Lifting the curtain on the emergency department crisis: a multi-method reception study of Larry Saves the Canadian Healthcare System.

BACKGROUND: Despite growing evidence of the potential of arts-based modalities to translate knowledge and spark discussion on complex issues, applications to health policy are rare. This study explored the potential of a research-based theatrical video to increase public capacity and motivation to engage with the complex issues that make Emergency Department wait times such an intractable problem. METHODS: Larry Saves the Canadian Healthcare System is a digital musical micro-series developed from extensive research examining system-level causes of Emergency crowding and the ineffectiveness of prevailing approaches. We released individual episodes and a revised full-length version on YouTube, using organic promotion strategies and paid advertising. We used YouTube Analytics to track views, engagement and viewer demographics, and content-analyzed viewer comments. We also conducted five university-based screenings; 92 students completed questionnaires, rating Larry on 16 descriptors using a 7-point Likert scale. RESULTS: From June 2022 through May 2023, Larry garnered over 100,000 views (76,752 of the full-length version, 35,535 of episodes), 1329 likes, 2780 shares, and 139 comments. Views and watch time were higher among women and positively associated with age. Among YouTube comments, the predominating themes were praise for the video and criticism of the healthcare system. Many commenters applauded the show's accuracy, humor, and/or resonance with their experience; several shared healthcare horror stories. Students overwhelmingly agreed with all positive and disagreed with all negative descriptors, and nearly unanimously deemed the video informative, thought-provoking, and entertaining. Most also affirmed that it had increased their knowledge, interest, and confidence to participate in discussions about healthcare issues. Neither gender, primary language, nor employment in healthcare predicted ratings, but graduate students and those 25+ years old evaluated the video most positively. DISCUSSION: These findings highlight the promise of research-informed musical satire to inform and invigorate discourse on an urgent health policy problem. Larry has reached tens of thousands of viewers, garnered excellent feedback, and received high student ratings. Further research should directly assess educational and behavioural outcomes and explore what facilitative strategies could maximize this knowledge translation product's potential to foster informed, impactful policy dialogue.

Integrating mindfulness and the expressive arts for meaning making in cancer care: A grounded theory of the processes, facilitators, and challenges.

PURPOSE: There is a growing interest in mindfulness-based expressive arts interventions in oncology, to help patients process their experiences, learn how to live with cancer, and ameliorate psychological distress. Our research purpose was to explore how patients with cancer experience a mindfulness-based expressive arts group intervention, and to articulate individual and contextual factors influencing their experiences. METHODS: We conducted a constructivist grounded theory study and recruited 32 participants who experienced a 10-week mindfulness-based expressive arts group intervention at a tertiary cancer center in mid-Western Canada. We gathered socio-demographic data and descriptions of their experiences through semi-structured interviews. Participants brought art they had created to facilitate art elicitation. Socio-demographic data were analyzed with descriptive statistics and all other data with grounded theory methods. RESULTS: Our findings revealed how entering the group and meaning making processes through mindfulness enabled participants to let go of their ruminations and calm their minds so they could fully engage in arts activities. Participants found inspiration for their artistic expressions in mindfulness meditation which allowed them to express themselves in new ways. Although this work was challenging, combining mindfulness and the arts created a unique healing space in which individual work was nested within group processes. There were notable personal factors and perspectives that influenced participants' experiences, as well as factors related to the group design and facilitator. CONCLUSIONS: Our findings provide insight into how and when this intervention was meaningful for patients, and have important implications to guide ongoing intervention development, implementation, and evaluation.

Mindfulness-based arts interventions for cancer care: A systematic review of the effects on wellbeing and fatigue.

OBJECTIVE: Upon receiving a cancer diagnosis, life irrevocably changes and complex experiences of emotional distress often occur. There is a growing interest in mindfulness-based arts interventions (MBAIs) to ameliorate the distress many patients experience. Our review objective was to synthesize the evidence on the effectiveness of MBAIs on psychological wellbeing and fatigue. METHOD: Relevant quantitative articles were identified through a systematic search of the grey literature and online databases including MEDLINE, CINAHL, Cochrane CENTRAL, Art Full Text, ART bibliographies Modern, PsycINFO, Scopus, and EMBASE. Two independent reviewers screened titles/abstracts against predetermined inclusion criteria, read full-text articles for eligibility, conducted quality appraisals of included articles, and extracted pertinent data with a standardized data extraction form. The heterogeneity of the included studies precluded a meta-analysis and a narrative synthesis of study outcomes was conducted. RESULTS: Our systematic search retrieved 4241 titles/abstracts, and 13 studies met our inclusion criteria (eight randomized controlled trials and five quasi-experiments). Most of the studies focused on patients with cancer (92.3%). There is a growing interest in MBAIs over time and significant heterogeneity in the types of interventions. A significant effect was found on several outcomes that are important in psychosocial oncology: quality of life, psychological state, spiritual wellbeing, and mindfulness. The effect on fatigue was equivocal. CONCLUSIONS: This novel intervention demonstrates promise for the psychosocial care of patients with cancer. These findings are an essential antecedent to the continued implementation, development, and evaluation of MBAIs in oncology.

Digital Storytelling as a Patient Engagement and Research Approach With First Nations Women: How the Medicine Wheel Guided Our Debwewin Journey.

When research is conducted from a Western paradigm alone, the findings and resultant policies often ignore Indigenous peoples' health practices and fail to align with their health care priorities. There is a need for decolonized approaches within qualitative health research to collaboratively identify intersecting reasons behind troubling health inequities and to integrate Indigenous knowledge into current health care services. We engaged with First Nations women to explore to what extent digital storytelling could be a feasible, acceptable, and meaningful research method to inform culturally safe health care services. This novel approach created a culturally safe and ethical space for authentic patient engagement. Our conversations were profound and provided deep insights into First Nations women's experiences with breast cancer and guidance for our future qualitative study. We found that the digital storytelling workshop facilitated a Debwewin journey, which is an ancient Anishinabe way of knowing that connects one's heart knowledge and mind knowledge.

Discriminating among grounded theory approaches.

To rationalize the selection of a research methodology, one must understand its philosophical origins and unique characteristics. This process can be challenging in the landscape of evolving qualitative methodologies. Grounded theory is a research methodology with a distinct history that has resulted in numerous approaches. Although the approaches have key similarities, they also have differing philosophical assumptions that influence the ways in which their methods are understood and implemented. The purpose of this discussion paper is to compare and contrast three widely used grounded theory approaches with key distinguishing characteristics, enabling a more thoughtful selection of approach. This work contributes to the existing literature through contrasting classic Glaserian grounded theory, Straussian grounded theory, and constructivist grounded theory in a systematic manner with prominent distinguishing characteristics developed from a review of the literature. These characteristics included historical development, philosophical perspective, role of the researcher, data analysis procedures, perspective of the grounded theory, and strengths/critique. Based on this analysis, three considerations are proposed to direct the methodological choice for a study: purpose, philosophy, and pragmatics. Understanding the similarities and differences in the grounded theory approaches can facilitate methodological transparency and determine the best fit for one's study and worldview as a researcher.

Should consultation recording use be a practice standard? A systematic review of the effectiveness and implementation of consultation recordings.

OBJECTIVE: To conduct a systematic review of the effectiveness of consultation recordings and identify factors contributing to their successful implementation in health-care settings. METHODS: A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in health care. Two independent reviewers assessed the relevance and quality of retrieved quantitative studies by using standardized criteria. Study findings were examined to determine consultation recording effectiveness and to identify barriers and facilitators to implementation. A supplementary review of qualitative evidence was performed to further explicate implementation factors. RESULTS: Of the 3373 articles retrieved in the quantitative search, 26 satisfied the standardized inclusion criteria (12 randomized controlled trials, 1 quasi-experiment, and 13 cross-sectional studies). Most patients found consultation recordings beneficial. Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes: knowledge, perception of being informed, information recall, decision-making factors, anxiety, and depression. Implementation barriers included strength of evidence concerns, patient distress, impact of the recording on consultation quality, clinic procedures, medico-legal issues, and resource costs. Facilitators included comfort with being recorded, clinical champions, legal strategies, efficient recording procedures, and a positive consultation recording experience. CONCLUSIONS: Consultation recordings are valuable to patients and positively associated with patient-reported outcomes. Successful integration of consultation recording use into clinical practice requires an administratively supported, systematic approach to addressing implementation factors.

Evaluating patient satisfaction on an acute leukemia/bone marrow transplant day/night treatment unit: A pilot project.

The transition from hospital to home following hematopoietic stem cell transplantation increases the vulnerability for treatment challenges in patients, often resulting in unscheduled and costly hospital re-admissions. Two Acute Leukemia/ Bone Marrow Transplant Day/Night (ALBMT) inpatient beds were established in 2011 at one tertiary care hospital to support successful transition from inpatient cancer treatment to home. This pilot study aimed to investigate patient satisfaction feedback on information provision, treatment, and emotional support on this care innovation. Fourteen former unit patients participated. Survey responses indicated positive satisfaction for treatment and emotional support, and opportunities for information provision enhancement. Findings of this preliminary study exploring satisfaction of this novel inpatient initiative provide important insights into the patient experience, informing future research and practice.

Exploring arts-based knowledge translation: sharing research findings through performing the patterns, rehearsing the results, staging the synthesis.

BACKGROUND: Cultivation of knowledge translation (KT) strategies that actively engage health professionals in critical reflection of their practice and research-based evidence are imperative to address the research-practice gap. While research-based evidence is exponentially growing, our ability to facilitate uptake by nurses and other health professionals has not kept pace. Innovative approaches that extend epistemological bias beyond a singular standpoint of postpositivism, such as the utilization of arts-based methods, expand the possibility to address the complexities of context, engage audience members, promote dissemination within communities of practice, and foster new audiences interested in research findings. AIM: In this paper, we address the importance of adopting a social constructivist epistemological stance to facilitate knowledge translation to diverse audiences, explore various arts-based knowledge translation (ABKT) strategies, and open a dialogue concerning evaluative tenets of ABKT. DISCUSSION: ABKT utilizes various art forms to disseminate research knowledge to diverse audiences and promote evidence-informed practice. ABKT initiatives translate knowledge not based upon a linear model, which views knowledge as an objective entity, but rather operate from the premise that knowledge is socially situated, which demands acknowledging and engaging the learner within their context. Theatre, dance, photography, and poetry are art forms that are commonly used to communicate research findings to diverse audiences. Given the emerging interest and importance of utilizing this KT strategy situated within a social constructivist epistemology, potential challenges and plausible evaluative criteria specific to ABKT are presented. CONCLUSION: ABKT is an emerging KT strategy that is grounded in social constructivist epistemological tenets, and holds potential for meaningfully sharing new research knowledge with diverse audiences. LINKING EVIDENCE TO ACTION: ABKT is an innovative and synergistic approach to traditional dissemination strategies. This creative KT approach is emerging as potent transformational learning tools that are congruent with the relational nature of nursing practice. ABKT facilitates learning about new research findings in an engaging and critical reflective manner that promotes learning within communities of practice.

Arts-based learning: analysis of the concept for nursing education.

Teaching and learning strategies are needed to support learner-centered curricula, and prepare nurses who are capable of working in today's challenging health care environments. Although the traditional lecture is still widely used in nursing education, innovative approaches are needed to encourage discussion, debate, and critical reflection, activities that support lifelong learning. Arts-based learning [ABL] is a creative strategy with the potential to engage learners, foster understanding of multiple perspectives, and simultaneously connect cognitive and affective domains of learning. Walker and Avant's method of concept analysis is applied to examine the uses of ABL in the literature, define the attributes, distinguish the antecedents and consequences, identify model and other cases, and determine empirical referents of this concept. This analysis is presented to facilitate the conceptual understanding of ABL for use in research and nursing education.

The experiences and needs of unpaid family caregivers for persons living with dementia in rural settings: A qualitative systematic review.

PURPOSE: Unpaid family caregivers provide extensive support for community-dwelling persons living with dementia, impacting family caregivers' health and wellbeing. Further, unpaid family caregiving in rural settings has additional challenges because of lower access to services. This systematic review examines qualitative evidence to summarize the experiences and needs of rural unpaid family caregivers of persons living with dementia. METHODS: CINAHL, SCOPUS, EMBASE, Web of Science, PsychINFO, ProQuest, and Medline were searched for articles investigating the experience and needs of rural family caregivers of persons living with dementia. Eligibility criteria were: 1) original qualitative research; 2) written in the English language; 3) focused on the perspectives of caregivers of community-dwelling persons with dementia; 4) focused on rural settings. Study findings were extracted from each article and a meta-aggregate process was used to synthesize the findings. FINDINGS: Of the 510 articles screened, 36 studies were included in this review. Studies were of moderate to high quality and produced 245 findings that were analyzed to produce three synthesized findings: 1) the challenge of dementia care; 2) rural limitations; 3) rural opportunities. CONCLUSIONS: Rurality is perceived as a limitation for family caregivers in relation to the scope of services provided but can be perceived as a benefit when caregivers experience trustworthy and helpful social networks in rural settings. Implications for practice include establishing and empowering community groups to partner in the provision of care. Further research must be conducted to better understand the strengths and limitations of rurality on caregiving.

"Just think of it as sexercise" - healthcare providers' perceptions about sexual health education in cardiac rehabilitation programs.

PURPOSE: Sexual health education (SHE) is an important rehabilitation component for acute coronary syndrome (ACS) survivors but is not routinely provided. This study's purpose was to explore healthcare providers' experiences of providing SHE to ACS survivors in cardiac rehabilitation programs to identify best practices. METHODS: This qualitative study used convenience sampling and an interpretive descriptive design. Inclusion criteria were a healthcare provider employed within a cardiac rehabilitation program in a Western Canadian province. Eight cardiac rehabilitation healthcare providers volunteered to participate. The first author conducted semi-structured, digitally recorded interviews that were transcribed verbatim. The interviews were guided by a semi-structured interview guide anchored in the strengths-based, sex positive guiding frameworks. A reflective journal and socio-demographic forms served as additional data sources. Data were analyzed using open, axial, and selective coding as well as constant comparative analysis. Credibility was ensured through peer-reviewed evaluation criteria. RESULTS: Eight healthcare providers participated in the study. Participants equated sexuality and sexual health with physical activity and physical health. Findings identified philosophical perspectives and several barriers and facilitators that impact SHE provision. Participants offered strategies that may be used in practice and their recommendations provide a beginning foundation to improve cardiac rehabilitation programs and the health of ACS survivors. CONCLUSION: Healthcare providers in cardiac rehabilitation programs described their SHE experiences as "just think of it as sexercise." Facilitation of SHE is important as previous studies found that SHE may reduce fear, depression, and anxiety and increase the return to sexual activity among ACS survivors.IMPLICATIONS FOR REHABILITATIONSexual health doesn't need to be a taboo topic.Approach sexual health conversations by thinking of it as "sexercise".Don't let silos stop sexual health education - talk to your coworkers and patients about sexual health.Knowledge about sexual health, timing of sexual health education, and communication between care providers and patients are important factors in delivery of sexual health education.

Five common pitfalls in mixed methods systematic reviews: lessons learned.

OBJECTIVES: Mixed methods systematic reviews (MMSRs) combine quantitative and qualitative evidence within a single review. Since the revision of the JBI methodology for MMSRs in 2020, there has been an increasing number of reviews published that claim to follow this approach. A preliminary examination of these indicated that authors frequently deviated from the methodology. This article outlines five common 'pitfalls' associated with undertaking MMSR and provides direction for future reviewers attempting MMSR. METHODS: Forward citation tracking identified 17 reviews published since the revision of the JBI mixed methods methodological guidance. Methods used in these reviews were then examined against the JBI methodology to identify deviations. RESULTS: The issues identified related to the rationale for choosing the methodological approach, an incorrect synthesis and integration approach chosen to answer the review question/s posed, the exclusion of primary mixed methods studies in the review, the lack of detail regarding the process of data transformation, and a lack of 'mixing' of the quantitative and qualitative components. CONCLUSION: This exercise was undertaken to assist systematic reviewers considering conducting an MMSR and MMSR users to identify potential areas where authors tend to deviate from the methodological approach. Based on these findings a series of recommendations are provided.

Protocol for a systematic review of living labs in healthcare.

INTRODUCTION: Healthcare is increasingly challenged to meet the demands of user involvement and knowledge mobilisation required by the 21st-century patient-centred and knowledge-based economies. Innovations are needed to reduce problematic barriers to knowledge exchange and improve collaborative problem solving. Living labs, as open knowledge systems, have the potential to address these gaps but are underexplored in healthcare. METHODS AND ANALYSIS: We will conduct the first systematic review of living labs across healthcare contexts. We will comprehensively search the following online databases from inception to 31 December 2020: Scopus, the Cochrane Library (Wiley), Medline (OVID), Embase (OVID), Web of Science, PsycINFO (OVID) and EBSCOhost databases including Academic Search Complete, Business Source Premier, Canadian Reference Centre, CINAHL, MasterFILE Premier, SPORTDiscus, Library & Information Science Source, Library, Information Science & Technology Abstracts, AgeLine, EconLit, Art Full Text, Women's Studies International and Social Work Abstracts. We will search for grey literature using Google advanced techniques and books/book chapters through scholarly and bibliographical databases. We will use a dual-reviewer, two-step selection process with pre-established inclusion criteria and limit to English language publications. Empirical studies of any design examining living lab development, implementation or evaluation in health or healthcare will be included. We will use the Mixed Methods Appraisal Tool (MMAT) for methodological quality appraisal and Covidence software for review management, and we will extract data on pre-established variables such as lab context and technological platforms. We will create evidence tables and analyse across variables such as focal aim and achievement of living lab principles, such as the use of cocreation and multimethod approaches. We will tabulate data for descriptive reporting and narrative synthesis to identify current applications, approaches and promising areas for living lab development across health contexts. ETHICS AND DISSEMINATION: Ethical approval was not required for this review. This review will inform research into living labs in health environments, including guidance for a living lab in paediatric rehabilitation. Academic publications shared through collaborative networks and social media channels will provide substantive knowledge to the growing tech-health development sector and to researchers, practitioners and organisations seeking enhanced patient/stakeholder engagement and innovations in knowledge translation and evidence-based practice. PROSPERO REGISTRATION NUMBER: CRD42020175275.

Evaluating the impact of an arts-based multimedia knowledge translation assignment on undergraduate nursing students.

BACKGROUND: Despite the expectation that nurses utilize research to provide excellent patient care, students often fail to recognize the value of learning about evidence-informed practice. Experiential, creative pedagogical approaches are needed to engage undergraduate nursing students in evidence-informed practice. In two undergraduate courses, we implemented an innovative assignment in which students created an arts-based multimedia knowledge translation presentation to communicate systematic review findings to patients. OBJECTIVE: To evaluate how the assignment affected nursing students' satisfaction, learning, and anticipated behaviour changes regarding evidence-informed practice and to assess what factors influenced their evaluation of the assignment. DESIGN AND METHODS: Kirkpatrick's Evaluation Model and Groff's Theory of Whole-Mindedness informed our study, incorporating an observational cross-sectional survey design. We recruited a convenience sample of nursing students (N = 242) from two baccalaureate programs. We collected data with an online survey comprised of closed- and open-ended questions. Quantitative data were analyzed with descriptive statistics, univariate analysis, and general linear models, and qualitative data with content analysis. RESULTS: Most students were satisfied (68%) and reported learning (77%) and benefits for their future practice (75%). Age, enjoyment of and experience with the arts, type of motivation, and valuing evidence-informed practice were significant predictors (p < 0.01) and the model predicted 59% of the variance in positive student perceptions of the assignment. Students reported experiencing relational and engaged learning, translating research findings creatively and clearly, understanding complex research concepts through experiential learning, and having frustrations and pragmatic concerns. CONCLUSION: Creative approaches that contextualize research findings hold potential to deepen students' understanding of evidence-informed practice. This study identified key factors that influenced students' evaluation and experience of the assignment. These results provide valuable insights to inform effective implementation of arts-based assignments in nursing education.

Methodological guidance for the conduct of mixed methods systematic reviews.

OBJECTIVE: The objective of this paper is to outline the updated methodological approach for conducting a JBI mixed methods systematic review with a focus on data synthesis, specifically, methods related to how data are combined and the overall integration of the quantitative and qualitative evidence. INTRODUCTION: Mixed methods systematic reviews provide a more complete basis for complex decision-making than that currently offered by single method reviews, thereby maximizing their usefulness to clinical and policy decision-makers. Although mixed methods systematic reviews are gaining traction, guidance regarding the methodology of combining quantitative and qualitative data is limited. In 2014, the JBI Mixed Methods Review Methodology Group developed guidance for mixed methods systematic reviews; however, since the introduction of this guidance, there have been significant developments in mixed methods synthesis. As such, the methodology group recognized the need to revise the guidance to align it with the current state of knowledge on evidence synthesis methodology. METHODS: Between 2015 and 2019, the JBI Mixed Methods Review Methodology Group undertook an extensive review of the literature, held annual face-to-face meetings (which were supplemented by teleconferences and regular email correspondence), sought advice from experts in the field, and presented at scientific conferences. This process led to the development of guidance in the form of a chapter in the JBI Manual for Evidence Synthesis, the official guidance for conducting JBI systematic reviews. In 2019, the guidance was ratified by the JBI International Scientific Committee. RESULTS: The updated JBI methodological guidance for conducting a mixed methods systematic review recommends that reviewers take a convergent approach to synthesis and integration whereby the specific method utilized is dependent on the nature/type of questions that are posed in the systematic review. The JBI guidance is primarily based on Hong et al. and Sandelowski's typology on mixed methods systematic reviews. If the review question can be addressed by both quantitative and qualitative research designs, the convergent integrated approach should be followed, which involves data transformation and allows reviewers to combine quantitative and qualitative data. If the focus of the review is on different aspects or dimensions of a particular phenomenon of interest, the convergent segregated approach is undertaken, which involves independent synthesis of quantitative and qualitative data leading to the generation of quantitative and qualitative evidence, which are then integrated together. CONCLUSIONS: The updated guidance on JBI mixed methods systematic reviews provides foundational work to a rapidly evolving methodology and aligns with other seminal work undertaken in the field of mixed methods synthesis. Limitations to the current guidance are acknowledged, and a series of methodological projects identified by the JBI Mixed Methods Review Methodology Group to further refine the methodology are proposed. Mixed methods reviews offer an innovative framework for generating unique insights related to the complexities associated with health care quality and safety.

The development of academic identity in graduate nursing students: An interpretive descriptive study.

BACKGROUND: Mentorship is an important element in the development of academic identity among graduate students in nursing. Although most often occurring within the context of faculty advisor-student relationships, mentorship should extend beyond formal advisor-advisee relationships. Peer mentorship is known to be beneficial for graduate students, yet little is known about how peer mentorship specifically impacts the development of academic identity. OBJECTIVE: The purpose of this study was to explore how peer mentorship, within the context of an international research conference, impacts the development of academic identity. DESIGN: Qualitative descriptive study. Graduate nursing students from a research-intensive university in Canada were invited to participate in a peer mentorship initiative. Data were collected through reflective journals. Data analysis was conducted iteratively and collaboratively using an interpretive descriptive approach. PARTICIPANTS: Eight mentees, two peer mentors and five faculty mentors participated in the initiative. With the exception of one faculty mentor, all participants provided reflective journals on their experiences, in response to journal prompts. RESULTS: Findings centered on five themes: walking through quicksand, navigating a complex academic world, developing academic identity through relationships, intentional cultivation of community, and finding solid ground. Our findings highlight the relational nature of academic identity development, and the significant benefit of providing mentorship to graduate nursing students outside of formal learning spaces. CONCLUSIONS: Given the urgent need to increase the numbers of nurses with advanced research training, it is important that effective strategies like this innovative mentorship initiative, that enhance professional identity development, are integrated into graduate education programs.

Factors shaping the provision of sexual health education for adults with acute coronary syndrome: A scoping review.

OBJECTIVE: Each year, 63,000 Canadians are diagnosed with acute coronary syndrome (ACS) and 73 % survive. Sexual health education for ACS survivors is recommended but is not routinely provided. A scoping review was performed to inform health care providers about factors shaping sexual health education for ACS survivors. METHODS: Three databases were searched, 208 studies were screened, and 24 were included in this scoping review. Significant points from the selected studies were charted and synthesized. RESULTS: This review confirmed absent to limited provision of sexual health education to individuals with ACS. Key factors influencing lack of provision of sexual health were categorized according to macro, meso, and micro levels. At the macro level, societal and cultural factors were noted. The meso level included healthcare environment and limited healthcare provider knowledge. At the micro level, healthcare professional-healthcare consumer relationships and role clarity were noted. CONCLUSION: A sex positive approach may facilitate provision of sexual health education. PRACTICE IMPLICATIONS: This scoping review points to the need to use a sex positive lens to identify and remove barriers to facilitate the provision of sexual health education. Providing this education may result in reduced fear, depression, and anxiety in ACS survivors.

Navigating creativity within arts-based pedagogy: Implications of a constructivist grounded theory study.

BACKGROUND: Educators implement arts-based pedagogy with the hope that it will foster meaningful learning for students. However, nursing students have varied reactions to artistic assignments, and there is a need to further understand students' learning processes with this novel approach and the factors influencing their learning. This understanding could promote the more effective implementation of arts-based pedagogy into nursing education. OBJECTIVE: To develop a theoretical understanding of how and when undergraduate nursing students learn through arts-based pedagogy. DESIGN: Constructivist grounded theory. SETTINGS: Canadian baccalaureate nursing program. PARTICIPANTS: Thirty third-year undergraduate nursing students and eight of their nursing instructors. METHODS: Participants who had experienced arts-based assignments were recruited with purposive and then theoretical sampling. We collected four sources of data: a socio-demographic questionnaire, semi-structured interviews, photo/art elicitation, and field notes. The socio-demographic data were analyzed with descriptive statistics and all other data with constructivist grounded theory procedures. RESULTS: Our findings revealed that students had to navigate a creative process with arts-based assignments, which involved several iterative phases. This type of learning was unique within their program and somewhat constrained by the context of nursing education. There was notable variation in the students' experiences. Although many reported meaningful learning, approximately 20% of the students did not value the assignment. Our findings elucidated multi-level enabling and restraining factors that influenced students' engagement with and learning from this creative process. CONCLUSIONS: These findings provide insight into modifiable factors that influenced students' engagement and learning, and have important implications for making ABP accessible and meaningful for more students.