Development of accreditation standards for interprofessional education: a Canadian Case Study.

BACKGROUND: Academic institutions worldwide are embedding interprofessional education (IPE) into their health/social services education programs in response to global evidence that this leads to interprofessional collaborative practice (IPC). The World Health Organization (WHO) is holding its 193 member countries accountable for Indicator 3-06 ('IPE Accreditation') through its National Health Workforce Accounts. Despite the major influence of accreditation on the quality of health and social services education programs, little has been written about accreditation of IPE. CASE STUDY: Canada has been a global leader in IPE Accreditation. The Accreditation of Interprofessional Health Education (AIPHE) projects (2007-2011) involved a collaborative of eight Canadian organizations that accredit pre-licensure education for six health/social services professions. The AIPHE vision was for learners to develop the necessary knowledge, skills and attitudes to provide IPC through IPE. The aim of this paper is to share the Canadian Case Study including policy context, supporting theories, preconditions, logic model and evaluation findings to achieve the primary project deliverable, increased awareness of the need to embed IPE language into the accreditation standards for health and social services academic programs. Future research implications are also discussed. CONCLUSIONS: As a result of AIPHE, Canada is the only country in the world in which, for over a decade, a collective of participating health/social services accrediting organizations have been looking for evidence of IPE in the programs they accredit. This puts Canada in the unique position to now examine the downstream impacts of IPE accreditation.

Perspectives from Academic Leaders of the Nursing Faculty Shortage in Canada.

There is a world-wide shortage of nursing faculty, which is complicated by the need for French, English, and bilingual professors in Canada. The purpose of this qualitative study was to explore the current status and effects of the nursing faculty shortage on Canadian Schools of Nursing (SON) from a leadership perspective. We conducted semi-structured interviews with 12 Deans and Directors of Canadian Schools of Nursing. The participants spoke about the faculty shortage in terms of demand, supply, and strategies employed. The participants were concerned about the ramifications of some of the decisions deemed necessary for continued viability of their programs, such as over-assigning teaching workloads. In light of mass upcoming retirements, shortening the time to completion for PhD studies and making graduate education more accessible are important priorities.

Cultural competence and cultural safety in Canadian schools of nursing: a mixed methods study.

Cultural competence and cultural safety are essential knowledge in contemporary nursing care. Using a three-phase, mixed methods sequential triangulation design, this study examines the extent to which Anglophone Schools of Nursing in Canada have integrated cultural competence and/or cultural safety into the undergraduate nursing curricula. Factors that influence successful integration are identified through the lens of Donabedian's structure, process, and outcome model. Results suggest that several facilitating factors are present, such as leadership, partnerships and linkages, and educational supports for students. Of particular concern is the lack of policies to recruit and retain Aboriginal faculty, financial resources, and outcome evaluation indicators. A conceptual model of integration is offered to explain how Schools of Nursing function to support the implementation of these concepts into their curriculum. This study provides theoretical and practical implications for initiation and improvement of cultural competence and/or cultural safety integration strategies in Schools of Nursing.

Advancing career counseling and employment support for survivors: an intervention evaluation.

The purpose of this research was to conduct a replication-based and extension study examining the effectiveness of a 5-week career group counseling intervention, Advancing Career Counseling and Employment Support for Survivors (ACCESS; Chronister, 2008). The present study was conducted in a markedly different geographic region within a larger community as compared with the original investigation conducted by Chronister and McWhirter (2006). Women survivors of intimate partner violence (N = 73) participated in ACCESS, with career-search self-efficacy, perceived career barriers, perceived career supports, anxiety, and depression assessed at preintervention, postintervention, and 8-week follow-up. Women survivors demonstrated significant improvements in career-search self-efficacy and perceived career barriers at postintervention. Moreover, these same improvements were maintained at the 8-week follow-up assessment with the addition of significant improvements in perceived future financial supports, anxiety, and depression compared with preintervention scores. This work replicates the initial findings regarding the effectiveness of ACCESS with respect to career-search self-efficacy (Chronister & McWhirter, 2006) as well as extends the initial research to include improvements in perceived career barriers and perceived career supports. Moreover, the present study extends the work to include the mental health outcomes of anxiety and depression; results demonstrated improvements in these areas at 8-week follow-up. This investigation begins to fill a critical need for evaluated career-focused interventions for the underserved population of women survivors of intimate partner violence.

The Perceived Impact of Ashwagandha on Stress, Sleep Quality, Energy, and Mental Clarity for College Students: Qualitative Analysis of a Double-Blind Randomized Control Trial.

Stress, anxiety, and depression, along with feeling overwhelmed and exhausted have been widely reported by college students as factors that negatively impact their academic performance, and overall well-being. Ashwagandha is an Ayurvedic herb that has been used historically to support healthy responses to stressors, but has recently gained popularity in the United States for its ability to support well-being for populations who experience chronic stress. To our knowledge, there have not been any human trials evaluating the efficacy of ashwagandha on stress in the United States. No studies to date have used qualitative research methods to consider the experiential impact of ashwagandha supplementation. Our purpose was to explore the lived experiences of college students participating in a double-blind randomized control trial evaluating the impact of ashwagandha as an intervention to support college students' well-being. Participants were college students (N = 60) age 18-50 years, who were randomized to either intervention or placebo group to take one capsule twice a day for 30 days. Intervention group participants took 700 mg of full spectrum extract of ashwagandha root per day, whereas those in the placebo group took glycerol capsules. Qualitative data included daily affect check-ins and focus groups. Data were analyzed using Dedoose qualitative coding software and thematic analysis. Four themes resulted regarding energy levels, mental clarity, sleep dynamics, and stress. Our findings demonstrated that ashwagandha increased college students' perceived well-being through supporting sustained energy, heightened mental clarity, and enhanced sleep quality, through a moderate dose of ashwagandha for the course of 30 days. Clinical Trial Registration number: NCT05430685.

The Impact of Ashwagandha on Stress, Sleep Quality, and Food Cravings in College Students: Quantitative Analysis of a Double-Blind Randomized Control Trial.

The purpose of this study was to examine the impact of ashwagandha (ASH) (Withania somnifera) on sleep, perceived stress, and cravings in a college student population. Sixty healthy students were screened/enrolled into a 30-day double-blinded placebo (PLA)-controlled intervention (700 mg daily, full spectrum extract of ASH root). Anthropometrics, demographics, and validated questionnaires assessing physical activity, restorative sleep, perceived stress, and food cravings were assessed before and after the study. Descriptive statistics, Pearson's correlations, and point biserial correlations were used to screen the data. For sleep and stress, a nonsignificant mixed (group × time) multivariate analysis of variance (MANOVA) was followed by one-way MANOVA (time on sleep/stress) and one-way multivariate analysis of covariance (MANCOVA) (group on sleep/stress, using initial sleep as a covariate) as follow-up tests. Further follow-up tests for this MANCOVA showed group membership affected final sleep (58.4 ± 12.4 vs. 48.2 ± 15.0 ASH vs. PLA respectively, P < .05) using initial sleep as a covariate. Initial sleep (confounder) affected final stress, but not final sleep. Mixed analysis of variance (group × time) showed an interaction effect on food cravings, where the ASH group experienced lower cravings than the PLA group over time at end of study. The 30-day intervention was shorter than most other studies where more pronounced stress differences were seen at six weeks, indicating ASH may need the longer time period to show more pronounced stress relieving differences. ASH can be an effective safe intervention in young adult populations to help manage stress and its detrimental impacts on sleep and satiety in as little as 30 days. Clinical Trial Registration number-NCT05430685.

Developing palliative care competencies for the education of entry level baccalaureate prepared Canadian nurses.

Educational preparation of health professionals for Palliative and End of Life Care (PEOLC) is inadequate, and nurses are no exception. In 2004, the Canadian Association of Schools of Nursing struck a Task Force to develop PEOLC competencies to address this issue. The development of national PEOLC nursing competencies involved a multi-step, emergent, interactive, and iterative process. An overarching principle guiding this process was building national consensus about the essential PEOLC specific competencies for nurses among experts in this field while simultaneously generating, revising, and refining them. There have been three stages in this iterative, multi-step process: 1) Generating a preliminary set of competencies, 2) Building a national consensus among educators and experts in the field on PEOLC specific competencies for nurses, and 3) Refining the consensus based competencies for curriculum development. Ongoing follow up work for this project is focusing on the integration of these competencies into nursing curricula.

Rapid Development of a COVID-19 Assessment and PPE Virtual Simulation Game.

OBJECTIVE: A virtual simulation game (VSG) educational module focused on COVID-19 assessment and personal protective equipment (PPE) was designed to strengthen the capacity of graduating nursing students and practicing nurses to provide care during the COVID-19 health crisis. METHODS: In less than two weeks, a team of simulation and clinical experts from the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim), the Canadian Association of Schools of Nursing (CASN) and the Canadian Nurses Association (CNA) collaborated to virtually developed a high-quality virtual simulation module. RESULTS: A bilingual VSG and related resources was created, focusing on the assessment and PPEs required when caring for a patient with or suspected of contracting COVID-19. CONCLUSIONS: This educational module has been accessed by over 600,000 users and implemented in nursing programs across Canada and globally.

Global standards for professional nursing education: The time is now.

A well-educated, professional nursing workforce is essential to good health care outcomes. Although nursing education is being strengthened globally, considerable diversity persists in the level and standards of nursing education both within and across countries. An international framework of guidelines for nursing education has, therefore, been developed to promote greater international consistency and high-quality nursing education globally. The purpose of this paper is to discuss the multinational methodology used to develop a global framework for professional nursing education and the policy implications of this framework in guiding the harmonization of nursing education demanded by the State of the World's Nursing 2020 (WHO, 2020a) call to action. The framework includes the underpinning assumption that nurses be prepared at the baccalaureate level and three pillars of global expectations targeting: a) learning outcomes for graduating preservice nursing students; b) standards for nursing programs, and c) standards for educational institutions delivering nursing programs. The Global Pillars Framework reflects international best practices, but the guidelines are adaptable across socio-cultural contexts facilitating the integration of locally relevant education. As 2020 has been declared the Year of the Nurse and Midwife globally, the ground has been laid for the next evolution in the education of the nursing workforce globally.

Attraction to cannabis among men with schizophrenia: a phenomenological study.

Cannabis use is common among persons with schizophrenia, particularly among men with this long-term chronic illness.A phenomenological study was undertaken to describe the perceptions of persons with schizophrenia regarding their attraction to cannabis. A sample of 8 men with schizophrenia who were living in the community and who had a history of current or past cannabis use were recruited by health professionals. Data were collected through in-depth interviewing and a sociodemographic questionnaire. Colaizzi's phenomenological method was used to analyze the interview data.The findings indicate that cannabis is used as a means of satisfying the schizophrenia-related need for relaxation, sense of self-worth, and distraction.The findings may be useful for nurses working with persons who have schizophrenia, a population that is frequently stigmatized and unheard.

Feasibility and preliminary efficacy of a parent-mediated sexual education curriculum for youth with autism spectrum disorders.

Youth with autism spectrum disorder can face social-communication challenges related to sexuality, dating, and friendships. The purpose of this study was to assess the feasibility, acceptability, and preliminary efficacy of the Supporting Teens with Autism on Relationships program. In total, 84 youth with autism spectrum disorder aged 9 to 18 and their parents participated in this study; two groups received the Supporting Teens with Autism on Relationships program (interventionist-led parent group vs parent self-guided), while an attentional control group received a substance abuse prevention program that included instruction in problem-solving and social skills. Feasibility and acceptability of the Supporting Teens with Autism on Relationships program was high overall. The Supporting Teens with Autism on Relationships program was effective in increasing parent and youth knowledge of sexuality, while the attentional control was not. There was preliminary support for improvement in parenting efficacy related to discussing sexuality with their children. Gains were seen among completers regardless of whether the parent received support from a facilitator. Implications and future directions are discussed.

Sticks and stones: racism as experienced by adolescents in New Brunswick.

The purpose of the study was to describe both the nature of racism as experienced by adolescent self-described victims in the province of New Brunswick, Canada, and their response to the perceived racist incidents. A qualitative methodology based on the constructivist paradigm was used. In-depth interviews were conducted with non-White adolescent victims of racism and with parents of victims. Although the study was initiated in response to an eruption of publicity about teenage racial violence, the findings indicate that racist incidents were not a new phenomenon for the participants. They described a low-key but long-term problem that had begun when they entered the public school system. Name-calling was by far the most common form of racism identified, and it played a part in most of the other incidents described; dismissed as harmless by authority figures, it appeared to have long-term consequences for its targets.The participants' response to racism was found to have 3 phases: splintered universe, spiralling resistance, and disengagement. The results suggest that nurses working in the field of school health should address issues of racism among children and adolescents.

Promoting Quality in Nursing Education in Canada through a Canadian Examination for Baccalaureate Nurses.

Since its creation in 1942, the Canadian Association of Schools of Nursing's mandate has been to foster high-quality nursing education in Canada in the interest of healthier Canadians. To this end, the Canadian Examination for Baccalaureate Nurses/l'examen canadien du baccalauréat en sciences infirmières (CEBN/ECBSI) has been developed and will be launched in 2020. Its purpose, what the Canadian Examination for Baccalaureate Nurses designation signifies and the development of the examination are described.

Congenital Muscular Torticollis: Bridging the Gap Between Research and Clinical Practice.

Congenital muscular torticollis (CMT) is a common postural deformity evident shortly after birth, typically characterized by ipsilateral cervical lateral flexion and contralateral cervical rotation due to unilateral shortening of the sternocleidomastoid muscle. New evidence is emerging on the pathogenesis of CMT, the negative long-term consequences of delaying intervention, and the importance of early identification and early intervention to maximize outcomes. Our purpose in this article is to inform pediatricians and health care providers about new research evidence and share selected recommendations and implementation strategies specifically relevant to pediatric practice to optimize outcomes and health services for infants with CMT.

Clinical Practice Guideline for the Management of Infantile Hemangiomas.

Infantile hemangiomas (IHs) occur in as many as 5% of infants, making them the most common benign tumor of infancy. Most IHs are small, innocuous, self-resolving, and require no treatment. However, because of their size or location, a significant minority of IHs are potentially problematic. These include IHs that may cause permanent scarring and disfigurement (eg, facial IHs), hepatic or airway IHs, and IHs with the potential for functional impairment (eg, periorbital IHs), ulceration (that may cause pain or scarring), and associated underlying abnormalities (eg, intracranial and aortic arch vascular abnormalities accompanying a large facial IH). This clinical practice guideline for the management of IHs emphasizes several key concepts. It defines those IHs that are potentially higher risk and should prompt concern, and emphasizes increased vigilance, consideration of active treatment and, when appropriate, specialty consultation. It discusses the specific growth characteristics of IHs, that is, that the most rapid and significant growth occurs between 1 and 3 months of age and that growth is completed by 5 months of age in most cases. Because many IHs leave behind permanent skin changes, there is a window of opportunity to treat higher-risk IHs and optimize outcomes. Early intervention and/or referral (ideally by 1 month of age) is recommended for infants who have potentially problematic IHs. When systemic treatment is indicated, propranolol is the drug of choice at a dose of 2 to 3 mg/kg per day. Treatment typically is continued for at least 6 months and often is maintained until 12 months of age (occasionally longer). Topical timolol may be used to treat select small, thin, superficial IHs. Surgery and/or laser treatment are most useful for the treatment of residual skin changes after involution and, less commonly, may be considered earlier to treat some IHs.

Simulation in interprofessional education for patient-centred collaborative care.

AIM: This paper is a report of preliminary evaluations of an interprofessional education through simulation project by focusing on learner and teacher reactions to the pilot modules. BACKGROUND: Approaches to interprofessional education vary widely. Studies indicate, however, that active, experiential learning facilitate it. Patient simulators require learners to incorporate knowing, being and doing in action. A theoretically based competency framework was developed to guide interprofessional education using simulation. The framework includes a typology of shared, complementary and profession-specific competencies. Each competency type is associated with an intraprofessional, multiprofessional, or interprofessional teaching modality and with the professional composition of learner groups. METHOD: The project is guided by an action research approach in which ongoing evaluation generates knowledge to modify and further develop it. Preliminary evaluations of the first pilot module, cardiac resuscitation rounds, among 101 nursing students, 42 medical students and 70 junior medical residents were conducted in 2005-2007 using a questionnaire with rating scales and open-ended questions. Another 20 medical students, 7 junior residents and 45 nursing students completed a questionnaire based on the Interdisciplinary Education Perception scale. FINDINGS: Simulation-based learning provided students with interprofessional activities they saw as relevant for their future as practitioners. They embraced both the interprofessional and simulation components enthusiastically. Attitudinal scores and responses were consistently positive among both medical and nursing students. CONCLUSION: Interprofessional education through simulation offers a promising approach to preparing future healthcare professionals for the collaborative models of healthcare delivery being developed internationally.

Patient perceptions of 595 nm pulsed dye laser through glass compression in the treatment of thick port wine stains and superficial venous malformations.

In treating thickened port wine stains and superficial venous malformations with the 595 nm pulse dye laser, we have sometimes compressed the lesion with a glass slide to enable the laser beam to penetrate more deeply. In order to evaluate the patients' perception of this modality, 54 subjects were treated with glass compression using ice applications to cool the skin surface and without glass compression using a cryospray to cool the surface. The subjects were asked to rate the difference in 2 questionnaires after the first and second treatments as to effectiveness, pain of procedure, and overall preference. Of those subjects who perceived a difference between modalities, a significant number perceived treatments with glass compression to be more effective than without (p=0.0002 and p=0.0006), but more painful (p<0.0001). There was no significant difference in overall preference. Blistering occurred in 5 subjects when the glass slide was left on the skin more than 1 minute between ice applications.

Entry-to-practice public health nursing competencies: A Delphi method and knowledge translation strategy.

BACKGROUND: Sustaining and strengthening nurses 'contributions to public and population health in the 21st century depends in part on nursing education. Clearly articulated entry-to-practice competencies will contribute to the capacity of undergraduate nursing education programs to prepare graduates to promote local, national and global population health. OBJECTIVES: The Canadian Association of Schools of Nursing created the Public Health Task Force to develop consensus on core, national entry-to-practice competencies in public health nursing for undergraduate nursing students and to support these competencies with corresponding online teaching strategies. DESIGN: Delphi approach. PARTICIPANTS: Nurses with public health experience in education and practice, and representatives from other public health professional organizations across Canada. METHOD: The three-phased competency development included: 1) an environmental scan; 2) an iterative process to draft competencies; and 3) a modified Delphi process to confirm the final competency framework using face to face consultations and a survey. The knowledge translation strategy involved soliciting submissions of teaching strategies for peer-review and subsequent inclusion in an interactive online resource. RESULTS: 242 public health educators and practitioners participated in the consensus consultation. The final document outlined five competency statements with 19 accompanying indicators. A total of 123 teaching strategies were submitted for the online resource, of which 50 were accepted as exemplary teaching strategies. CONCLUSION: This competency development process can provide guidance for the development of competencies in other countries, thus strengthening public health nursing education globally. The decision to intentionally level the competencies to entry-to-practice, as opposed to an advanced level, enhanced their application to undergraduate nursing education. The development of the additional inventory of teaching strategies created a sustainable innovative resource for public health nursing educators and practitioners world-wide to support the adoption of entry-to-practice public health nursing competencies.

Procedures for the Evaluation of the Visual System by Pediatricians.

Vision screening is crucial for the detection of visual and systemic disorders. It should begin in the newborn nursery and continue throughout childhood. This clinical report provides details regarding methods for pediatricians to use for screening.