Usability of Standards for Scaffolding in a Health Sciences Programme: A feasibility Study.

BACKGROUND: Standards contribute to comprehensive and programmatic implementation of educational strategies, such as scaffolding. Although the development of educational standards follows a rigorous consensus approach, they are socially constructed and could result in varied interpretations by users. Reports of varied implementation of standards in health professions education underscore the need to test the developed standards for scaffolding in health sciences programmes. Usability entails determining whether a product like standards works as intended under the expected conditions and contexts. This study aimed to describe the usability of standards for scaffolding in a health sciences programme through a pilot study. METHODS: A multi-method design employing user and expert-based usability evaluation techniques sought to describe the usability of the standards for scaffolding in a three-year pre-registration nursing programme. The user sample of nurse educators drawn from the programme, conducted a self-assessment on scaffolding practices in the programme using a developed standards checklist. For the expert sample, three-panel members with an understanding of the discipline and programme context were purposively sampled. These panelists studied the users' self-assessment reports before completing an author-generated heuristics checklist to support or refute any of the standards. Descriptive statistics, comparative and content analysis were applied to analyse data from users' interviews and expert's completed heuristics checklist, determining the standards' usability, and identifying the usability flaws or strengths. RESULTS: The users had three or more years of teaching experience in the competency-based curriculum for nursing. The experts shared an average of 16 years of experience in teaching in higher education, and seven years of experience in quality assurance and programme accreditation. The four standards had a usability score of above average (68%). Seven usability strengths and four usability flaws were identified. Usability flaws related to misinterpretation of some criteria statements and terminologies, multiple meanings, and users' challenges in generating evidence for some criteria. CONCLUSIONS: The pilot study revealed the context-based 'truth' regarding the fidelity of a health sciences programme evaluation on scaffolding, as well as identifying the ideal contextual conditions in which the standards for scaffolding health sciences programmes would work best. The identified usability flaws highlighted the need for further revisions of the standards. Future research on the feasibility of the standards in other health sciences programmes and contexts is recommended.

The primary health care environment and the performance of advanced antenatal care trained nurse-midwives in South Africa.

Transfer of learning in the workplace depends on various factors, one of which is the work environment. The aim of this study was to describe the interplay between the primary healthcare work environment, the performance of advanced antenatal care trained nurse-midwives, and birth outcomes. A cross-sectional, quantitative study was conducted in two purposely selected districts in South Africa. Document analyses were also completed. Statistical Analysis Software version 9.4 was used for descriptive statistical data analysis. The participating clinics, in the TM and LJ districts, both achieved ideal clinic status. The scores for the management of low- and high-risk pregnancies ranged between 86-89% and 87%, respectively. Babies born had Apgar scores of between 7-9 and 8-10 in 1 minute and 5 minutes after birth, respectively. Nurse-midwives scored low on interpreting assessment findings. Contrary to the Transfer of Learning Theory, nurse-midwives performed better in poorer work environments. The study suggests that the performance of advanced antenatal care trained nurse-midwives may not solely depend on a well-equipped work environment. Further studies should highlight the broader determinants of advanced antenatal care nurse-midwives services output.

Le transfert des apprentissages en milieu de travail dépend de divers facteurs, dont l'environnement de travail. Le but de cette étude était de décrire l'interaction entre l'environnement de travail des soins de santé primaires, la performance des infirmières sages-femmes formées en soins prénatals avancés et les résultats de l'accouchement. Une étude transversale et quantitative a été menée dans deux districts délibérément sélectionnés en Afrique du Sud. Des analyses de documents ont également été réalisées. Le logiciel d'analyse statistique version 9.4 a été utilisé pour l'analyse de données statistiques descriptives. Les cliniques participantes, dans les districts de TM et LJ, ont toutes deux atteint le statut de clinique idéale. Les scores pour la gestion des grossesses à faible et à haut risque variaient respectivement entre 86 et 89 % et 87 %. Les bébés nés avaient des scores d'Apgar compris entre 7-9 et 8-10 respectivement 1 minute et 5 minutes après la naissance. Les infirmières sages-femmes ont obtenu de faibles résultats dans l'interprétation des résultats de l'évaluation. Contrairement à la théorie du transfert de l'apprentissage, les infirmières sages-femmes ont de meilleurs résultats dans des environnements de travail plus pauvres. L'étude suggère que la performance des infirmières sages-femmes formées en soins prénatals avancés ne dépend peut-être pas uniquement d'un environnement de travail bien équipé. D'autres études devraient mettre en évidence les déterminants plus larges de la production des services avancés d'infirmières et de sages-femmes en soins prénatals.

Mindfulness-based interventions to support wellbeing of adults in low socio-economic settings: a realist review.

BACKGROUND: Mindfulness as a modality involves training the innate human capacity for present-moment awareness with a view to cultivating a more harmonious and integrated life experience, especially in the face of hardship. Over the past four decades, the field of mindfulness has grown rapidly. Despite a substantial body of literature outlining the many benefits of mindfulness practice within a range of contexts and populations, the authors noticed that studies addressing the adaptation, application and value of mindfulness-based interventions (MBIs) for adults within socio-economically challenged setting were scant. To address this gap, we conducted a realist review of studies pertaining to MBIs within low socio-economic settings, to determine the extend and nature of research in this sector and culminating in a program theory which may be useful for the design of interventions going forward. METHODS: We selected realist review as the methodology as it is well suited to investigating the complex nature of social interventions. The value of realist review is that the exploration of the causal relationships between the mechanisms (M) within a specific context (C) towards particular outcomes (O) offers a deeper understanding of the intervention which may assist in more effective delivery going forward. The review follows the guidelines presented by the Realist and Meta-narrative Evidence Synthesis - Evolving Standards project. RESULTS: Of the 112 documents identified, 12 articles met the inclusion criteria. Of these 12 studies, 10 were conducted in the United States, with little representation across the rest of the globe. The interventions described in these articles were varied. We identified mechanisms that offered beneficial outcomes for participants across a range of contexts, with indications of how interventions might be adapted towards greater accessibility, acceptability, and feasibility within communities. CONCLUSION: By reviewing the various programs in their respective contexts, we developed a program theory for implementing socio-culturally adapted MBIs in low socio-economic settings. In the future, this program theory could be tested as a means to create a sense of wellbeing for people living in low socio-economic settings.

Doctoral Contribution to Nursing Science in Sub-Saharan Africa: A Document Review.

Nursing science is at serious risk of extinction. The lack of funding for research, absence of healthcare policies underpinned by nursing science, and general lack of understanding of nursing metaparadigms all contribute to the stunted growth in nursing science. Doctoral research is a platform for the development and refinement of nursing science. The purpose of this qualitative retrospective document review was to describe the doctoral contribution to nursing in sub-Saharan Africa (SSA). Electronic dissertations for doctoral degrees in nursing within a 5-year period from universities in SSA were included. The extracted data comprising the purpose of the studies, the models used in the studies, and the studies' contributions to nursing science were analyzed against a knowledge contribution framework. In total, 166 documents were included, mostly from South African universities, with a predominant focus on developing models, frameworks, and strategies within nursing practice. Only 17% of the studies applied grand nursing theories or models, with the rest of the studies applying theories from other disciplines. The contribution to nursing science from the doctoral studies was poor. The low uptake of nursing models in doctoral research in SSA may significantly contribute to the lack of refinement of nursing science within SSA. Structured approaches focused on integrating the nursing metaparadigms, theories, and models and fundamental underpins for doctoral education in Africa are essential to influencing the refinement of nursing science.

WhatsApp as a support strategy for emergency nursing students during the COVID­19 pandemic

Students in emergency nursing had already commenced their postbasic training at universities when the Higher Education Institutions were compelled to discontinue face-to-face contact with students and switched to various online modes of delivering content and facilitating learning in response to the government's hard lockdown rules. Health services assumed students reverted to fulltime staff, while students envisaged completing the postbasic programme. In addition to the stressors all frontline workers encounter, these students had academic-related stressors. This short report aims to describe the use of WhatsApp™ as a support strategy for emergency nursing students during the COVID-19 pandemic. The lecturer initiated a WhatsApp™ group, including all students and the clinical facilitators from various healthcare facilities. The communication stream from 1 March to December 2020 was exported in a Portable Document Format, followed by thematic analysis to identify the support provided. Support for emergency nursing students during the COVID-19 was multifaceted and included system, academic and emotional support. WhatsApp™ as a strategy to provide support to students during the COVID-19 pandemic served its purpose but could add to additional workload for the lecturer at odd or inconvenient hours.