Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation tool for rigor in mixed methods implementation research.

BACKGROUND: Implementation science helps generate approaches to expedite the uptake of evidence in practice. Mixed methods are commonly used in implementation research because they allow researchers to integrate distinct qualitative and quantitative methods and data sets to unravel the implementation process and context and design contextual tools for optimizing the implementation. To date, there has been limited discussion on how to ensure rigor in mixed methods implementation research. PURPOSE: To present Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation (PEARL) as a practical tool for understanding various components of rigor in mixed methods implementation research. DATA SOURCES: This methodological discussion is based on a nurse-led mixed methods implementation study. The PEARL tool was developed based on an interpretive, critical reflection, and purposive reading of selected literature sources drawn from the researchers' knowledge, experiences of designing and conducting mixed methods implementation research, and published methodological papers about mixed methods, implementation science, and research rigor. CONCLUSION: An exemplar exploratory sequential mixed methods study in nursing is provided to illustrate the application of the PEARL tool. The proposed tool can be a useful and innovative tool for researchers and students intending to use mixed methods in implementation research. The tool offers a straightforward approach to learning the key rigor components of mixed methods implementation research for application in designing and conducting implementation research using mixed methods. CLINICAL RELEVANCE: Rigorous implementation research is critical for effective uptake of innovations and evidence-based knowledge into practice and policymaking. The proposed tool can be used as the means to establish rigor in mixed methods implementation research in nursing and health sciences.

The Listening Guide: Illustrating an underused voice-centred methodology to foreground underrepresented research populations.

AIM: To highlight the value of utilizing the Listening Guide methodology for nursing research and provide an exemplar applying this methodology to explore a novel concept in an underrepresented group-inner strength in persons newly diagnosed with mild cognitive impairment along with their care partners. DESIGN: Methodology discussion paper. METHODS: The exemplar study used the Listening Guide methods for data elicitation and analysis. Methods included adaptations for the study population and novice qualitative researchers. RESULTS: The Listening Guide methodology with adaptations enabled the research team to centre the voices of persons living with mild cognitive impairment, highlight an abstract phenomenon and attend to the influences of the sociopolitical context. Further, this methodology helped address common challenges emerging qualitative researchers encounter, including understanding methods of application, engaging reflexively and immersing in the data. CONCLUSION: The Listening Guide is a voice-centred qualitative methodology that is well suited to foreground the experiences of groups underrepresented in research and explore emerging phenomena. IMPLICATIONS FOR NURSING: Nurses are central to striving for health equity. The Listening Guide methodology offers a valuable and accessible research tool to understand the experiences and needs of underrepresented groups and shape healthcare in response. IMPACT: The Listening Guide methodology can be broadly applied to research with persons with mild cognitive impairment, and other underrepresented groups, to explore other phenomena beyond inner strength and move the science forward in representing the perspectives of groups underrepresented by research. PATIENT OR PUBLIC CONTRIBUTION: Persons living with cognitive impairment and their care partners participated in study conceptualization, interview guide development, methods development and dissemination plans.

[Application of Artificial Intelligence Models in Nursing Research].

In recent years, the rapid development of artificial intelligence has enhanced the efficiency of medical services, accuracy of disease prediction, and innovation in the healthcare industry. Among the many advances, machine learning has become a focal point of development in various fields. Although its use in nursing research and clinical care has been limited, technological progress promises broader applications of machine learning in these areas in the future. In this paper, the authors discuss the application of machine learning in nursing research and care. First, the types and classifications of machine learning are introduced. Next, common neural machine learning models, including recurrent neural networks, transformers, and natural language processing, are described and analyzed. Subsequently, the principles and steps of machine learning are explored and compared to traditional statistical methods, highlighting the quality-monitoring strategies used by machine learning models and the potential limitations and challenges of using machine learning. Finally, interdisciplinary collaboration is encouraged to share knowledge between information technology and nursing disciplines, analyze the advantages and disadvantages of various analytical models, continuously review the research process, and reflect on methodological limitations. Following this course, can help maximize the potential of artificial-intelligence-based technologies to drive innovation and progress in nursing research.

Methodological and theoretical contributions of critical discourse analysis to nursing research / Les apports méthodologiques et théoriques de l'analyse critique du discours pour la recherche en sciences infirmières.

Critical discourse analysis is a methodological approach that allows for the questioning of structures that relegate certain ideas and certain people to the margins. In health sciences, this approach, with its origins in the field of critical linguistics, is useful for highlighting the many societal processes that privilege certain conceptions of health and health care while labelling other perspectives as « alternative" or "fringe". However, critical discourse analysis is still underused in nursing science despite its emancipatory potential. We attribute this reluctance, among other things, to its theoretical anchoring, to its linguistic origin, and to the vagueness and variability of its analysis methods. The objective of this article is therefore to better understand how critical discourse analysis can be used in the discipline of nursing to shed light on the power dynamics and social inequalities that persist. Different examples of studies carried out using critical discourse analysis are also presented to concretely illustrate how this approach can be used in nursing sciences.

L'analyse critique du discours est une approche méthodologique qui permet une remise en question des structures qui relèguent certaines idées et personnes à la marge. Dans le domaine de la santé, cette approche, issue de la linguistique critique, est utile pour mettre en relief les nombreux processus sociétaux qui privilégient une certaine conception de la santé et des soins au profit d'autres perspectives considérées comme « alternatives ¼. Pourtant, en sciences infirmières, l'analyse critique du discours est encore trop peu utilisée malgré son potentiel émancipatoire. Nous attribuons cette réticence entre autres à ses ancrages théoriques, à son origine linguistique, et au flou et à la variabilité dans ses méthodes d'analyse. L'objectif de cet article est donc de mieux comprendre comment l'analyse critique du discours peut être utilisée dans la discipline des sciences infirmières afin de mettre en exergue les inégalités sociales et enjeux de pouvoir. Différents exemples d'études réalisées en utilisant l'analyse critique de discours sont aussi présentés afin d'illustrer concrètement comment cette approche peut être utilisée en sciences infirmières.

An Integrative Review of Response Rates in Nursing Research Utilizing Online Surveys.

BACKGROUND: Online surveys in nursing research have both advantages and disadvantages. Reaching a sample and attaining an appropriate response rate is an ongoing challenge and necessitates careful consideration when designing a nursing research study using an online survey approach. OBJECTIVE: In this study, we aimed to explore response rates and survey characteristics of studies by nurse researchers that used online methodologies to survey nurses, nursing students, and nursing faculty. METHODS: We conducted an integrative review of research studies that used online surveys for data collection published from 2011 to 2021. We examined response rates and survey characteristics such as recruitment method, use of incentives, question type, length of survey, time to complete the survey, and use of reminders. RESULTS: Our review included 51 studies published by nurses with target samples of nurses, nursing students, or nursing faculty. Study sample sizes ranged from 48 to 29,283, the number of respondents ranged from 29 to 3,607, and the response rates ranged from 3.4% to 98%, with an average of 42.46%. Few patterns emerged regarding recruitment or other factors to enhance response rates; only five studies used incentives. CONCLUSION: Response rates to online surveys are unlikely to reach the rates seen in older mailed surveys. Researchers need to design online survey studies to be easily accessible, concise, and appealing to participants.

Challenges and opportunities faced by nurse scientists in integrating data and technology in research to promote health equity.

Advances in technologies including omics, apps, imaging, sensors, and big data are increasingly being integrated into research by nurse scientists, but the impact on improving health equity is still unclear. In this article, nursing research faculty from one institution discuss challenges and opportunities experienced when integrating various technologies into their research aimed at promoting health equity. Using exemplars from faculty experiences, a three-pronged approach to keeping patients and communities and the goal of health equity central in research while incorporating advancing technologies is described. This approach includes establishing long-term engagement with populations underrepresented in research, adopting strategies to increase diversity in study participant recruitment, and training and collaboration among a diverse workforce of educators, clinicians, and researchers. Training nurse scientists in integrating data and technology for advancing the science on health equity will shift the culture of how we understand, collaborate, and grow with the communities in which we train and practice as nurse scientists.

Philosophical underpinnings of intersubjectivity and its significance to phenomenological research: A discussion paper.

Intersubjectivity is the proposition that human experience occurs in a world of shared and embodied understandings, mediated by culture and language. Nursing is fundamentally relational, and nursing research stems from an exchange between participants and researchers and indeed around the transaction of the patient and the nurse in the intersubjective space of clinical settings. Through the philosophical standpoints of Husserl, Merleau-Ponty, Heidegger, and Gadamer we examine these differing philosophical constructs of intersubjectivity and the contribution of these positions to phenomenological nursing inquiry. Particular framings of intersubjectivity should influence the way researchers interact with their participants and data so that the chosen philosophy sits coherently within a research plan and methodology. This exploration of philosophical standpoints is extended through examples of, and reflections upon, the authors' experiences of intersubjectivity in our published phenomenological nursing studies and through dynamic interactions that characterise interpretive activities within a research team.

Examining characteristics of descriptive phenomenological nursing studies: A scoping review.

AIM: To evaluate the characteristics and methodology consistency in nursing research with descriptive phenomenological design. DESIGN: Scoping review methodology. DATA SOURCES: Three electronic databases (CINAHL, Embase, PubMed) were systematically searched for qualitative studies with a descriptive phenomenological design published in nursing journals between January 2021 and December 2021. REVIEW METHODS: Quality appraisal of each study was conducted using the Critical Appraisal Skills Programme checklist. Data were extracted and presented narratively based on research objective, design justification and consistency, theoretical framework, sampling method and sample size, data collection method, data analysis approach and presentation of findings. RESULTS: One hundred and three studies were included in the review. Overall, the characteristics of the studies are mostly consistent with Husserl's phenomenology approach in terms of research objectives, the use of other theoretical frameworks, sampling and data collection methods. However, the findings revealed several inconsistencies between research design and data analysis techniques, the lack of design justification and the lack of mention of bracketing. CONCLUSIONS: Apart from the need for more research and standardized guidelines to clarify the various qualitative research methods, future nurse researchers are urged to provide more methodological details when publishing a descriptive phenomenological study so that readers can examine the effectiveness and quality of the method.

Theory utilization in applied qualitative nursing research.

AIMS: To explore the nuances of theory utilization in qualitative methodologies, discuss the different relationships that applied qualitative methodologies have with theory and use the foundational underpinnings of interpretive description to challenge strongly entrenched ideas of theory that have extended into applied qualitative nursing research. DESIGN: Methodology discussion paper. DATA SOURCES: Narrative literature review and personal observations. CONCLUSION: Many qualitative research traditions have viewed the use of an explicit theoretical framework as an integral grounding for qualitative research studies. Much of the discussion of theory in extant qualitative methodological literature focuses on its use in the context of traditional methodologies such as ethnography, phenomenology and grounded theory, with less attention on methodological approaches developed for applied and practice disciplines such as nursing. Uncritical adoption of ideas about theory based on traditional qualitative methodological conventions can result in findings with little utility for application to the practice context. IMPACT: Nursing researchers should think critically about how theory is used in research endeavours geared towards applied practice and ensure that their methodological choices are in alignment with their philosophical and disciplinary epistemological positionings.

Inclusion of Effect Size Measures and Clinical Relevance in Research Papers.

BACKGROUND: There are multiple issues that arise when researchers focus on and only report "statistical significance" of study findings. An important element that is often not included in reports is a discussion of clinical relevance. OBJECTIVES: The authors address issues related to significance, the use of effect sizes, confidence or credible intervals, and the inclusion of clinical relevance in reports of research findings. METHODS: Measures of magnitude, precision, and relevance such as effect sizes, confidence intervals (CIs), and clinically relevant effects are described in detail. In addition, recommendations for reporting and evaluating effect sizes and CIs are included. Example scenarios are presented to illustrate the interplay of statistical significance and clinical relevance. RESULTS: There are several issues that may arise when significance is the focus of clinical research reporting. One issue is the lack of attention to nonsignificant findings in published works although findings show clinical relevance. Another issue is that significance is interpreted as clinical relevance. As well, clinically relevant results from small-sample studies are often not considered for publication, and thus, findings might not be available for meta-analysis. DISCUSSION: Findings in research reports should address effect sizes and clinical relevance and significance. Failure to publish clinically relevant effects and CIs may preclude the inclusion of clinically relevant studies in systematic reviews and meta-analyses, thereby limiting the advancement of evidence-based practice. Several accessible resources for researchers to generate, report, and evaluate measures of magnitude, precision, and relevance are included in this article.

Ethical Considerations of Social Media to Recruit Caregivers of Children With Cancer.

BACKGROUND: Social media platforms are useful for recruiting hard-to-reach populations, such as caregivers of children with cancer, for research. However, there are unique ethical considerations in using social media. OBJECTIVES: The aim of the study was to describe the methods used to recruit hard-to-reach caregivers (parents of children with cancer) for research and related ethical considerations. METHODS: We used The Belmont Report tenets (respect for persons, beneficence, and justice) as a guiding framework to identify issues relevant to social media recruitment of hard-to-reach populations and to describe how we addressed these issues in our study. RESULTS: We engaged leaders of two online communities that offer peer support for caregivers of children with cancer to help with recruitment to our study on financial effect of pediatric cancer. We identified issues in using social media for recruiting hard-to-reach populations in alignment with The Belmont Report, including risk for subject selection bias, privacy rights, protecting identity of participants, data security issues, and access to research. We addressed issues by deliberate study design decisions and engagement with online community advocates. DISCUSSION: Using social media to recruit hard-to-reach populations may be a successful way to engage them in research. Although researchers may remain compliant with the institutional review board of their facilities and are faithful to the tenets of The Belmont Report, unanticipated ethical issues may arise directly or indirectly as a result of using social media. This article identifies these issues and provides suggestions for dealing with them.

Using Twitter for Nursing Research: A Tweet Analysis on Heat Illness and Health.

AIM: To provide an example of a tweet analysis for nurse researchers using Twitter in their research. DESIGN: A content analysis using tweets about "heat illness + health." METHODS: Tweets were pulled from Twitter's application programming interface with premium access using Postman and the key words "heat illness + health." All data cleaning and analysis was performed in R Version 3.5.2, and the tweet set was analyzed for term frequency, sentiment, and topic modeling. Principal R packages included LDAvis, tidytext, tm, and zyuzhet. RESULTS: 6,317 tweets were analyzed with a date range of April 6, 2009, to December 30, 2019. The most common terms in the tweets were heat (n = 4,532), illness (n = 4,085), and health (n = 2,257). Sentiment analysis showed that the majority of tweets (55%) had a negative sentiment. Topic modeling showed that there were three topics within the tweet set: increasing impact, prevention and safety, and symptoms. CONCLUSIONS: Twitter can be a useful tool for nursing researchers, serving as a viable adjunct to current research methodologies. This practical example has facilitated a deeper understanding of the social media representation of heat illness and health that can be applied to other research. CLINICAL RELEVANCE: Twitter serves as a tool for collecting health information for multiple groups, ranging from clinicians and researchers to patients. By utilizing the plethora of data that comes from the platform, we can work towards developing theories and interventions related to numerous health conditions and phenomena.

Critical thinking in nursing clinical practice, education and research: From attitudes to virtue.

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science.

Establishing the Omics Nursing Science & Education Network.

PURPOSE: To establish a website to advance nursing research and education involving omics technologies and methodologies through facilitating collaborations, use of existing data and samples, mentoring, and access to training opportunities. METHODS: The Omics Nursing Science & Education Network (ONSEN) website was established following identification of gaps in omics nursing infrastructure and resources that could be addressed via a concerted, collaborative effort. ONSEN content was created using input from a workgroup of experts in genomics and other omics, education, practice, and nursing research. Alpha testing was conducted with workgroup members, followed by website refinements and enhancements, and subsequent beta testing by potential end users. ONSEN was launched in August 2018. FINDINGS: ONSEN has three main sections. The Education and Training section provides information on mentoring and pre- or postdoctoral opportunities in addition to a knowledge matrix to advance education and skills in genomic nursing science. The Research Collaborations section promotes awareness of ongoing omics nursing research in order to foster collaborations and sharing of samples or data among investigators with programs in omics nursing research or an interest in developing such programs. The Common Data Elements (CDE) section provides information on the benefits of incorporating CDEs into nursing science as well as links to National Institutes of Health resources to facilitate use of CDEs. CONCLUSIONS: ONSEN provides opportunities for nurse scientists and trainees to leverage samples and datasets, locate mentors and pre- or postdoctoral positions, further the use of CDEs, and enhance education and skills for integrating omics into nursing science. CLINICAL RELEVANCE: Advancing omics nursing science via ONSEN resources will accelerate the elucidation of the molecular underpinnings of disease and associated symptoms as well as inform the development of rapidly translatable, personalized intervention strategies, grounded in biological mechanisms, for improved health outcomes across populations and the lifespan.

Implementation Science Training and Resources for Nurses and Nurse Scientists.

PURPOSE: The purpose of this article is to describe the differences between quality improvement and implementation science, the urgency for nurses and nurse scientists to engage in implementation science, and international educational opportunities and resources for implementation science. ORGANIZING CONSTRUCT: There is a push for providing safe, effective, patient-centered, timely, efficient, and equitable health care. Implementation science plays a key role in adoption and integration of evidence-based practices to improve quality of care. METHODS: We reviewed implementation science programs, organizations, and literature to analyze the roles of nurses and nurse scientists in translating evidence into routine practice. FINDINGS: Implementation-trained nurses and nurse scientists are needed as part of multidisciplinary teams to advance implementation science because of their unique understanding of contextual barriers within nursing practice. Likewise, nurses are uniquely qualified for recognizing what implementation strategies are needed to improve nursing care across practice settings. CONCLUSIONS: Many international clinical and training resources exist and are supplied to aid interested readers in learning more about implementation science. CLINICAL RELEVANCE: Half of research evidence never reaches the clinical setting, and the other half takes 20 years to translate into clinical practice. Implementation science-trained nurses are in a position to be excellent improvers for meaningful change in practice.

Characteristics of joint displays illustrating data integration in mixed-methods nursing studies.

AIMS: To identify the characteristics of joint displays illustrating the data integration in mixed-methods nursing studies and to make recommendations for effective use of joint displays for the integration of qualitative and quantitative data in mixed-methods studies. DESIGN: Discussion Paper. DATA SOURCES: We have completed this paper as a part of a mixed-methods prevalence review of 190 studies published in nursing journals. We searched 10 nursing journals and three databases from January 2014-April 2018, additional journal search was performed from May-September 2018. We reviewed 17 studies that used joint displays as the method of data integration. Using a joint display typology, checklists, summary tables, and personal experiences of using joint displays, we evaluated the quality of displays. IMPLICATIONS FOR NURSING: Nurse researchers should use advanced data integration approaches to increase the rigour of the mixed-methods studies. Joint displays can enable nurse researchers to efficiently integrate and synthesize the qualitative and quantitative data in mixed-methods studies. However, nurse researchers should clearly label the type and title of the display, include both qualitative and quantitative data and interpretations, and highlight the mixed-methods interpretations as confirmed, divergent, or expanded in the displays. CONCLUSION: Joint displays are adopted for data integration in nursing mixed-methods studies. Improvements are required concerning data presentation in the displays. Researchers should provide clear titles and supporting data and inferences and identify the meta-inferences by assessing the fit between quantitative and qualitative data. IMPACT: Despite the importance of integration in mixed methods, reviews indicated a consistent lack of integration in nursing research. Joint displays are structured frameworks used for the integration and synthesis of the qualitative and quantitative data at the analysis and interpretation levels. The discussed typology and characteristics of displays can enable nurse researchers to enhance the quality and presentation of integrated results in mixed-methods studies.

Contemporary nursing graduates' transition to practice: A critical review of transition models.

AIM AND OBJECTIVE: To critically review contemporary transition theories to determine how they apply to the newly qualified graduate registered nurse programmes. BACKGROUND: Graduate nurse transition to employment is the time of significant change which has resulted in high attrition rates. Graduates are often challenged by their expectation of nursing practice and the reality of the role. The transition from hospital-based training to university-based training has resulted in the need for primary employment to commence with graduate/orientation/internship programmes to help support new graduates transition into clinical practice. One transition model, Duchscher's stages of transition theory, utilised three former theories to develop a final model. DESIGN: A narrative critical literature review. METHOD: The theories selected for the review were Kramer's reality shock theory, Benner's novice to expert theory, Bridges transition theory and Duchscher's stages of transition theory. CONCLUSION: Duchscher's stages of transition theory reflects the experiences of registered nursing transition into the workforce directly from university. The application of the theory is effective to guide understanding of the current challenges that new graduate nurse's experience today. There is a need for new graduates to complete their university degree as advanced beginners in order to decrease the experience of transition shock and keep pace with rapidly changing demands of the clinical environment. This may be achieved by increasing ward-based simulation in university education. A theoretical framework can provide a deep understanding of the various stages and processes of transition and enable development of successful programmes. RELEVANCE TO CLINICAL PRACTICE: Both universities and hospitals need to adapt their current practice to align with the needs of new graduates due to large student numbers and ongoing systematic advancements to decrease the attrition rate.

Fundamental care for people with cognitive impairment in the hospital setting: A study combining positive organisational scholarship and video-reflexive ethnography.

AIMS AND OBJECTIVES: To clarify how high-quality fundamentals of care for people with dementia and/or delirium were practised in a specialist geriatric evaluation and management unit. BACKGROUND: Older people with cognitive impairment represent a significant number of people who are admitted to hospital. They are at increased risk of dying, readmission and long hospital stays, relative to those without cognitive impairment. There is an urgent need to elucidate the conditions that underpin safe and high-quality fundamental care for these patients and their families. METHODS: Using the innovative methodologies of positive organisational scholarship in healthcare and video-reflexive ethnography, this 18-month study was conducted within an inpatient geriatric evaluation and management unit for people with dementia and/or delirium in South Australia. Patients, family members and staff members (managerial, clinical and nonclinical) participated by allowing researchers to document ethnographic fieldwork notes and film their practices and/or accounts thereof; and/or interpreting digital recordings with researchers in order to make sense of data in a process of co-analysis. This study is reported using Standards for Reporting Qualitative Research reporting guidelines. RESULTS: High-quality fundamental care for people with dementia and/or delirium in hospital and their families was associated with the special space of the hospital unit; an aptitude for people with dementia; a capacity to translate person-centred fundamentals of care from rhetoric to reality; and an appreciation for teamwork. CONCLUSION: This study clarified how teams working in hospital can practise high-quality fundamentals of care for older people with dementia and/or delirium. Delivery of high-quality fundamental care in this setting was dependent, not only on nurses, but the entire ward team working cohesively in a "weave of commitment." RELEVANCE TO CLINICAL PRACTICE: Efforts to improve fundamental care for people with cognitive impairment need to encompass values and philosophy of person-centred care, including the contributions by all staff to care delivery.

To explore the experience of research nurses who obtain consent from adults in emergency settings to participate in clinical trials, either prospectively or post enrolment.

AIM: To explore the understanding and experiences of research nurses who obtain informed consent from adult patients participating in emergency care research. DESIGN: Qualitative phenomenographic descriptive study. METHODS: Ten research nurses from six hospitals in England were recruited. Data were collected using semi-structured face-to-face and telephone interviews between January 2019 and March 2019. Interviews were transcribed verbatim and analysed thematically, informed by phenomenography. COREQ was followed. RESULTS: Three main themes were identified: (a) emergency research is different, (b) protecting the patient, and (c) experience and confidence with recruitment. It was found that obtaining patient consent in emergency care research was challenging and timing of the process was crucial. Nurses with more experience of emergency care were more confident in approaching patients and their families. There was variability in out-of-hours recruitment which was a consequence of the range of informed consent processes used and the different levels of engagement of clinical teams. CONCLUSION: There is a variety of organisational cultures, processes and procedures which affect the way consent is obtained in emergency care research. A team approach was evident in the hospitals where consent rates were high and was more successful than those reliant solely on the presence of a research nurse. Organisations were able to recruit successfully to emergency care research studies irrespective of size and configuration. Further investigation of their models of working and strategies for engagement is needed. Experienced research nurses made a positive difference to recruitment and were more likely to approach patients to obtain consent. RELEVANCE TO CLINICAL PRACTICE: The understanding and experiences of recruitment to clinical trials in emergency care research by research nurses can help identify barriers to recruitment. This study provides useful insights for healthcare practitioners, clinical trials coordinators and sponsors about how best to develop protocols and policies to increase recruitment to emergency care research.

The Scholarship Circle: an introduction to writing for publication for nursing faculty.

BACKGROUND: This case report describes a collaborative effort between a health sciences librarian and an instructional designer to create and implement a writing professional development experience called the Scholarship Circle. It was aimed at increasing scholarly productivity by junior and nontenure-track faculty in a college of nursing. CASE PRESENTATION: The Scholarship Circle activities were carried out in a synchronous and an asynchronous online environment over ten weeks and included weekly lectures from nurse-scholars, discussions and peer reviews, and writing support from the librarian. The Scholarship Circle designers surveyed participants before and after the course to explore faculty perceptions and conducted a bibliographic analysis to gauge increases in scholarly productivity. CONCLUSIONS: While both tenure-track and nontenure-track faculty perceived lack of time as a significant barrier to publication, only nontenure-track faculty perceived lack of writing experience and getting started as significant obstacles. In the two years following the Scholarship Circle, faculty with doctor of philosophy and doctor of education degrees produced the greatest number of scholarly publications, whereas faculty with other degrees demonstrated a modest increase in scholarship. Online writing support programs have the potential to positively impact scholarly productivity for junior and nontenure-track faculty, especially if they emphasize time management for writing, confidence-building strategies, and a flexible format that allows peer review and collaboration as well as participation by seasoned scholars and remote participants. Partnership between health sciences librarians and instructional designers is key to the successful design and implementation of writing support programs.