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Abstract: Aim: To explore how adult, child and mental health nursing and midwifery students, selected using multiple mini interviews, describe their ‘values journey’ following exposure to the clinical practice environment. Background: Values based recruitment (VBR) incorporates assessment of healthcare students’ personal values using approaches like multiple mini interviews. Students’ experience of adjustment to their values during their programme is conceptualized as a ‘values journey’. The impact of VBR in alleviating erosion of personal values remains unclear. Design: A cross‐professional longitudinal cohort study was commenced at one university in England in 2016 with data collection points at the end of years one, two and three. Non‐probability consecutive sampling resulted in 42 healthcare students (8 adult, 8 child and 9 mental health nursing and 17 midwifery students) taking part. Methods: Six semi‐structured focus groups were conducted at the end of participants’ Year One (DC1). Data analysis incorporated inductive and deductive approaches in a hybrid synthesis. Findings: Participants described a ‘values journey’ where their values, particularly communication, courage and wanting to make a difference, were both challenged and retained. Participants personal journeys also acknowledged the: ‘courage it takes to use values’; ‘reality of values in practice’ and ‘need for self‐reflection on values’. Conclusion: A ‘values journey’ may begin early in a healthcare student's education programme. This is important to recognize so that appropriate interventions designed to support students in higher education and clinical practice can be implemented. The values incorporated in VBR should be continually evaluated for fitness for purpose. [ABSTRACT FROM AUTHOR]

The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile's (Practice‐based education: Perspectives and strategies, Rotterdam: Sense, 2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the healthcare assistant. In the British context, delegation and supervision are thought of as skills which are learnt “on the job.” We suggest that learning “on‐the‐job” is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011 to 2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and healthcare assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the “invisible learning” which occurs as newly qualified nurses learn to delegate and supervise. [ABSTRACT FROM AUTHOR]

Aim and objective To understand how nurses and midwives manage informal complaints at ward level. Background The provision of high quality, compassionate clinical nursing and midwifery is a global priority. Complaints management systems have been established within the National Health Service in the UK to improve patient experience yet little is known about effective responses to informal complaints in clinical practice by nurses and midwives. Design Collaborative action research. Methods Four phases of data collection and analysis relating to primarily one National Health Service trust during 2011-2014 including: scoping of complaints data, interviews with five service users and six key stakeholders and eight reflective discussion groups with six midwives over a period of nine months, two sessions of communications training with separate groups of midwives and one focus group with four nurses in the collaborating trust. Results Three key themes emerged from these data: multiple and domino complaints; ward staff need support; and unclear complaints systems. Conclusions Current research does not capture the complexities of complaints and the nursing and midwifery response to informal complaints. Relevance to clinical practice Robust systems are required to support clinical staff to improve their response to informal complaints and thereby improve the patient experience. [ABSTRACT FROM AUTHOR]

This paper aims to increase our understanding about how student nurses' experiences of supernumerary status are embedded in the hidden curriculum in clinical practice and contribute to the theory-practice gap in nursing. Current literature suggests that the hidden curriculum exists in many professional curricula and that it functions to socialise students into professional behaviours and practice. However, in nursing, there is a gap in our understanding of how these socialisation processes have been influenced by supernumerary status and what forms the hidden curriculum might take currently in clinical practice. An ethnographic case study design. Data were collected in four sites using fieldwork in clinical practice as well as interviews with students, mentors and key stakeholders, an online survey of student bodies and curriculum analysis in four universities. The findings in this paper are drawn from the qualitative fieldwork and interviews and were analysed thematically. The findings suggest that supernumerary status is an important aspect of the hidden curriculum in clinical learning for nursing students; that students are expected by trained staff to work while they learn and that on registration, they are expected to be competent to work immediately as registered nurses. These expectations are at odds with those of academic nurses and contribute to a theory-practice gap for student nurses. These expectations form part of the hidden curriculum that shapes the clinical context, and students have to learn to negotiate their status as supernumerary students in practice to meet these expectations. Consequently, students have to learn in a disintegrated learning context where opposing values of learning exist. To reintegrate student nurses' learning, educators in universities and clinical practice have to understand how the hidden curriculum and expectations around supernumerary status among trained staff affect learning for students. [ABSTRACT FROM AUTHOR]

The study reported in this paper explores how infertile women cope with infertility using their religious and spiritual beliefs. In total, 30 infertile women affiliated to different denominations of Christianity and Islam were interviewed in the UK and Iranian fertility clinics using grounded theory. The categories which emerged included governing ones' 'Self' through gaining control of emotions, adopting religious coping strategies, and handling the burden of infertility peacefully, which all related to the core category of 'relying on a higher being'. We argue that infertile women employ a variety of religious and spiritual coping strategies which are associated with adaptive health outcomes. Further scientific inquiry is required to investigate how religion and spirituality promote adaptation to infertility.

Objectives: To explore the experiences of governance and incentives during organizational change for managers and clinical staff., Study Setting: Three primary care settings in England in 2006-2008., Study Design: Data collection involved three group interviews with 32 service users, individual interviews with 32 managers, and 56 frontline professionals in three sites. The Realistic Evaluation framework was used in analysis to examine the effects of new policies and their implementation., Principal Findings: Integrating new interprofessional teams to work effectively is a slow process, especially if structures in place do not acknowledge the painful feelings involved in change and do not support staff during periods of uncertainty., Conclusions: Eliciting multiple perspectives, often dependent on individual occupational positioning or place in new team configurations, illuminates the need to incorporate the emotional as well as technocratic and system factors when implementing change. Some suggestions are made for facilitating change in health care systems. These are discussed in the context of similar health care reform initiatives in the United States., (© Health Research and Educational Trust.)