The impact of COVID 19 restrictions on Australian nurse academics attitudes to technology: A survey of Technology Readiness Index 2.0.

AIM: This study aimed to determine the attitude of Australian nursing lecturers to the use of technology applied to the teaching and learning of nursing students. BACKGROUND: The use of technology in teaching was accelerated in reaction to the COVID-19 restrictions whereby measures, including social distancing and lockdowns, forced many higher education courses to transition online. Lecturers play a key role in the integration of technology in teaching, as it is the lecturer, not the technology, who facilitates the students' learning experience. DESIGN: A cross sectional survey design was used for this study, distributed from April to June of 2022. The purpose of the survey was to gather technology readiness data (via the TRI 2 questions) and descriptive data representative of the nursing academic population in Australia. RESULTS: There was no statistically significant differences between participants based on demographic data (such as gender or age). There was an association between TRI 2 score and: the sum of elearning technologies engaged with; the frequency of engagement with technology and self-rated confidence with elearning. Of note were statistically significant differences of TRI between states/territories. Finally, there was an inverse relationship between the impact of COVID-19 restrictions and TRI 2 score. CONCLUSION: The study found that there was significant variation between states/territories and self-reported impact of TRI. Given that increased frequency and increased number of technologies engaged with are associated with technology readiness the variation between states/territories lockdowns which required engagement with technology, may have had an impact on the nursing academics attitude to technology. Importantly, this study found those who were highly technology ready found COVID-19 restrictions had less impact on them, suggesting that technology readiness may have assisted their transition to online learning.

Dissolution Failure of Solid Oral Drug Products in Field Alert Reports.

From 2005 to 2014, 370 data entries of dissolution failures of solid oral drug products were assessed with respect to the solubility of drug substances, dosage forms [immediate release (IR) vs. modified release (MR)], and manufacturers (brand name vs. generic). The study results show that the solubility of drug substances does not play a significant role in dissolution failures; however, MR drug products fail dissolution tests more frequently than IR drug products. When multiple variables were analyzed simultaneously, poorly water-soluble IR drug products failed the most dissolution tests, followed by poorly soluble MR drug products and very soluble MR drug products. Interestingly, the generic drug products fail dissolution tests at an earlier time point during a stability study than the brand name drug products. Whether the dissolution failure of these solid oral drug products has any in vivo implication will require further pharmacokinetic, pharmacodynamic, clinical, and drug safety evaluation. Food and Drug Administration is currently conducting risk-based assessment using in-house dissolution testing, physiologically based pharmacokinetic modeling and simulation, and post-market surveillance tools. At the meantime, this interim report will outline a general scheme of monitoring dissolution failures of solid oral dosage forms as a pharmaceutical quality indicator.

The use and limits of eye-tracking in high-fidelity clinical scenarios: A pilot study.

AIM: To explore the potential of mobile eye-tracking to identify healthcare students' area of visual interest and its relationship to performance ratings. BACKGROUND: Eye-tracking identifies an individual's visual attention focus, and has been used as a training technique in medicine and in nursing. In this study participants wore a point of view (PoV) camera within a spectacle frame during simulation education experiences. METHODS: Thirty-nine final year nursing and paramedicine students individually participated in three 8 minute clinical simulations with debriefing using videoed eye-tracking recordings. Coloured dots on the video depicted the participant's pupil fixation on five targeted areas. Data extracted from the video camera were collated to report time spent on each target (their 'gaze'). RESULTS: The mean total gaze of expert designated targets in the environment for three 8 minute scenarios was 40-77%. Of 35 participants' focus on three main areas of interest, their priority was the patient's head (34%), the patient's trunk (24%) and their clinical assistant (5%), with significant differences between nursing and paramedic disciplines (P < 0.05). Objectively rated clinical performance improved significantly by the third scenario (P ≤ 0.001). Participants were positive regarding use of eye tracking during debriefing. CONCLUSIONS: Eye tracking has the potential to enhance debriefing and educational outcomes, although there are limitations to gaze capture in high fidelity environments and resource cost is high. Further study is warranted to enable better understanding of how expert clinicians achieve high levels of performance.

Supporting nursing student supervision: An assessment of an innovative approach to supervisor support.

UNLABELLED: The responsibility for clinical supervision is recognised by both the nursing literature and the Australian Nursing and Midwifery Council, through an expectation that RNs will provide support and facilitate student learning in the clinical environment (Atack et al., 2000; Gray and Smith, 2000; Brammer, 2005; Australian Nursing and Midwifery Council, 2006; Hallin and Danielson, 2008). RNs identify with and acknowledge the need for the supervisory role and are willing participants however, request strategies to guide and support students in the clinical environment (Bourbonnais and Kerr, 2007; Hallin and Danielson, 2008). OBJECTIVES: The aim of this study was to provide a means of support to clinical supervisors of nursing students through a computer-based clinical supervisor educational package (CSEP) and to test the effectiveness of the CSEP. DESIGN: The effectiveness of the CSEP was determined by a pre-test-post-test evaluation sheet that included open and Likert scale questions. SETTINGS: 4 regional hospitals in South Australia, Australia. PARTICIPANTS: 28 participants completed the questionnaire on their experience with the CSEP. METHODS: Analysis of quantitative data utilised non-parametric testing with SPSS version 20. A Wilcoxon Signed Rank Test was performed on the Likert scale questions to establish any significant difference between the pre- and post-tests. The responses to the open-ended questions were thematically analysed separately by the two authors. The themes were then amalgamated. The results were then compared to find similarities or differences. CONCLUSIONS: The CSEP is an effective education package in promoting increased preparedness to supervise and increased confidence to promote learning.

Developing situation awareness amongst nursing and paramedicine students utilizing eye tracking technology and video debriefing techniques: a proof of concept paper.

OBJECTIVE: The aims of this quasi-experimental before-and-after study were to first determine whether the use of eye tracking technology combined with video debriefing techniques has the potential to improve the quality of feedback and enhance situation awareness (SA) in simulated settings and second to determine students' satisfaction towards simulated learning. METHODS: Nursing and paramedicine students from three universities participated in three 8-minute simulation scenarios of acutely deteriorating patients. Eye tracking glasses video recorded the scenarios and tracked right eye movement. On completion, participants were questioned using the Situation Awareness Global Assessment Technique, completed the Satisfaction with Simulation Experience Scale (SSES), and provided textual feedback and received video-based verbal feedback. RESULTS: Participants lacked awareness of presenting medical conditions and patient environments and had poor recall of patient vital signs. Significant improvements in SA scores were demonstrated between the first and third scenarios (P = 0.04). Participants reported greater insight into their performance and were satisfied with simulated learning. CONCLUSIONS: Use of visual field review techniques appears to enhance the use of realistic simulated practice as a means of addressing significant performance deficits. Eye tracking and point of view recording techniques are feasible and with applicable debriefing techniques could enhance clinical and situated performance.

A comprehensive water management program for multicampus healthcare facilities.

OBJECTIVE: Develop and implement an effective program for hazard analysis and control of waterborne pathogens at a multicampus hospital with clinics. DESIGN: A longitudinal study. Several-year study including analysis of results from monitoring and tests of 26 building water systems. SETTING: Outpatient and inpatient healthcare facilities network. METHODS: The hazard analysis and critical control point (HACCP) process was used to develop a water management program (WMP) for the hospital campuses. The HACCP method systematically addressed 3 questions: (1) What are the potential waterborne hazards in the building water systems of these facilities? (2) How are the hazards being controlled? (3) How do we know that the hazards have been controlled? Microbiological and chemical tests of building water samples were used to validate the performance of the WMP; disease surveillance data further validated effective hazard control. RESULTS: Hazard analysis showed that waterborne pathogens were generally in good control and that the water quality was good in all facilities. The hospital network has had several legionellosis cases that were identified as presumptive hospital acquired, but none was confirmed or substantiated by water testing in follow-up investigations. Building water system studies unrelated to these cases showed that pressure tanks and electronic automatic faucets required additional hazard control. CONCLUSIONS: Application of the HACCP process for long-term building water systems management was practical and effective. The need for critical control point management of temperature, flow, and oxidant (chlorine) residual concentration was emphasized. The process resulted in discovery of water system components requiring additional hazard control.

Preparing nursing students for the future: Development and implementation of an Australian Bachelor of Nursing programme with a community health focus.

This paper focuses on changes in the educational preparation of undergraduate nurses in line with contemporary primary and preventative healthcare models. We evaluated a new Australian nursing and community care degree programme using focus groups with 38 students in their first years of study, and quantitative performance data (regarding entry, performance and course attrition). Four main themes were identified related to students' course experience: 'I think community health should be an elective'; 'Focus on relevance to practice'; 'Teaching by non-nursing academics' and 'Access to support during transition to university.' Overall pass rates were 94% (first year) and 97% (second year) with a low 11% attrition rate. We conclude that based on prior experiences and stereotypical views, students may be ambivalent about the inclusion of primary and preventative care models which nevertheless are essential to enhance practice and to prepare the future nursing workforce.

Hoosier Oncology Group randomized phase II study of docetaxel, vinorelbine, and estramustine in combination in hormone-refractory prostate cancer with pharmacogenetic survival analysis.

PURPOSE: To determine the safety and efficacy of two docetaxel doublets in hormone-refractory prostate cancer (HRPC) patients and to examine the prognostic role of polymorphisms in host genes important to docetaxel metabolism and transport. EXPERIMENTAL DESIGN: Sixty-four chemotherapy-naive patients with HRPC were randomized to docetaxel and vinorelbine (D, 20 mg/m2 i.v. days 1 and 8; V, 25 mg/m2 i.v. days 1 and 8) or docetaxel and estramustine phosphate (D, 60-70 mg/m2 i.v. day 1; E, 280 mg oral thrice daily days 1-5) administered q21d. Primary end point was clinically significant toxicity. A pharmacogenetic analysis of host genes was done in patients who received at least one cycle of docetaxel therapy. RESULTS: Grade 3/4 toxicity occurred in 15.6% of DV patients and in 28.6% DE patients. Neither arm exceeded the threshold of clinically significant toxicity. In the DV arm, objective response rate was 33%, prostate-specific antigen response rate was 20%, and median survival was 16.2 months. In the DE arm, objective response rate was 67%, prostate-specific antigen response rate was 43%, and median survival was 19.7 months. Pharmacogenetic analyses showed a significant association between survival beyond 15 months and the ABCG2 421 C > A (Q141K) polymorphism compared with the wild-type (C/C) genotype (66% versus 27%; P = 0.05). CONCLUSIONS: DV and DE doublets are active with a tolerable toxicity profile in patients with HRPC; however, efficacy does not seem superior to standard single-agent docetaxel. The ABCG2 421 C > A (Q141K) polymorphism may be an important predictor of response and survival in HRPC patients treated with docetaxel-based chemotherapy.