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Background: In the Indian State of Madhya Pradesh maternal health is poor, and women's social status is low. For some women, autonomy and decision-making within the family is limited as they seek medical treatment through their husband or father-in-law. The then state government identified a need to strengthen midwifery care given by auxiliary nurse midwives to improve maternal and neonatal health.>* Methods: This cross-cultural, two phase study was designed in partnership with an Indian non-governmental organisation, utilising Elliot's action research model within the paradigm of critical theory. Phase 1 investigated the then current situation and established a potential solution to strengthening midwifery practice within Madhya Pradesh. This comprised an educational approach using a specifically designed self-directed distance learning programme focussing on normal pregnancy and childbirth. The distance learning programme was a hard copy workbook supported by a multimedia resource informed by the Rowntree and Analysis Design Development Implementation Evaluation models of educational material development. Phase 2 involved the use and evaluation of the distance learning programme with an initial primary group sample of 28 comprising auxiliary nurse midwives (22), lady health visitors (4) and staff nurses (2) in Madhya Pradesh. Fourteen auxiliary nurse midwife participants completed knowledge tests using a pre- and post-programme multiple choice question paper. This primary group negotiated a 3-day workshop to cover identified gaps within their original 12-week study period. Nineteen additional auxiliary nurse midwife participants joined this workshop (group 2). Results: The multiple choice question test results indicated that the first group had poor knowledge of the normal process of pregnancy and childbirth. After the workshop, they marginally improved their personal performance scores. The second group demonstrated greater change, which suggests that coupling self-directed guided study material with an enabling, face-to-face environment can be successful. Conclusions: Distance learning among auxiliary nurse midwives in central India may be enhanced when accompanied by face-to-face workshops. Partnership working – at organisational, team and individual levels, was a crucial, and empowering, component of this cross-cultural action research study. Both points have relevance for others undertaking similar studies. [ABSTRACT FROM AUTHOR]

Demonstrating the impact and effectiveness of nursing leadership, influence and power within the European space is a challenging endeavour. Using the example of the European Directive on Professional Qualifications (2005/36/EC) and its successor legislation (Modernised Directive 2013/55/EU), this paper reviews the collaborative strategies, drivers and leadership actions which have influenced the recent legislation, albeit without complete success. Looking to the future, it is argued that nursing will struggle to achieve further positive political outcomes until there is a more coherent, assertive and collaborative leadership at pan-European level. Given the complexity of the European ‘trilogue’, namely the co-decision powers and interactions between the European Parliament, Commission, and Council, it is essential that far-reaching and sustained network(s) of influence are established within each country, including prospective accession countries. A failure to co-ordinate, co-operate, strategically lobby, garner research evidence and argue for standards of education, practice, care and workforce conditions, could lead to significant threats to public protection and safety. Drawing upon the related historical and contemporary context, sources of contemporary leadership, ‘absent and strident voices’ and European Union (EU) policy drivers, recommendations for future leadership directions are proposed. Political engagement is crucial to enabling reforms for the next Directive revision. [ABSTRACT FROM PUBLISHER]

Demonstrating the impact and effectiveness of educational interventions, including medium and high-fidelity simulation, has long been fraught with methodological challenges and ambiguities. This is particularly the case when there are several confounding factors and variables operating in situations where control trials are inappropriate, and investigative costs can be high. Current theoretical and empirical evidence, while emerging, is parsimonious and fails to take account of the characteristics of different modes of simulation, their contested theoretical models of learning and the opportunities presented by cutting edge computer science. Medium and high-fidelity simulations, situated within technology-rich environments, generate new forms of complex data that have the potential to provide insights into ‘real-world’ practices. Drawing on a range of locally based studies, we argue that until the methodological questions and data management systems can be addressed, the evidence to determine the judicious and optimal use of simulation to improve student and practitioner performance and patient outcomes will remain primarily reliant on proxy measures of self-efficacy and competence. [ABSTRACT FROM PUBLISHER]

The article discusses research on the role of the Bologna process in changing the career pathways of nurse educator in Europe. It references a study by R. Davies in this same issue. It offers an overview of nurse education literature related to European nurse education career pathways, European nursing networks and the Tuning Project. The author believes that the study failed to provide detailed analysis of the current European nursing education situation.

The author reviews the paper "Nurse Teacherhood and the Categories Influencing It." She states that the paper analyses nurse teacher perceptions concerning teacher experiences, roles and activities during a period of change in Finland. She notes that the paper captures the change associated with the move from vocational to higher education for nurse educators and their students. She also mentions the paper's lack of clarity regarding the criteria for purposive sampling.