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Students’ perception of the role of team-based learning in shaping individual learning style, team skills and clinical practice
Papers and Poster Abstracts / Australian Critical Care 29 (2016) 110–123
Development of an instrument to assess nurses’ perceptions of their responsibility for healthcare quality Elizabeth Oldland ∗ , Mohammadreza Mohebbi, Bernice Redley, Alison Hutchinson, Mari Botti Deakin University, Victoria, Australia Critical care nurses have a responsibility to deliver safe and high quality healthcare. Instruments measuring nurses’ safety and quality competencies exist, but focus on one domain of quality; none measure nurses’ perceived responsibilities across domains of healthcare quality. The aim was to develop and test the psychometric properties of an instrument to assess nurses’ perceived responsibility for healthcare quality. A conceptual model for the domains of nurses’ responsibilities in healthcare quality emerged from a review of safety and quality frameworks, health professionals’ competencies, professional standards, and peer reviewed literature. Existing instruments designed to measure specific quality domains if available, provided the elements to operationalise each domain and guide item generation. Ninety-six items, with 4-point Likert scale response options, were constructed and piloted with postgraduate critical care nursing students in 2014 (n = 138) to establish reliability and validity, and inform scale development using exploratory factor analysis. Item-total correlations were above .454 for all but one item and Cronbach’s alpha for each domain subscale were excellent (0.811 to 0.958). To achieve a more parsimonious tool, we reduced the number of items using decision rules leaving 55 items that underwent exploratory factor analysis with orthogonal varimax rotation to optimise the factor structure. The resulting 10 component solution accounted for 78% of the variance. Statistical evidence and content relevance were considered in labelling 7 conceptually meaningful factors: Organisational governance; Clinical leadership; Evidence-based practice; Person-centered care; Positive interpersonal relationships/behaviours; Medical/Technical knowledge; and Promotion of safety. The factors reflected and further defined the conceptual basis of the questionnaire. Psychometric testing indicated preliminary evidence for instrument validity and reliability. The instrument shows promise as a tool to assess nurses’ ownership of safety and quality related healthcare responsibilities. Further testing using confirmatory factor analysis in larger, heterogeneous nursing populations is now required. http://dx.doi.org/10.1016/j.aucc.2015.12.019
Students’ perception of the role of team-based learning in shaping individual learning style, team skills and clinical practice Elizabeth Oldland ∗ , Josh Allen, Judy Currey Deakin University, Burwood, Melbourne, Australia The Deakin University Master of Nursing Practice (Intensive Care, Cardiac Care, Emergency Care and Critical Care) supports students to develop the knowledge, skills and behaviours required for safe, high quality healthcare delivery. Team-Based Learning (TBL) is used to improve these learning outcomes through the development of self-reflective skills, positive team behaviours and mastery of specialist knowledge. We have previously reported that industry educators perceived an enhanced development of these attributes
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in TBL students in clinical practice. Whether students believe these outcomes are achieved was unknown. The aim was to explore student perceptions of the role of TBL in shaping their learning style, team skills, and professional behaviours in clinical practice. After ethics approval, all students in the Master of Nursing Practice (Critical Care Suite) in 2012 and 2013 were invited to provide a written individual reflection on whether and how TBL influenced their learning style, teamwork skills and professional behaviours both in the classroom and clinical practice. Extended responses were thematically analysed. A sample of 143 students from 174 (82% response rate) consented to participate. Thematic analysis of the student reflections revealed three themes: Deep Learning, the adaptations students made to their learning style that resulted in mastery of specialist knowledge; Confidence, in knowledge, problem solving and rationales for practice decisions; and Professional and Clinical Behaviours, including positive changes in their interactions with colleagues and patients in the clinical setting described as patient advocacy, multidisciplinary communication skills and peer mentorship. Students believed participating in TBL helped them to develop more effective learning styles and increased confidence in their knowledge and decision making in clinical practice. They reported enhanced communication and team work skills in the classroom and in clinical practice as a result of TBL. http://dx.doi.org/10.1016/j.aucc.2015.12.020
An exploration of knowledge exchanged in an intensive care virtual community Kaye Rolls 1,∗ , Margaret Hansen 2 , Debra Jackson 3 , Doug Elliott 4 1
ACI-ICCMU, Claremont Meadows, Australia University of San Francisco, San Francisco, USA 3 Oxford Brookes University, Oxford, United Kingdom 4 University of Technology, Sydney, Australia 2
Current organisational structures and cultures limit knowledge sharing opportunities among healthcare professionals. Virtual communities can facilitate knowledge and clinical expertise exchange in professional networks however their effectiveness has not been established. The aim was to identify the nature of knowledge exchanged on a multi-disciplinary Australasian intensive care virtual community established in 2003. A retrospective qualitative descriptive research design employing summative content analysis was used. The email archive (2003–2013) was interrogated using a two-stage sampling technique to identify discussion threads (with >2 emails) where ventilation or airway management was the focus (cluster) and two sets of 20 threads (stratified). There were 326 emails over 40 threads (median 6; IQR 5–10) contributed by 131 individuals (mode 1; range 1–55). Nurses were responsible for most posts (n = 218; requests – 73.02%; supplied – 65.40%) followed by doctors (n = 88; requests – 19.05%; supplied – 28.90%). The main subject area was identified as clinical practices (25 threads; 70.55%) with artificial airway procedures the most common (14 threads, 169 emails). Other subject areas related to equipment (12 threads; 23.01%) and clinical governance (3 threads; 6.44%). Knowledge types exchanged are shown below. Substantial interrater agreement was demonstrated (Cohen’s K 0.695; p = 0.000).
Development of an instrument to assess nurses’ perceptions of their responsibility for healthcare quality Elizabeth Oldland ∗ , Mohammadreza Mohebbi, Bernice Redley, Alison Hutchinson, Mari Botti Deakin University, Victoria, Australia Critical care nurses have a responsibility to deliver safe and high quality healthcare. Instruments measuring nurses’ safety and quality competencies exist, but focus on one domain of quality; none measure nurses’ perceived responsibilities across domains of healthcare quality. The aim was to develop and test the psychometric properties of an instrument to assess nurses’ perceived responsibility for healthcare quality. A conceptual model for the domains of nurses’ responsibilities in healthcare quality emerged from a review of safety and quality frameworks, health professionals’ competencies, professional standards, and peer reviewed literature. Existing instruments designed to measure specific quality domains if available, provided the elements to operationalise each domain and guide item generation. Ninety-six items, with 4-point Likert scale response options, were constructed and piloted with postgraduate critical care nursing students in 2014 (n = 138) to establish reliability and validity, and inform scale development using exploratory factor analysis. Item-total correlations were above .454 for all but one item and Cronbach’s alpha for each domain subscale were excellent (0.811 to 0.958). To achieve a more parsimonious tool, we reduced the number of items using decision rules leaving 55 items that underwent exploratory factor analysis with orthogonal varimax rotation to optimise the factor structure. The resulting 10 component solution accounted for 78% of the variance. Statistical evidence and content relevance were considered in labelling 7 conceptually meaningful factors: Organisational governance; Clinical leadership; Evidence-based practice; Person-centered care; Positive interpersonal relationships/behaviours; Medical/Technical knowledge; and Promotion of safety. The factors reflected and further defined the conceptual basis of the questionnaire. Psychometric testing indicated preliminary evidence for instrument validity and reliability. The instrument shows promise as a tool to assess nurses’ ownership of safety and quality related healthcare responsibilities. Further testing using confirmatory factor analysis in larger, heterogeneous nursing populations is now required. http://dx.doi.org/10.1016/j.aucc.2015.12.019
Students’ perception of the role of team-based learning in shaping individual learning style, team skills and clinical practice Elizabeth Oldland ∗ , Josh Allen, Judy Currey Deakin University, Burwood, Melbourne, Australia The Deakin University Master of Nursing Practice (Intensive Care, Cardiac Care, Emergency Care and Critical Care) supports students to develop the knowledge, skills and behaviours required for safe, high quality healthcare delivery. Team-Based Learning (TBL) is used to improve these learning outcomes through the development of self-reflective skills, positive team behaviours and mastery of specialist knowledge. We have previously reported that industry educators perceived an enhanced development of these attributes
117
in TBL students in clinical practice. Whether students believe these outcomes are achieved was unknown. The aim was to explore student perceptions of the role of TBL in shaping their learning style, team skills, and professional behaviours in clinical practice. After ethics approval, all students in the Master of Nursing Practice (Critical Care Suite) in 2012 and 2013 were invited to provide a written individual reflection on whether and how TBL influenced their learning style, teamwork skills and professional behaviours both in the classroom and clinical practice. Extended responses were thematically analysed. A sample of 143 students from 174 (82% response rate) consented to participate. Thematic analysis of the student reflections revealed three themes: Deep Learning, the adaptations students made to their learning style that resulted in mastery of specialist knowledge; Confidence, in knowledge, problem solving and rationales for practice decisions; and Professional and Clinical Behaviours, including positive changes in their interactions with colleagues and patients in the clinical setting described as patient advocacy, multidisciplinary communication skills and peer mentorship. Students believed participating in TBL helped them to develop more effective learning styles and increased confidence in their knowledge and decision making in clinical practice. They reported enhanced communication and team work skills in the classroom and in clinical practice as a result of TBL. http://dx.doi.org/10.1016/j.aucc.2015.12.020
An exploration of knowledge exchanged in an intensive care virtual community Kaye Rolls 1,∗ , Margaret Hansen 2 , Debra Jackson 3 , Doug Elliott 4 1
ACI-ICCMU, Claremont Meadows, Australia University of San Francisco, San Francisco, USA 3 Oxford Brookes University, Oxford, United Kingdom 4 University of Technology, Sydney, Australia 2
Current organisational structures and cultures limit knowledge sharing opportunities among healthcare professionals. Virtual communities can facilitate knowledge and clinical expertise exchange in professional networks however their effectiveness has not been established. The aim was to identify the nature of knowledge exchanged on a multi-disciplinary Australasian intensive care virtual community established in 2003. A retrospective qualitative descriptive research design employing summative content analysis was used. The email archive (2003–2013) was interrogated using a two-stage sampling technique to identify discussion threads (with >2 emails) where ventilation or airway management was the focus (cluster) and two sets of 20 threads (stratified). There were 326 emails over 40 threads (median 6; IQR 5–10) contributed by 131 individuals (mode 1; range 1–55). Nurses were responsible for most posts (n = 218; requests – 73.02%; supplied – 65.40%) followed by doctors (n = 88; requests – 19.05%; supplied – 28.90%). The main subject area was identified as clinical practices (25 threads; 70.55%) with artificial airway procedures the most common (14 threads, 169 emails). Other subject areas related to equipment (12 threads; 23.01%) and clinical governance (3 threads; 6.44%). Knowledge types exchanged are shown below. Substantial interrater agreement was demonstrated (Cohen’s K 0.695; p = 0.000).