Reflection in the training of general practitioners in clinical practice settings: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to explore formalized methods of reflection that are used in clinical settings in general practice when training medical students, postgraduate trainees, general practitioners, and family physicians. INTRODUCTION: Medical professionals are increasingly required to demonstrate competency in their ability to reflect on clinical practice. To accommodate this, the teaching of reflection is common in medical programs; however, there is a lack of clarity in the literature on how reflection is taught. INCLUSION CRITERIA: This review will seek evidence describing the tools and approaches to reflection used by medical students, postgraduate trainees, and other registered medical professionals in general practice. The review will also include any evidence from those who teach reflection in a general practice setting. Evidence regarding reflection in training programs for other medical specialties will not be considered for inclusion. METHODS: This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), and the JBI methodology for scoping reviews. Databases to be searched will include MEDLINE (Ovid), Emcare (Ovid), Embase (Ovid), Web of Science, Scopus, and the Cochrane Database of Systematic Reviews. Extracted evidence will be presented using figurative, tabular, and accompanying narrative synthesis, in line with the review questions. REVIEW REGISTRATION NUMBER: Open Science Framework https://osf.io/uxw7d.

Barriers and enablers of culturally safe care for transgender and gender-diverse people in hospital emergency departments: a scoping review protocol.

OBJECTIVE: The objective of this review is to identify barriers and enablers of the provision and accessibility of culturally safe care to transgender (trans) and gender-diverse patients in the emergency department. INTRODUCTION: Emergency departments have a unique role in creating patient experiences that influence positive or negative health outcomes. It is vital that emergency departments provide equitable experiences for all patients regardless of gender. Culturally safe care aims to support inclusive, effective, and appropriate care for trans and gender-diverse patients. Identifying the reported barriers and enablers of culturally safe care for trans and gender-diverse people in emergency departments will support knowledge users to advocate for and implement improvements to care. INCLUSION CRITERIA: This review will consider studies that describe barriers and enablers of accessing culturally safe care in emergency departments reported by trans and gender-diverse people, their families and loved ones, as well as health care workers involved in the provision of care. English-language, published, and gray literature sources from January 1, 2000, to the present from all countries will be eligible. METHODS: The review will follow the JBI methodology for scoping reviews and will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Database searches of MEDLINE, Emcare, Embase, ScienceDirect, PsycINFO, Web of Science, Scopus, Google Scholar, and ProQuest will be undertaken. Data will be presented in tabular format or graphs, with an accompanying narrative summary.

Nurse practitioner models of care in aged care: a scoping review protocol.

OBJECTIVE: The objective of this review is to identify current and potential use of nurse practitioner models of care in aged care and to examine factors that have been linked to their failure or success in terms of establishment, sustainability, and expansion. INTRODUCTION: Nurse practitioners work across a variety of sectors, including aged care. Nurse practitioner models of care have been found to be safe, effective, and highly regarded by clients and patients across many areas. They have particular benefit in areas where access to physicians is challenging, as well as for vulnerable populations. This review will provide a consolidated evidence base to determine the current state of the evidence on nurse practitioner models of care in the aged care sector. INCLUSION CRITERIA: The review will consider studies on nurse practitioner models of care within aged care that report barriers/challenges and facilitators/success factors to their establishment, sustainability, and expansion. Evidence from all countries will be examined. Published and gray literature primary studies in English produced from 2010 onward will be eligible for inclusion. Expert opinion, including literature reviews, commentaries, and discussion, papers will be ineligible. METHODS: This review will utilize the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Databases to be searched include MEDLINE, Emcare, Embase, Web of Science, and Scopus. Figurative, tabular, and accompanying narrative synthesis will be used to present the results, in line with the review questions.

Putting People First: The Importance of Recommending Minimum Staffing Levels and Skills Mix.

Australia's Royal Commission into Aged Care Quality and Safety has concluded. The Commission's final report described a sector failing to deliver care that older Australians deserve despite the best efforts of many staff. Throughout the Commission, staffing was a frequent concern, with the size and composition of the direct care workforce a prominent focus. Throughout the Commission, many stakeholders campaigned for mandated staffing levels in skills mix in nursing homes and the Commission's report and Commonwealth Government response included recommendations for these. While this is a necessary step toward wider reform, the Royal Commission's recommendation and the Australian Government's response must support the delivery of best practice care more strongly. This column argues that the minimum standard for nursing home staff care time must be higher, and that higher minimum staffing levels and more clearly defined skills mix are critical to the delivery of safe, respectful, dignified person-centred care.

Best practice guidance and reporting items for the development of scoping review protocols.

OBJECTIVE: The purpose of this article is to clearly describe how to develop a robust and detailed scoping review protocol, which is the first stage of the scoping review process. This paper provides detailed guidance and a checklist for prospective authors to ensure that their protocols adequately inform both the conduct of the ensuing review and their readership. INTRODUCTION: Scoping reviews are a common approach to evidence synthesis for researchers, clinicians, and policymakers across a variety of fields. Scoping reviews are not concerned with making analytical comparisons based on pooling results data from multiple primary sources of evidence, but rather on collating and describing the evidence and presenting the summation in a clearly illustrated format. Methods for undertaking and reporting scoping reviews continue to be refined. Some prospective reviewers may be uncertain how to plan, structure, and report scoping review protocols, as there is little or no specific guidance for scoping review protocols yet available. METHODS: This guidance was developed by members of the JBI Scoping Review Methodology Group based on previous experience and expertise in developing scoping review and evidence synthesis methodologies, protocols, and reviews, as well as through experiences working with and guiding authors to develop scoping review protocols. Elements of a comprehensive scoping review protocol are outlined and explained in detail. CONCLUSION: Knowledge users of evidence syntheses rely on clear and transparent reporting to understand and use the results of published work to drive evidence-based improvements within health care and beyond. It is hoped that readers will be able to use this guidance when developing protocols to assist them in planning future scoping reviews and to carry them out with a high degree of transparency.

Rapid reviews and the methodological rigor of evidence synthesis: a JBI position statement.

ABSTRACT: The demand for rapid reviews has exploded in recent years. A rapid review is an approach to evidence synthesis that provides timely information to decision-makers (eg, health care planners, providers, policymakers, patients) by simplifying the evidence synthesis process. A rapid review is particularly appealing for urgent decisions. JBI is a world-renowned international collaboration for evidence synthesis and implementation methodologies. The principles for JBI evidence synthesis include comprehensiveness, rigor, transparency, and a focus on applicability to clinical practice. As such, JBI has not yet endorsed a specific approach for rapid reviews. In this paper, we compare rapid reviews versus other types of evidence synthesis, provide a range of rapid evidence products, outline how to appraise the quality of rapid reviews, and present the JBI position on rapid reviews. JBI Collaborating Centers conduct rapid reviews for decision-makers in specific circumstances, such as limited time or funding constraints. A standardized approach is not used for these cases;instead, the evidence synthesis methods are tailored to the needs of the decision-maker. The urgent need to deliver timely evidence to decision-makers poses challenges to JBI's mission to produce high-quality, trustworthy evidence. However, JBI recognizes the value of rapid reviews as part of the evidence synthesis ecosystem. As such, it is recommended that rapid reviews be conducted with the same methodological rigor and transparency expected of JBI reviews. Most importantly, transparency is essential, and the rapid review should clearly report where any simplification in the steps of the evidence synthesis process has been taken.

Royal Commission into Aged Care recommendations on minimum staff time standard for nursing homes.

The Royal Commission's recommendation for nursing home minimum time standards and the Australian Government's response do not support best practice resident care. We recommend that higher mandated minimum staffing levels and skills mix should be phased in by mid-2026. What is known about the topic? The Australian Government has not committed to fully implementing the Commission's recommendations for mandated minimum staff time standards. What does this paper add? We highlight issues with the Commission's recommendations and the Australian Government's response where they do not support sufficient minimum time to provide best practice care. What are the implications for practitioners? Mandated evidence-based minimum staffing levels and skills mix should be phased in by mid-2026 to support best practice care.

Scoping reviews: reinforcing and advancing the methodology and application.

Scoping reviews are an increasingly common approach to evidence synthesis with a growing suite of methodological guidance and resources to assist review authors with their planning, conduct and reporting. The latest guidance for scoping reviews includes the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews. This paper provides readers with a brief update regarding ongoing work to enhance and improve the conduct and reporting of scoping reviews as well as information regarding the future steps in scoping review methods development. The purpose of this paper is to provide readers with a concise source of information regarding the difference between scoping reviews and other review types, the reasons for undertaking scoping reviews, and an update on methodological guidance for the conduct and reporting of scoping reviews.Despite available guidance, some publications use the term 'scoping review' without clear consideration of available reporting and methodological tools. Selection of the most appropriate review type for the stated research objectives or questions, standardised use of methodological approaches and terminology in scoping reviews, clarity and consistency of reporting and ensuring that the reporting and presentation of the results clearly addresses the review's objective(s) and question(s) are critical components for improving the rigour of scoping reviews.Rigourous, high-quality scoping reviews should clearly follow up to date methodological guidance and reporting criteria. Stakeholder engagement is one area where further work could occur to enhance integration of consultation with the results of evidence syntheses and to support effective knowledge translation. Scoping review methodology is evolving as a policy and decision-making tool. Ensuring the integrity of scoping reviews by adherence to up-to-date reporting standards is integral to supporting well-informed decision-making.

Delivering, funding, and rating safe staffing levels and skills mix in aged care.

BACKGROUND: Staffing levels and skill mix are critical issues within residential aged care. The positive impact of a sufficient number and skills mix of staff is upheld by abundant evidence within and beyond the sector. While being able to determine suitable staffing levels and skills mix to provide care to nursing home residents is vital, having an appropriate approach to funding the delivery of care is also critical. Beyond determining staffing levels and skills mix and funding care delivery, transparently rating the adequacy of staffing is also important to enable informed decision-making amongst consumers, policy makers, staff, and other stakeholders. There are existing tools for determining nursing home staffing levels and skills mix, funding care, and rating and reporting staffing, however there appears to be ongoing confusion regarding how these different tools might work together to achieve different things in order to ensure safe, quality care. OBJECTIVES: In order to explain the importance of ensuring at least a minimum number (staffing level) of the right kind of staff (skills mix) to provide care to nursing home residents, in this paper we briefly explain key differences and interrelationships between three tools; one for determining staffing and skills mix, one for determining funding, and one for rating and reporting the level of staffing within a facility as a measure of quality. RESULTS: Our explanation of the three existing tools has resulted in the development of a conceptual model for how minimum staffing levels and skills mix supports the delivery of safe, quality care and how this can be understood in relation to determining, funding, and rating staffing levels and skills mix. CONCLUSIONS: Our conceptual model of how determining, funding, and rating staffing levels and skills mix relate to one another and fulfil different but related purposes can be used to demonstrate how minimum staffing levels and skills mix can be understood as foundational to ensuring respectful, safe, quality care.

Updated methodological guidance for the conduct of scoping reviews.

OBJECTIVE: The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). INTRODUCTION: Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. METHODS: Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. RESULTS: The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues, such as when a scoping review is (or is not) appropriate, and how to extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. CONCLUSIONS: The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned.

Updated methodological guidance for the conduct of scoping reviews.

OBJECTIVE: The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). INTRODUCTION: Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. METHODS: Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. RESULTS: The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues, such as when a scoping review is (or is not) appropriate, and how to extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. CONCLUSIONS: The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned.

Recency of Practice and the Maintenance of Professional Competence for Nurses and Midwives: A Scoping Review Protocol.

Australian and international nursing regulators have specific requirements for continuing competence and the professional, safe practice of nurses and midwives. Requirements can dictate duration of practice, time away from/recency of practice, revalidation policies, and time between study program completion and practice commencement. Requirements vary between contexts and are periodically updated. To identify and examine Australian and international evidence for best regulatory practices relating to recency and the maintenance of professional competence among nurses and midwives, a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be undertaken. This protocol details the scope, inclusion criteria, and methodology that will guide the scoping review, which will inform an update to the Nursing and Midwifery Board of Australia's Registration Standard: Recency of Practice.