Escape Rooms in Nursing Education: A Systematic Review

BACKGROUND

Escape rooms (ERs) are being increasingly used in nursing education as an active and game-based learning method.

PURPOSE

To conduct a systematic review to synthesize evidence on the current use of ERs in nursing education.

METHODS

A mixed methods systematic review was performed to identify and synthesize existing literature. Five databases were searched in July 2023. Descriptive and thematic analysis were used to synthesize quantitative and qualitative data, respectively.

RESULTS

A total of 333 studies were found after searching 5 databases. After 2 independent reviews, a total of 57 studies were identified across 5 countries. There were 16 qualitative studies, 34 quantitative studies, and 7 mixed methods studies. Four main themes were identified.

CONCLUSIONS

ERs are widely used across different topics and settings in nursing education and are enjoyed by the majority of participants; however, more rigorous research is needed to confirm whether ERs improve learning outcomes.

Celebrating Australian nurses who are pioneering the response to climate change: a compilation of case studies

BACKGROUND

Nurses, the largest healthcare workforce, are well placed to provide leadership in initiatives that promote planetary health. Yet, few practical examples of nurse leadership in the health sector's response to climate change are evident in the scholarly literature.

AIM

The aim of this discussion paper is to profile Australian nurses who are leading initiatives designed to champion planetary health and promote sustainable practice.

METHODS

The paper presents a series of case studies derived from interviews conducted in October and November 2023.

FINDINGS

The nurses' experiences and insights, along with the challenges they have encountered, are presented as evidence of Kouzes and Posner's five practices of exemplary leadership.

CONCLUSION

The case studies demonstrate that appointment of more nurses with climate and sustainability expertise will accelerate the implementation of responsive strategies that target waste management, emissions reduction and climate resilience across healthcare organisations.

Promoting sustainability in nursing and midwifery clinical laboratories: Strategies for resource reduction, reuse, and recycling

BACKGROUND

The impacts of climate change on planetary health are multifaceted and threaten public health gains made since World War II. Healthcare is the fifth largest global emitter of greenhouse gas emissions, demanding significant efforts to transition to an environmentally sustainable future. Addressing these issues will require collective societal action. In this regard, universities have a dual responsibility - (1) to tackle complex social, economic, and environmental challenges by championing sustainability initiatives designed to positively impact planetary health; and (2) to ensure that graduates are equipped with the knowledge, attitudes and skills needed to steward planetary health towards a more sustainable future. The future nursing and midwifery workforce must be educated to mitigate the health sector's impact on the environment, advocate for action on climate change, prepare for ongoing health impacts of unpredictable climate and environmental changes, and help communities and healthcare systems become more climate resilient.

WHAT THIS PAPER CONTRIBUTES

To help increase nursing and midwifery educators' and students' capacity to support planetary-health related interventions, the overarching purpose of this paper is to provide a series of exemplars that illustrate sustainability initiatives used in four university-based clinical skills laboratories. These initiatives each demonstrate a commitment to the United Nation's Sustainable Development Goals and can be used to help embed the importance of planetary health in student learning.

'You don't see what I see': Co-designing simulation to uncover and address cognitive bias in healthcare

EDUCATIONAL CHALLENGE

Each year, adverse events are reported in healthcare, of which many relate to healthcare workforce cognitive bias. The active involvement of workforce and consumers in the review and co-design of effective training for the healthcare workforce to recognise, monitor, and manage unconscious bias is required.

PROPOSED SOLUTION

We used participatory action research to co-design an innovative, interprofessional simulation based on 'real world' clinical incidents and lived experiences to improve the delivery of safe, high quality, consumer-focused healthcare. Following ethics approval, content analysis of serious adverse patient safety events involving cognitive bias was conducted. These data informed audio-recorded interviews with the healthcare workforce and consumers to explore their experiences of cognitive bias. Following thematic analysis, key themes of communication, stigma, diagnostic overshadowing, and fragmented systems were uncovered. Guided by consumers, these themes were interwoven into a simulation scenario that included real places, stories, and verbatim quotes delivered through mixed media artefacts. This heightened the immersive and experiential learning that aimed to uncover unconscious bias and help learners recognise its impact on clinical decisions and practice.

POTENTIAL BENEFITS AND NEXT STEPS

To our knowledge, this is the first interprofessional, co-designed simulation to specifically address cognitive bias in current and future healthcare workforce. Plans to translate this research into a practical framework on how to work with key stakeholders (including consumers) to identify 'real-world' health service risks and co-design targeted simulations to address these gaps are described, including lessons learned.

What does consumer and community involvement in health-related education look like? A mixed methods study

Consumer and community involvement (also referred to as patient and public involvement) in health-related curricula involves actively partnering with people with lived experience of health and social care systems. While health professions education has a long history of interaction with patients or consumers, a shift in the way consumer and community engage in health-related education has created novel opportunities for mutual relationships valuing lived experience expertise and shifting traditional education power relations. Drawing on a mixed methods design, we explored consumer and community involvement practices in the design and delivery of health-related education using the capability, opportunity, motivation and behaviour framework (COM-B). In our results, we describe educator capabilities, opportunities and motivations, including identifying barriers and enablers to consumer and community involvement in health-related education. Educators have varying philosophical reasons and approaches for involving consumers and community. There is a focus on augmenting student learning through inclusion of lived and living experience, and on mutual transformative learning through embedding lived experience and co-creating learning. How these philosophical positionings and motivations shape the degree by which educators involve consumers and community members in health-related curricula is important for further understanding these educational partnerships within universities.

"I teach it because it is the biggest threat to health": Integrating sustainable healthcare into health professions education

BACKGROUND

Steering planetary and human health towards a more sustainable future demands educated and prepared health professionals.

AIM

This research aimed: to explore health professions educators' sustainable healthcare education (SHE) knowledge, attitudes, self-efficacy and teaching practices across 13 health professions courses in one Australian university.

METHODS

Utilising a sequential mixed-methods design: Phase one (understanding) involved an online survey to ascertain educators' SHE knowledge, attitudes, self-efficacy and teaching practices to inform phase two (solution generation), 'Teach Green' Hackathon. Survey data was descriptively analysed and a gap analysis performed to promote generation of solutions during phase two. Results from the hackathon were thematically analysed to produce five recommendations.

RESULTS

Regarding SHE, survey data across 13 health professions disciplines (n = 163) identified strong content knowledge (90.8%); however, only (36.9%) reported confidence to 'explain' and (44.2%) to 'inspire' students. Two thirds of participants (67.5%) reported not knowing how best to teach SHE. Hackathon data revealed three main influencing factors: regulatory, policy and socio-cultural drivers.

CONCLUSIONS

The five actionable recommendations to strengthen interdisciplinary capacity to integrate SHE include: inspire multi-level leadership and collaboration; privilege student voice; develop a SHE curriculum and resources repository; and integrate SHE into course accreditation standards.

Holding Multiple Identities: a Personal Narrative of Young Onset Colorectal Cancer

This is a personal narrative of my experience as a young man diagnosed with colorectal cancer. It is an exploration of the tension between multiple identities, including a clinical nurse specialist, academic and oncology patient. Young patients with colorectal cancer face particular challenges. They are often diagnosed with more advanced and poorly differentiated cancers. Research around young onset colorectal cancer is controversial, with some studies suggesting poorer survival. Although there is research in this area, there are few qualitative accounts that describe raw, honest and diverse narratives of colorectal cancer experiences, especially in young people. Writing personal narratives is a powerful experience, it has allowed me to tell my story to the world and given me time to reflect and make sense of my new reality. Although this journey has forced me to let go of my old identity, and embrace a new and challenging existence, the truth is that being diagnosed with cancer stinks. Writing this narrative is an uncomfortable process, punctuated with truths that are difficult to speak. However, sharing my story has provided a platform for self-exploration, a safe space to narrate my experience with cancer in the hope that it helps other clinicians, researchers and patients.

'12 tips for teaching environmental sustainability to health professionals'

Background: As recognition of the health impacts of climate change and other environmental challenges increases, so too does the need for health care professionals to practice healthcare sustainably. Environmental sustainability in healthcare extends beyond our traditional understanding of environmental health, which is often limited to environmental hazards and disease. Health services, professional organizations, and training institutions are increasingly forming climate and sustainability position statements and policies accordingly. To prepare future health professionals for global environmental change, environmental sustainability must be meaningfully integrated into health curricula.Aim: To provide educators with 12 tips for integrating environmental sustainability into health professional education.Methods: The authors reviewed the literature relating to climate change, environmental sustainability and health, and health professional education. By combining findings from this search with reflections on their own experience in clinical and public health teaching across nursing and midwifery, paramedicine, medicine, and public health, the authors developed recommendations for integrating environmental sustainability into health professional education.Results: These 12 tips can be used to teach students and qualified health professionals in nursing, allied health, and medicine to practice healthcare in an environmentally sustainable manner.Conclusions: Empowering health professionals to practice environmentally sustainable healthcare has economic, social, health, and environmental benefits. Teaching environmental sustainability to health professionals enhances existing learning by updating curricula with the latest evidence of how environmental determinants of health are rapidly changing and enables both educators and students to make an important contribution to safeguarding human health, the environment, and healthcare for future generations.

Improving student-centered feedback through self-assessment

BACKGROUND

Traditionally, feedback on written work is unidirectional, with academics feeding back to students. This project aimed to establish bi-directional feedback between the student and academics through a process of self-assessment.

OBJECTIVES

To improve the process of student-centered feedback by including a self-assessment component to an assessment task.

DESIGN

A two-phased, mixed methods explanatory sequential approach was used.

SETTINGS

Students were enrolled across two campuses at a large university in Victoria, Australia.

PARTICIPANTS

The Phase One sample consisted of all students enrolled in Year One and Year Three of the Bachelor of Nursing. There were 484 students enrolled in Year One, and 419 students enrolled in Year Three. Some students elected not to complete the self-assessment rubric, and those students were removed from the sample. This left 430 Year One, and 324 Year Three assessments in the sample. Convenience sampling was used in Phase Two to collect qualitative data via semi-structured focus groups from students in years One and Three.

METHODS

Quantitative data of student-assessed and academic-assessed marks were entered by a research assistant and then analysed using SPSS. Qualitative data were collected from a semi-structured interview and focus group with Year One and Year Three students. Qualitative data were then thematically analysed.

RESULTS AND CONCLUSIONS

Year One students were closer at estimating their own grade (M = 3.60; SD = 11.94) than Year Three students (M = 6.47; SD = 12.81). Students often underestimated their grade to see if the marker would match it or provide them with a higher grade. Year One students have trouble finding and utilising evidence while Year Three students cite this as a strength. When students engaged with the process, their self-review of work enabled them to improve the work prior to submission, and academic feedback was more meaningful. However, many students lacked trust in the process, and instead opted to 'game the system', hoping to hide flaws in their work, or draw extra marks from an academic by marking their own work down.

HEALTH HISTORY TAKING WITH VOLUNTEER PATIENTS

Monash University aims to produce dynamic graduate nurses and midwives recognized for their excellent, innovative practice and positive impact on people's lives.

Nurses' experiences of supervising nursing students who demonstrate unsafe practices in clinical placements: a systematic review protocol

This review explores the experiences of nurses who have supervised nursing students on clinical placement who demonstrate unsafe practices. The primary objective is to identify and synthesize the best available evidence on the experiences of nurses supervising students who demonstrate unsafe practices in clinical placements. The secondary objective is to explore why nurses award pass grades to students who demonstrate unsafe performance in clinical placements. The review question is "what is the experience of nurses supervising nursing students who demonstrate unsafe practices in clinical placements?"