Learning to be a doctoral supervisor: Experiences and views of nurse supervisors of higher degree research students.

AIMS AND OBJECTIVES: Given the importance of doctoral training to the future of the discipline, we sought to gain insight into nurse doctoral supervisor's experiences of supervision training and preparation and their views on what quality training for doctoral supervisors in nursing would look like. BACKGROUND: Doctorally prepared nurses have been found to contribute significantly to improvements in knowledge to inform patient care; yet there is little focus on the development of this aspect of the nursing workforce, and little evaluation of supervisor training, confidence and competence. DESIGN: Qualitative storytelling, semi-structured interviews were conducted via a videoconferencing programme, audio-recorded and thematically analysed with twenty-one experienced nurse doctoral supervisors. Findings are reported in line with the COREQ guidelines. RESULTS: Thematic analysis revealed four themes: 'I had a great mentor': the importance of mentorship and role modelling; 'Sometimes it's just trial and error': learning through experience; 'It's like tick a box': strengths and limitations of formal supervisor training; and 'The training should be more holistic': what should be in supervisor training. CONCLUSIONS: We recommend doctoral supervisors be encouraged to seek mentoring for supervision, formal mentoring and clinical supervision for the first five completions and the formation of discipline-based supervisor learning groups in nursing as an adjunct to generic mandatory supervisor training. RELEVANCE TO CLINICAL PRACTICE: Further development of clinical nursing is inextricably linked to quality nurse-led research, and doctorally prepared nurses are essential to the continued development of nursing as an evidence-informed practice discipline. Quality doctoral supervision for and by nurses is crucial and we argue that focus must be given to ensuring the development of a skilled doctoral supervision workforce in nursing.

Calm to chaos: Engaging undergraduate nursing students with the complex nature of interruptions during medication administration.

AIMS AND OBJECTIVES: To describe undergraduate student nurse responses to a simulated role-play experience focussing on managing interruptions during medication administration. BACKGROUND: Improving patient safety requires that we find creative and innovative methods of teaching medication administration to undergraduate nurses in real-world conditions. Nurses are responsible for the majority of medication administrations in health care. Incidents and errors associated with medications are a significant patient safety issue and often occur as a result of interruptions. Undergraduate nursing students are generally taught medication administration skills in a calm and uninterrupted simulated environment. However, in the clinical environment medication administration is challenged by multiple interruptions. DESIGN/METHODS: A qualitative study using convenience sampling was used to examine student perceptions of a simulated role-play experience. Data were collected from 451 of a possible 528 student written reflective responses and subject to thematic analysis. RESULTS: Students reported an increased understanding of the impacts of interruptions while administering medications and an improved awareness of how to manage disruptions. This study reports on one of three emergent themes: "Calm to chaos: engaging with the complex nature of clinical practice." CONCLUSIONS: Interrupting medication administration in realistic and safe settings facilitates awareness, allows for students to begin to develop management strategies in relation to interruption and increases their confidence. Students were given the opportunity to consolidate and integrate prior and new knowledge and skills through this role-play simulation.

Nurse interrupted: Development of a realistic medication administration simulation for undergraduate nurses.

BACKGROUND: Medication errors are a global phenomenon. Each year Australia-wide there are up to 96,000 preventable medication errors and in the United States there are approximately 450,000 preventable medication errors. One of the leading causes of errors is interruption yet some interruptions are unavoidable. In the interest of patient safety, nurses need to not only understand the impact of interruptions, but also be empowered with the knowledge and skills required to develop effective interruption management strategies. Well-planned simulation experiences have the potential to expose students to authentic clinical cases, otherwise unavailable to them, building critical thinking and clinical reasoning skills and preparing them for practice. AIM: This paper describes a simulated role-play experience that was developed to enable undergraduate nurses to experience, reflect on and analyse their responses to interruptions during medication administration. METHODS: The simulation design presented in this paper was underpinned by both nursing and educational theorists, in combination with established simulation frameworks. SETTING AND PARTICIPANTS: Embedded within a clinical subject in 2013, the simulation experience was run over two campuses within a large Australian University. Participants included 528 second year undergraduate nursing students and 8 academic teaching staff. OUTCOME MAPPING: To stimulate reflective learning debriefing immediately followed the simulation experience. Written reflections were completed and submitted over the following 4weeks to extend the reflective learning process and review the impact of the experience from the student perspective. CONCLUSIONS: Undergraduate student nurses often have limited experiential background from which to draw knowledge and develop sound clinical judgements. Through exposure to clinical experiences in a safe environment, simulation technologies have been shown to create positive learning experiences and improve deductive reasoning and analysis. The heightened awareness of interruptions and their impacts on the medication administration process, along with techniques to manage interruptions more effectively serves to better prepare nurses for practice.