No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Expanding clinical research capacity through a community of practice (CoPER)
Abstract
The proposed CoPER project (Community of Practice for Engaging in Research) responds to a need for increased research capacity in a clinical setting. We put forward an argument and a design for a prospective action research project to extend research capacity via an integrated academic and practitioner community of practice in an Emergency Department (ED).
This paper explores the research needs of clinicians, articulates the concept of community of practice in light of these needs, and outlines the rationale for considering communities of practice as a potential contributor to building research capacity in a clinical setting.
A potential methodology is suggested to test the linkage between research needs, the concept of a community of practice model in a clinical setting, and the contribution of such a model to building research capacity in a clinical setting via the CoPER framework.
Combined data from this proposed mixed method action research (survey, focus groups, interviews, observation) are expected to enable the production of a set of facilitators and enablers with a view to building a community of research practice which make the case study transferable to other clinical and non-clinical work settings.
... [31] It is also a mean to promote clinical nursing research. [32] The communities of practice offer an infrastructure built upon interactions between professionals that may take place virtually. Although, this training strategy differs from the PCGs in one significant respect: the communities of practice are characterized by a shared agenda, [32] interest, motivation and values, [33] whereas in PCGs each participant leads his/her own project. ...
... [32] The communities of practice offer an infrastructure built upon interactions between professionals that may take place virtually. Although, this training strategy differs from the PCGs in one significant respect: the communities of practice are characterized by a shared agenda, [32] interest, motivation and values, [33] whereas in PCGs each participant leads his/her own project. ...
The active participation of nurses in research activities is desirable in clinical settings. This manuscript highlights the Professional Codevelopment Groups (PCGs) as an opportunity for clinical nurses to be the leading instigators of research projects relevant to their nursing practice, emphasizing another facet of their professional role in clinical settings.
... Creating spaces to promote collaborative, sense-making and improvised conversation between different stakeholders in which learning can take place is essential to reducing this gap [9]. A vast array of collaborative research approaches have been proposed to increase the implementation of research findings into practice [2,[10][11][12]. The premise is that by bringing together individuals from research and clinical domains early in the process, these groups will better understand each other, thus making research findings more useable for the clinicians [10,13]. ...
... A vast array of collaborative research approaches have been proposed to increase the implementation of research findings into practice [2,[10][11][12]. The premise is that by bringing together individuals from research and clinical domains early in the process, these groups will better understand each other, thus making research findings more useable for the clinicians [10,13]. Kothari et al., [14] have thus argued that there is a need for a much wider range of stakeholders in public health-based KTA processes. ...
Communities of practice (CoP) can facilitate collaboration between people who share a common interest, but do not usually work together. A CoP was initiated and OPEN ACCESS Int. J. Environ. Res. Public Health 2015, 12 4440 developed including stakeholders from clinical, research, community and governmental backgrounds involved in a large multidisciplinary and multi-sectorial project: the Rehabilitation Living Lab in a Mall (RehabMaLL). This study aimed to evaluate the structure, process and outcomes of this CoP. A single case-study, using mixed-methods, evaluated the RehabMaLL CoP initiative after one year, based on Donabedian's conceptual evaluation model. Forty-three participants took part in the RehabMaLL CoP with 60.5% (n = 26) participating at least once on the online platform where 234 comments were posted. Four in-person meetings were held. Members expressed satisfaction regarding the opportunity to share knowledge with people from diverse backgrounds and the usefulness of the CoP for the RehabMaLL project. Collaboration led to concrete outcomes, such as a sensitization activity and a research project. Common challenges included lack of time and difficulty finding common objectives. A CoP can be a useful strategy to facilitate knowledge sharing on disability issues. Future research is necessary to determine strategies of increasing knowledge creation between members.
... To stimulate research interest among nurses, and to overcome barriers to building research capacity in nursing, there is a need for a systematic, co-ordinated approach to building substantive, sustainable research programmes in nursing (Bishop & Freshwater 2003, Thompson 2009). Targeted interventions like training programmes (Purkis et al. 2008, Short et al. 2010) and a financial commitment to invest in research training and funding research projects are regarded as important (Ross et al. 2004). When it comes to helping practice, nurses become active in research, the level of education appears to be equally important. ...
... This allows them to take pride in the developing uniqueness of their contribution to the R&D culture and working life. This kind of empowerment can be expected to enhance staff recruitment and retention (Short et al. 2010). A common course of action for clinical nurses wishing to pursue research is to leave clinical work and enter academia either as a student or as an academic (Watson 2005 ). ...
To describe clinical nurses' experience of participating in a Research and Development (R&D) programme and its influence on their research interest and ability to conduct and apply nursing research.
To stimulate nurses' research interest and to overcome barriers for building research capacity in nursing, there is a need for sustainable research programmes. A two-year programme was designed for nurses, to take part in both an academic education for master and research seminars and workshops to conduct a research project from idea to publication.
A qualitative approach using using focus group interviews.
Registered nurses (n = 12) with a bachelor's degree in nursing, participated. Data were collected in focus group interviews, after one year and when the programme ended. Content analysis was used to analyse the data.
The findings consist of two themes: being a traveller in the world of nursing research, which included three categories, and experiencing professional growth as a result of nursing research training, in both cases focusing on the experience of students involved in a cohesive programme which included four categories: discovering new dimensions of clinical nursing practice; selected and confirmed; supported by professional others; development of professional self-concept.
To support early career researchers, there is a need for strong leadership, an organisational and supportive infrastructure underpinning research capability building in nurses. In this context, research strategies, programmes and collaboration between leaders of academia and clinical institutions appear to be essential.
The R&D programme illustrates an effective way of stimulating nurses' lifelong learning by building the capacity to conduct and apply nursing research in clinical practice. The structure of the programme can be used as a model in other contexts.
... However, fewer have addressed innovative strategies to overcome them. Several authors proposed targeted interventions for overcoming the barriers to implementing evidence-based practice (Melnyk & Fineout-Overholt 2002, Schmidt & Brown 2007), or for research capacity building (Owen & Cooke 2004, Purkis et al. 2008, Short et al. 2010). For instance, strengthening beliefs among nurses about the benefits of research; training programmes, creating research teams or increasing available library resources (Purkis et al. 2008). ...
... These might be some of the reasons why they did not achieve the expected outcomes (Thompson 2003, Gerrish & Clayton 2004). Health professionals work in complex organisations, and more effort to understand how the organisational culture might affect research development is needed (Findlay & Golden-Biddle 2005, Scott & Pollock 2008, Short et al. 2010). In other words, the research capacity of the context should be considered. ...
To evaluate a contextually framed intervention to increase nursing research capacity among clinical nurses in a Spanish hospital.
In Spain, there has been a paucity of nursing research and a lack of nursing research culture. Currently, with the European Convergence of educational programmes and qualifications, there is a growing interest in promoting nursing research in this country.
A quasi-experimental design.
Using a control (n = 81) and an intervention group (n = 89) of nurses, pre- and postintervention data were collected from both groups to evaluate the impact of the intervention at three times. The intervention, implemented over one year, consisted of the establishment of a mentors' network and an educational programme with research courses and journal clubs. Data collection methods included questionnaires, objective tests and scales.
The nursing research capacity of the hospital developed moderately after the intervention, with an increase in participants' research capability (knowledge, skills and attitudes) and a decrease in some of the inhibiting factors identified in the context.
A new comprehensive and contextually framed intervention to develop nursing research capacity has been designed, implemented and evaluated in a hospital. It contributed to the development of the nursing research culture in the context. Relevance to clinical practice. An increase in nursing research activity could improve the quality of nursing care through the incorporation of research evidence in practice. This intervention could be used as a model in other hospitals, and it should be evaluated in other contexts.
... Several authors proposed targeted interventions for overcoming the barriers to implementing research capacity building [12] [13]. The main barriers include lack of time, nurses' authority, support and research knowledge [14] [15]. ...
Background
Little is known about PhD-prepared nurses employed at Nordic university hospitals, how they are organised, what their practices look like or what career pathway they have chosen.
Aims
The purpose was to investigate and compare the prevalence of PhD-prepared nurses employed at university hospitals in the Nordic countries, to investigate what functions they fulfil and what research activities they undertake and to document how they describe their ideal work life.
Methods
A descriptive cross-sectional study. An electronic questionnaire was sent to 245 PhD-prepared nurses working at a university hospital in one of six Nordic countries and 166 responses were achieved (response rate 67%). Descriptive analyses were performed using SPSS Statistics.
Results
The study found notable differences among PhD-prepared nurses employed at university hospitals with respect to work function; organisational structure; satisfaction about time split between research and practice; and the mean scores of time spend on research, clinical practice and teaching, supervision and administration.
Conclusions
In order to succeed with capacity building among the nursing workforce, collaboration and networking with other researchers and close contact to clinical practice is important. The role of the hospital-based, PhD-prepared nurse needs to be better described and defined to ensure that evidence-based care is provided.
... Researchers in Australia, Norway, and the United States pointed out that research training and education was significant to enhance clinical nurses' research capacity (Akerjordet et al., 2012;Scala et al., 2016;Short, Jackson, & Nugus, 2010). An Ireland-based study has reported that demand-based training courses can improve the nursing research ability of clinical nurses (McKee et al., 2017). ...
Background:
Several studies examined the research capacity of nurses in the United States and other countries. However, the research capacity of clinical nurses in China has not been systematically surveyed. Thus, there is a need to investigate and report the research capacity and training needs of nurses in China.
Method:
A cross-sectional survey was conducted using a structured questionnaire.
Results:
In 17 hospitals, 2,324 clinical nurses were surveyed. The results indicated that most of the nurses self-assessed that their research capacity was relatively low, as the average score was 65.47 ± 21.31 (total score = 30 to 150). Most of the nurses (n = 1,890, 83.1%) expressed the need for training in research. Linear regression analysis showed participation in nursing research practices and pursuing a higher degree could improve nurses' research capacity.
Conclusion:
Nurses' research capacity needs further improvement. More training courses on nursing research tailored to the requirements of nurses are needed. [J Contin Educ Nurs. 2019;50(9):423-432.].
... The variation in application of CoPs has resulted in a body of theoretical work that largely has its origins in mono- professional contexts (Lave & Wenger, 1991;Orr, 1990), for example the development of a tailor's identity or the problem-solving practices of photocopier technicians, and offers varying degrees of analysis on the varying conceptual cornerstones of CoPs. This can also be seen in nursing practice concerned with professional identity and expanding professional capacity (Andrew, Ferguson, Wilkie, Corcoran & Simpson, 2009;Garrow & Tawse, 2009;Short, Jackson, & Nugus, 2010), teaching and pedagogy (Evans & Powell, 2007;Kimble, Hildreth & Bourdon, 2008), organisational learning and knowledge management (Bresnen, Edelman, Newell, Scarbrough & Swan, 2003;Coakes & Clarke, 2006;Gilley & Kerno, 2010) and more latterly interpreted into new domains such as virtual spaces (see for example, Dube΄, Bourhis & Jacob, 2006;Johnson, 2001). What this literature does not address is how working across multiple and often disparate contexts leaves a unique set of problems in relation to knowledge management and the development of democratic learning spaces. ...
... Various research capacity building frameworks (RCBF) utilised to enable and support a culture of critical enquiry whilst simultaneously developing individual, team and/or organisational research capacity and capability have been reported in the literature. Descriptive accounts of these approaches range from; providing clinicians with targeted and structured research training and skills development opportunities and initiatives [14,15], coordinating research activity around the deployment of key individuals, teams and units that are responsible for mentoring and leading clinicians through small local, practice-based research projects [9,[16][17][18], and whole of service/organisation models that aim to increase research activity and capacity across communities or groups of health care clinicians with a shared goal for driving a collective research agenda, usually within specialist multidisciplinary clinical contexts [12,[19][20][21]. ...
Background
Improving health, patient and system outcomes through a practice-based research agenda requires infrastructural supports, leadership and capacity building approaches, at both the individual and organisational levels. Embedding research as normal nursing and midwifery practice requires a flexible approach that is responsive to the diverse clinical contexts within which care is delivered and the variable research skills and interest of clinicians. This paper reports the study protocol for research being undertaken in a Local Health District (LHD) in New South Wales (NSW) Australia. The study aims to evaluate existing nursing and midwifery research activity, culture, capacity and capability across the LHD. This information, in addition to input from key stakeholders will be used to develop a responsive, productive and sustainable research capacity building framework aimed at enculturating practice-based research activities within and across diverse clinical settings of the LHD.
Methods
A three-phased, sequential mixed-methods action research design underpinned by Normalization Process Theory (NPT).
Participants will be nursing and midwifery clinicians and managers across rural and metropolitan services. A combination of survey, focus group, individual interviews and peer supported action-learning groups will be used to gather data. Quantitative data will be analysed using descriptive statistics, correlation and regression, together with thematic analysis of qualitative data to produce an integrated report.
Discussion
Understanding the current research activity and capacity of nurses and midwives, together with organisational supports and culture is essential to developing a productive and sustainable research environment. However, knowledge alone will not bring about change. This study will move beyond description of barriers to research participation for nurses and midwives and the promulgation of various capacity building frameworks to employ a theory driven action-oriented approach to normalisation of nursing and midwifery research practice. In doing so, our aim is to make possible the utilisation, generation and translation of practice based research that informs improved patient and service delivery outcomes.
Electronic supplementary material
The online version of this article (10.1186/s12912-017-0249-8) contains supplementary material, which is available to authorized users.
... Communities of practice have been defined as 'groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly' . Such communities have been established in different disciplines, clinical conditions and skill areas (Short et al., 2010;Lin and Ringdal, 2013;Evans et al., 2014;Little et al., 2014;Lynch and Frost, 2015). This community's focus was 'research'. ...
Background: The Community of Practice Research was established as a new local health district service initiative. The community comprises novice and experienced multidisciplinary health researchers.
Aims: This paper reflects our experience of being Community of Practice Research members and aims to explore the practice development principles aligned to the purpose, progress and outcomes of this community.
Conclusions: The journey is compared to walking a tightrope from the beginning to the end. Success in moving forward is attributed to positive leadership and group dynamics enabling a supportive environment. This environment allowed for different types of learning: new research skills and new understandings about oneself. Competing demands such as fluctuating membership and leadership, and the selection of a large initial project were identified as barriers to the Community of Practice Research.
Implications for practice:
As well as contributing to communities’ shared goals members should identify and make explicit their own learning goals to themselves, the community and their managers
Community of practice meetings should include regular facilitated reflection about the learning that is occurring, the challenges and assumptions being made by the group, and the way forward
A community of practice uses social processes to aid learning and collaboration across disciplines and organisations and therefore has potential to promote local culture change
... The variation in application of CoPs has resulted in a body of theoretical work that largely has its origins in mono-professional contexts (Lave & Wenger, 1991;Orr, 1990), for example the development of a tailor's identity or the problem-solving practices of photocopier technicians, and offers varying degrees of analysis on the varying conceptual cornerstones of CoPs. This can also be seen in nursing practice concerned with professional identity and expanding professional capacity (Andrew, Ferguson, Wilkie, Corcoran, & Simpson, 2009;Garrow & Tawse, 2009;Short, Jackson, & Nugus, 2010), teaching and pedagogy (Evans & Powell, 2007;Kimble, Hildreth, & Bourdon, 2008), organisational learning and knowledge management (Bresnen, Edelman, Newell, Scarbrough, & Swan, 2003;Coakes & Clarke, 2006;Gilley & Kerno, 2010) and more latterly interpreted into new domains such as virtual spaces (see for example, Dube´, Bourhis, & Jacob, 2006;Johnson, 2001). What this literature does not address is how working across multiple and often disparate contexts leaves a unique set of problems in relation to knowledge management and the development of democratic learning spaces. ...
Over the past decade different approaches to mobilising knowledge in Community-University Partnership (CUP) contexts have emerged in the UK. Despite this, detailed accounts of the intricate texture of these approaches, enabling others to replicate or learn from them, are lacking. This paper adds to the literature which begins to address this gap. The case considered here concentrates on one particular approach to knowledge mobilisation (KM) developed in the UK context. It provides an account of the authors' involvement in applying the concept, and practical lessons from a community of practice (CoP) approach, to developing knowledge exchange (KE) between academics, parents and practitioners. The authors' approach to KM explicitly attempts to combat power differentials between academics and community partners, and problematises knowledge power hierarchies. The paper explores the CoP concept and critically investigates key elements of relevance to developing KE in the CUP context. Specific themes addressed are those of power, participation and working across boundaries by CoP members with very different subject positions and knowledge capitals. The paper concludes that CoPs can be a useful mechanism for KM, but have many limitations depending on the specific context in which KM is being undertaken.
... Several authors proposed targeted interventions for overcoming the barriers to implementing research capacity building [12] [13]. The main barriers include lack of time, nurses' authority, support and research knowledge [14] [15]. ...
The aim of this study was to identify and evaluate evidence of clinical nurses’ research capacity building in practice. A systematic review of studies of nurses’ research capacity building in practice was performed. The quality of the articles was evaluated and reflected on in accordance with the Quality Assessment and Validity Tool for Correlation Studies. The literature searches identified a total of 4748 abstracts and titles. Eight quantitative studies were included in the evaluation. Three themes emerged from the analysis: Failure to ensure research quality and standards, Developing a research culture and Collaboration and organization of research utilization. The first theme has one sub-theme: Lack of knowledge about how to increase research utilization. The second theme is based on three sub-themes: Ability to identify clinical problems, changing nurses’ attitudes to research and research supervision. Finally, the third theme has one sub-theme: Funding as a success factor. In conclusion, research capacity building requires the development of research competence to generate knowledge that enhances quality and patient safety. Nurse leaders are essential for establishing evidence-based practice and a research culture, thus enhancing nurses’ scientific attitudes and capacity.
... CoPs in the CUP context are subject to the challenge of working across and between organisations and sectors. This contrasts with much of the literature which documents learning and effectiveness within shared, rather than different organisations (Garrow and Tawse 2009);(Hodgkinson-Williams, Slay et al. 2008); (Kimble, Hildreth et al. 2008); (Short, Jackson et al. 2010); (Wesley and Buysse 2001). ...
... The variation in application of CoPs has resulted in a body of theoretical work that largely has its origins in mono-professional contexts (Lave & Wenger, 1991;Orr, 1990), for example the development of a tailor's identity or the problem-solving practices of photocopier technicians, and offers varying degrees of analysis on the varying conceptual cornerstones of CoPs. This can also be seen in nursing practice concerned with professional identity and expanding professional capacity (Andrew, Ferguson, Wilkie, Corcoran, & Simpson, 2009;Garrow & Tawse, 2009;Short, Jackson, & Nugus, 2010), teaching and pedagogy (Evans & Powell, 2007;Kimble, Hildreth, & Bourdon, 2008), organisational learning and knowledge management (Bresnen, Edelman, Newell, Scarbrough, & Swan, 2003;Coakes & Clarke, 2006;Gilley & Kerno, 2010) and more latterly interpreted into new domains such as virtual spaces (see for example, Dube´, Bourhis, & Jacob, 2006;Johnson, 2001). What this literature does not address is how working across multiple and often disparate contexts leaves a unique set of problems in relation to knowledge management and the development of democratic learning spaces. ...
Over the past decade different approaches to mobilising knowledge in Community-University Partnership (CUP) contexts have emerged in the UK. Despite this, detailed accounts of the intricate texture of these approaches, enabling others to replicate or learn from them, are lacking. This paper adds to the literature which begins to address this gap. The case considered here concentrates on one particular approach to knowledge mobilisation (KM) developed in the UK context. It provides an account of the authors’ involvement in applying the concept, and practical lessons from a community of practice (CoP) approach, to developing knowledge exchange (KE) between academics, parents and practitioners. The authors’ approach to KM explicitly attempts to combat power differentials between academics and community partners, and problematises knowledge power hierarchies. The paper explores the CoP concept and critically investigates key elements of relevance to developing KE in the CUP context. Specific themes addressed are those of power, participation and working across boundaries by CoP members with very different subject positions and knowledge capitals. The paper concludes that CoPs can be a useful mechanism for KM, but have many limitations depending on the specific context in which KM is being undertaken.
This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings,
Background
Having a research-engaged health and medical workforce is associated with improvements in clinical outcomes for patients. As such, there has been significant government investment internationally to support health care organisations and services to increase staff engagement with research.
Objectives
This scoping review sought to provide an overview of the literature describing strategies employed to increase research engagement by health care providers and organisations, and to undertake a qualitative analysis to generate a list of research engagement strategies.
Methods
A scoping review using systematic search strategies was undertaken to locate peer-review publications and grey literature related to research engagement by health care providers and organisations. Research engagement was defined as a ‘deliberate set of intellectual and practical activities undertaken by health care staff and organisations to conduct research’. A database search of electronic records was performed with no limit on publication date. Publications were included regardless of study type (excluding systematic reviews) and categorised as either databased (presenting data or new analysis of existing data) and non-databased (no new data or analyses). Databased publications were further classified according to study type, study design and setting. A qualitative synthesis using a Framework Approach was undertaken with all studies that described a strategy to improve research engagement.
Results
A total of 152 publications were included in this study with 54% categorised as non-databased. Of the databased articles, the majority (72%) were descriptive studies describing prevalence of correlates of research engagement, 17 (25%) described intervention studies where only two were controlled studies. The following research engagement strategies were identified: i) dual skilled team/staff, ii) resources or physical infrastructure, iii) incentives, iv) leadership support of research, v) education/training, vi) networks, vii) forming partnerships or collaborations and viii) overall leadership structure of entity.
Conclusions
The literature on research engagement is primarily opinion-based and descriptive in nature. To provide the evidence needed to inform strategies, this needs to progress beyond descriptive to more rigorous well-designed intervention research.
Introduction: There is evidence to suggest that the use of visual schedules within music therapy practice is beneficial; however, there is a paucity of supporting literature for using these tools in programs for families with complex needs. This study investigates the application of the existing Music Therapy Visual Schedule Approach (MT-ViSA) to this focus population group.
Method: Participants considered to be families with complex needs were recruited using a purposive sampling strategy to attend a 6-week music therapy program. Data collection was informed by a hybrid mixed methods design with observation, survey and interview methods being used. A bricolage research approach forms the theoretical framework for the analysis, demonstrating the joint juxtapositioning of qualitative and quantitative data.
Results: Eight parent–child dyads participated in the study with a 100% attendance rate achieved. The use of the MT-ViSA assisted participants with the routine and structure of the sessions, supporting attendance and engagement. When investigating how the visual flip-book schedule primed the children for music-making, four themes emerged: understanding, anticipating, self-regulating and exercising agency. A single embedded case example is included to further illustrate these themes.
Discussion: This paper has implications for music therapy practice. The work highlights the beneficial role of the MT-ViSA for families with complex needs and suggests that this approach may potentially benefit different population groups. The theoretical model is presented and discussed, along with project limitations including the small sample size and data collection tools. In conclusion, future research plans and training are shared.
Clinical research is an information and resource intensive endeavor, incorporating a broad variety of stakeholders spanning a spectrum from patients to providers to policymakers. Increasingly, the modern clinical research environment incorporates a number of informatics methods and technologies, informed by sociotechnical and information-theoretic frameworks. In this chapter, we introduce the major facets that serve to define the clinical research setting, including the design of clinical studies, clinical research workflow, and information management needs incumbent to such activities. Throughout this review, we will provide a number of exemplary linkages to core biomedical informatics challenges and opportunities and the foundational theories and frameworks underlying such issues. Finally, this chapter places the preceding review in the context of a number of national-scale initiatives that seek to address such needs and requirements.
Objectives:
To comprehensively review the Community of Practice literature from nursing contexts to explore whether and how these communities contribute to the social construction of nurse educator professional identity.
Design:
Due to the wide scope of predominately qualitative literature on the topic, papers were analysed and themed inductively.
Data sources:
CINAHL, MEDLINE, COCHRANE, EBSCO databases, Emerald, Proquest & Google Scholar.
Review methods:
These online databases were searched for relevant peer-reviewed journal papers in the English language with no date range specified. The search terms 'nurs* educator' and 'nurs* teacher' were combined with each of the terms 'communit* of practice', 'identity' and 'role' resulting in 293 peer-reviewed journal papers. Where abstracts were missing, introductory and background sections were skimmed for related content. Papers that made incidental reference to either professional identity or a Community of Practice were excluded.
Results:
In total, 63 primary study or discussion papers were found to have a focus on nurse educator identity and/or communities of practice in healthcare contexts. Papers specifically focused on communities of practice in nursing (n=33) could only be found from the last 10years (2005-2015). Only five of these focused on nurse educators.
Conclusions:
Community of Practice theory and the professional teaching literature offers collaborative and active ways for nurse educators to further develop their professional identities. Despite the emergence of communities of practice in the nursing literature, further studies are required to explore how such a construct can facilitate the social construction of nurse educator professional identity.
AimThe aim of this study was to evaluate Wenger's Community of Practice as a framework for building research capacity and productivity. Background
While research productivity is an expected domain in influential models of advanced nursing practice, internationally it remains largely unmet. Establishment of nursing research capacity precedes productivity and consequently, there is a strong imperative to identify successful capacity-building models for nursing-focussed research in busy clinical environments. DesignProspective, longitudinal, qualitative descriptive design was used in this study. Methods
Bruyn's participant observation framed evaluation of a Community of Practice comprising 25 advanced practice nurses. Data from focus groups, education evaluations, blog/email transcripts and field observations, collected between 2007 and 2014, were analysed using a qualitative descriptive method. FindingsThe Community of Practice model invited differing levels of participation, allowed for evolution of the research community and created a rhythm of research-related interactions and enduring research relationships. Participants described the value of research for their patients and families and the significance of the developing research culture in providing richness to their practice and visibility of their work to multidisciplinary colleagues. Extensive examples of research dissemination and enrolment in doctoral programmes further confirmed this value. ConclusionA Community of Practice framework is a powerful model enabling research capacity and productivity evidenced by publication. In developing a solid foundation for a nursing research culture, it should be recognized that research skills, confidence and growth develop over an extended period of time and success depends on skilled coordination and leadership.
Abstract Although the community of practice (CoP) concept has been heavily utilized in business literature since its inception in the 1990s, it has not been significantly featured in nursing research. With student-centered approaches increasingly infusing nursing classrooms, including opportunities for collaborative learning and the development of student learning communities, it may be time to ask: Do we practice what we teach? Nursing academia faces challenges related to recruitment and retention, scholarly productivity and engagement of new faculty, and increasing demands for collaborative research. Challenges, some would argue, that could be addressed through CoPs; a sentiment reflected in the recent expansion of nursing CoP literature. What is the current state of the application of this concept in nursing academia and what barriers present in the promotion and development of CoPs in the academy? This article addresses these questions and provides guidance for those in search of community.
Introduction:
Clinical research in the emergency department provides supporting evidence needed for the development of practice guidelines, such as door-to-needle and door-to-balloon times for treatment of acute coronary syndromes, and is vital to improvements in patient outcomes. The purpose of this article is to describe barriers and lessons learned in launching a multisite clinical research study of symptoms of acute coronary syndromes in the emergency department.
Methods:
Participants included ED and research staff in 4 busy emergency departments in 3 states. At each step of the study launch, the principal investigator at the clinical site identified barriers that either were anticipated or experienced and discussed them with the site staff and study principal investigator to validate the issue as a barrier. Orientation sessions and ongoing communication between clinicians, research staff, and the research study team provided opportunity for adjustment of study protocols.
Results:
Barriers were lack of staff engagement in research, difficulty identifying eligible patients, perception of interference in clinical care, variability in research staff education and training, patient refusals, nurses' perceptions of lack of time, undifferentiated patients, and time-sensitive quality improvement indicators necessitating acceleration in care.
Discussion:
Important strategies to overcome barriers were developed, including identification and support of unit champions in emergency nursing and medicine; minor protocol modifications to improve enrollment goals; development of specific written expectations, roles, research protocols, and algorithms; and sharing successes among sites.
To examine clinical nurses' research capacity and investigate related factors (i.e. the different phases of the research process).
Research capacity includes research-related activities, being informed and applying research.
A descriptive-correlational design was used and data were collected by means of a structured questionnaire (59-items). A total of 364 registered nurses from a University Hospital participated. The response rate was 61%. A majority reported that their research capacity was acceptable or weak (77.7%), while 7.6% who were involved in research rated it good or excellent; 19.6% evaluated their level of research competence as fairly good and 4.1% wanted to increase their research involvement.
The result demonstrated high statistical correlation, indicating that nurses are aware of the areas involved in research-related activities. Areas of perceived low competence were associated with reliability, sensitivity and specificity, control of confounding variables, sources of funding and computerised statistical packages. Areas of capacity reported were access to literature, data collection, such as interviews and field notes, as well as research ethics.
Enhanced research supervision is central for improving registered nurses' research capacity.
The findings from this survey should be useful for professional development.
Background: Many interdisciplinary collaborative research programs in the health sector are adopting the community of practice concept within virtual environ-ments. This study explores the factors that affect the members of a geographically dispersed group of health professionals in their attempt to create an interprofes-sional Virtual Community of Practice (VCoP) from which to promote clinical education research. Method & Findings: A survey was used to determine participants' degree of com-puter competency. System logs recorded members' access details and site activity. Member perceptions and beliefs were established using focus groups. While mem-bers stated they were enthusiastic about the VCoP, the primary use was viewing. Their online behaviour indicated that on average it took six visits to generate a post. This suggests a stronger focus on viewing (consumption of) information than on contributing (construction of) information.
This study explored the use of action learning with first-year part-time occupational therapy students. The aims were: (1) to identify the issues raised by students relating to their needs on the course and any changes they made; (2) to explore the influence of action learning in facilitating change. It was also hoped that through action learning students could rehearse appropriate professional skills. Fifteen students in two action learning sets with a known tutor as facilitator met for 10 weekly one-hour sets. Action research was used with methods including a pre-questionnaire to capture initial thoughts of students; participant observation yielding field-notes; reflective diaries; students' written feedback and a final group interview. Inductive analysis was used to identify emerging themes. A range of personal, professional and academic issues were identified and some students reported changes across these domains. The use of new ways of learning and the use of peer support offered by action learning seemed to facilitate these changes in students. Changes in key professional skills such as communication and group skills were also noted. Challenges which acted against change were lack of need for peer support and lack of a deep understanding of group work processes. The need for integration of action learning into the wider curriculum was indicated.
John Seely Brown notes that context must be added to data and information to produce meaning. To move forward, Brown suggests, we must not merely look ahead but we must also learn to look around because learning occurs when members of a community of practice (CoP) socially construct and share their understanding of some text, issue or event. We draw explicitly here on the structural components of a Habermasian lifeworld in order to identify some dynamic processes through which a specific intellectual capital creating context, community of practice (CoP), may be theoretically positioned. Rejecting the individualistic Cogito, ergo sum of the Cartesians, we move in line with Brown's We participate, therefore we are to arrive within a Habermasian community of practice: We communicate, ergo, we create.
What makes organizations so similar? We contend that the engine of rationalization
and bureaucratization has moved from the competitive marketplace to the state and
the professions. Once a set of organizations emerges as a field, a paradox arises:
rational actors make their organizations increasingly similar as they try to
change them. We describe three isomorphic processes--coercive, mimetic, and
normative-leading to this outcome. We then specib hypotheses about the impact of
resource centralization and dependency, goal ambiguity and technical uncertainty,
and professionalization and structuration on isomorphic change. Finally, we suggest
implications for theories of organizations and social change.
The interdisciplinary context of the emergency department encompasses diverse clinical presentations requiring teamwork by doctors, nurses and allied health workers to achieve optimal patient care. This interdisciplinary focus is extended by adding a research perspective. This project sought to systematically examine the current research capacity of emergency department staff at a major Australian tertiary urban hospital and to derive information about further research-related needs with a view to enhancing research capacity. The mixed method project utilized a department-wide staff survey followed by focus groups and individual interviews. Adequate response rates to the two phases were achieved (n = 67, n = 17 respectively). Not surprisingly, 89% of participants reported that they needed help with developing their research skills. Clinicians reported little or no experience with (i) finding literature (35%) and critical review (50%), (ii) research skills and techniques, both qualitative (72%) and quantitative (63%), and (iii) research output: publishing (68%), writing & presenting (34%). Data from focus groups and individual interviews yielded themes around developing research skills, communication, meaningfulness, team work and interdisciplinary strategies, forming part of the Dimensional Enhancing Research Capacity (DERC) model. This project highlighted not only interdisciplinary needs for research but also the way that research may additionally assist with building interprofessional linkage.
The importance of evidence based medicine in improving clinical care has been emphasised significantly in recent years.1 Opportunities to conduct research within emergency care, however, have been restricted by time and financial constraints as well as a lack of a research tradition.2 Research networks in primary care have enabled healthcare professionals to conduct research despite similar difficulties.3 Recognising this as a possible approach to developing and providing support for research in emergency care, funding was sought to develop a local emergency care network. With funding from the Southampton University Hospitals’ Trust Strategic Research Fund, the Wessex Emergency Care Research and Development Network (WECReN) was launched in October 2001. This paper reports on the activities and experiences of the network in its first year. Reflections and recommendations on the role of networks in the support of research in emergency medicine are provided.
We propose the time is right for the Scholarship of Engagement to serve as a model of scholarship in schools of nursing given the shift towards community-based research and the emphasis of community-based research in the recently published National Institutes of Health (NIH) roadmap initiative. Thus, this article addresses the need of nursing academe to embrace a broader paradigm of scholarship, the Scholarship of Engagement, in order to expand knowledge development via implementation of the NIH roadmap. The need for implementation of a broader paradigm of nursing science within the context of nursing academics' roles is discussed.
Despite the size and importance of primary health care (including general practice) within the health system, traditional research output has been relatively low, both here and overseas. General-practice and primary-care research in Australia has been criticised for the preponderance of small-scale, descriptive and survey-based studies. If we are to conduct larger-scale clinical, epidemiological and health-services research, new structures and processes are needed. The research networks set up under the first phase of the Australian Government's Primary Health Care Research, Evaluation and Development (PHCRED) Strategy have tended to focus on up-skilling, research literacy and dissemination. This is important, but for general-practice research to evolve, a new type of practice-based research network is needed. These new practice-based networks require commitment and funding from policymakers, a base in academic departments, plus active involvement from Divisions of General Practice and the practitioners themselves.
The Research Governance Framework (DoH, 2001) requires health and social care organisations to promote a research culture in their organisation and ensure that staff are supported in, and held accountable for, the professional conduct of research. In Wales, recent policy documents also necessitate the building of research capacity in health and social care in order to develop a high-quality workforce (WAG, 2002: 31) and deal with recruitment and retention problems by supporting initiatives and developments (NAfW, 2001). A literature search revealed that, although such strategies exist, none were reported to use an action research framework.
This paper, therefore, reports on the progress of an action research project to develop, implement and evaluate a Joint Research and Development Strategy between North East Wales NHS Trust and North East Wales Institute of Higher Education. The strategy reported on in this paper used action research as a means of empowering stakeholders to become involved in research, whilst ensuring that the strategy continues to be implemented and evaluated. The paper reports on progress made in the first cycle of this action research process and outlines plans for future cycles.
Occupational therapy practitioners need to incorporate evidence-based practice into their professional role to remain competent, relevant and clinically effective. However, therapists may feel uncomfortable with the emphasis on evidence, may not know how to use it in practice and may not know where to start to develop the necessary skills. This paper explores these issues and proposes six strategies for continuing professional development which individual therapists can consider using or promoting to become evidence-based practitioners. These strategies are: (i) changing individual practitioner behaviours; (ii) changing consumer behaviours and expectations; (iii) using evidence about how best to get evidence into practice; (iv) developing institutional requirements for evidence-based practice; (v) supporting professional association initiatives; and (vi) using or developing local clinical guidelines. Each of these strategies is described in detail.
The essay examines what organizations are as they happen. It first argues that the happening of an organization has two basic components: the performance of its constituent actions and practices and the occurrence of events whereby its material arrangements causally support these activities. Equating the idea of something as it happens with that of something in real time, the essay then examines two kinds of real time in which organizations occur. The first is the unfoldings of the performances and events that are the happening of the organization. The second is the co-occurrences of the teleological past, present, and future in organizational actions. As it happens, however, an organization is more than what there is to it in real time. It also embraces the persisting structures of its practices and its enduring material arrangements, both of which, among other things, institute possible real times for the organization. The essay argues that the perpetuation of practice structure should be understood as organizational memory.
This article begins by reassessing the nature and value of practice-based learning in the health professions. The role and status of work-based learning are then examined in the context of recent policy developments in the field of health care. The authors report the findings from a 1-year qualitative study of clinicians' perceptions of the workplace as an environment for learning, funded by the Scottish Council for Postgraduate Medical and Dental Education (SCPMDE). Focusing in particular upon in-depth interviews with junior and senior clinicians in two hospital specialties, they explore the process through which novice clinicians become part of a ‘community of practice˚s, and their senior colleagues continue to learn in an environment which poses fewer professional challenges. Finally, the implications for the development of competent professionals are discussed.
Observers of management education see a paradox, an expanding activity bombarded with profound complaints from all of the constituencies involved. But this only seems paradoxical to those with a unidimensional notion of managerial knowledge. Following the lead of philosophers such as William James and Polanyi, and experimental psychologists, we argue that managerial knowledge is of several distinct types. We set these out in a 2 X 2 matrix built from the individual-social and the explicit-taken-for-granted dichotomies. Each type of knowledge implies a different kind of managerial activity. The matrix also reveals characteristically different relationships between knowledge and action. Given this variety, we see that the complaints relate to the areas in which management education is weak, while the growth relates to areas in which it is strong. Vygotsky's 'activity theory' adds to our understanding of the dynamics of the managerial learning process and of the interaction between the different types of knowledge. In the final section we explore the implications of this dynamic epistemology for management educators.
This paper reports on a comparative qualitative study across four European countries which explored the formation of work identity amongst nurses and other professionals in the field of health care. Within this sector, it identifies trends towards a more flexible, more highly skilled and more mobile workforce. Conversely, however, it is becoming difficult to recruit and retain staff due to increasing workload, decreasing job satisfaction and comparatively low pay. Occupational identity is theorised as a multi-dimensional phenomenon, with structural, social and individual-psychological components. A number of emerging common themes across the three dimensions and across the four national settings include structural conflicts between cost efficiency and quality of care, and individual conflicts between the core activity of caring for patients and the increasing demands of administration and other peripheral work. The study identifies a number of strategies used by nurses to balance these conflicting demands. Overall, the professional identity of nurses remains strong, but it is important for policy makers to be aware of the potential negative effects, in terms of staff turnover, mobility and job (dis)satisfaction, of the current state of the health care sector.
Youth clinical practice and research have rich traditions and share important goals. Linking the two traditions could capitalize on their complementary strengths. The thoughtful review by Herschell, McNeil, and McNeil (this issue) highlights several efforts at linkage; these could help launch a new generation of collaborative work. In this work, several aims will require attention: (a) building consensus on how to identify empirically supported treatments, (b) matching these treatments with empirically sound assessment and diagnosis in practice, (c) expanding the concept of evidence-based practice to encompass an assessment-intervention dialectic, (d) ongoing testing of the impact of evidence-based care on practice outcomes, and (e) rethinking the model that guides intervention development, by focusing on what is needed for eventual deployment.
Today’s economy runs on knowledge, and most companies work assiduously to capitalize on that fact. They use cross-functional teams, customer- or product-focused business units, and work groups—to name just a few organizational forms—to capture and spread ideas and know-how. In many cases, these ways of organizing are very effective, and no one would argue for their demise. But a new organizational form is emerging that promises to complement existing structures and radically galvanize knowledge sharing, learning, and change. It’s called the community of practice.
What are communities of practice? In brief, they’re groups of people informally bound together by shared expertise and passion for a joint enterprise—engineers engaged in deep-water drilling, for example, consultants who specialize in strategic marketing, or frontline managers in charge of check processing at a large commercial bank. Some communities of practice meet regularly—for lunch on Thursdays, say. Others are connected primarily by e-mail networks. A community of practice may or may not have an explicit agenda on a given week, and even if it does, it may not follow the agenda closely. Inevitably, however, people in communities of practice share their experiences and knowledge in free-flowing, creative ways that foster new approaches to problems.
The aim of nursing research is generally agreed to be the generation of knowledge, and whilst this is a relevant aim in theory-based disciplines such as sociology, the primary concern of nursing is with practice. Using examples drawn mainly from the field of mental health, it will be argued in this paper that the application of generalizable, research-based knowledge to individual, unique, person-centred practice, the so-called 'research-based practice' advocated by the Department of Health, is one of the main causes of the theory-practice gap. It will be further suggested that nursing requires a paradigm of clinical research which focuses on the individual therapeutic encounter in order to complement the existing sociological paradigm of theoretical research which is best suited to the generation of generalizable knowledge and theory. The paper will conclude by suggesting that such a clinically based research paradigm must not only focus on the individual nurse-patient relationship, but that it must be carried out by the nurse herself. Clinical research, if it is to make a difference to practice, must therefore be practitioner-based research.
The 1999 Cambridge Conference was held in Northern Queensland, Australia, on the theme of clinical teaching and learning. It provided an opportunity for groups of academic medical educators to consider some of the challenges posed by recent changes to health care delivery and medical education across a number of countries.
This paper describes the issues raised by the practical challenges posed by the current environment and how they might be addressed in ways that could promote more effective learning in clinical settings.
A SWOT analysis is a tool that can help in forward planning by identifying the strengths, weaknesses, opportunities and threats presented by any situation. Our SWOT analysis was used to generate a list of items, from which we chose those most feasible and most likely to promote positive change.
Twenty different issues were identified, with four of them chosen by consensus for further elaboration. The discussion gave rise to four main recommended strategies: ensuring that clinical teachers thoroughly understand the purpose and process of learning in clinical settings; equipping learners with 'survival skills'; making the best use of learning resources within different clinical environments and making judicious use of information technology to enhance learning efficiency.
The four strategies were selected not only because of their inherent importance, but also because of their feasibility. Modest changes can motivate students to feel part of a clinical team and a 'community of practice' and enhance their capacity for self-regulated practice.
Recent policy reports highlight the need to increase the number of primary care practitioners with academic experience, research skills and higher level qualifications. Various courses, training schemes and awards are available but it is not clear what advice and support might best assist practitioners to access and successfully pursue such opportunities.
To understand and document the professional development support needs of primary care practitioners who wish to develop their own paths forward in research.
A research adviser based in the Unit of General Practice, University of Cambridge invited enquiries on any aspect of research activity from practitioners. Summaries of contacts, enquiries and other relevant issues were prepared on a monthly basis. Through the process of offering help and through reflexive engagement with the summaries we sought to understand and document practitioner support needs.
Many enquiries from practitioners concerned professional development. Practitioners requested help before embarking on a new course of action and during the course of their progress along a chosen track. The advice required went beyond the provision of information about the opportunities which existed and often evolved into a mentoring relationship. The impact of the advice offered can be viewed in terms of contribution to the journey of the individual practitioner and contribution to nationally recognized strategic aims.
The need for professional development advice and educational guidance for those interested in research may be more widespread than appreciated. If this need is to be successfully addressed we should consider the skills and expertise required of advisers and the specific outcomes to be anticipated from their roles.
To critically examine concepts of methodological rigour in action research and consider how these affect its capacity to enable change.
Action research is potentially attractive to managers of nursing because it is a problem-focused approach. As action research is identified as a continuum of definitions and philosophies rather than a single approach, caution is expressed that the search for definition may obscure the underlying process of change. Issues of reliability and validity are explored, suggesting that concern for methodological rigour may limit the potential for change and improvement in practice. Ethical issues in action research are considered identifying areas for tension between researchers, managers and practitioners. Some examples of action research in nursing are discussed.
Action research may be valuable in individual practitioners' development or in fostering collaboration between academe and practice. However the demands for methodological rigour in research limit its effectiveness as a strategy for managing change.
VIEWPOINT Reform of health-care systems in the past decade has been driven by ideas such as public/private partnerships, managed competition, managed care, and integrated care. These abstractions betray the grand nature of ambitions harboured by reformers. Faced with funding pressures on the one hand, and failures of service delivery on the other, policymakers have entertained radical solutions in the hope they will lead to improvements in health-system performance. In practice, reform has generally fallen short of both rhetoric and expectations, leading to reappraisal of the strategies pursued and a search for new policies. The failure of radical solutions stems in part from their limited effect on clinical practice. Improvement of the performance of health care depends first and foremost on making a difference to the experience of patients and service users, which in turn hinges on changing the day-today decisions of doctors, nurses, and other staff. Reforms based on ideas like managed competition and integrated care might have some effect on clinical decisions, but in professional organisations like hospitals and primary-care practices, many effects on decision-making exist. In these organisations, policies initiated by health-care reformers have to compete for attention with established ways of working and other imperatives, which may result in a gap between policy intent on the one hand and delivery on the other. A key feature of professional organisations, as Henry Mintzberg noted over 20 years ago, 1 is that professionals have a large degree of control. As a result, the ability of managers, politicians, and others to influence decisionmaking is more constrained and contingent than in other organisations. Thus, ways have to be found of generating change bottom-up, not just top-down, especially by engaging professionals in the reform process. This includes recognition of the importance of collegial mechanisms in professional organisations and the role that leaders from professional backgrounds themselves can have in bringing about change. Mintzberg’s insights into the nature of professional organisations have been reinforced by studies of the effect of quality-improvement initiatives in healthcare organisations in several countries, and we now draw on findings of these studies to explore the challenges entailed in improvement of performance.
Midwifery practice settings offer ideal opportunities to conduct research on normal childbearing. Increasing the output of midwifery research would benefit midwives, as well as the women they serve. But finding ways to add research activities to a busy clinical schedule is a challenge. Factors thought to promote clinician participation in research are as follows: perceived relevance of the research topic, a relationship with a lead researcher, regular feedback to clinicians, minimal impact of a study on usual clinical care, and some level of compensation for clinicians who participate in research. Barriers include time constraints, lack of research updates and support, and limited research skills of clinicians. Joint projects by academic researchers teamed with active clinician groups are suggested as one way to move a midwifery research agenda forward.
This paper examines the reactions of leaders of established health professions in Ontario, Canada to the efforts of selected complementary and alternative (CAM) occupational groups (chiropractors, naturopaths, acupuncture/traditional Chinese doctors, homeopaths and Reiki practitioners) to professionalize. Stakeholder theory provides the framework for analysis of competing interests among the various groups in the healthcare system. The data are derived from personal interviews with 10 formal leaders from medicine, nursing, physiotherapy, clinical nutrition and public health. We conceived of these leaders as one group of stakeholders, with both common and conflicting interests. The findings demonstrate that these stakeholders are reluctant to endorse the professionalization of CAM. They propose a series of strategies to contain the acceptance of CAM groups, such as insisting on scientific evidence of safety and efficacy, resisting integration of CAM with conventional medicine and opposing government support for research and education. These strategies serve to protect the dominant position of medicine and its allied professions, and to maintain existing jurisdictional boundaries within the healthcare system. The popular support for CAM will require that health professional stakeholders continue to address the challenges this poses, and at the same time protect their position at the apex of the healthcare pyramid.
The history of health service research has been characterized by an overwhelming volume of literature that has little impact on those who actually get on and do the work. The focus has been on an examination of why evidence is not accommodated into practice and how the barriers to implementation can be reduced. The fact that the evidence-based product may not be relevant to those at whom it is directed had not until recently been considered a possibility. Over the past 20 years there has been a consolidation of two cultures in the National Health Service--the academic/researcher and the clinician/practitioner. This paper sets the two cultures within the context of a community of practice framework and argues that the emphasis should move away from managing the interface to a fundamental reappraisal of the health service academic community.
To demonstrate the potential value of screening for Down's Syndrome using highly correlated repeated measures of serum markers taken in the first and second trimesters of pregnancy.
A Monte Carlo simulation study.
Detection rates and false positive rates relating to the maternal age distribution of England and Wales for the period 1996 to 1998 were obtained using marker distributions from the SURUSS study.
Screening using first trimester nuchal translucency and repeated measures of uE3 and PAPP-A in the first and second trimester has an estimated false positive rate of 0.3% for an 85% detection rate. This should be compared with the integrated test with an estimated false positive rate of 1.2% for the same detection rate.
The performance of repeated measures screening tests, and their acceptability to women, should be assessed in further prospective studies.
Since Ernest Boyer's landmark 1990 report, Scholarship Reconsidered: Priorities of the Professoriate, leaders in higher education, including academic medicine, have advocated that faculty members apply their expertise in new and creative ways in partnership with communities. Such community engagement can take many forms, including community-based teaching, research, clinical care, and service. There continues to be a gap, however, between the rhetoric of this idea and the reality of how promotion and tenure actually work in health professions schools. The Commission on Community-Engaged Scholarship in the Health Professions was established in October 2003 with funding from the W.K. Kellogg Foundation to take a leadership role in creating a more supportive culture and reward system for community-engaged faculty in the nation's health professions schools. The authors prepared this article to inform the commission's deliberations and to stimulate discussion among educators in the health professions. The authors define the work that faculty engage in with communities, consider whether all work by faculty in community-based settings is actually scholarship, and propose a framework for documenting and assessing community-engaged scholarship for promotion and tenure decisions. They conclude with recommendations for change in academic health centers and health professions schools.
Evidence-based practice is a common goal in hospitals, but learning about research so that the practice can be done is often challenging for clinicians.
The aims of this study were to (a) develop a process that supports organizational and staff development while conducting research and (b) conduct a research study in the emergency department (ED) to examine patient population, satisfaction, and waiting room issues.
A multidisciplinary team of clinicians and scientists was assembled to learn and do research while evaluating the ED waiting room of a Level I trauma center. A cooperative learning method approach was used to teach research concepts as the study was designed and implemented.
The team demonstrated their knowledge and understanding of research concepts by being involved actively in the creation and implementation of the preintervention study. Using information from photographs, observations, and a questionnaire, the team identified the following key dissatisfaction areas: (a) atmosphere (including comfort with environment, neatness and cleanliness, and noise), (b) telephones, (c) parking and thoroughfare, (d) professional behavior and staff presence (including personal attention), (e) security, and (f) triage and confidentiality.
The model of working in partnership with researchers and using cooperative, collaborative research is an effective way to evaluate and address issues related to quality of care while learning about the research concepts needed to put evidence into practice.
The focus of the discipline of neuropsychology is shifting towards a greater emphasis on understanding the relationship between assessment results and performance of everyday tasks (ecological validity). To date, the literature has highlighted the importance of this concept in the assessment of patients with brain injury or disease (e.g. in rehabilitation and forensic settings). This paper presents the argument that there is another important area in which the ecological validity of neuropsychological assessments should be considered: in clinical outcomes studies using neurologically intact participants. For example, determining the extent to which a medical procedure or intervention affects performance of everyday cognitive tasks can provide useful information that can potentially guide decision-making regarding treatment options. It is argued that tests designed with ecological validity in mind (the verisimilitude approach), as opposed to traditional tests, may be most effective at predicting everyday functioning. Explanations are proposed as to why researchers may be reluctant to use tests with verisimilitude in favor of more traditional measures.
A recent editorial by David Thompson and Roger Watson prompted the question 'Nursing professors: what do they profess?', with the stated intention of stimulating thought about the role of professors and their scholarly endeavours. This paper has been written in response to their challenge, and outlines a scholarly role for the professor of nursing which is very different from Thompson and Watson's 'pipe dream' of the university without students. In particular, I argue for a fully-rounded 'symmetrical professor' whose role is not predominantly to conduct research, but rather to 'profess the profession'.
Learning as social participation: why we must change our assumptions about how we learn and share knowledge
- Wenger
Wenger, E.C., 1999. Learning as social participation: why we must change our assumptions about how we learn and share knowledge. Knowledge Management Review 6, 30–33.
Clinical Wisdom and Interventions in Critical Care: A Thinking-In-Action Approach The scholarship of engagement
- P Benner
- P Hooper-Kyriakides
- D Stannard
Benner, P., Hooper-Kyriakides, P., Stannard, D., 1999. Clinical Wisdom and Interventions in Critical Care: A Thinking-In-Action Approach. Saunders, Philadelphia. Boyer, E.L., 1996. The scholarship of engagement. Journal of Public Service and Outreach 1 (1), 11–20.
Scholarship Reconsidered: Priorities of the Professoriate. The Carnegie Foundation for the Advancement of Teaching The scholarship of engagement in nursing
- E L Boyer
Boyer, E.L., 1997. Scholarship Reconsidered: Priorities of the Professoriate. The Carnegie Foundation for the Advancement of Teaching, Princeton, NJ. Burrage, J., Shattell, M., Habermann, B., 2005. The scholarship of engagement in nursing. Nursing Outlook 53 (5), 220–223.
Understanding Organizational Culture Submission for Accreditation: Australian Medical Council Action research, change and methodological rigour
- M Alvesson
Alvesson, M., 2002. Understanding Organizational Culture. Sage, London. Australasian College for Emergency Medicine (ACEM), 2006. Submission for Accreditation: Australian Medical Council, Retrieved 29/2/2008, <http:// www.acem.org.au/media/publications/ACEM_Submission_to_AMC.pdf>. Badger, T.G., 2000. Action research, change and methodological rigour. Journal of Nursing Management 8 (4), 201–207.
Anyone, Anything, Anytime: A History of Emergency Medicine. Mosby-Elsevier Inc., Philadelphia Supporting research in primary care: are practice-based research networks the missing link?
- B J Zink
- N Zwar
- D Weller
- L Mccloughan
- V Traynor
Zink, B.J., 2006. Anyone, Anything, Anytime: A History of Emergency Medicine. Mosby-Elsevier Inc., Philadelphia. Zwar, N., Weller, D., McCloughan, L., Traynor, V., 2006. Supporting research in primary care: are practice-based research networks the missing link? Medical Journal of Australia 185 (2), 110–113.
Promoting enthusiasm and initiative in clinical inquiry: exploring the research needs of emergency department clinicians
- A E Short
- A Holdgate
- N C Ahern
- J Morris
Short, A.E., Holdgate, A., Ahern, N.C., Morris, J., 2007. Promoting enthusiasm and initiative in clinical inquiry: exploring the research needs of emergency department clinicians. Emergency Medicine Research Unit, University of New South Wales, Sydney. South Western Sydney Health Network (SWSHN), 2004. The way forward 2004– 2008.
The Virtuous Cycle: Working together for Health and Medical Research. Health and Medical Research Strategic Review
- P Wills
Wills, P., 1998. The Virtuous Cycle: Working together for Health and Medical Research. Health and Medical Research Strategic Review. AusInfo, Canberra.
The Organisational World of Emergency Clinicians Unpublished PhD thesis Creating intellectual capital A Habermasian community of practice (CoP) introduction
- P Nugus
- Wales
- Sydney
- O Australia
- D Donnell
- G Porter
- D Mcguire
- T N Garavan
- M Heffernan
- P Cleary
Nugus, P., 2007. The Organisational World of Emergency Clinicians. Unpublished PhD thesis. The University of New South Wales, Sydney, Australia. O'Donnell, D., Porter, G., McGuire, D., Garavan, T.N., Heffernan, M., Cleary, P., 2003. Creating intellectual capital A Habermasian community of practice (CoP) introduction. Journal of European Industrial Training 27, 2–4.
Chronic Disease Management Community of Practice
HARP, 2008. Chronic Disease Management Community of Practice, Retrieved 22/2/
2008, <http://www.health.vic.gov.au/harp-cdm/cop.htm>.
Anyone, Anything, Anytime: A History of Emergency Medicine
- B J Zink
Zink, B.J., 2006. Anyone, Anything, Anytime: A History of Emergency Medicine.
Mosby-Elsevier Inc., Philadelphia.
The Organisational World of Emergency Clinicians. Unpublished PhD thesis
- P Nugus
Nugus, P., 2007. The Organisational World of Emergency Clinicians. Unpublished
PhD thesis. The University of New South Wales, Sydney, Australia.
Clinical Wisdom and Interventions in Critical Care: A Thinking-In-Action Approach
- P Benner
- P Hooper-Kyriakides
- D Stannard
Benner, P., Hooper-Kyriakides, P., Stannard, D., 1999. Clinical Wisdom and
Interventions in Critical Care: A Thinking-In-Action Approach. Saunders,
Philadelphia.
Understanding Organizational Culture Australasian College for Emergency Medicine (ACEM) Submission for Accreditation: Australian Medical Council
- M Alvesson
Alvesson, M., 2002. Understanding Organizational Culture. Sage, London.
Australasian College for Emergency Medicine (ACEM), 2006. Submission for
Accreditation: Australian Medical Council, Retrieved 29/2/2008, <http://
www.acem.org.au/media/publications/ACEM_Submission_to_AMC.pdf>.