A systematic review of online team based learning approaches in health professional education.

AIMS AND OBJECTIVES: The purpose of this study was to systematically review studies related to the use of online Team Based Learning (TBL) platforms with a focus on health professional education. The objectives were to identify best practices, highlight what technological platforms are effective for TBL processes and evaluate educational outcomes in terms of student experience, learning and preference. DESIGN: A systematic review of published TBL research was undertaken between August and October 2021 and supplemented in September 2022. DATA SOURCES: ERIC, PsycINFO, Scopus, Embase, Medline, and Cinahl databases were used. The keywords were identified from researchers' knowledge and PICO/PICo framework. REVIEW METHODS: Titles and abstracts were screened individually by two reviewers for eligibility. Data extraction was undertaken by two researchers independently and checked for consistency by discussion between the two. Articles were appraised using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Out of 656 articles 14 were involved in the final review. All others were rejected due to duplication, ineligibility, or poor quality. The studies were from a range of countries and focussed on a range of health professionals including nursing. Inconsistencies in approaches for TBL, platforms used and mixed results in terms of outcomes were noted. There was no real consensus other than that TBL was equally as effective if carried out online or face-to-face, with no clear differences to outcomes related to satisfaction in online or traditional TBL approaches. CONCLUSIONS: It is recommended that further research is carried out into the outcomes of TBL on learning and experiences of students in health professional courses. The development and appraisal of integrated TBL platforms should be invested in and infrastructure and resources are put in place to support this.

Indigenous-led First Peoples health interprofessional and simulation-based learning innovations: mixed methods study of nursing academics' experience of working in partnership.

Background: Collaborative, Indigenous-led pedagogical and research approaches in nursing education are fundamental to ensuring culturally safe curriculum innovations that address institutional racism. These approaches privilege, or make central, Indigenous worldviews in the ways healthcare practices are valued and assessed. With the aim of informing excellence in cultural safety teaching and learning, and research approaches, this study draws on the experiences and key learnings of non-Indigenous nursing academics in the collaborative implementation of First Peoples Health interprofessional and simulation-based learning (IPSBL) innovations in an Australian Bachelor of Nursing (BN) program.Methods: An Indigenous-led sequential mixed method design was used to investigate non-Indigenous nursing academics' experiences in the design, development and delivery of two IPSBL innovations. A validated survey (the Awareness of Cultural Safety Scale, (ACSS)) was administered to nursing academics before and after the innovations were delivered. Phenomenological interviews were also conducted following the implementation of the innovations.Results: Of the 27 staff involved in the delivery of the innovations, six nursing academics completed both pre-and post-surveys (22%). Nine (33%) participated in phenomenological interviews. There was a non-significant trend towards improved scores on the ACSS following the delivery of the innovations. Nursing academics' perceptions of the innovations' relevance to their practice were enhanced. An increased awareness of culturally safe academic practices was reported among those actively involved in innovations.Impact statement: Indigenous-led approaches in teaching and research promote excellence within mandatory cultural safety education for nurses and midwives.Conclusions: This study confirms the importance of educating the educators about cultural safety in teaching and learning, and research approaches. It also provides important insights into how non-Indigenous nursing academics can work within Indigenous-led pedagogical and research approaches to design culturally safe curriculum innovations.

The use of interprofessional learning and simulation in undergraduate nursing programs to address interprofessional communication and collaboration: An integrative review of the literature.

OBJECTIVE: To identify how simulation and interprofessional learning are used together in undergraduate nursing programs and undertaken in schools of nursing to address interprofessional communication and collaboration. DESIGN: An integrative literature review. DATA SOURCES: The databases CINAHL, ProQuest, PubMed, Scopus, PsycInfo and Science Direct were searched to identify articles from 2006 to 2016 that reported on the use of IPL and simulation together in undergraduate nursing education. REVIEW METHOD: Whittemore and Knafl's five step process was used to guide the integrative review of quantitative and qualitative literature. Only peer reviewed articles written in English that addressed undergraduate nursing studies, were included in the review. Articles that did not aim to improve communication and collaboration were excluded. All articles selected were examined to determine their contribution to interprofessional learning and simulation in undergraduate nursing knowledge. RESULTS: The faculties of nursing used interprofessional learning and simulation in undergraduate nursing programs that in some cases were connected to a specific course. A total of nine articles, eight research papers and one narrative report, that focused on collaboration and communication were selected for this review. Studies predominantly used nursing and medical student participants. None of the included studies identified prior student experience with interprofessional learning and simulation. Four key themes were identified: communication, collaboration/teamwork, learning in practice and understanding of roles, and communication. CONCLUSION: This review highlights the identified research relating to the combined teaching strategy of interprofessional learning and simulation that addressed communication and collaboration in undergraduate nursing programs. Further research into the implementation of interprofessional learning and simulation may benefit the emergent challenges. Information drawn from this review can be used in informing education and educational development in the future.

Older folks in hospitals: the contributing factors and recommendations for incident prevention.

OBJECTIVES: To identify the most common errors and adverse events and their contributing factors among the older patients admitted to hospital and examine recommendations from an expert review panel for prevention and reduction of the adverse events. BACKGROUND: Older patients are at an increased risk of errors and adverse events while hospitalized. The increasing evidence suggests that understanding the risks factors that contribute to these errors and adverse events facilitates the education of health professionals and the reduction and preventions of the harm. METHOD: A retrospective audit of the Incident Information Management System and Root Cause Analysis databases from July 1, 2005, to June 30, 2006, was undertaken in 1 large tertiary metropolitan hospital in New South Wales, Australia. RESULTS: Of the 643 incidents identified, falls (n = 309), medication errors (n = 136), and clinical management (n = 104) were the most common errors among older patients, and the failure of clinicians to follow policies and procedures and poor communication between clinicians contributed to these incidents. CONCLUSIONS: Although systems are in place for incident reporting and analysis of the contributing factors, improvement depends upon clinicians taking responsibility for anticipating and moderating risk using previous data to identify system weaknesses and monitoring improvements especially in hospitalized older patients.

Effectiveness of strategies to promote safe transition of elderly people across care settings.

BACKGROUND: Errors and adverse events have major impact on elderly patients due to their recurrent hospitalisation and particularly as they move between settings to receive care for comorbid chronic conditions. A range of strategies such as discharge planners, use of patients transfer sheet, medications reconciliation and patients education have been implemented to improve care transition. However, there have been no systematic reviews undertaken to evaluate the effectiveness of these strategies in a concise format for the development of evidence-based guidelines. Therefore, a systematic review is urgently needed to support clinicians in implementing safe quality care transition and also use as a front line to improve patient safety. OBJECTIVE: The objective of this review is to appraise and synthesise the best available evidence in promoting a safer transfer of elderly patients across care settings. SELECTION CRITERIA: Types of studies Only randomised controlled trials (RCTs) evaluating the effectiveness of strategies to promote safe transfer of elderly patients across care settings were eligible for inclusion in this review.Types of participants The review included studies undertaken in participants aged >65 years who have been transferred between care settings.The review focused on any interventions that were undertaken to reduce or minimise errors and adverse events and promote safe transition of the elderly patients from one setting to another.The primary outcome of interest was the effect of the interventions on the use of health care resources. SEARCH STRATEGY: A comprehensive search of the literature published in the English language was undertaken using all major electronic databases ranging from 1966 to 2008. Reference lists and bibliographies of all possible trials and reviews of studies were searched. Relevant conference proceedings were searched; experts in the field were also contacted to identify further trials. RESULTS: 12 studies were included in the review. The results indicated that comprehensive plan of care and well-trained healthcare practitioners such as nurses or pharmacists, who have current information about the patient's clinical status and care plan, ensured smoother transition from hospital to home. The use of multi-faceted interventions such as elderly patient education and collaborative team approach reduce the incidence of errors and adverse events during care transition. CONCLUSION AND IMPLICATION FOR PRACTICE: There is evidence of benefits to demonstrate:1. Strategies that involve structured communication improve outcomes for elderly patients during care transition.2. Nurse-led interventions and multidisciplinary team interventions were effective in reducing readmission to hospital at one to nine months.3. Pharmacist-led interventions and multidisciplinary team led interventions reduced frequency of hospital services utilisation such as emergency visits, long-term institutions and rehabilitation clinics.4. Pharmacist-led interventions were effective in improving quality of medications prescribed by physician. In addition, significantly reduced non-adherence in patients taking four or more medication at three months.5. Nurse-led interventions effectively improved quality of life in patients receiving the interventions.6. Nurse-led and multidisciplinary team led interventions reduced costs associated with the interventions. IMPLICATION FOR RESEARCH: The review has provided a guide for future research priorities which involves larger randomised controlled trials assessing transitions between hospital and in-patient settings; comprehensive standardised method to assess outcomes such as medication adherence and studies to clearly demonstrate the association between adverse events and transfer.

A mapper's reflection on Dementia Care Mapping with older residents living in a nursing home.

Aim and objective. This paper explores reflection stemming from a Dementia Care Mapper's own learning and development concerning person-centred care with older residents living in a dementia specific nursing home. Background. Dementia Care Mapping has been employed in few Australian residential care facilities to promote person-centred care and the well-being of residents. Reflection has also been used selectively in some practices to improve and evaluate the care process. However, contemporary nursing literature has failed to highlight the usefulness of applying reflection following Dementia Care Mapping with older residents. Method. The mapper's reflections arose from the Dementia Care Mapping observation of five older residents and writing a daily reflective journal. Findings. From the reflection, a dominant major theme emerged named as the Learning Experience from Mapping Residents with two sub-themes entitled Mapper's Identification of Resident's Unique Needs and Mapper's Empowerment of Clinicians. Dementia Care Mapping recommendations from the mapper's experience highlighted effective approaches to conducting Dementia Care Mapping in residential care facilities. Conclusions. The valuable process of reflection to Dementia Care Mapping provided the mapper with clinical insights. Further from the mapper's final reflection, a poem entitled Come Back Mind, Come Back to Me was conceived and penned. Relevance to clinical practice. The mapper's engagement in ongoing reflection incorporated with Dementia Care Mapping has the potential to promote best practice for the care of older people living in aged care facilities.