A pan-Canadian web-based education program to support screening for distress: evaluation of outcomes.

OBJECTIVE: Cancer-related distress has been endorsed as the sixth vital sign by many international cancer organizations, and some countries such as Canada have implemented national screening for distress programs. The completion of a screening tool is an important first step in improving responsiveness to cancer-related distress, but screening must be followed with skilled supportive care to make a difference in patient-reported outcomes. Our objective was to create a web-based education program to support nurses and other frontline staff in providing an initial response to screening results. METHOD: To address screening and supportive care learning needs, the Canadian Association of Psychosocial Oncology (CAPO), with support from the Canadian Partnership Against Cancer, created a web-based education program as one component of the national screening for distress agenda. The program provides clinically grounded and interactive learning through the use of PowerPoint presentations, video clips of clinical interactions with patients and family members, and test questions. Presentation topics include, for example, strategies for dealing with screening results, managing referrals, and supportive counseling. We employed a matched pairs, pre-post survey design to assess the effect of the education program on confidence in screening and in providing initial supportive care. RESULTS: Our analysis of the first 147 matched pairs to complete the course suggests that satisfaction with the course was high. Statistically significant increases in confidence in relation to screening for distress and assessing distress, and in providing initial supportive care, were evident. SIGNIFICANCE OF RESULTS: Our ongoing experience with CAPO's Interprofessional Psychosocial Oncology Distance Education (IPODE) project (www.ipode.ca) project suggests that healthcare professionals value web-based learning for its accessibility and convenience. Such programs appear to offer excellent opportunities for cost-effective education that supports practice change.

Examining pedagogical practices in family systems nursing: intentionality, complexity, and doing well by families.

Teaching graduate family nursing students the important and delicate practice of entering into and mitigating families' illness suffering signifies an educational practice that is rigorous, intense, and contextual, yet not articulated as expounded knowledge. This study examined the pedagogical practices of the advanced practice of Family Systems Nursing (FSN) as taught to master's and doctoral nursing students at the Family Nursing Unit, University of Calgary, using observation of expert and novice clinical practice, live supervision, videotape review, presession hypothesizing, clinical documentation, and the writing of therapeutic letters to families. A triangulation of research methods and data collection strategies, interpretive ethnography, autoethnography, and hermeneutics, were used. Students reported an intensity of learning that had both useful and limiting consequences as they developed skills in therapeutic conversations with families experiencing illness. Faculty used an intentional pedagogical process to encourage growth in perceptual, conceptual, and executive knowledge and skills of working with families.

Patient safety: a consumer's perspective.

In this article we provide a reconceptualization of patient-centered health care practice through a collaborative person-centered model for enhanced patient safety. Twenty-one participants were selected and interviewed from the internationally diverse population of individuals attending the Chicago Patient Safety Workshop (CPSW) sponsored by Consumers Advancing Patient Safety (CAPS). Analysis of the participant transcripts revealed three findings related to patient experience: the impact and meaning of communication and relationship within the health care setting, trust and expectation for the patient and family with the health care provider, and the meaning and application of patient-centeredness. Researchers concluded that successful planning toward enhanced patient-centered care requires multiple perspectives, including the voices of the patient and family members who have experienced the trauma of preventable medical error. Collaborative initiatives such as the CPSW and CAPS offer a positive way forward for enhanced patient safety and quality of care.

Learning to see the other: a vehicle of reflection.

A contemporary challenge for nursing educators is to connect theory with practice for nursing students in a curriculum which is largely theory based. The use of reflective writing has been widely used to increase students' critical thinking, and writing skills, as well as to help students integrate concepts within the context of clinical nursing. In the clinical context, the concept of seeing the other can be challenging for students whose life experiences may not have included many of the crises faced by patients and their families. This paper embeds an undergraduate nursing student's reflective writing response to an exercise, from a family nursing course, utilized to help students relate more confidently to the patient as the other.