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In a rapidly emerging world, knowledge management capabilities, including knowledge creation, acquisition, sharing, and utilization, become more critical for organizational change, growth, and competitiveness. Therefore, this article argues that organizations should consider implementing effective journal club meetings as an opportunity to acquire external knowledge, evaluate and integrate new knowledge into previous existing knowledge, and disseminate and utilize new knowledge to enhance product or service quality, innovation, and the performance of an organization. The article reviews relevant literature, proposes a framework for conducting effective journal club meetings, and aligns those activities with the knowledge management processes. The article proposes a framework for conducting effective journal club meetings and a process that integrates both journal club activities and the knowledge management process. By adopting this framework, journal club activities would be more effective in developing new knowledge management capabilities among individual members and enhancing organizational performance, i.e., implementing evidence-based practices (EBP), improving service quality, and producing research.

In the nursing profession, post-graduate in-service trainings are scheduled to increase efficiency and improve the quality of service. There are barriers to participation in training programs due to some reasons such as the intense work pace, incompatible shifts, a lack of personnel, the training program is not being at the knowledge and skill level of the personnel to be trained, the poor physical environment of the training environment. The purpose of this methodological study is to develop mobile training material to provide nurses working in university hospital with professional literature and also, to evaluate its visual design, reliability and the quality of information in the developed training material. The information quality, reliability, readability and visual design of the mobile training material developed for use on Android and IOS smartphones was assessed by 10 experts, twice, by means of the Discern Measurement Questionnaire and Visual Design Control Scale. After the first expert evaluation, the content was updated and a second evaluation completed. Content validity index (CVI) analyzes were performed. The Discern Measurement Questionnaire's total score for the training material configured for smartphones was calculated at 70.80 ±2.57 out of 75. CVI analysis results of the Discern Measurement Questionnaire and Visual Design Control Scale scales of the training material were found to be 0.75 and 0.78, respectively. According to Gagne's events of instructions, the information quality and the reliability of the training material configured for smartphones is high and this training material is validated.

Purpose: Many young children in need of early intervention are not identified in a timely manner. This preliminary study explored the emerging role of speech language pathologists (SLPs), providing training to improve the use of developmental screening in pediatric primary care. Method: A quantitative, descriptive methodology with a one-group pretest, posttest interventional design was utilized to assess the impact of an SLP-led educational intervention on the knowledge of 17 paraprofessional medical support personnel to administer a standardized developmental screening tool. Results: Data analysis revealed a significant increase on knowledge posttest scores from pretest scores. Conclusion: SLPs providing educational training in pediatric primary care is an important first step in identifying solutions to improving the early identification of children with developmental concerns.

Background: Critical reflection is an essential curricular component for learning from experience that determines placement quality in postsecondary experiential learning placements. However, there are poor empirical connections between the use of critically reflective processes and learning outcomes. Purpose: This research explored reflective processes professionals use in their practice and how these processes compare with the reflective activities postsecondary instructors in professional faculties use during experiential learning. Methodology/Approach: This collective case study used focus group interviews, field notes, and professional grey literature to examine the research questions. Findings/Conclusions: Professional training programs must align their reflective practices with more integrated and holistic models of reflective practice to better mirror the professional skills demanded in professional practice contexts. Professionals in context-laden professional environments should integrate reflective activities into their practice based on emergent, iterative, and cocreative models that are more like their lived realities at work. Reflective practices which better fit and mirror these lived realities may lead to better connections between reflective activities and work outcomes. Implications: Professional environments are complex, dynamic, and affected by contextual factors. New integrated and holistic models of reflective experience should replace the separated, stepwise, or automatic models that have guided reflective practices in the past.

Staff in 24/7 group housing services for adults with intellectual disability are responsible for ensuring safe medication management processes and supporting the residents in their health-related issues. Ten interviewed nurses reported several challenges in the medication management process emerging at the staff level, the level of the group home, and the level of the social and healthcare system, and were often related to issues in communication and responsibility. They reported a variety of complex tasks in the medication management process, for which they need a multiple skill set. They also act as healthcare advocates for residents, but healthcare services do not always match residents' needs. Training for social and healthcare professionals, access to healthcare services and the collaboration of social and healthcare services should be improved to provide the people with intellectual disability the best possible pharmacotherapy and healthcare.

Children with autism spectrum disorder have unique needs during medical procedures involving anesthesia. However, with early patient identification, provider champions can adapt their practice to better serve this population, thereby improving patient satisfaction and outcomes. This article describes a novel protocol developed by an anesthesia resource center to modify care for children with autism spectrum disorder and their families. This information serves as a template for perianesthesia nurses and advanced care providers to implement practice accommodations. Two case examples, based on parent interviews and chart review, are presented to exemplify this protocol.

This article presents an immediate evaluation of a professional development course in community health literacy for Brazilian nurses. An evaluation based on an applied thematic analysis of the accounts of 63 attendees in three Brazilian cities (January 2020) was guided by the following themes: (a) expansion of understanding about community health literacy as a pillar for planning and providing health care; (b) encouragement of innovation in research and/or practice; and (c) plans to incorporate the information shared in the course into professional projects. The evaluation disclosed the complexity of social contexts for health literacy, which is intertwined with ethnocultural diversity and deep socioeconomic disparities, such as restricted access to essential public health services for socially deprived and vulnerable individuals. Expanded understanding about community health literacy is a pillar for care planning and delivery, as well as innovation in research and practice projects. Participants' evaluations revealed ideas to improve nurses' practice in promoting community health literacy and empowerment, as well as quality of life and social well-being. Future knowledge dissemination may impact nurses' clinical practice and management actions, bringing changes in various areas of practice to redesign more socially inclusive actions for clientele.

The demand for online education is rising for working nurses because of its flexibility and accessibility, which allows them to further their studies and enhance their professional development. Self-directed learning is imperative for nurses to continue their education using the elearning approach. This study investigates gender differences in overall self-directed learning among working nurses in elearning nursing programs in Malaysia. The conceptual framework for the study is based on the concepts of the self-directed learning model. This is a cross-sectional quantitative correlational study using a multivariate analysis method. Stratified random sampling technique was employed to query 241 nursing students through an online survey. The Self-directed Learning Instrument (SDLI) was adopted to measure the dependent variables of the study. The findings of the study revealed statistically significant differences between gender and the dependent variables (p < 0.05) of learning motivation, planning and implementation, interpersonal communication, and self-monitoring. Male nurses reported higher levels of self-directed learning than females. This study highlights the important concepts of self-directed learning among online learners. The role of educators is essential to support students for self-direction in elearning education. Future studies to explore other possible determinants in elearning context are recommended

Thailand is now a medical center in Asia. There has been an increase in the number of foreign patients receiving medical services in Thailand. The employees in the healthcare industry, like the registered nurse, are the center of the relationship with that service. The vital learning promotion course for these registered nurses dealing with patients of various nationalities is cultural competence promotion. With the nature of the learning style of the registered nurse, they need more flexibility and respond to their learning nature. Ultimately, the enhancement of cultural competency learning still needs to be achieved. Therefore, this research study aimed to: 1) develop a self-directed learning program in the workplace to promote cultural competence for registered nurses in international hospitals and 2) study the effect of implementing a self-directed workplace learning program to promote cultural competency. The researcher adopted a Research and Development methodology divided into two phases. The first phase is to develop a self-directed workplace learning program to enhance cultural competency. The second phase is to study the effect of implementing a self-directed learning program. The findings revealed that: 1) a draft of a self-directed workplace learning program to enhance cultural competence consisting of concepts and principles, the primary goal of the program, the guideline for promoting cultural competence learning based on the idea of self-directed workplace learning, the learning program, the learning facilitators of the program, the learning spaces are locations or areas within an organization, the international hospital's networks and the learning resources include information sources from diverse places. Plus, 2) registered nurses had better levels of cultural competency learning in attitudes, knowledge, and skills than before participating in the program trial and had improved scores in all areas.

Objective: This study was carried out to determine the knowledge levels of nurses working in Family Health Centers (FHCs) about childhood autism. Methods: This study is a descriptive and cross-sectional study. The sample of the study consisted of 361 nurses working in FHCs in the province with the highest child population rate in Turkey. Data were obtained using the personal information form and the Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire. Results: The findings show that the mean score for the KCAHW questionnaire was 10.95 ± 3.7. Gender, education level, previous employment in a mental health clinic, the presence of a person with autism in their environment or family, their previous participation in any autism-related education program, and knowledge of the autism screening and follow-up program conducted by the Ministry of Health significantly affected the scores that were obtained from the KCAHW questionnaire (p < 0.05). Conclusion: Educational practices that will increase the knowledge and awareness of nurses about autism can contribute to the diagnosis of children with autism at an earlier age.

Background: The attitudes, perceptions and inherent biases of healthcare professionals (HCPs) have the potential to influence and inform health outcomes of people with intellectual disability. This review aimed to identify what educational interventions have been conducted to improve the attitude, knowledge, and confidence of HCPs in caring for people with intellectual disability. Method: A systematic literature review was conducted using Medline, ERIC and PsycINFO. Inclusion criteria included: articles published after 1980 in English, quantitative and mixed methods studies. Results: Of 1444 articles yielded, 10 met the inclusion criteria. Studies predominantly included doctors and nurses. Almost half (40%) of the studies reported interventions that were effective in changing perceived confidence and attitudes, while 60% achieved improvement in knowledge or skills based on Kirkpatrick classification. Conclusions: Training is valuable in improving knowledge, broadening perspectives, and increasing confidence in managing people with intellectual disability but there are limited studies in this area.

There is a growing worldwide interest in educating nurses at an advanced level. Advanced practice nursing (APN) refers to an umbrella term for master-educated nurses working within expanded nursing practice. Previous APN research has primarily addressed comparative characteristics of education globally and several aspects related to practice after graduation. This study aimed to explore how higher education institutions position and legitimize APN as an education requisite for nurses, the health care system, and society. Program descriptions of relevant educational programs in the Norwegian context were analyzed using documentary reality construction. The findings point to how APNs are positioned to have a prominent contextual perspective, which are given precedence over direct patient care, legitimized through descriptions of societal problems and demands. This paper argues that APNs are positioned to hold individual responsibility to solve unmet societal demands.

Autistic adults often experience health problems and a range of healthcare barriers. Therefore, the aim of this study was to evaluate barriers and explore how primary care providers and autistic adults want to improve their primary healthcare. Semi-structured interviews with three autistic adults, two parents of autistic children and six care providers, were performed to evaluate barriers in Dutch healthcare. Next, in a three-round Delphi-study, 21 autistic adults and 20 primary care providers rated barriers in primary healthcare and assessed recommendations based on usefulness and feasibility. In the thematically analysed interviews, 20 barriers in Dutch healthcare for autistic people were identified. In the Delphi-study, the primary care providers rated the negative impact of most barriers lower than the autistic adults. The Delphi-study resulted in 22 recommendations to improve primary healthcare for autistic adults, focused on: primary care providers (i.e. education in collaboration with autistic people), autistic adults (i.e. improvement of preparation for general practitioner-appointments) and organization of general practice (i.e. enhancement of continuity in care). In conclusion, primary care providers seem to assess healthcare barriers as less impactful than autistic adults. With the use of the Delphi-method, useful and feasible recommendations to improve primary healthcare for autistic adults were identified, based on the needs of autistic adults and primary care providers.

Background: People with intellectual/intellectual and physical disabilities frequently use day-service centres, an array of services that involve the provision of care and social activities during the daytime and offer homebound people with disabilities opportunities to live in their communities. While nurses working at day-service centres for people with disabilities are expected to promote service-users' health, little research has focused on this area. Nurses' relationships with service-users of day-service centres have not been sufficiently investigated regarding how their interactions determine service-users' specific activities and daily lives within such facilities. This study sought to address this research gap. Methods: We conducted a qualitative descriptive study with six nurses working at day-service centres located in Tohoku region, Japan. Six participants were interviewed 16 times. The psychological-phenomenological method developed by Amedeo Giorgi was used as the model for data analysis. Findings: The analysis generated five themes. First, nurses show interest in service-users by 'continuing to show interest' and by 'trying to understand the service-users from the perspective of what they can do'. Additionally, the nurses ensure that service-users enjoy their time in the facility by 'supporting enjoyment through nursing and medical care', 'stabilising feelings' and 'creating an environment conducive to everyone's comfort'. Conclusions: Nurses working at day-service centres for people with intellectual/intellectual and physical disabilities provide support for social participation while maintaining the service-users' mental and physical health. Thus, these nurses support enjoyment among service-users from the nursing and medical care aspect; they also devise ways for service-users to interact and adjust to the environment to improve service-users' comfort at day-service centres. Furthermore, participation in daytime activities at day-service centres indicated that nurses are interested in service-users' activities, and they perceive service-users as positive individuals.

Background: In most African countries, disability is explained by cultural beliefs. This has implications for healthcare delivery for persons with intellectual disabilities. Methods: With the aid of a qualitative approach, we explore the interplay between cultural beliefs and the training of health professionals and their implications for the healthcare delivery to persons living with intellectual disabilities in the Asokwa and Oforikrom Municipalities. Findings: Findings revealed that cultural beliefs about intellectually disabled people include the idea that their facilities are forbidden and that pregnant women who pass by them may have a child with a disability. Further, health professionals received little intellectual disability training. As a result, healthcare professionals lack knowledge of the needs and care of this group. Conclusion: This study recommends that professionals should take comprehensive intellectual disability courses in training schools. Also, health professionals should attend periodic workshops on the range of intellectual disabilities to raise awareness of their needs and care.

Nurses have important responsibilities in the development of health and care services for children with intellectual disabilities. This is because it is usually the nurse who first encounters the child in all kinds of care and treatment services. Barriers to the provision of sexual healthcare by nurses have not yet been clearly discovered. This study aimed to identify the barriers experienced by nurses regarding communication for sexual health education for children with intellectual disabilities. This study was carried out with 19 nurses through in-depth interviews. The thematic analysis method was used for data analysis. Four themes emerged related to barriers in communication for sexual health education for children with intellectual disabilities by nurses as: (1) communication of nurses with their patients; (2) communication on an individual level; (3) communication on the family level; and (4) institutional factors. These barriers included the lack of knowledge of children, families, and nurses, insufficient institutional support, attitudes towards sexuality and stigmatization of the family, and the prevention of sexual health education services by the aggressive behaviors of children. It is recommended to provide sexual health education to nurses and families to minimize problems in the sexual health of children with intellectual disabilities. Nurses should also be trained on sexual health policy and how to put it into practice.

The challenge faced by newly graduated nurses from undergraduate study to practice is a persistent theme in nursing practice literatures. However, there is a lack of understanding about how this transition happens. This focused ethnographic study explored how newly graduated nurses (novices) interacted with experienced nurses and learnt in a hospital ward in Singapore. Using the 'Trajectory of identification framework' developed from Wenger's Community of Practice theory, data was collected through observation and focused group discussions. This research revealed the participating rules as the sociocultural characteristics of the nursing community, and how these characteristics are ongoingly negotiated among the nurses. The nurses' changing performative competence and identity in different situations are conceptualised as the 'Participation Space'. This study also showed how concepts of Community of Practice theory can be analytically applied and further developed in empirical study. Specifically, a conceptual 'Participation Matrix' is theorised which adds an additional tool to understand the nurses' dynamic participation and negotiation of membership in a Community of Practice. Novices' transition should be viewed as an ongoing dynamic workplace learning, through which negotiation of performative competence and identity among members take place. The soon to be novices and workplaces should be prepared with this understanding.

There is a rising recognition of the crucial role self-care plays in managing heart failure (HF). Yet patients often have difficulties implementing ongoing self-care recommendations into their daily lives. There is also recognition of the importance of theory for successful intervention design, and understanding of key factors for implementation so interventions fit a given context. Local key stakeholders can provide valuable insights to help understand relevant context-specific factors for intervention implementation. This study sought to engage stakeholders to explore and determine relevant contextual factors needed to design and facilitate successful implementation of an HF self-care intervention in the German health care system. A ranking-type Delphi approach was used to establish consensus from stakeholders (i.e., clinicians, patients, policymakers/potential funders) regarding eight factors (content, interventionist, target group, location, mode of delivery, intensity, duration, and format) to adequately define the components and implementation strategy of the intervention. Seventeen participants were invited to participate in the first Delphi round. A response rate of 94% (16/17) was achieved and maintained for all three Delphi rounds. Stakeholder consensus determined that nurses specializing in HF are the most appropriate interventionists, target groups should include patients and carers, and the intervention should occur in an outpatient HF clinic, be a mixture of group and individual training sessions, and last for 30 minutes. Sessions should take place more frequently in the beginning and less often over time. Local stakeholders can help determine contextual factors that must be taken into account for successful delivery of an intervention. This enables the intervention to be developed and applied based on these factors, to make it suitable for the target context and to enhance participation to achieve the desired outcomes.

Our study explored the experiences of fully online nursing faculty during COVID-19. Using Mezirow's transformative learning theory and Hoggan's typology as our framework, we engaged in qualitative hermeneutic phenomenology, interviewing 10 online nursing faculty members to learn about their experiences teaching online during the pandemic. Results from our findings suggest COVID-19 was a collective disorienting dilemma. While working through this disorienting dilemma, faculty discovered the importance of both collaboration and professional development in the sense-making process. Furthermore, faculty pedagogical practices transformed as flexibility and compassion emerged as a necessary part of supporting students during the pandemic.

STEM undergraduates navigate lengthy sequences of prerequisite courses covering volumes of science content. Given that these courses may contribute to attrition and equity gaps in STEM, research is needed to test the assumption that prerequisite content benefits students in their future studies and careers. We investigated the relevance of prerequisite course content for students' careers through semistructured interviews with practicing nurses regarding their undergraduate anatomy and physiology (A&P) courses. Nurses reported that A&P content does not align with the skills and knowledge needed in the nursing profession. Interviewees averaged 39% on a brief A&P assessment, suggesting A&P prerequisites failed to impart a high degree of long-term A&P knowledge among nurses. Further, practicing nurses perceived overcommitment to A&P content coverage as an exclusionary practice that eliminates capable individuals from the prenursing pathway. These findings challenge assumptions surrounding the justification for prerequisite course content and raise questions of whether content expectations actively exclude individuals from STEM or healthcare careers. We aspire for this study to stimulate conversation and research about the goals of prerequisite content, who is best positioned to articulate prerequisite content objectives, and the influence of content coverage on equity and justice in undergraduate STEM education.

Stress experienced during high-risk decision-making may impair performance, but can also be a cue, provoking the move from intuitive and automatic application of expertise to reflective and deliberative approaches. This article reports an exploratory intervention designed to provoke reflection-in-action and, ultimately, to improve practice decision making in experienced clinicians. The intervention combined: classroom-based education on decision-making science, practice-based self-monitoring with the aid of wearable technology, decision-making logs intended to provoke reflection, and opportunities to engage in guided reflection-on-action. The intervention supported recognition and use of physiological cues to moderate action and decision making, and provoked experienced professionals to reconnect with the element of surprise they experienced early in their careers, and to use these moments to improve their practice.

Effective health service delivery hinges on the interface between professionals rendering health services to the sick and the injured. This paper examined the inter-professional collaboration and knowledge management practices among the clinical workforce in Federal Tertiary Hospitals in three Geopolitical Zones of Nigeria. The study employed a non-experimental survey design. 550 questionnaires were administered out of which 479 were completed for analysis comprising 204 Medical Doctors, 180 Nurses and 95 Health Information Management Officers, which resulted into 87% response rate. Findings from the study revealed that knowledge acquisition was the most practiced, closely followed by knowledge application. In addition, cooperation was the most practiced form of inter-professional collaboration, next to it is partnership. The study revealed a significant relationship between inter-professional collaboration and knowledge management practices. It shows that only cooperation significantly influenced knowledge management practices while knowledge capturing and knowledge dissemination significantly influenced inter-professional collaboration. The study concluded that Federal Tertiary Hospitals in Nigeria will perform better if they can sustain the culture of knowledge management practices and inter-professional collaboration.

Children require accessible, affordable health care to support health and education outcomes. Health care access is affected by children's social determinants of health. School-based health centers (SBHC) bypass larger social structures and social determinants of health, providing accessible health care to children. New SBHC development should consider university collaboration partnerships to establish funding sustainability. University interprofessional health programs allow for high-quality, advanced practice nurse care models to staff SBHCs. When developing an SBHC, founders should utilize access theory to ensure conformity between the targeted population's needs and health services. The dimensions of the theory assist in building and evaluating access. As the pandemic continues to cause health care access barriers for children, advocates, and policymakers should focus efforts on sustaining and expanding SBHCs.

Background: The Online Registered Nurse to Baccalaureate Science in Nursing (RN- BSN) Program has a retention rate of close to 97.5% (UTEP, 2020). Attrition rates in nursing programs are high. The National League for Nursing (NLN) last reported a 25 % attrition rate which may double for minority students in four-year nursing programs (NLN, 2014; Elkin, 2019). As online courses in colleges and universities are growing and are predicted to become mainstream by 2025, it is essential to identify factors contributing to our retention rates. American Association of Colleges of Nursing (AACN) has made it part of its 2021-2022 policy priorities to increase access to nursing programs (AACN, 2021). Objective: The purpose of this study was to ascertain the factors affecting nursing student retention. The information was used to make changes to the existing online programs in our school and better support our students. The research question was "What factors do students identify that influenced their RN to BSN program retention?" Methodology: The participants were chosen using a convenience sampling technique. The university was a public institution located in a border town. Three types of questions were asked: (1) general demographic information, (2) nursing career, and (3) program requirements for the RNBSN. Results: A total of 33 participants completed the RN-BSN retention program study. The findings indicated that several general factors contribute to retention and student success, including student support services, mandatory orientation programs for students and faculty, credit student success courses, remedial academic ability programs (which discuss support services, particularly computer tech support), and recognizing the importance of diversity in the classroom and at work. Conclusion: Examining the characteristics of distance education students, as well as their distinct abilities and needs, may assist schools in improving student retention. Reconsidering the characteristics and unique features of distance learning students may help schools retain students with a variety of needs, such as access to scholarships, loans, and financial incentives to continue their education.

In caring professions, such as childcare and healthcare, empathy and narrative underpin important aspects of the emotional work of early childhood educators and nurses (Rogers, Jefferies & Ng, 2022). Unfortunately, they are not given much attention in scholarly articles, but it is important for practitioners to understand them (Barton & Garvis, 2019). This cross-disciplinary paper discusses the virtue of empathy from a philosophical stance, and its relationship to narrative when building shared understandings. There is a sense in which empathy and narrative are interdependent: storytelling helps to cultivate empathy in others, and empathy can be essential if we are to elicit and understand the stories that others have to tell. In fact, when it comes to eliciting and understanding the kinds of stories that are of particular interest for this paper (i.e., the personal stories to be told by young children participating in a research project, and those of patients in a healthcare setting), empathy tends to be especially important. As we argue, these examples drawn from early childhood education and care and healthcare serve to illustrate certain ways in which empathy, storytelling, and the development of shared understandings can be of deep significance; not only for researchers, educators and healthcare professionals, but also for senior administrative and public policy officials.

Nurses are expected to provide culturally competent care. Many health care organizations support the need for more emphasis on cultural competency in nursing academia. Institutions of higher education have begun encouraging more course internationalization and globalization to help accomplish this goal. The purpose of the current article is to describe the steps involved in the internationalization of NURS 3630: Conceptual Basis of Professional Nursing course at Albany State University. This course is a part of the required courses within the Darton College of Health Professions Post-Licensure Registered Nursing program and was purposefully selected for internationalization. Conversations between nursing faculty, the Office for International Education, and nursing leaders occurred in the decision-making process. Course objectives and assignments were recreated or altered to have a more cultural and global focus. Four student learning outcomes were addressed in the internationalized course. Positive student feedback regarding course information learned and usefulness was received at the end of the semester. Future suggestions for the course include integrating culture grading rubrics, pretest and posttest administration, faculty professional development, course design team collaboration, and student input.

Over a half century ago, researchers found that so-called classic professions attract socially advantaged recruits with better labour market outcomes; however, as semi professions become increasingly institutionalized, and classic professional programs expand, differences between these two groups may be less pronounced. Using Statistics Canada's 2018 National Graduate Survey, we compare inputs and outcomes of four classic professions (law, pharmacy, medicine, and dentistry) and three semi-professions (teaching, social work, and nursing). Bivariate statistics show semi-professions have more non-traditional graduates who invest less in training. Multiple linear regression models also show that after controlling for demographics, classic professions have stronger education-job matches and higher earnings three years after graduation. We interpret these findings as being consistent with our theory of intensifying logic, where classic professions have tight training-job connections, and accommodating logic which suggests semi-professions have looser labour market connections. We end by discussing directions for future research on the classic and semi-professions.

The purpose of this study is to explore a practical nursing bridging program's education environment and the role transition of internationally educated nurses (IENs) who were enrolled full-time at a community college in Toronto, Canada, during the winter semester of school year 2018-2019. A survey questionnaire consisting of three parts was used to gather data from 68 IEN students who volunteered to participate in this study. Descriptive statistics and multiple regression analysis were used to analyze data. Participants' responses to the open-ended question "Could you please list any problems/issues you have encountered in the bridging program?" were thematically analyzed. Results indicate that all bridging program education environment components, as well as role transition subscales, were described as "agree." There is a significant relationship between the respondents' perception of learning within their bridging program's education environment and role transition. However, views on teachers and atmosphere, as well as academic and social self-perception, seemed insignificant predictors of role transition. Participants' responses to the open-ended question were analyzed and grouped into four themes: concern with teachers, program content issues, program pace, and financial issues.

Managing health and well-being issues can be challenging for college students. Alternative supports, such as online programs, have been identified as cost-effective and efficient methods of providing inclusive support to college students, removing numerous barriers to health and well-being promotion. The article summarized a novel, evidence-based approach to developing an online health and well-being program. The program is based on Cognitive Behavioral Therapy (CBT), the positive emotion, engagement, relationships, meaning, and accomplishments (PERMA) construct, and the analysis, design, development, implementation, and evaluation (ADDIE) model. It discusses future directions in the evaluation, assessment, and documentation of the fitness-for-purpose process.

Since its implementation in 2004, the Canadian English Language Benchmark Assessment for Nurses (CELBAN) has been accepted as evidence of language ability for licensure of internationally educated nurses (IENs) in Canada. This article focuses on the complexities of sustaining an occupation-specific assessment over time. The authors reference the seminal work of Epp and Lewis, who developed the original CELBAN test forms and aligned the test results with the Canadian Language Benchmarks (CLB), and then go on to describe a research and development project that was carried out under the direction of Touchstone Institute and overseen by the Centre for Canadian Language Benchmarks (CCLB) to renew the test model and develop additional content. This is followed by a discussion of the maintenance strategies required to sustain a secure assessment within the evolving Canadian context.

Transformational leaders have been shown to influence positive work environments and support the retention of nursing staff. While exemplars have been found in upper-level management, the implementation of these characteristics in unit-based leaders is less explained. The elements of the transformational leader on followers and the organization--individual consideration, individual stimulation, inspirational motivation, and idealized influence--can engage nursing staff to remain in an organization which will promote positive patient outcomes. This article will review the elements of the transformational leader and share two exemplars of the transformational metanarrative as demonstrated in nursing care units. Both exemplars demonstrate how the transformational leader can influence the retention of nursing staff and support unit level change to support positive patient outcomes.

Background: The use of virtual reality (VR) in medical education allows learners to make mistakes safely without risk to patients and to refine a range of clinical skills by repetition. However, there is still wide variability both between, and within countries regarding the amount of training delivered using VR, particularly in relation to intensive care medicine Objectives: To identify the range of uses, phase of development and effectiveness of VR for intensive care unit (ICU) staff training. Methods: The review followed the scoping review framework set out by Levac et al. (2010). A multi-database search was undertaken. All study types were included if they explored the use of VR for intensive care staff (ICU) staff training. Full paper screening, data extraction and assessment of bias was carried out by a single reviewer with verification by a second reviewer. A narrative synthesis was chosen to summarize the data. Results: The search strategy identified 647 records. Following the removal of duplicates, screening of titles, abstracts and full texts, five studies were included. VR for ICU training has primarily focused on skill acquisition for surgical procedures. The majority of studies in this area were classified to be at an early stage of assessing acceptability, tolerability and efficacy. There was very low-quality evidence that VR for ICU training is effective. Conclusions: Studies have explored the use of VR for a small number of surgical procedures and emergency patient scenarios. VR for ICU training demonstrates some potential, however further development and high-quality research is required. Research relating to virtual reality for ICU staff training is currently of weak methodological quality and as such, no recommendations to clinical practise can be made. Wherever possible when using VR for ICU staff training it should be utilized as part of a high-quality study.

Background: Patient navigation programs have shown promise for improving health but are not widely used in obstetric care. Our objective was to understand obstetric provider perspectives on how to implement patient navigation to optimize care during the postpartum period for low-income patients. Method: Focus groups were conducted with obstetric physicians, nurses, and social workers who care for low-income pregnant and postpartum patients in an academic medical center. Semistructured interview guides were developed to elicit conversations about the potential value of patient navigators, recommendations for navigator training, and how navigators could be most effective in improving postpartum care. Analysis of themes was based on the constant comparative method. Results: Twenty-six obstetric providers (six focus groups) discussed elements for a successful obstetric navigation program. Successful implementation themes included selecting navigators with appropriate interpersonal attributes, arranging navigator training, and identifying the most valuable services navigators could render. Desirable navigator attributes included persistence in patient advocacy, consistency, relatability, and a supportive manner. Training recommendations included learning the health care system, identifying where to obtain health system and community resources, and learning how be effective health educators. Suggested services were broad, ranging from traditional care coordination to specific educational and resource-driven tasks. Conclusions: Obstetric providers perceive patient navigation to be a potentially beneficial resource to support low-income patients and offered recommendations for navigation implementation. These included suggestions for patient-centered navigators, with specific training and services focused on promoting care continuity and coordination.

The purpose of this study was to determine the difficulties and expectations of foreign nursing students during their nursing practice in the clinic. This qualitative study was conducted with six foreign students studying in the department of nursing at a university in Turkey. The data were collected by using a focus group interview method, and two focus group interviews were held. Two main themes, namely, difficulties during the nursing practices in the clinic and expectations, and related subthemes were determined. All the students described the difficulties they experienced regarding nursing practices in the hospital. The foreign and migrant students participating in this study experienced difficulties regarding communication, applying treatments, providing training to patients, and applying care interventions to patients during nursing practice in the clinic; they also had expectations from nursing educators to spend sufficient time with them and be present with them in the clinic, and from nurses to assist them for adaptation to the clinic.

This paper presents the findings of the lived experience of black and minority ethnic (BME) nurses when applying to access training and development programmes in the National Health Service (NHS). Research has shown that black nurses in particular, are less likely to be selected for training and development programmes when compared to their white counterparts which can impact on the quality of care given to patients. Despite interventions in place to promote equal opportunities, oppressive practices persist. A conceptual model of issues to be considered in the development of an equality framework has been proposed to help facilitate improvement in training opportunities for black nurses. The framework has been proposed on the basis that taking a collective approach to a longstanding problem to include stakeholders such as black nurses, NHS Trusts and the Government, may help towards improving training opportunities for black and minority ethnic nurses.

This study explores the student nurses' perception of the clinical learning triad, its benefits and challenges with regards to their clinical learning. A qualitative descriptive methodology guided this study. Using semi-structured interview focus group discussions were conducted to elicit data from 30 participants. Data was analyzed manually to identify the key themes. Five themes identified are "Bridging the gap between theory and practice," "Skill Acquisition," "Interpersonal Skills and Communication," "Clinical Instructor-the Centre for Clinical Learning Triad," "Benefits and Challenges of Clinical Learning Triad." Students verbalized that the availability of nurses enhanced the learning experience. However, expressed that at times the busy ward routines hindered them from approaching the staff nurses for their learning needs. A specialized clinical instructor is mandatory to channelize objective based clinical learning in nursing education. They also verbalized support from the clinical environment alleviated anxiety and progressed their practical learning. Clinical Instructors coordinate the clinical learning from the beginning of a shift but staff nurses play a major role in helping students to complete student learning through skill training while the instructor is busy handling other students. The study concludes that the practical knowledge of staff nurses combined with the efforts of clinical instructors to bridge the gaps between the theory and practice supported by the positive clinical environment equips the nursing students with required skills and knowledge thus establishing the effectiveness of the Clinical Learning Triad.