master of Science in nursing and midwifery students, participated in the study. Participants with a General Health Questionnaire-28 (GHQ-28) total score ≥ 24 were considered to have clinically significant mental distress symptoms. Descriptive and inferential statistics were evaluated, and Pearson's chi-square test for group differences was used to analyse the data. Analysis of variance and t-tests were used for comparisons between two or more groups, and regression analyses were employed to identify the predictors of GHQ-28 scores and clinical mental distress symptoms.

RESULTS

The final sample comprised 90 students (response rate: 97.8%), 33 (36.7%) of whom reported clinically significant symptoms of mental distress. Students with divorced parents [29.92 (± 10.62), p < .05] scored high on the GHQ-28. Participants who had low/no satisfaction with the education system posted higher scores than participants who had high/very high satisfaction [24.82 (± 11.68) vs. 17.93 (± 9.78), p < .05]. In the subscale measuring depressive symptoms, there was a statistically significant gender difference, with men reporting higher scores than females. [3.0± (3.69) vs. 1.60 (± 2.42), p = .034]. In multiple analyses of sociodemographic characteristics and those who scored higher on the Life Events Scale for Students (LESS) scale (≥ 340), the loss of parent/s was associated with the total GHQ-28 score (B=-17.046, p < .001). In multiple analyses, chronic physical disorders or disabilities and numerous stressful life events among students (≥ 8 events) were correlated with higher overall GHQ-28 scores (B = 15.232, p < .005).

CONCLUSION

The high frequency of clinical symptoms of mental distress among postgraduate university nursing students and their correlation with stressful life events highlights the need for university counselling services to provide psychological support strategies to students.

Exploring the contribution and impact of master's education for leadership development in adult general nursing: A scoping review

AIM

The aim of this scoping review was to explore the evidence relating to master's education for leadership development in adult/general nurses who are not in advanced practice or leadership roles and its impact on practice.

BACKGROUND

The importance of effective, clinical leadership in nursing and health care, has been highlighted following failings reported by Public Inquiries both nationally and internationally. While initiatives have been implemented to address these, the provision of safe, quality care remains problematic. Complex care requires highly skilled professionals to challenge and lead improvements in practice. Master's education results in graduates with the skills and confidence to make these changes and to become the clinical leaders of the future.

METHODS

An a priori scoping review protocol was developed by the review team. This was used to undertake searches across CINAHL Ultimate; Medline (Ovid), Scopus and ProQuest Complete databases, chosen due to their relevance to the subject area. Articles were limited to those in the English Language, peer reviewed and published since 2009. Citation chaining via the reference lists of frequently identified articles were also searched. A further search for relevant grey material using the same relevant keywords and phrases was performed using the limited, Trip Database and Google Scholar.

RESULTS

Eight articles were selected for data extraction, and these were published between 2011 and 2019. The articles were predominantly from the UK and Europe, with a focus either on master's education or on aspects of leadership in nursing and healthcare. Themes identified: a) The need for clinical leadership; b) master's education for clinical leadership skills; and c) master's education for professional and organisational outcomes.

CONCLUSIONS

The scoping review identified that there is a need for strong clinical leadership in the practice setting. Evidence shows that effective nursing leadership can improve patient outcomes as well as enhancing workplace culture and staff retention. The review has shown that the skills required for clinical leadership are those produced by master's education. Studies of the impact of master's education are often self reported and tend to focus on nurses in advanced practice roles. More research is required into master's education for adult/general nurses not in advanced roles and in examining the link between master's education and improved patient, professional and organisational outcomes.

Nurses' knowledge and self-assessment of their clinical experiences of intraosseous access: A multicentre cross-sectional study

BACKGROUND

Intraosseous access is an effective and safe option when difficult vascular access occurs. The knowledge, competence, and clinical experience of nurses are collectively essential for the successful implementation of this approach in clinical practice. Education and clinical learning are the main pillars supporting this new practice to ensure patient safety. The aim of this study was to identify the nurses' knowledge and clinical experience of intraosseous access and the factors associated with the adoption of this procedure.

METHODS

A cross-sectional study was carried out from October to December 2020. A convenience sample of 432 nurses from four Italian hospitals were involved. A structured questionnaire was used to assess the nurses' knowledge of the intraosseous access guidelines and their clinical experience.

RESULTS

Most participants were female (71.5%) with more than 10 years of experience (63.7%) working in an emergency (38.9%) and medical (37.7%) setting. Most of the participants demonstrated their knowledge of the use of a device e.g., it is used if vascular access is not rapidly achieved in a child (83.1%) and the boluses of liquids required in the intraosseous procedure (72.7%). A few participants reported having placed intraosseous access (3.5%). A higher level of educational preparation and working in emergency and paediatric settings were associated with increased knowledge.

CONCLUSIONS

Our findings highlighted a sub-optimal level of knowledge of the IO procedure, little experience of this practice in clinical contexts, also associated with a lack of adequate protocols and devices available to nurses. Nurses need to develop their knowledge and practice the skill clinically to embed this practice. University and nurse educators should emphasise the relevance of this practice in nursing education and training, so as to improve the nursing care practice and level of patient safety.

Moral courage of master's students of nursing during COVID-19

BACKGROUND

Moral courage is a recognized virtue. In the context of the COVID-19 pandemic, the master's students of nursing (MSNs) in China have shown tenacious moral courage.

OBJECTIVE

This study elaborates on the moral courage of Chinese MSNs through their experiences of volunteering during the pandemic.

RESEARCH DESIGN

Descriptive qualitative, interview-based.

PARTICIPANTS AND RESEARCH CONTEXT

Participants were nursing postgraduate students who participated in the prevention and control of the COVID-19 pandemic selected by purposeful sampling. The sample size was determined by data saturation, which was reached with 10 participants. Data were analyzed using a deductive method of content analysis. Because of the isolation policy, telephone interviews were adopted.

ETHICAL CONSIDERATIONS

After obtaining the approval of the ethical institution of the author's school (No. 138, 30 August 2021), verbal consent was obtained before the interview with the participants. All data were processed anonymously and confidentially. In addition, we recruited participants through MSNs' counselors, and obtained their phone numbers with their permission.

RESULTS

Data analysis resulted in 15 subcategories that were subsequently grouped into 3 major categories including proceed without hesitation, the outcome of practicing moral courage, and develop and maintain moral courage.

CONCLUSION

This qualitative study is based on the special background of the COVID-19 pandemic, and the MSNs in China have shown tenacious moral courage in the work of epidemic prevention and control. Five factors led them to take action without hesitation, and six possible outcomes followed. Lastly, this study provides some suggestions for nurses and nursing students to enhance their moral courage. To better develop and support moral courage in the future, it is necessary to use different methods and multidisciplinary approaches to study moral courage.

Nurses' Perceptions of the Clinical Nurse Specialist Role Implemented in a Highly Specialized University Hospital in Spain: A Qualitative Study

PURPOSE/AIMS

To explore nurses' perceptions of clinical nurse specialist practice as implemented in a highly specialized university hospital in Spain.

DESIGN

A descriptive qualitative study was carried out in 3 inpatient wards, with a clinical nurse specialist within the team, at a high specialized university hospital in Spain.

METHOD

Semistructured interviews were conducted by purposive sampling with 17 selected nurses with at least 2 years of professional experience who voluntarily agreed to participate and signed the informed consent form. Analysis of the qualitative data was conducted according to Burnard's method of content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used.

RESULTS

Four main categories emerged from the analysis of the data: "qualities of the role-holder," "role competencies in practice," "integration with the team," and "impact of the role" on nursing, the patient, and the organization.

CONCLUSIONS

The findings of this study have interesting implications for the development and implementation of clinical nurse specialist practice in healthcare organizations. They also provide evidence of the benefit of implementing clinical nurse specialist practice for improving the quality of care, patient outcomes, and healthcare efficiency.

Nurses' Willingness and Demand for Internet +home Care Services and Its Influencing Factors in Different Levels of Hospitals in China - A Nationwide Survey

Purpose

The present study aimed to investigate nurses’ willingness and demand for Internet +home care services in different levels of hospitals in China and analyze the influencing factors.

Participants and Methods

From October 1 to December 31, 2021, 5714 nurses from 15 hospitals in five regions of China were recruited in this cross-sectional study using a two-stage random sampling method. A self-designed questionnaire with good reliability and validity was used to measure nurses’ willingness and demand for Internet +home care services. χ² test, Welch t-test, and multiple linear regression analyses were used to analyze the data.

Results

Nurses were highly willing to provide Internet +home care services. Statistical differences were found in the willingness to provide Internet +home care services and the preference for service distance, service platform, and single service fee between nurses in different levels of hospitals (both P<0.05). The willingness to provide “catheter maintenance service” and “rehabilitation nursing service” of nurses in different levels of hospitals were statistically significant (both P<0.05). Nurses’ demand for Internet +home care services increased with the level of their hospital. Multiple linear regression showed that professional title, educational level, monthly family income, and mortgage or car loan influence nurses’ demand for Internet +home care services.

Conclusion

Nurses’ willingness and demand for Internet +home care services vary with the level of their hospitals. It is recommended that government and hospitals regulate the service items, the service distance, single service fee, and other contents according to nurses’ willingness and demand and establish relevant laws and regulations to ensure the steady and orderly development of the Internet +home care services.

Capitalizing Upon Graduate Student Projects to Sustain Clinical Outcomes

As part of a clinical-academic partnership, graduate nursing students initiated evidence-based quality improvement projects in a large, metropolitan, 5-time Magnet®-designated pediatric hospital to encourage continuous innovation and evidence-based practice. This article describes the evolution and strategies used by leadership and staff to sustain the projects over time. Data collected by the organization report trended outcomes, highlight themes for success from graduate nursing students from 2017 through 2020, and report the implications for nurse executives.

Searching for a new normal-Hospital-employed researchers' experiences during the COVID-19 pandemic

BACKGROUND

This study focuses on hospital-employed researchers, a relatively new staff group. Their job descriptions vary, which may lead to lack of clarity or preparedness regarding their roles and core tasks during a crisis such as COVID-19.

AIM

The aim of this study was to explore hospital-employed healthcare researchers' experiences of work during the COVID-19 pandemic.

DESIGN

A qualitative design based on Graneheim and Lundman's latent content analysis of two focus groups with researchers in clinical practice was chosen to explore researchers' experiences of work during the COVID-19 pandemic.

METHODS

Fifteen hospital researchers participated in two focus groups, divided into predoctoral and postdoctoral researchers. Focus groups were conducted in May 2020 during the COVID-19 pandemic, using the voice over IP service, Skype®, due to risk of contagion.

FINDINGS

'Searching for a new normal during the COVID-19 pandemic' was the main theme during the latent content interpretation, with subthemes of (i) balancing calm and insecurity, (ii) negotiating core tasks and (iii) considering the future.

CONCLUSION

The 15 researchers tried to balance calm and insecurity within work and family, on standby for the hospital's contingency plan, and in their research tasks. This led them to negotiate their core tasks and to reflect on the changes and consequences for their positions as researchers in clinical practice in the future.

Evaluation index system of education quality for nursing professional degree postgraduate using the analytic hierarchy process

ABSTRACT

Nursing is an inseparable job with the healthy life of human beings. High-level nursing talents have a greater influence on patients. It is the future trend for schools to train Nursing Professional Degree Postgraduate, and the evaluation of their education quality is the top priority.To construct the education quality evaluation index system of Nursing Professional Degree Postgraduate and to determine the weight of each indicator.Firstly, the indicators of the evaluation index system of education quality were identified from the literature review. Meanwhile, the Delphi questionnaire was designed and 13 experts evaluated and rated the indictors who were invited to conduct two rounds of the questionnaire. The weights associated with the factors were determined using the analytic hierarchy process and percentage methods, Finally, we developed the evaluation index system of education quality for a postgraduate nursing professional degree.The evaluation system consisted of 4 first-level indicators, 17 second-level indicators, and 71 third-level indicators. According to the weights computed by analytic hierarchy process, first-level indicators are ranked as "Input quality" (0.1273), "Process quality" (0.3111), "Output quality" (0.0846), "Development quality" (0.4770). Among the secondary indicators, experts pay the most attention to career development (0.3180). The top three indicators of third-level indicators are workplace (0.2385), matching degree between personal expectations and job opportunities (0.1272), and promotion opportunities (0.0795).The quality index system of nursing postgraduate education is scientific and reliable, and the weight distribution is reasonable. It is an effective tool for evaluating the quality of nursing graduate education.

Maximising intercultural learning opportunities: learning with, from and about students from different cultures

Nurses continue to experience challenges when caring for culturally diverse patients and while working with staff from different cultural, ethnic and linguistic backgrounds. The widening landscape of cultural diversity in the nursing classroom provides a vehicle for intercultural learning, supporting intercultural competence development. However, students must embrace culturally diverse learning environments and maximise opportunities to learn with, from and about students from different cultural backgrounds. This requires developing the courage, curiosity and commitment to maximise all intercultural learning opportunities. Drawing on experiences of international students studying in culturally diverse classrooms, this article presents some practical suggestions for meaningfully engaging and capitalising on intercultural learning opportunities.

A survey of nurses' experience integrating oncology clinical and academic worlds

Aim

To better understand how oncology nurses (a) navigate graduate studies; (b) perceive the impact of their academic work on their clinical practice, and vice versa; and (c) engage with clinical settings following graduate work.

Design

Interpretive descriptive cross‐sectional survey.

Methods

A qualitative exploratory web‐based survey exploring integration of graduate studies and clinical nursing practice.

Results

About 87 participants from seven countries responded. 71% were employed in clinical settings, 53% were enrolled in/graduated from Master's programs; 47% were enrolled in/graduated from doctoral programs. Participants had diverse motivations for pursuing graduate studies and improving clinical care. Participants reported graduate preparation increased their ability to provide quality care and conduct research. Lack of time and institutional structures were challenges to integrating clinical work and academic pursuits.

Conclusions

Given the many constraints and numerous benefits of nurses engaging in graduate work, structures and strategies to support hybrid roles should be explored.

The role of Allied Health Professions and Nursing Research Internships in developing a research culture: a mixed-methods exploration of stakeholder perspectives

BACKGROUND

Developing research capability and capacity within the healthcare professions is a challenge throughout diverse international settings. Within England, the National Institute for Health Research aimed to address these challenges through the Integrated Clinical Academic (ICA) research careers escalator for nurses, midwives and allied health professionals. Poor academic progression has been identified in the advanced stages of the pathway, though progression from the earlier entry point (Internship) has not previously been investigated. A national evaluation of four completed Internship cohorts was undertaken to explore stakeholder perspectives and progression beyond the Internship programme.

METHODS

A mixed methods project used sequential qualitative and quantitative data collection phases commencing with two stakeholder focus groups (n = 10); the findings informed the development of an online survey distributed to previous cohorts of interns (n = 104), their managers (n = 12) and academic mentors (n = 36). Eight semi-structured interviews subsequently explored the challenges and opportunities afforded by the internships. Thematic analysis was used to review qualitative data from focus groups and interviews, with survey data analysed and displayed using descriptive statistics. Synthesis of data from each phase is displayed within the four level evaluation framework outlined within the New World Kirkpatrick® Training Evaluation Model.

RESULTS

Important regional differences exist yet the internships are highly valued by all stakeholders. Representation varied between different professions, with nursing and some service-based professions poorly represented. All interns successfully completed the programme (n = 104), with evidence of positive impacts on interns, colleagues and patient care. Balancing research commitments with clinical activity was challenging; middle managers were seen as gatekeepers to programme success. Progression to the next stage of the ICA pathway is highly competitive and was achieved by only a quarter of interns; access to mentors outside of the funded programme is vital for a successful transition.

CONCLUSIONS

The Internship programme succeeds in providing a range of important early experiences in research, though progression beyond the programme is challenging due, in part, to a widening gap between Internship and the next level of the ICA framework. Vital mentorship support to bridge this gap is threatened by a lack of time and funding; therefore, the pursuit of a clinical-academic career will continue to be elusive for many nurses and allied health professionals. A partnership approach to clinical academic support at institutional level is needed with several international models offering alternative strategies for consideration.

Does improved postgraduate capacity shift the balance of power for nurse specialists in a low-income country: A mixed methods study

AIM

To explore nurse specialists' experiences of change and influence on practice two years after graduating with a postgraduate degree.

BACKGROUND

In the absence of further study opportunities for nurses in their own country, a master's degree was introduced to train the first group of nurse specialists in Mozambique.

DESIGN

Within a hybrid evaluation framework an exploratory, sequential mixed methods design was followed.

METHODS

Qualitative data from focus group interviews with nurse specialists (N = 12) led to five thematic data sets from which survey questions were formulated for the sequential quantitative component.

FINDINGS

"Change expectations", "Ambiguous practice environments", "Feeling powerless", "Having some influence" and "Workplace support" were emergent themes from interview data. Areas of positive change occurred in research (100%) and the use of evidence (88.9%) and involvement in decision-making (77.8%). For some change did not happen as anticipated-reasons included lack of nurse mentors to support new graduates (55.6%); lesser respect compared with doctors (44.4%) and poor understanding of the value of a master's degree (44.4%). Improvements in service quality and elevating the status of nursing were areas of greatest influence (77.8%).

CONCLUSION

Several enabling and limiting factors were identified in the experiences of change and influence on practice of newly qualified nurse specialists. Tacit change with respect to the value of the degree in improving the status of nursing seems not to have affected nurse specialists' own ability and power to influence practice. Improved postgraduate capacity on its own does not empower nurses in their role as specialists.

IMPACT

The findings point to a two-tiered strategy to be developed to dismantle barriers to the empowerment and advancement of nurse specialists. The identification of designated nurse mentors is essential to induct and sustain newly graduated nurse specialists. A clear research policy should be developed that supports the conduct of relevant research and the use of evidence in specialist practice.

Postgraduate nurses' self-assessment of clinical competence and need for further training. A European cross-sectional survey

BACKGROUND

Nursing practice requires application of knowledge, skills and values in various combinations and has undergone substantial changes the last decades. An increased focus on inter-professional collaboration and possible new and more independent roles for nurses are described. A variety of programs have been developed in order to educate registered nurses (RN) to meet the changes and demands in health and nursing care throughout the world.

AIM

The aims were to 1) describe nurses' self-assessment of clinical competence and need for further training, and 2) explore possible differences between nurses in specialist vs master's programs.

METHODS

A cross-sectional survey design was applied. 97 nurses in postgraduate programs from five countries responded (response rate 45%). A revised version of the Professional Nurse Self-Assessment Scale of clinical core competencies (PROFFNurseSASII) was used for data collection. Independent student t-test and regression analyses were carried out.

RESULTS

The respondents rated their competence highest in taking full responsibility, cooperation with other health professionals and in acting ethically. Items where they considered themselves needing further training most were competence on medications, interaction and side effects and differential diagnoses. For all items, nurses in master's programs rated their competence higher than nurses in the specialist programs. Nurses in specialist programs rated their need for more training for all items higher than nurses in master's degree programs, and for 47 out of the 50 items these differences were statistically significant.

CONCLUSION

Even though the nurses rated their competence high for important competence aspects such as taking responsibility and cooperation with other health professionals, it is worrying that their need for further training was highest for effects and interaction of various types of medications. Further studies are needed to conclude if and how master's education improves patient outcome.

Evaluating a nurse scholarship programme: realising potential

Evaluation is an integral component of any nurse education programme and ideally requires a multi-method approach. This article describes both the formative and summative evaluation of the St Mark's Burdett nurse scholarship from the perspective of the health professionals involved. During the nursing scholar's specialty placements, their achievements were recorded alongside a more detailed insight into their ongoing development during weekly supervision sessions. The summative evaluation comprised recording their attendance at taught study days, progress in academic modules and one-to-one interviews. A survey was also conducted to gather feedback about the scholarship. The evaluation indicated that this programme helped the nursing scholars gain exposure to a broad range of gastrointestinal nursing clinical environments, provided them with the resources needed to continue to develop academically and professionally, and helped them to achieve career progression in specialist nursing.

Assessing the value of practice-based leg ulcer education to inform recommendations for change in practice

The purpose of this paper is to assess the value of accredited leg ulcer education in influencing changes in practice. This is a before and after educational evaluation that adopted a qualitative survey approach of 12 primary care nurses attending the Nurse-Led Assessment and Management of Leg Ulcers accredited CPD module at a London university. The findings revealed that 6 out of the 8 nurses who completed the final interviews were satisfied that all learning outcomes for the module had been met. All of the nurses commented they had changed at least one aspect of practice following the module with the majority stating a number of improvements had been made relating to improved knowledge, practical skills, treatment and patient concordance. The evaluation was limited to a small cohort of primary care nurses and further longitudinal research is required to investigate the effectiveness across multiple cohorts.