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In tertiary education, generic professional skills should be developed along with discipline-specific knowledge and skills. Team-Based Learning (TBL), an active learning strategy, creates deep learning and enhanced student engagement; however, its effects on the development of generic learning outcomes are unknown. The aim of this study was to evaluate postgraduate specialty nursing students' perspectives of how TBL impacts the acquisition of skills defined by the university's eight Graduate Learning Outcomes (GLOs). A descriptive exploratory design was used in this study. Postgraduate nursing students in 2016-2017 at one university were invited to participate. Data were collected via demographic survey, a ranking tool, and written reflections. Data were analysed using descriptive statistics and content analysis. The response rate was 97.2 per cent (172/177). Participants were mostly females (n=152, 88.4%) aged 25-34 years (n=115, 66.9%). Student (n=156) rankings showed TBL contributed to the acquisition of critical thinking (n=90, 57.7%) and problem solving skills (n=56, 35.9%) the most. Students (n=144) made 2719 comments regarding how TBL led to the acquisition of GLOs in written reflections. Almost 98 per cent (n=2657) of all reflective comments were positive. All students mentioned at least one GLO positively due to TBL. Most positive reflections related to self-management (n=520, 19.6%) and communication (n=434, 16.3%). Postgraduate specialty nursing students perceived TBL classes contributed to the acquisition of their university's GLOs, particularly critical thinking, problem solving, and self-management skills. The active learning strategy of TBL facilitates learning and engagement, and the attainment of essential professional attributes which are highly valued by employers.

Aim(s): To explore the published research related to nurses' documentation and use of vital signs in recognising and responding to deteriorating patients. Design: Scoping review of international, peer‐reviewed research studies. Data Sources: Cumulative Index to Nursing and Allied Health Literature Complete, Medline Complete, American Psychological Association PsycInfo and Excerpta Medica were searched on 25 July 2023. Reporting Method: Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews. Results: Of 3880 potentially eligible publications, 32 were included. There were 26 studies of nurses' vital sign documentation: 21 adults and five paediatric. The most and least frequently documented vital signs were blood pressure and respiratory rate respectively. Seven studies focused on vital signs and rapid response activation or afferent limb failure. Five studies of vital signs used to trigger the rapid response system showed heart rate was the most frequent and respiratory rate and conscious state were the least frequent. Heart rate was least likely and oxygen saturation was most likely to be associated with afferent limb failure (n = 4 studies). Conclusion: Despite high reliance on using vital signs to recognise clinical deterioration and activate a response to deteriorating patients in hospital settings, nurses' documentation of vital signs and use of vital signs to activate rapid response systems is poorly understood. There were 21studies of nurses' vital sign documentation in adult patients and five studies related to children. Implications for the profession and/or patient care: A deeper understanding of nurses' decisions to assess (or not assess) specific vital signs, analysis of the value or importance nurses place (or not) on specific vital sign parameters is warranted. The influence of patient characteristics (such as age) or the clinical practice setting, and the impact of nurses' workflows of vital sign assessment warrants further investigation. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

There is mounting evidence that the pre-medical emergency team (pre-MET) of rapid response systems is underutilised in clinical practice due to suboptimal structures and processes and resource constraints. In this perspective article, we argue for examining the pre-MET through a 'Behaviour Change Wheel' lens to improve the pre-MET and maximise the associated patient safety benefits. Using pre-MET communication practices as an example, we illustrate the value of the COM-B model, where clinicians' 'capability', 'opportunity', and 'motivation' drive 'behaviour'. Optimising clinicians' behaviours and establishing failsafe rapid response systems is a complex undertaking; however, examining clinicians' behaviours through the COM-B model enables reframing barriers and facilitators to develop multifaceted and coordinated solutions that are behaviourally and theoretically based. The COM-B model is recommended to clinical governance leaders and health services researchers to explore the underlying causes of behaviour and successfully enact change in the design, implementation, and use of the pre-MET to improve patient safety. What is known about the topic? The pre-medical emergency team (pre-MET) was implemented to enhance hospital patient safety; however, there is evidence that it is underused by health professionals. What does this paper add? We argue that health professionals' behaviours within the pre-MET be understood differently by using the 'Behaviour Change Wheel', where behaviour is driven by capability, opportunity, and motivation. What are the implications for practitioners? To improve patient safety and assist in formulating theory-based solutions, hospital leaders and health services researchers are called upon to examine the pre-MET using behaviour change theory. [ABSTRACT FROM AUTHOR]

Objective: To explore clinicians' use and perceptions of interdisciplinary communication pathways for escalating care within the pre-medical emergency team (pre-MET) tier of rapid response systems. Method: A sequential mixed-methods study was conducted using observations and interviews. Participants were clinicians (nurses, allied health, doctors) caring for orthopaedic and general medicine patients at one hospital. Descriptive and thematic analyses were conducted. Results: Escalation practices were observed for 13 of 27 pre-MET events. Leading communication methods for escalating pre-MET events were alphanumeric pagers (61.5%) and in-person discussions (30.8%). Seven escalated pre-MET events led to bedside pre-MET reviews by doctors. Clinician interviews (n = 29) culminated in two themes: challenges in escalation of care, and navigating information gaps. Clinicians reported deficiencies in communication methods for escalating care that hindered interdisciplinary communication and clinical decision-making pertaining to pre-MET deterioration. Conclusion: Policy-defined escalation pathways were inconsistently utilised for pre-MET deterioration. Available communication methods for escalating pre-MET events inadequately fulfilled clinicians' needs. Variable perceptions of escalation pathways illuminated a lack of of a shared mental model about clinicians' roles and responsibilities. To optimise timely and appropriate management of patient deterioration, communication infrastructure and interdisciplinary collaboration must be enhanced. What is known about the topic? To promote earlier recognition of, and response to, deteriorating ward patients, Australian rapid response systems include a pre-medical emergency team (pre-MET) tier. Escalation pathways within the pre-MET tier are poorly understood. What does this paper add? Policy-defined escalation pathways were inconsistently utilised. Clinicians identified deficiencies in communication methods (e.g. alphanumeric pagers) for escalating pre-MET deterioration. Perceptions of escalation pathways illuminated a lack of of a shared mental model about clinicians' roles and responsibilities. What are the implications for practitioners? To optimise the management of pre-MET deterioration, ward-based communication infrastructure and interdisciplinary collaboration must be enhanced. [ABSTRACT FROM AUTHOR]