PURPOSE: The overall aim of this scoping review was to identify, explore and map the existing literature pertaining to healthcare access for transgender and non-binary individuals. DESIGN: The scoping review followed Arksey and O'Malley's methodological framework, and the reporting adhered to the guidelines provided by the PRISMA Extension for Scoping Reviews. METHODS: To gather relevant articles, a comprehensive search strategy was employed across four electronic databases, with the assistance of a university librarian. In addition, manual and internet searches were conducted for grey literature. From the initial search, a pool of 2,452 potentially relevant articles was retrieved, which was supplemented by an additional 23 articles from the supplemental search. After an independent review by two researchers, 93 articles were assessed, resulting in the inclusion of 41 articles in the review. RESULTS: The literature highlights the identification of barriers and enablers, spanning across 32 individual data sets that affect healthcare accessibility for transgender and non-binary individuals. Leveque's five dimensions of healthcare access, namely approachability, acceptability, availability and accommodation, affordability, and appropriateness, were utilized to categorise these 42 factors. Some of the key themes that emerged in these dimensions include challenges in accessing information about services, concerns about acceptance from family and peers, past experiences of discrimination in healthcare settings, considerations related to cost and insurance, and the difficulty in finding appropriately trained competent providers. CONCLUSIONS: The review focused on the most commonly researched aspects of healthcare access and identified gaps in research and opportunities for future studies. The findings provide recommendations for policy and practice, which could guide the development of interventions aimed at addressing the barriers faced by transgender individuals seeking gender-affirming care.
Health Services Accessibility , Transgender Persons , Humans , Transgender Persons/psychology , Female , Male , Gender-Affirming Care
BACKGROUND: â¯Internationally, the demand for gender-affirming care has increased exponentially in recent years. The clinical presentation of those seeking care has changed with an increase in transmasculine and non-binary identities and a decrease in the average age of those seeking care. Healthcare navigation remains complicated for this population and warrants further investigation in light of ongoing changes in the field. This paper presents a protocol for a scoping review to map and synthesise the academic and grey literature on instruments used to assess healthcare navigation and access for transgender and non-binary individuals seeking gender-affirming care. METHODS: This review will search databases (PsychINFO, CINAHL, Medline, and Embase.) and grey literature sources. In line with the methodological framework for scoping reviews, the following six stages will be undertaken: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarising and reporting results and (6) consultation. The PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation will be utilised and reported. The research team will undertake the study as outlined in this protocol and an expert panel of young transgender and non-binary youth will oversee the project through patient and public involvement. Conclusions:â¯This scoping review has the potential to inform policy, practice, and future research through enhanced understanding of the complex interplay of factors that impact healthcare navigation for transgender and non-binary people seeking gender-affirming care. The results from this study will inform further research into healthcare navigation considerations generally and will inform a research project entitled "Navigating access to gender care in Ireland-a mixed-method study on the experiences of transgender and non-binary youth".
AIM: To explore Irish nursing students' experiences of caring for dying patients and their families to understand these experiences and determine whether or not students felt prepared for this role. DESIGN: This study used a qualitative descriptive research design. METHODS: One to one semi-structured interviews were used to collect data, implementing open-ended questions to explore seven student nurses' experiences. RESULTS: Five main themes emerged: Student's first experiences, emotional experience of caring, educational preparation, challenging aspects of caring for dying patients and their families and need for support in practice. Students' first experience of caring for a dying patient and their family was a confronting event for students, both personally and professionally. Nursing students require adequate and timely education on end of life care and a practical and supportive clinical learning environment to effectively support and prepare students for caring for a dying patient and their family.
Students, Nursing , Terminal Care , Humans , Students, Nursing/psychology , Terminal Care/psychology , Learning , Emotions , Qualitative Research
AIM: The complete examination and screening of the neonate is a recommended assessment of neonatal well-being conducted by appropriately trained medical, midwifery and nursing personnel at specific intervals during the first 6-week post-birth. Our aim was to identify and critically evaluate instruments that measure practitioner performance of this important assessment of neonatal health. METHODS: Using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology, a systematic review was undertaken. RESULTS: Four studies were identified as suitable for data extraction and analysis. This paper briefly describes the four instruments, discusses and compares the COSMIN analysis and ratings of each instrument. A recommendation for the instrument identified as the most suitable to measure practitioner performance is provided. CONCLUSION: Most instruments were designed by educators to measure the performance of practitioners developing competence in the complete examination and screening of the neonate. Further development and piloting of instruments designed to measure the performance and continuing competence of qualified practitioners of the newborn examination are required.
Consensus , Infant, Newborn , Humans , Psychometrics
AIM: The aim of this systematic scoping review is to examine and synthesise the available literature on developing interpersonal and communication skills in general nursing preceptorship education programmes. BACKGROUND: Highly developed interpersonal and communication skills are an essential component of nursing preceptorship. Preceptors are integral in facilitating, guiding, and developing positive interpersonal relationships between the nursing student (the preceptee), the qualified nurse (the preceptor), and patients. They also have a responsibility to foster and develop preceptees' interpersonal and communication skills and assess and deem preceptees as competent in such skills. Furthermore, preceptors require effective interpersonal and communication skills to carry out key responsibilities of their role, including creating a safe clinical learning environment, teaching, and providing effective feedback. DESIGN: A scoping review was conducted using the methodological framework of Arksey and O'Malley. The PRISMA Extension for Scoping Reviews guided the reporting. METHODS: Five electronic databases were searched for relevant articles in consultation with a librarian, supplemented by hand-searching and internet searches for grey literature. A total of 19,431 potentially relevant articles published between Jan 2000 and August 2021 were retrieved from the initial search, and an additional six articles were obtained from the supplemental search. A total of 146 articles were independently reviewed by two researchers, resulting in 24 articles eligible for inclusion in the review. RESULTS: Several themes were identified in the literature that influenced the development of interpersonal and communication skills in preceptorship education and training programmes, including design and development of programmes, key learning outcomes, pedagogical approaches of preceptorship education and training programmes and interpersonal & communication skills development in preceptorship education and training programmes. Conclusions This review highlighted that research on developing interpersonal and communication skills amongst preceptors is mainly absent from the literature. Further research to address these knowledge gaps is warranted. The results from this review can be used to inform future curriculum design and development of nursing preceptorship education and training programmes.
Education, Nursing , Students, Nursing , Humans , Preceptorship/methods , Curriculum , Communication
Having psychological safety embedded in preceptorship relationships facilitates positive interpersonal and educational experiences for students. Psychological safety refers to a student's belief as to whether or not it is safe for them to take interpersonal risks, such as asking questions, sharing an idea for improvement or speaking up to maintain patient safety. Having psychological safety leads to collaboration, positive student learning experiences and effective patient care. This article presents key guidelines for preceptors to provide a psychologically safe learning environment for their students. Guidelines fall under four categories 1) before meeting students, 2) first meeting students, 3) continued relationship with students, and 4) general rules. These guidelines are informed by current literature on psychological safety and preceptorship and the author's clinical expertise in nursing preceptorship. We conceptualise psychological safety in a nursing preceptorship for preceptors to denote the experience of inclusivity, empowerment, and well-being of students within the social, cultural and physical clinical learning environment. A crucial attribute to cultivating a psychologically safe environment involves being an accessible and approachable preceptor.
Learning , Students , Humans , Preceptorship , Educational Status , Physical Education and Training
AIM: The purpose of this study was to examine midwifery students' views and experiences of learning perineal suturing skills through a blended learning approach. BACKGROUND: Evidence suggests that not all midwifery students are gaining sufficient experience in perineal trauma and suturing to sufficiently prepare them to achieve competency in this skill at the point of registration. DESIGN: The blended learning approach included lectures, a bespoke 'suture at home kit', online reusable learning objects, and an optional face-to-face drop-in suture clinic. Midwifery students submitted a video demonstration of the skills acquired and then attended a clinical skills laboratory in preparation for a face-to-face competency assessment on campus. RESULTS: A qualitative descriptive evaluation research design study was undertaken from 22 participants. Deductive thematic analysis was selected to analyse the qualitative data. Two themes were identified. The first theme, 'learning at home', included sub-themes of 'deliberate practice' and 'the ability to make mistakes. The second theme, 'achieving competency', included sub-themes of 'equipment' and 'bringing it all together' CONCLUSIONS: The blended learning approach of the programme applied to teach perineal suturing had a positive influence on midwifery students learning of the skill. The acquisition of knowledge using the suture at home kit gave the students confidence and prepared them for laboratory practice and assessment, and ultimately prepared them for practice placement. They identified other clinical skills suited to using an 'at home' simulation pack. The validation of the perineal suturing programme by midwifery students supports the need for a blended learning approach for this and other clinical skills. All participants expressed a positive view of the programme and found it beneficial for their learning. Midwifery students recognised that the suture at home kit gave them confidence, knowledge of the skill and preparedness for the clinical skills laboratory practice and assessment. They identified other clinical skills suited to using an 'at home' simulation pack. The positive experiences of midwifery students in this study to a blended-learning programme for perineal suturing education and training further validated the recognised need to develop and include online, and face to face learning approaches for this vital aspect of intrapartum care.
Midwifery , Students, Nursing , Clinical Competence , Female , Humans , Learning , Midwifery/education , Pregnancy , Sutures
BACKGROUND: Patients play a central role in nursing preceptorship relationships, a professional educational relationship between a staff nurse and student nurse that is grounded in providing patient care. Yet the patient experiences and perspectives are largely uncaptured in the literature or represented in current preceptorship education programmes. Furthermore, the lack of student, staff nurse & patient involvement in the design of preceptorship education programmes has been noted. OBJECTIVE: To use a co-design process to develop an innovative educational programme for developing interpersonal and communication skills among nurses who act as preceptors. We sought to (a) clarify experiences and events from all three members involved in a preceptorship relationship (student nurse, preceptor, and patient (SPP) in order to develop a shared understanding of nursing preceptorship relationships and (b) identify the key informational and educational needs recommended by SPP for the educational programme. METHODS: Using the principles and the iterative process of Experienced Based Co Design (EBCD), data was collected from qualitative interviews and used to inform a series of co-design workshops and the co-production of the new educational programme. RESULTS: Twenty-six individuals, including undergraduate student nurses, staff nurses, patients, and a team of nursing, educational and educational technologist experts, contributed to developing a blended learning preceptorship educational programme that consists of three core elements (1) six online reusable learning objects, (2) two role play simulations and (3) a virtual reality storytelling simulated experience. CONCLUSIONS: The EBCD process ensured that the educational programme was developed to meet SPP viewpoints associated with fostering positive interpersonal relationships in a nursing preceptorship. EBCD is a valuable framework for developing human-centred educational resources that combine experiential knowledge (experiences) and scientific knowledge (literature-based knowledge). It facilitated the identification and the development of Interpersonal and Communications skills (IP & C skills) training required within a nursing preceptorship relationship, creating an authentic and memorable learning programme. The structure of EBCD harnesses SPP involvement throughout the research and development process, ensuring transparency and continuity of message, scope, and outcomes.
Nursing preceptorship is a professional educational relationship between a staff nurse and student nurse based on providing patient care. The preceptor is a role model for the student, demonstrating professional roles and practice responsibilities. Furthermore, the preceptor accesses the student's clinical competence, providing valuable feedback, support and guidance. Therefore, an effective preceptor must develop interpersonal, teaching and competency assessment skills. This paper describes a co-design project that involved engaging nursing students, nurses, former patients, and educational and nursing specialists in creating a new nursing preceptorship education programme. The goal was to develop an educational programme that combined scientific evidence with real-life experiences of nursing students, nurses, and patients focusing on developing nurses' interpersonal and communication skills required to be an effective preceptor. Collaborative co-design workshops were held virtually over several months. Activities included one to one interviews, group discussions and feedback on various drafts of the developing educational programme. Participants provided their stories, opinions, and ideas to create an outline of the new programme. The co-design team then collaborated with educational technologists and a virtual reality production company to complete the state-of-the-art innovative educational programme. The programme is now ready to be piloted. It is hoped this new innovative programme that blends both scientific knowledge with real-life experiences will help nurses develop the interpersonal and communication skills required when interacting with students and patients.
The preceptorship model is an education-focused model for teaching and learning within a clinical environment in nursing. It formulates a professional educational relationship between a staff nurse (preceptor) and student nurse and is based on the provision of providing patient care. Preceptorship is widely acknowledged in the literature as a positive pedagogical approach in clinical nursing education in terms of knowledge and skill acquisition, confidence, and professional socialisation of undergraduate nursing students. However, the literature also widely reports negative interpersonal experiences within this professional educational relationship resulting in negative educational experiences and in some cases, negative patient experiences. Therefore, the authors set out to examine what teaching strategies are being implemented by nurse educators to encourage the development of interpersonal and communication skills in facilitating positive interpersonal relationships between the preceptor, nursing student and patient. This paper outlines the protocol for an exploratory scoping review that aims to systematically and comprehensively map out the available published and unpublished literature on the teaching strategies to develop interpersonal and communication skills in preceptorship education and training programmes. To conduct a systematic and comprehensive scoping review, the review will be guided by the Joanna Briggs Institute and Arksey & O' Malley (2005) six-stage iterative framework, as well as PRISMA-ScR framework guidelines, to ensure the quality of the methodological and reporting approaches to the review. It is anticipated that the results of the scoping review will inform nurse educators on the current educational practices for developing interpersonal and communication skills in preceptorship education and training programmes and identify any educational practices that are worthy of further consideration for future research.
BACKGROUND: Immersive Virtual Reality (iVR) storytelling is a concept that merges ground-breaking virtual reality technology with the traditional art of storytelling. Virtual reality storytelling offers a rare opportunity to present abstract experiences that challenge boundaries, heighten emotions, and convey previously intangible concepts. Scientific research into immersive virtual reality storytelling is still in its infancy, particularly regarding the field of education in Nursing and Midwifery. Therefore, this study set out to investigate the subjective experience of using an immersive virtual reality storytelling experience as an active pedagogy. METHODS: This was an evaluative study incorporating a multimodal approach encompassing a cross-sectional survey and observational study conducted in a large University in Ireland, offering major undergraduate and graduate degree programmes in the fields of Nursing and Midwifery. Students were invited to view the innovative virtual reality storytelling experience "Wonderful You" (BHD Immersive) that tells the story of the first 9 months of a baby's life inside the woman's womb. On completion, students were asked to complete an anonymous survey about their experience. Observational studies were also carried out, examining the student's engagement and interaction with the iVR experience. A combination of statistical and thematic qualitative analysis was employed to interpret the respective summative rating scale and open-ended response questions in the evaluation survey. Data captured from the observations were grouped into categories and analysed capturing key themes. RESULTS: A response rate of 71.2% (n = 94) identified iVR storytelling as a memorable learning experience that triggered students' engagement and motivation to learn. IVR storytelling enabled students to visualise and better understand abstract concepts. Qualitative analysis of narrative responses revealed the positive evaluations of the iVR storytelling experience. Observational studies further revealed students were highly engaged and interacted positively with the iVR storytelling experience. CONCLUSIONS: The full potential of this new medium of iVR storytelling has yet to be seen. However, this study provides an encouraging insight into the positive attributes of iVR storytelling that engages students and creates authentic active learning experiences.
Concerns have arisen internationally over the competency of student nurses to perform wound care. A global shortage of nursing faculty and clinical practice opportunities is regarded as a contributing factor. Virtual simulation offers a possible solution. The aim of this study was to describe the development and educational evaluation of a virtual patient to supplement undergraduate learning of wound care. The National League for Nursing Jeffries model informed the design of the media. Evaluation of the virtual patient by penultimate year nursing students (n = 148) was conducted using a survey design. Findings are presented from statistical and directed content analyses. Most students rated the educational value of the virtual patient and its support of learning highly. They reported a perceived increase in confidence and ability to meet wound care competency outcomes. The virtual patient also provided students with opportunities to develop their clinical reasoning skills. This study provides evidence that virtual patient simulation is an effective pedagogy to increase clinical competence in wound care. It allows nursing students the opportunity to practice skills and utilise theory repetitively in a safe environment, unhampered by a lack of resources such as clinical placement availability and a declining faculty.
Clinical Competence , Learning , Patient Simulation , Students, Nursing/statistics & numerical data , Wound Infection/prevention & control , Adult , Cross-Sectional Studies , Curriculum , Education, Nursing, Baccalaureate , Educational Measurement/statistics & numerical data , Female , Humans , Male , Surveys and Questionnaires , Young Adult
