Interplay between leadership and patient safety in dentistry: a dental hospital-based cross-sectional study.

OBJECTIVES: The study aimed to study the association of leadership practices and patient safety culture in a dental hospital. DESIGN: Hospital-based, cross-sectional study SETTING: Riphah Dental Hospital (RDH), Islamabad, Pakistan. PARTICIPANTS: All dentists working at RDH were invited to participate. MAIN OUTCOME MEASURES: A questionnaire comprised of the Transformational Leadership Scale (TLS) and the Dental adapted version of the Medical Office Survey of Patient Safety Culture (DMOSOPS) was distributed among the participants. The response rates for each dimension were calculated. The positive responses were added to calculate scores for each of the patient safety and leadership dimensions and the Total Leadership Score (TLS) and total patient safety score (TPSS). Correlational analysis is performed to assess any associations. RESULTS: A total of 104 dentists participated in the study. A high positive response was observed on three of the leadership dimensions: inspirational communication (85.25%), intellectual stimulation (86%), and supportive leadership (75.17%). A low positive response was found on the following items: 'acknowledges improvement in my quality of work' (19%) and 'has a clear sense of where he/she wants our unit to be in 5 years' (35.64%). The reported positive responses in the patient safety dimensions were high on three of the patient safety dimensions: organisational learning (78.41%), teamwork (82.91%), and patient care tracking/follow-up (77.05%); and low on work pressure and pace (32.02%). A moderately positive correlation was found between TLS and TPSS (r=0.455, p<0.001). CONCLUSIONS: Leadership was found to be associated with patient safety culture in a dental hospital. Leadership training programmes should be incorporated during dental training to prepare future leaders who can inspire a positive patient safety culture.

Mentoring student nurses in Uganda: A phenomenological study of mentors' perceptions of their own knowledge and skills.

This paper will report on the findings of a qualitative research study exploring mentorship in a rural hospital in Uganda. It explored how mentors perceived their roles and their own knowledge and skills in mentoring nurse students. Participants were confident in their ability to teach clinical skills, but they identified gaps in relation to the application of theory to these skills and they the need to update their own knowledge and to act more on their own initiative. The paper reports on the nature of the relationship between mentor and students, the teaching approaches used and the challenges of the role. Recommendations are proposed to develop a bespoke Ugandan curriculum to prepare mentors for their role, and to provide additional support, to enhance students' experiences of learning in this context.

Mentors' perceptions and experiences of supporting student nurses in practice.

This paper reports on a funded project that explored the perceptions and experiences of mentors regarding student nurse support in practice. The study employed a mixed-method approach, using questionnaires and focus groups with mentors from one acute Trust and one community Trust. The findings highlighted the multifaceted nature of student learning in practice, with mentors reporting that clinical skills, adjustment to the placement and integrating into the team were the aspects students needed most support with. Mentors were aware of their roles and responsibilities in supporting students and recognized the importance of their own personal attributes. The participants reported a number of challenges, particularly time, competing demands and paperwork, and suggested that a team approach and support groups could help to overcome these. The support for students provided by peers and health-care assistants was recognized, as was the need to ensure that students are prepared to take responsibility for their learning.

Students' and lecturers' perceptions of support in a UK pre-registration midwifery programme.

This paper reports on a study that explored the perceptions of students and lecturers regarding support within a pre-registration midwifery programme in one Higher Education Institution in England. A mixed method design was used: questionnaires were completed by first year and third year students and lecturers, complemented by focus groups with each of the three sets of participants. The findings showed that there are multi-focal challenges for student midwives in undertaking their programme of study. The main theme that emerged was of the difficulties involved in maintaining an appropriate work-life balance, especially within what was seen as a relatively inflexible programme structure. The value of peer support was also highlighted as a key factor in helping the students succeed in their studies. There were a number of implications for midwifery educators to consider in optimising support for students. These include ensuring that students have realistic expectations at the outset of their studies, formalising peer support mechanisms and reviewing programmes to provide more flexibility to better underpin the maintenance of an appropriate work-life balance. Further study is warranted to explore perceptions of support in practice and to identify the factors that help students to persevere in their studies.

Listening to stories: valuing knowledge from patient experience.

This paper reports on a research project which explored students' perceptions of learning from listening to patient stories. There is a plethora of literature to support the value of learning from service users within professional education programmes and a growing body of literature suggesting that storytelling is an effective learning and teaching strategy. However, little evidence focuses on the process of learning from patients' stories during practice placements and this study was designed to address this knowledge gap. The study adopted a descriptive phenomenological approach employing in-depth, conversational interviews with a sample of twelve pre-qualifying nursing, midwifery and social work students. The findings confirm the value of service users as a resource for student learning and indicate that listening to patient stories was a strategy which all respondents adopted to access this source of knowledge. This paper recommends that educators should recognise and value this alternative form of knowledge; provide the space and opportunities for students to listen to stories during their placements and actively facilitate reflection on these learning experiences.

Effective mentoring in the community setting.

As nurses, we are expected to demonstrate the linking of theory to practice, undertake continuous assessment and to facilitate reflective practice. Literature suggests that the majority of mentors feel unprepared for the role and lack confidence in their ability to support students (Duffy, 2004). The main challenges facing mentors are understanding the needs of each individual and adapting and developing strategies in order to support them effectively. Whilst there is a major cognitive / intellectual component to mentorship both student and mentor often experience difficulties with these aspects of their roles (Moseley and Davies, 2008). By recognizing the need to gain insight into the students individual needs mentors will be able to identify any concerns and develop action plans in order to alleviate them.

Juggling the dual role of practitioner and educator: practice teachers' perceptions.

This paper reports on a study exploring the role (caseload manager; practitioner; educator) of Specialist Community Public Health Nursing (SCPHN) Practice Teachers (PTs) and mentors for Specialist Practice Community (SPC) district nursing students. Methodological triangulation was used, comprising questionnaires completed by 15 PTs and mentors, followed by six semistructured interviews, to provide quantitative and qualitative data. The results of the study identify that post-registration students demanded considerable time due to their need to develop leadership and higher cognitive skills in practice. PTs and mentors identified feeling undervalued by the organisation and colleagues as they tried to maintain their dual role with limited time or resources allocated. Respondents reported that they often worked over their hours to maintain both roles which impacted on their work life balance. They reported that both peer and university support groups were valuable and suggested that increased contact from lecturers and greater flexibility in university courses would accommodate their continuing professional development. It is, therefore, concluded that further support is needed by both the organisation and the university to enable this dual role.

CPTs' perceptions of their role satisfaction and levels of professional burnout.

This paper reports on a multi-method research project that explored perceived role satisfaction and professional burnout among community practice teachers (CPTs) while facilitating post-registration education and caseload management. A bespoke Satisfaction Questionnaire and the Maslach Burnout Inventory (Educators) were completed by 23 participants to elicit quantitative and qualitative data. Findings are presented in relation to three themes--aspects of the CPT role leading to satisfaction, aspects leading to dissatisfaction or burnout, and ways to enhance satisfaction and reduce burnout. The majority of CPTs were satisfied with their current role. A number of factors were elicited that affected participants' perceived satisfaction. Respondents scored low levels of burnout overall, with high levels of personal accomplishment and low levels of depersonalisation. The relationship between participants' satisfaction and their levels of burnout was not found to be statistically significant. However, mean scores on the emotional exhaustion subscale indicate moderate levels of emotional exhaustion. The paper concludes with recommendations to improve the support provided by employers and partner universities for CPTs.

Student perceptions of support in practice.

This paper reports on a funded research project exploring perceptions and experiences of pre-registration nursing students of support in practice in one Higher Education Institution in England. The study used a mixed method approach with samples of new students (within the first six months) and finishing students (within the last three months). Students reported that the most important areas they needed support with were clinical skills, placement situations, documentation and personal issues. The mentor qualities that were valued were personal attributes, being facilitative and being knowledgeable; newly qualified mentors and experienced students were seen as being the most supportive. Students saw their own responsibilities as learning and gaining skills, being professional and caring for patients. The finishing students also felt that accountability and teaching were part of their role. Reported challenges encompassed personal issues, including work-life balance and finances, dealing with elements such as patient death and uncertainties in new situations. The best aspects of practice emerged as being involved in patient care, feeling part of a team and experiencing positive support from mentors. The findings explicated the multi-faceted nature of student support in practice that need to be taken into account when putting support frameworks in place.

Reflecting on the learning experiences of student nurses in rural Uganda.

This article presents the first author, Wanda Lovett's experiences of pre-qualifying nurse education in rural Uganda, with a particular focus on promoting effective learning within community placements. The culture and context of health care and of nurse education are very different in this area when compared to the UK. Additionally there are a number of challenges associated with the mentorship of nursing students in practice, both in relation to facilitating learning and to the assessment of competence. This article describes the author's experiences of developing a more appropriate approach that reflects adult-centred learning, to promote the level of thinking that students will need to meet the demands of their roles once qualified.