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This paper considers the development of multidisciplinary advanced clinical practice in the UK and further afield. Consideration is given to education, governance and the four pillars of advanced practice: clinical, education, leadership and management, and research, as defined in Health Education England's Multi-Professional Framework for Advanced Clinical Practice (2017) . The research pillar is subsequently considered in more detail, with the following aspects being explored: the key drivers and support for increasing research engagement; the value of advance care practitioners (ACPs) developing research capabilities to enhance the provision of high-quality evidence-based patient care; and the barriers to achieving the research capabilities. The close relationship between advanced practice and clinical academic roles is identified, alongside both the evolving situation regarding clinical academic roles within the NHS, and the need to develop the research pillar through doctoral level study (to support the development of ACPs into future research leaders). This paper concludes by offering the Health Education England/National Institute for Health and Care Research's Integrated Clinical and Practitioner Academic programme as a potential solution to the challenges surrounding ACPs accessing additional training and development avenues—which are necessary for them to progress as professionals and active researching academics.

An empathic approach to patient‐centred care is a core of nursing practice. One of the methods to develop empathy, which is gaining currency is the use of virtual reality simulations in education. This paper posits some questions, does it simply reinforce a ‘type’ of patient, neglecting caring for the patient as unique, is empathy what results or is it pity, does it result in a greater distance being created between the patient and the health care provider? Can we ever really know what it is like to walk in a patient's shoes when what we experience through virtual reality provides a small snapshot of the vicissitudes of living with an illness or disability. We suggest that what matters most in simulations using virtual reality is how the student exits the experience and if they leave knowing just what patients ‘like that’ feel, or whether they leave with humility and curiosity.

Introduction: The purpose of this study was to explore the characteristics of undergraduate nursing students, which may determine the nature of their relationship with clinical nurses. Relationships between nursing students and clinical nurses are critical to maximize student learning outcomes and produce skilled graduates for the future health workforce. Methods: This qualitative content analysis study was conducted from January to August 2016. Twenty nine semi-structured in-depth interviews were conducted with 20 undergraduate nursing students in Tabriz nursing and midwifery faculty. Interviews were recorded and transcribed verbatim (in Persian), and analyzed using conventional content analysis to identify themes. Results: Four key themes emerged: educational factors (cognitive knowledge and practical skills, and learning motivation); communication skills; perceived support (perceived support from nurses and educators); and psychological state (fear of the relationship and self-confidence). Self-confidence is an emphasized concept in nursing students' willingness and ability to relate with clinical nurses. Conclusion: The results of the study showed that educational, communicative and psychological factors are important determinants of student communication with nurses. However, self-confidence is the most important factor in establishing such relationship. Self-confidence could be further assessed to identify nursing students who need greater support or would benefit from greater educational interventions to achieve relational skills.

Background/Aims The primary percutaneous coronary intervention pathway for patients experiencing an ST segment elevation acute coronary syndrome excludes patients with aVR ST elevation. These patients are treated on the non-ST segment elevation acute coronary syndrome pathway, which means that they have a coronary angiogram +/− intervention during their inpatient stay. Patients with non-ST segment elevation acute coronary syndrome have worse outcomes nationally. As such, research is required to demonstrate areas for improvement. This article examines the association between aVR ST segment elevation on the electrocardiogram and significant left main stem, proximal left anterior descending, or 3-vessel coronary artery stenosis in acute coronary syndrome to establish whether the primary percutaneous coronary intervention pathway should be redesigned. Methods Existing literature was searched, and relevant studies were considered and evaluated. Data were collected within local NHS Trusts on patients who had aVR ST segment elevation on the electrocardiogram. The data were analysed, and the findings were compared and synthesised with the literature. Results The study demonstrated a relationship between aVR ST segment elevation and significant disease. However, because of the numbers involved, analysis to demonstrate statistical significance was not possible, with the exception of aVR ST segment elevation and left main stem coronary artery, left anterior descending coronary artery and triple vessel disease, where pConclusion The need for a change in the primary percutaneous coronary intervention pathway was established.

Workplace violence against nursing students is a common phenomenon. This study aimed to investigate Iranian nursing students' experiences of workplace violence, including their reaction to violence and the consequences and the effects of such violence on the students.The study participants were undergraduate nursing students. The data were collected using semi-structured, in-depth face-to-face interviews. Data analysis was carried out with qualitative approach using conventional content analysis.Four categories were extracted from the analysis of the interview transcriptions: vertical violence, horizontal violence, reaction to violence and consequences of violence. Nurses were the major imposers of violence against students and psychological and verbal violations were the most of used forms of violence. The students reacted to violence in the forms of counteracting, reporting, disregarding and considering as commonplace.Workplace violence is a common phenomenon experienced by nursing students in this study, which causes devastating individual, educational, and professional impacts. Action plans including providing safe environment and appropriate support from nurses and educators should be developed in clinical settings to intervene and to prevent workplace violence.

Objective To measure empathy within the therapeutic relationship between fourth year Traditional Chinese Medicine (TCM) intern practitioners and their patients, who are first-year students within the same program. Methods An observational design was used to examine the interns’ empathic communication, evaluated by first year students ‘mystery shoppers’ using the Consultation and Relational Empathy Measure (CARE). First year TCM students went undercover to experience a clinical treatment (acupuncture) by a fourth-year intern in a public Chinese Medicine clinic attached to a metropolitan university in Sydney, Australia. Results Thirty-nine consultations were assessed by 39 undercover shopper students. The Intern practitioners’ consultation and relational empathy was rated as a mean 76.4% (38.2 points of a possible 50 (median 78%; 39); range 24–50. Significant response differences were found between female and male interns with males rated higher. The underlying elements are presented and discussed. Conclusion The intern practitioners’ level of empathy averaged 76.4% which is consistent with empathy ratings for international studies of healthcare students. Results showed that males were rated higher for empathy than females, indicating further studies examining the specific behaviours that characterise empathy of different genders would be a useful addition to knowledge and assist teaching.

The coronavirus pandemic has led to public and private outpourings of appreciation for nurses and doctors. In the UK, for instance, the Clap for Carers tribute, which started as an online campaign ...

© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Mindfulness practices provide numerous benefits for individuals with a variety of health issues. Recent research has highlighted the benefits of mindfulness for health professionals. The potential benefits for physical and occupational therapists or students however, are currently unclear. Objectives: To perform a scoping review on the effects of mindfulness practices among physical (PT) and occupational therapists (OT) and students of those disciplines. Methods: Eligible published articles in English were identified through a literature search of MEDLINE, PsycINFO, Cochrane Library, and AMED from the inception of databases to November 2015. Titles, abstracts, and full-text articles were screened for the selection of relevant papers. Articles identified as editorials, correspondences, commentaries, case reports, abstracts alone, and review papers were excluded. Results: Six studies (two qualitative studies, one quantitative study, one mixed-method study, and two experimental studies) met the inclusion criteria. Three studies focused on PT/OT students, two on clinicians and one on current clinicians who had previously failed a course. These studies highlighted the potential benefits of mindfulness for physical and occupational therapists. They should be interpreted with caution however, due to the small number of relevant studies, high heterogeneity in mindfulness interventions and methodological limitations. Conclusions: There is a paucity of research on the effects of mindfulness among physical and occupational therapists and students of those disciplines. The lack of relevant studies makes a systematic review challenging but the findings of the current studies suggest potentially promising effects.

In healthcare, empathy is considered a basic component of therapeutic relationships and a critical factor in patients’ definitions of quality care. More than 200 studies have demonstrated the positive impact of empathic healthcare interactions on patient outcomes.1 There is also compelling research demonstrating that healthcare devoid of empathy results in a wide range of negative psychological and physiological outcomes for patients.2 Further, healthcare professionals who practise without empathy are at heightened risk of depression, burnout and attrition.2 While it is reasonable to assume that most healthcare students have an empathic disposition, evidence suggests that empathy levels often decline during the period of enrolment in an undergraduate health degree. Despite the need for more attention to the development of empathy as an employability skill, many healthcare programs only pay lip service to this concept. Against this backdrop we developed a Virtual Empathy Museum (VEM): an innovative digital resource funded by an Australian Technology Network of Universities grant. The VEM includes evidenced-based simulations, digital stories, and a range of other educational materials, designed to enhance healthcare students and practitioners’ empathy skills and enable them to make a positive impact on patient care. This presentation will introduce the VEM with the aim of starting a conversation (or perhaps even a ‘movement’) that leads to empathy being included as an integral component of every healthcare curriculum. The relationship between empathy and patient outcomes will be explored; and the results of a systemic review that examined the effectiveness of immersive and experiential simulation-based interventions in empathy education will be presented.2 References Trzeciak, S., Roberts, B.W., and A. J. Mazzarelli (2017). Compassionomics: Hypothesis and experimental approach. Medical Hypotheses107: 92–97. Levett-Jones, T., Cant, R., Lapkin, S. (2019). A systematic review of the effectiveness of empathy education for undergraduate nursing students. Nurse Education Today. 75 April 2019, 80–94.

Nurses comprise the largest group of healthcare providers (Auerbach, Staiger, Muench, & Buerhaus, 2013), and a strong and resilient nursing workforce is crucial to effective healthcare delivery (Pr...

Objective : To explore students’ perceptions of the efficacy and value of teaching communication skills in a health professional course for Traditional Chinese Medicine (TCM). Methods : Individual surveys were used to evaluate students’ self-assessment of their communication skills pre and post a communication subject in a four-year degree course in a Bachelor of Health Science in TCM at a large metropolitan university in Australia. Quantitative and qualitative data were collected. Results : Findings indicate that students recognise the need for good communication skills training as part of their professional training and self-reported that their communication skills improved following a semester of study of a communication subject. Conclusions : One of the primary components driving increasing demand for complementary and alternative medicine (CAM), which includes TCM, is that consumers place a high value on effective communication and quality engagement with their CAM provider. Communication skills are often seen as the cornerstone of good health care practice, patient recovery and practitioner job satisfaction. Implementing a focused communication skills component in health professional educational programs, including those for TCM, is therefore essential. Further research is needed to explore the retention of these skills throughout health professionals’ degree programs and after graduation and clinical experience, to evaluate the effectiveness and sustainability of personal communication skills education. Practice implications : Communication skills training should be incorporated into health care profession curricula, early in the program and integrated with clinical exposure.

© 2016 Informa UK Limited, trading as Taylor & Francis Group. Purposes: This study evaluated the experiences of undergraduate student nurses with highfidelity Human Patient Simulation Mannequins (HPSMs) and their perceptions of empathy. Methods: An exploratory case-study method was used to investigate the literature on empathy and the use of high-fidelity mannequins in nurse education. Two focus groups were conducted with eight third-year undergraduate nursing students in order to elicit responses to their experiences with HPSMs in their learning, especially in relation to empathy. Findings: Undergraduate nurses found it challenging when using HPSMs in the learning environment to relate to the mannequins as real. Students reported that in their experience, the use of mannequins was not conducive currently to the development of skills necessary for positive interpersonal development of the nurse–patient relationship. Conclusions: Focus group data and the empirical literature suggest that more research needs to be conducted into the use of mannequins in the development of nurse–patient interpersonal skills. Educators need to make evidence-based and pedagogically sound decisions about the use and limitations of HPSMs in undergraduate nursing.

Unless you are a visiting your local general practice clinic where you may be recognised by friends and neighbours, it is unlikely that you will come away from a modern health service with the feeling of having had a warm and empathic encounter with a nurse or doctor. As a patient in an outpatient clinic, one needs to endure time that undulates between long waiting times, with single, brief and hurried encounters with clinicians. There will be complex machinery, crowds of people – other patients, visitors and hospital staff – generating noise and making demands. This article is protected by copyright. All rights reserved.

Enumeration of viable CD34(+) cells provides critical information for the bone marrow (BM) transplant physician. The single-platform ISHAGE protocol is the most reliable method currently available to quantitate accurately this important subset of cells. Previous studies have shown that 5 CD34(+) cells/microL blood predicts the collection of at least 0.5x10(6) CD34(+) cells/kg patient weight. From the apheresis product, infusion of 2.5x10(6) viable CD34(+) cells (measured pre-cryopreservation)/kg patient weight will reliably permit engraftment of the hematopoietic system (as measured by the time to 20000 platelets/microL) by day 12-14 post-infusion.We compared the CD34(+) cell numbers derived from Flow Count-based Stem-Kit; (Beckman Coulter) and Trucount tube-based stem cell enumeration (SCE) kit (BD Biosciences) ISHAGE templates on BD FACSCalibur and BD FACSCanto cytometers on 12 granulocyte-colony-stimulating factor (G-CSF)-mobilized peripheral blood (MPB) and 10 peripheral blood stem cell (PBSC) samples.Comparison of results showed that there was no statistical difference between samples run with Stem-Kit on the FACSCalibur versus SCE kit-based assays on either the FACSCalibur or FACSCanto. Mean results for the Stem-Kit/Calibur combination were 137, for SCE kit/Calibur 140 and for SCE kit/Canto 137 cells/microL. Pair-wise comparison of data based on rank order showed no statistically significant difference and all correlation coefficients had an R(2)0.98.The two kits generated very similar data on a range of fresh samples regardless of instrument platform. These results confirm and extend the utility of the single-platform ISHAGE protocols with a variety of reagent kits and instrument platforms.

Dealing with the problems of daily living is an important objective for all of us and most discussions by academics or health professionals centre on the use of effective interventions. In this paper we draw on both the psychoanalytic and socio-cultural literature to examine claims of an increased cultural and pathological narcissism attributable directly to underlying changes in the psychological constituents of Western populations. In our discussion we examine some of the intended and unintended consequences of cultural and pathological narcissism and the underlying pattern of social and cultural change.

Sue Dean, manager of Steps Professional Development, shows how to use teaching and learning approaches from the First Steps reading and oral language resources for a week’s literacy based on traditional nursery rhymes.

of work on reading for learning skills. The unit was team taught by a head of English and an LEA English consultant. Details of the unit of work as it developed, examples of the students’ work, the issues that arose and how the English Department has developed an overview to tackle this cross-curricular aspect of the Key Stage 3 reading curriculum are included. The potential impact across the range of subject areas is also considered.

Nurses have a crucial role in play in supporting parents and in delivering and referring parents to family-support services. In this editorial, we reflect on papers recently published in Contemporary Nurse. We sought to consider data-based papers on parenting published between 2008 and 2012 and elucidate the role/s and potential roles of nurses in enhancing and supporting parenting. Parenting is recognised as a crucial variable for achieving positive outcomes for children (Dawson et al 2012). Poor, inconsistent or abusive parenting is linked to poor outcomes (Griffin et al. 2000, Holt et al.2008, Patterson et al.1989), while consistent and effective parenting is associated with enhanced child outcomes (Lamb 2012, Landry et al.2001). In addition to being important to outcomes for children, perceived parenting quality is also important to parents themselves. Disrupted relationships between parents and their children have been identified as distressing and potentially damaging to both parties (Jackson 2000; East 2006, 2007; Power 2012).