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Spence, D., & Anderson, M. (2007). Implementing a prescribing practicum within a Master's degree in advanced nursing practice. Nursing Praxis in New Zealand, 23(2), 27–42.
Abstract: This article reports the implementation of a collaborative project undertaken to monitor and improve the effectiveness of the prescribing practicum papers delivered within two Master's degree programmes in advanced nursing practice. The recent introduction of Nurse Practitioner registration in New Zealand has resulted in the development of a number of Master's degree programmes in which students can complete a Nursing Council of New Zealand approved programme for prescribing. For the study, a developmental action research approach was used. Data were collected through interviews with practicum students, their medical supervisors and academic staff. Formative findings were progressively used to refine delivery of the practicum papers and a thematic analysis of summative findings identified areas for further improvement. The findings suggest that the processes being implemented are developing well. The researchers recommend that further education is required to clearly differentiate medical and advanced nursing roles. They recommend that greater attention needs to be paid to the preparation of medical supervisors and, most significantly, revision of funding is required to more equitably support the ongoing development of nurses for advanced practice roles.
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Greenwood, S., Wright, T., & Nielsen, H. (2006). Conversations in context: Cultural safety and reflexivity in child and family health nursing. Journal of Family Nursing, 12(2), 201–224.
Abstract: This article outlines some key aspects of the practice of a number of nurse educators and researchers, and their commitment to the needs of their specific region. The group has been based at the Waikato Institute of Technology (WINTEC) over the last decade and have worked collaboratively across primary health, cultural safety, and child and family health domains of the nursing curriculum. They share a common philosophy underpinned by notions of diversity and health equity. The philosophy informs their theoretical inquiry, practice and research interests, and pedagogical concerns. In this article, the nurse researchers begin by situating themselves within the region, its people, and influences before moving into a consideration of the wider political and policy environment. They then consider the destabilising effects of cultural safety education and the tension between biculturalism and multiculturalism in their context. Finally, they reflect on how these ideas inform their work with postgraduate child and family nurses.
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Wepa, D. (2003). An exploration of the experiences of cultural safety educators. Ph.D. thesis, , .
Abstract: This thesis is a study of the experiences of four cultural safety lecturers in nursing education in Aotearoa / New Zealand. A review of literature reveals the recent and turbulent evolution of cultural safety. The media which documented this journey in a negative light in the 1990s prompted ministerial inquiries and the publication of the Nursing Council of New Zealand's guidelines for cultural safety in nursing and midwifery education (1996). Action research methods enabled the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action and reflecting. The findings of the research revealed that the participants not only coped with every day stressors of teaching but they were also required to formulate knowledge of cultural safety. For the Maori participants their stress was confounded with recruiting and retaining Maori students and macro issues such as commitments to iwi. Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that it was organisational in nature and out of their immediate control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations have been made which focus on supporting cultural safety educators to dialogue on a regular basis through attendance at related hui; the introduction of nurse educator programmes; paid leave provisions for cultural safety educators to conduct and publish research so that a body of knowledge can be developed; and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burn out.
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Richardson, F. I., & Carryer, J. B. (2005). Teaching cultural safety in a New Zealand nursing education program. Journal of Nursing Education, 44(5), 201–208.
Abstract: This article describes the findings of a research study on the experience of teaching cultural safety. As a teacher of cultural safety, the first author was interested in exploring the experience of teaching the topic with other cultural safety teachers. A qualitative approach situated in a critical theory paradigm was used for the study. The study was informed by the ideas of Foucault and feminist theory. Fourteen women between ages 20 and 60 were interviewed about their experience of teaching cultural safety. Five women were Maori and 9 were Pakeha. Following data analysis, three major themes were identified: that the Treaty of Waitangi provides for an examination of power in cultural safety education; that the broad concept of difference influences the experience of teaching cultural safety; and that the experience of teaching cultural safety has personal, professional, and political dimensions. These dimensions were experienced differently by Maori and Pakeha teachers.
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Wepa, D. (2003). An exploration of the experiences of cultural safety educators in New Zealand: An action research approach. Journal of Transcultural Nursing, 14(4), 339–348.
Abstract: This research is a study of the experiences of four cultural safety educators in nursing education in Aotearoa, New Zealand. Action research methods assisted the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action, and reflecting. The findings of the research revealed that the participants not only coped with everyday stressors of teaching but were also required to formulate knowledge for cultural safety. For the Maori participants, their stress was confounded with recruiting and retaining Maori students and macro issues such as commitment to their iwi (tribe). Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that many issues were organisational in nature and out of their control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations include the following: support for cultural safety educators to have a dialogue on a regular basis, the introduction of nurse educator programmes, paid leave provisions for educators to conduct and publish research so that a body of knowledge can be developed, and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burnout.
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Laracy, K. (2003). Exploration of the self: The journey of one pakeha cultural safety nurse educator. Ph.D. thesis, , .
Abstract: Cultural safety is taught in all undergraduate nursing programmes in Aotearoa/New Zealand. There is a predominance of Pakeha nurse educators in teaching this content. There is little explanation of what being Pakeha entails. This perpetuates a silence and continues the dominant hegemonic position of Pakeha in Aotearoa/New Zealand. This study suggests that as Pakeha cultural safety nurse educators we examine our dominance and critique the delivery of cultural safety education. This autobiographical study undertakes to explore the Pakeha identity of a cultural safety nurse educator. The author discusses identity in the context of a globalised world, and challenges the idea of a definitive Pakeha identity. There are multiple descriptions of Pakeha, all underdeveloped and inadequate for the purposes of cultural safety education. In this study, the author uses the heuristic process of Moustakas (1990) and Maalouf's (2000) ideas of vertical and horizontal heritage to locate and present the essence of the self. In keeping with the purpose of cultural safety education, the author considers her ethnic cultural self as described by Bloch (1983) and explores Helms' (1990) theory of White racial identity development. This thesis describes the position of one Pakeha in the context of teaching cultural safety in an undergraduate nursing degree programme in Aotearoa/New Zealand. For Pakeha cultural safety nurse educators the author argues that exploration of one's heritages and location of a personal Pakeha identity is pivotal to progressing the enactment of cultural safety in Aotearoa /New Zealand.
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Hickson, E. K. (2006). Developing clinical learning environment evaluation tools using an action research methodology. Ph.D. thesis, , .
Abstract: The author notes that learning nurses require real clinical experiences in order to apply learnt theory to actual practice. Clinical learning environments have consistently been found to function variably and sub-optimally for both learners and teachers. In order to improve the quality of the clinical learning environment it is necessary to first evaluate how effectively a clinical learning environment is functioning. A number of different methodologies have been used to evaluate clinical learning environments, a recent and successful method being the use of questionnaires or clinical learning environment evaluation tools. The objective of the present study was to develop clinical learning environment evaluation tools for use in a New Zealand hospital health service. Four tools appropriate to evaluate the clinical learning environment from the different perspectives of any type of clinical learner, clinical teacher, clinical manager and programme co-ordinator or nurse lecturer were developed. Six newly graduated nurses, three senior nurses, and the researcher were involved in the development of the evaluation tools over a five month period. A participatory action research methodology was employed. The resultant tools had a unique local focus and were suitably similar to other internationally developed tools. After testing the clinical learning environment evaluation tools, it is hoped that the implementation of the tools will support all stakeholders to understand and consequently optimise the functionality of their clinical learning environment.
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Honey, M. (2007). Teaching and learning with technology as enabler: A case study on flexible learning for postgraduate nurses. Ph.D. thesis, , .
Abstract: The aim of this study was to explore the practice of flexible learning for postgraduate nurses. Flexible learning is a contemporary approach to learning that utilises the benefits of technology. Flexible learning can be understood as a continuum, from fully on-line or web-based courses, to those that are on-campus and supported by technology. Internationally, the rise of flexible learning has been influenced by increased demand for higher education and competition among providers within the context of reduced education funding. The study population, New Zealand postgraduate nurses, are accessing higher education in increasing numbers to advance their practice and to position themselves for new roles and opportunities. These are often experienced nurses yet inexperienced in higher university education, who combine study, work and other commitments. The study employed a qualitative case study design because it enabled multiple perspectives to be gained. Data included documentation, participant observation, survey, students' assessed work and interviews with key stakeholders: student, teacher and the organisation. Thematic analysis was conducted on reviewed documentation, participant observation and interviews. The study identifies the elements that contribute to flexible learning and the interconnectedness between the elements within the dynamic context of a university to illustrate that effective flexible learning can be provided by using a student centred approach to ensure the learning needs of postgraduate nurses are met. The author concludes that flexible learning improved access, choice, and provided an emphasis on the student as central to learning. In response to these findings the weighting of recommendations are toward the organisation as, the author suggests, it is at this level where greater change can be made to improve support for flexible learning provision.
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Manning, J. (2005). Formative assessment: Using feedback to enhance learning. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp. 47-65). Dunedin: Otago Polytechnic.
Abstract: This paper explores the literature surrounding the development, definition, process and value of formative feedback. In particular, this review considers how formative assessment can be used by a clinical educator in the practice setting. At the end of the chapter, discussion questions are provided by Rebecca Hennephof.
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Kent, B., Fineout-Overholt, E., & Wimpenny, P. (2007). Teaching EBP: Part 2 – making sense of clinical practice guidelines. Worldviews on Evidence-Based Nursing, 4(3), 164–169.
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Harris, C., Crozier, I., Smyth, J., Elliot, J., Watson, P. B., Sands, J., et al. (2007). An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI.
Abstract: This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
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de Carlo Ahuarangi, K. (2000). Hei watea taupuhipuhi: The space of symbiosis: A conceptual framework for nursing practice. Ph.D. thesis, , .
Abstract: Te watea taupuhipuhi, the space of symbiosis is a framework for nursing practice. It examines the notion of the nursing presence as holding continuity and multiplicity of viewpoint in space of symbiosis. The author developed a teaching-learning situation as an introduction of key ideas in his work where the Maori word “ako” becomes the catalyst of a particular pedagogy that outlines the central notions of symbiosis. Thus, he notes, his work realises that symbiosis occurs not only on the clinical arena of nursing but in the teaching – learning environment as well, his own space of symbiosis. Four rites of passage coalesce a totality of experience within the space of symbiosis, revealing that the central role of the nursing presence is to surface meaning and sense for all of experience which can be fearful, mysterious, paradoxical and chaotic. These four rites of passage are described as the interpretive, integrative, transformations and transcendent. The twelve dynamics of nursing from the axle around which a praxis of nursing revolves. An analysis of those twelve dynamics in rite of passage is situated within narratives taken from the author's nursing practice. He also draws extensively from Maori ontology and autobiography in positioning his exposition within this local context.
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Thompson, R., & Farrow, T. (1999). The Workbook Portfolio: Facilitating undergraduate student learning in the mental health clinical area. Nursing Praxis in New Zealand, 14(2), 21–30.
Abstract: This article describes the use of a model that has been developed to assist students in tackling the complex issues surrounding mental health nursing. The Workbook Portfolio has identifiable components that encourage the development of reflective and analytical skills, which allow nurses to practice within an environment that is influenced and determined by a complex, and sometimes contradictory, range of external influences. The article explains the workings of this model so it can be used by educators to for students in the mental health setting.
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Walker, J., & Bailey, S. (1999). The clinical performance of new degree graduates. Nursing Praxis in New Zealand, 14(2), 31–42.
Abstract: This study aimed to identify how graduates perceived their clinical performance during their first year of practice. A convenience sample of 30 graduates was surveyed after 3 months and 7 months in practice, using an adapted form of a questionnaire devised by Ryan and Hodson (1992). The results showed that over time, graduates generally required less direction in all areas of clinical competence. After 7 months in practice, the majority of the graduates rated their performance in nursing skills, communication skills, and professionalism at the expected level or above. However, some still required direction with using theory and research in practice, with meeting client's psychosocial needs and with teaching clients. In the leadership competency, after 7 months, most graduates saw themselves functioning at the expected level related to client care and needed less direction in unit management skills. However, many of the unit management skills were rated as 'not applicable' indicating that new graduates are not initially placed in a management role. Implications for nursing education and limitations of the research are discussed.
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Milligan, K. (2002). Aesthetic knowledge and the use of arts in nursing. Beginning Journeys: A Collection of Work, 7, 9–14.
Abstract: The author considers aesthetic knowing and the use of the arts in nursing. She identifies concepts that pertain to the art of nursing. The interrelationship of the moral sense and the art of nursing is explored. The author concludes that the mediums of non-fiction, fiction and poetry can provide valuable contributions to the aesthetic way of knowing in nursing education, practice and research.
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