The invisible work of co-creating disability access in work integrated learning.

Promoting health equity necessitates the diversification of healthcare workforces. Disability is one aspect of diversity that is increasing in healthcare. While the number of Disabled students in health professions increases, barriers in their work integrated learning (WIL), such as placements in hospitals or clinics, persist. While literature has addressed some of these barriers, there is less known about the social processes that enable access in work integrated learning when it does occur. Therefore, an interdisciplinary team from design, geography, occupational science, nursing, occupational therapy, critical disability studies, and knowledge mobilization explored questions regarding social processes involved in WIL accessibility in clinical settings. The team conducted twenty-five in-depth interviews with 4 placement coordinators, 8 placement supervisors, 6 access professionals, 4 education leaders (e.g. Deans) and 3 healthcare leaders (e.g. site education leaders) from two hospitals and two universities in eastern Canada. The team's collaborative thematic analysis of participant narratives constructed four themes regarding the invisible work clinical and academic educators engage in to create access: putting in extra time, doing emotional labour, engaging in relational work, and navigating complexities. This labour is unrecognized and optional, and therefore its result-access to education-is inequitably distributed. Educators, policy makers, and institutions need to know how access is created in WIL to promote diversity within health professions and systems.

Thinking rhizomatically and becoming successful with disabled students in the accommodations assemblage: Using storytelling as method.

The number of disabled students enrolled in higher education institutions is increasing. Yet in disciplines such as nursing, where placements are an important part of student success, students' lived experiences, though an important and necessary aspect of promoting equity, diversity, and inclusion, has been ignored. In this paper, we respond to such issues by creating and utilizing a novel storytelling method that harnesses the antiessentialist philosophy of Deleuze and Guattari. Storytelling empowers students to both describe their experiences and inform institutions on how to better serve them, and we use concepts from Deleuze and Guattari to provide a framework for thinking about students and their pathways toward success as multiple. As we show, applying storytelling as a method through this lens offers an expansion of strategies to put students first and, therefore, promote equity at the administrative, research, educational, and practical levels. We describe how thinking rhizomatically opens new avenues of insight, allowing for the creation of institutional assemblages based on a diverse array of students' needs, enabling them to become successful in their own ways.

Can improvement in hormonal and energy balance reverse cardiovascular risk factors in athletes with amenorrhea?

Female athletes display a high prevalence of hypothalamic amenorrhea as a result of energy imbalance. In these athletes with amenorrhea, decreased luteinizing hormone/follicule-stimulating hormone secretion leads to deficiency in endogenous estrogen. The severe estrogen deficiency in these athletes may increase cardiovascular risk similar to that in postmenopausal women. This review discusses the potential cardiovascular risk factors in athletes with amenorrhea as a result of hypoestrogenism, which include endothelial dysfunction and unfavorable lipid profiles. We also consider the potential to reverse the cardiovascular risk by restoring energy or hormonal imbalance along the reproductive axis in athletes with amenorrhea.

Medical Aesthetics Training: Shifting to Collective Competence.

With increased demands for medical aesthetics procedures and the sudden profusion of newly licensed, and unlicensed, providers who are performing these medical aesthetics procedures also comes the responsibility to shift to collective competence. Collective competence refers to what occurs among professionals in action, emphasizing the sharing of experiences, knowledge, and perceptions among those who are providing services to the medical aesthetics client. Registered nurses and medical students are not taught to perform cosmetic procedures in basic nursing or medical programs and thus require a post-entry-level education to validate their competency. The current medical aesthetics apprenticeship training approach of see one, do one, and teach one focuses on teaching technical skills and thus does not sufficiently address the ever-changing health care context and the ambiguity in practitioner role. Recent scholars highlight that when health care failed or an error has been identified, it is rarely adduced to an individual's competence but rather is more likely to be a failure of the collective team. In this article, we are advocating for a change in how medical aesthetics practitioners are trained. In particular, it advocates creating opportunities within the curricula to train practitioners as a collective body, as opposed to providing training that focuses on the individual's competence and technical skills alone.

To Blog or Not to Blog: What Do Nursing Faculty Think?

BACKGROUND: Nurse educators find themselves tasked with developing content that both is aesthetically appealing and engages today's technological learners while empowering them to apply their knowledge in clinical and classroom settings. Students engaging with social networking systems reported increased satisfaction with collaborative peer-to-peer learning experiences, socialization, self-reflection, peer critique, problem-solving skills, collation of evidence-based resources, and instructor performance. METHOD: This project included identifying the needs of nursing faculty regarding the use of blogging in their courses and barriers faced by faculty with implementing blogging in nursing curricula. A convenience sampling method was used, with surveys e-mailed to 49 schools of nursing in Illinois and 38 in Ontario. RESULTS: One hundred twenty-two surveys were completed: 78 in Illinois and 44 in Ontario. Results suggest there are many pedagogical, philosophical, and ethical issues associated with using blogging and technology in nursing education. CONCLUSION: Although significant challenges exist, blogging and technology can be useful collaborative learning tools. [J Nurs Educ. 2016;55(12):683-689.].

An Inquiry Into the Role of the Aesthetic Nurse: "Should Nurses Sell?".

I am a registered nurse, working for more than a decade. In the last few years, I decided to pursue my passion in the field of medical aesthetics. I invested in learning new skills through training and certification programs and was excited to attain employment in my chosen field. Yet, despite my qualifications, many employers were measuring my competency as an aesthetic nurse on the number of neuromodulators and dermal fillers I was able to inject or, to put it bluntly, able to sell. Many asked me to role-play exactly how and what I would say to "close the sale." These experiences caused me to reflect "Should nurses sell?" and "Is it ethical for nurses to sell?" In this article, I set out to explore these dilemmas and their implications on the role of the aesthetic nurse, using diverse perspectives in the current literature.

Older Adults' and Caregivers' Perspectives on In-Home Monitoring Technology.

In the past decade, there has been an increase in the application and investigation of in-home monitoring systems to support older adults with dementia and their caregivers. The current study focused on a monitoring system that included the use of motion sensors and Internet connections with one-way communication capabilities. Only a limited number of studies have explored and compared older adults' and caregivers' perspectives on such monitoring systems. The purpose of the current study was to explore older adults' and caregivers' perspectives on in-home monitoring systems using photo elicitation techniques. Three overarching themes emerged: (a) feeling cared for (which included two sub-themes), (b) feeling cared about (which included three sub-themes), and (c) suggestions for change (which included four sub-themes). These results revealed the duality of care when using in-home monitoring. Clinical and other future implications are discussed. [Journal of Gerontological Nursing, 42(6), 43-50.].

Integrative review of blogging: implications for nursing education.

This integrative review explores the question, "What is known about blogging as a pedagogical tool in nursing education?" The qualitative methods of this review are based in social constructivism and collaborative learning principles. Results of a literature search that used inclusion and exclusion criteria identified 15 articles, five of which were related to nursing. Deductive analysis was focused on capturing data under three broad themes that reflect collaborative learning principles with respect to blogging and microblogging. These themes include (a) learning occurs through dialogue and collaboration, (b) learning involves challenging opportunities that stimulate learner engagement, and (c) learning is a social process. Analysis indicates that blogging has the potential to enhance knowledge acquisition, provide stimulating learning opportunities, and recognize the social aspects of learning. However, further research is needed to fully understand the development, implementation, and evaluation of blogging on student knowledge acquisition in nursing education.

Learn the game but don't play it: nurses' perspectives on learning and applying statistics in practice.

BACKGROUND: An integrative review regarding undergraduate level statistics pedagogy for nurses revealed a paucity of research to inform curricula development and delivery. OBJECTIVE: The aim of the study was to explore alumni nurses' perspectives about statistics education and its application to practice. DESIGN: A mixed-method approach was used whereby a quantitative approach was used to complement and develop the qualitative aspect. SETTING: This study was conducted in Toronto, Ontario, Canada. PARTICIPANTS: Participants were nursing alumni who graduated from four types of nursing degree programs (BScN) in two Ontario universities between the years 2005-2009. METHODS: Data were collected via surveys (n=232) followed by interviews (n=36). RESULTS: Participants reported that they did not fear statistics and that they thought their math skills were very good or excellent. They felt that statistics courses were important to their nursing practice but they were not required to use statistics. Qualitative findings emerged in the two major themes: 1) nurses value statistics and 2) nurses do not feel comfortable using statistics. CONCLUSIONS: Nurses recognize the inherent value of statistics to improve their professional image and interprofessional communication; yet they feel denied of full participation in application to their practice. Our findings have major implications for changes in pedagogy and practice.

Ethical concerns in the student/preceptor relationship: a need for change.

Nursing schools are required to ensure that the clinical and academic milieu prepares nurses not only to recognize but also to act on various ethical issues. As a result of our years teaching nursing ethics to undergraduate nursing students we have come to believe there is a disconnect between classroom teaching and students' experiences in practice. How then can nurse educators help nursing students not only to see the ethical components of their work but also to take the necessary steps to solve ethical dilemmas and challenge unethical practice? One such strategy is the use of preceptorship. In this paper, we set out to learn about nursing students' ethical encounters in the clinical area, specifically those within the preceptor/student relationship. To this end we conducted an integrative review and are weaving in Gesler's (1992) concepts who argued that ethical issues play out in our physical and social environments. We identified nine articles that describe students' perceptions of ethical problems in their relationships with preceptors. However, it was rare for the authors of these articles to label these as 'ethical' issues. The integrative review revealed first, that students describe ethical issues in their narratives, and second, their most common response to these issues is silence. We continue to be concerned that nursing students' classroom learning of ethics is disconnected from their everyday nursing practice. Further research and education implications are discussed and explored in this paper.

Using puppetry to elicit children's talk for research.

Although puppets have been employed by various disciplines in clinical and community (e.g. homes and schools) environments, little has been written about their use as a communication tool in research. In this article, a critical review of the literature is undertaken integrating the use of puppets in a qualitative research study exploring children's perspectives on and responses to a camp for children with cancer. Methodological considerations and ethical issues of using puppets as a data collection technique are discussed. Although some limitations exist, using puppets in interviews with children appear to help them to identify, clarify and verbalize their feelings.

Children receiving chemotherapy at home: perceptions of children and parents.

The aim of this descriptive exploratory study was to determine the perspectives of parents and children with cancer on a home chemotherapy program. Qualitative analyses were used to organize data from 24 parents and 14 children into emerging themes. Themes included (1) financial and time costs, (2) disruption to daily routines, (3) psychological and physical effects, (4) recommendations and caveats, and (5) preference for home chemotherapy. When home chemotherapy was compared with hospital clinic-based chemotherapy, parents reported fewer financial and time costs and less disruption to their work and family schedules, and children reported more time to play/study, improved school attendance, and engagement in normal activities. Although some parents felt more secure with hospital chemotherapy, most found it more exhausting and stressful. At home, children selected places for their treatment and some experienced fewer side effects. Although some coordination/communication problems existed, the majority of parents and children preferred home chemo-therapy. Home chemotherapy treatment is a viable, acceptable, and positive health care delivery alternative from the perspective of parents and children with cancer.

The effects of camp on health-related quality of life in children with chronic illnesses: a review of the literature.

Chronic illness in children may negatively affect aspects of health-related quality of life (HRQL). Over many years, camps have been organized to address the physical and psychosocial needs of children with various chronic illnesses, while providing a "normal" as possible camp experience. The aim of this study was to critically review all research examining the effect of camps on HRQL in children with chronic illnesses. The literature review yielded no randomized, controlled clinical trials; 8 pretest-posttest study designs with repeated measures; 9 pre-post studies; and 1 survey design. A total of 1270 children, ranging in age from 6 to 25 years, participated in the studies.

Adventure therapy for adolescents with cancer.

The objective of this study was to describe adolescents' with cancer experience in an adventure therapy program from a health related quality of life (HRQL) perspective. A qualitative descriptive research method was used. Eleven adolescents and five health professionals participated in a guided group adventure therapy expedition in a remote area of Canada. The expedition was videotaped and data were collected using an unstructured interview format with both adolescents and health professionals. Emerging themes were identified using a qualitative descriptive exploratory analysis. Four major themes and related sub-themes were generated. The major themes were: developing connections, togetherness, rebuilding self-esteem, and creating memories. Adventure therapy was viewed by the adolescents and health care professionals as a positive experience with multiple benefits. This preliminary research will contribute to an understanding of adolescents' experiences with cancer and provide a basis for future studies evaluating the impact of adventure therapy on HRQL.

Adventure therapy: a mental health promotion strategy in pediatric oncology.

In adventure therapy (AT), health professionals and adolescents with cancer come together to explore the wilderness of nature. One goal of this therapy is to encourage the adolescents to enhance their self-concept as part of an overall physical, cognitive, emotional or spiritual, social and psychological, or developmental rehabilitation that promotes health. The adolescents with cancer who participate in AT also learn about themselves through self-evaluation, self-exploration, self-reevaluation, self-acceptance, and self-realization. Mental health promotion (MHP) is considered a perspective and a strategy to promote health. An AT experience could be an example of an MHP initiative in which nurses can take a leadership role in participating, and further investigating, the health effects of AT on adolescents with cancer.