"A Different Normal": Living With Cancer During the COVID-19 Pandemic in Australia.

BACKGROUND: The COVID-19 pandemic has seen mass disruptions to healthcare globally. People with cancer are in a vulnerable position, and treatment teams may be anxious in making decisions that try to balance risks associated with malignant disease with those of potential exposure to COVID-19. In addition, palliative care is likely to have experienced significant burdens during the pandemic. As a result of COVID-19 disturbances, people with cancer and their caregivers may have increased stressors and therefore poor outcomes. OBJECTIVE: The aim of this study was to explore the experiences of people with cancer and their caregivers during the COVID-19 pandemic, with the aim to inform future oncology practice during infectious crises. METHODS: This qualitative study had 2 stages. Stage 1 involved key informant interviews (n = 16) conducted with healthcare professionals working in cancer care. These were used to inform the stage 2 interview guide for participants who had cancer or were caregivers of someone with cancer (n = 19). Data were thematically analyzed using NVivo. RESULTS: Five interconnected themes were identified from the interviews: uncertainty and vulnerability, constraints and restrictions, isolation and disconnection, burdens and stressors, and adaptability and resilience. Across themes, complexity and diversity in experience were demonstrated. CONCLUSIONS: The findings suggest cancer concerns outweigh those associated with the COVID-19 pandemic. Many difficulties experienced by healthcare professionals and people with cancer during the COVID-19 pandemic were related to social isolation. IMPLICATIONS FOR PRACTICE: Provision of psychosocial and spiritual telehealth services should be increased. It is important during times of crisis to pay attention to those who are most vulnerable.

The relationship between feedback and evaluative judgement in undergraduate nursing and midwifery education: An integrative review.

AIM: This integrative review aims to explore the relationship between feedback and evaluative judgement in undergraduate nursing and midwifery education. BACKGROUND: Research in higher education has shown that feedback practices can lead to students' developing evaluative judgement; thought critical for performance improvement and life-long learning. While literature in nursing and midwifery education has not yet employed the term 'evaluative judgement' explicitly, there might be similar concepts and practices that seek to develop students' judgement of performance that sustain learning beyond the immediate task. DESIGN: An integrative review of the nursing and midwifery feedback literature. METHODS: In February 2020, six online databases (CINAHL, ProQuest, Scopus, ERIC, PsycINFO, Ovid MEDLINE) were systematically searched for literature published between January 1989-February 2020. Synonyms for feedback and evaluative judgement were used to inform our search. This review included a rigorous team-based, five-stage approach: (1) identifying the problem; (2) conducting the search; (3) evaluating the data; (4) analysing the data; and (5) presenting the integrative review. RESULTS: A total of 1408 studies were initially retrieved with 543 duplicates. 865 abstracts were screened using eligibility criteria, resulting in the exclusion of 835 studies. Thirty full-text studies were appraised for quality. Eighteen studies with diverse methodologies achieved a medium-high quality score for inclusion in data analysis. Conceptions of feedback and evaluative judgement were identified in all studies; despite none using the term 'evaluative judgement' explicitly. Thematic analysis of the studies resulted in seven themes: conceptions of feedback, purposes of feedback, sources of feedback, modes of feedback, conceptions of evaluative judgement, purposes of evaluative judgement and relationships between feedback and evaluative judgement. CONCLUSIONS: While our findings supported contemporary higher education research, the feedback-evaluative judgement relationship is novel in nursing education. We encourage educators to design feedback activities privileging students' active engagement through dialogic feedback, reflection and self-assessment, to develop their evaluative judgement of practice.

"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.

Caring for deteriorating paediatric patients in the emergency department: A mixed method study.

BACKGROUND: Paediatric presentations to emergency departments are common for a range of conditions with varying severity. Children can compensate well and early signs of deterioration may not be obvious. Nurses working in emergency departments (ED) should not only have the knowledge and skill to recognise the unwell child, but also be confident and competent to provide care. AIM: To explore the self-reported preparedness, confidence and competence of emergency nurses in caring for deteriorating paediatric patients, and to identify how their confidence and competence could be improved. METHODS: An exploratory sequential mixed methods study with two phases was used. In Phase One, qualitative data were collected via focus group and thematically analysed. The findings from Phase One informed Phase Two survey development, with quantitative data collected and analysed. RESULTS: Findings from both phases identified that emergency nurses' confidence and competence when caring for deteriorating paediatric patients did not correlate with their level of qualification. In contrast, increased years of experience in caring for this cohort did increase level of confidence. Availability of human resources further impacted nurses' confidence when caring for deteriorating paediatric patients and emergency nurses showed an interest and enthusiasm for further education in caring for the deteriorating paediatric patient. CONCLUSIONS: Regular exposure to paediatrics was key to nurses having confidence and competence to care for deteriorating patients, irrespective of educational qualifications. A focus on interprofessional insitu simulation could address human resource challenges to enhance skill development.