The impact of cultural immersion international learning experiences on cultural competence of nursing students: A critical integrative review.

BACKGROUND: Cultural immersion international learning experiences (CIILEs) are commonly offered in undergraduate nursing education programs worldwide, often with the goal to enhance students' cultural competence. PURPOSE: The purpose of this integrative review was to explore the most recent existing literature concerning the impact of CIILEs on nursing students' cultural competence and to cast a critical eye on the findings. METHOD: We searched the CINAHL database for articles published from 2015 to 2019 and found 30 that met inclusion criteria. RESULTS: The majority of the studies were descriptive or qualitative designs and reported positive overall student cultural competence outcomes. CONCLUSION: The findings support the use of CIILEs with a critical eye for potential negative consequences. The authors recommend further longitudinal, observational studies to identify factors that facilitate substantial long-term positive outcomes.

Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector.

BACKGROUND: Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. METHODS: An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. RESULTS: The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers. CONCLUSIONS: Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this.

Theoretical framing of high-fidelity simulation with Carper's fundamental patterns of knowing in nursing.

Many nursing programs integrate high-fidelity simulation(HFS) into the curriculum. The manikins used are modeled to resemble humans and are programmed to talk and reproduce physiological functions via computer interfaces.When HFS design negates a theoretical framework consistent with the interpersonal and relational nature of nursing,it can problematically focus simulation on psychomotor skills and the physical body. This article highlights a theorized approach to HFS design informed by Carper's seminal work on the fundamental patterns of knowing in nursing(i.e., empirics, esthetics, personal knowing, and ethics). It also describes how a team of Canadian nurse educators adopted these patterns of knowing as a theoretical lens to frame scenarios, learning objectives, and debriefing probes in the context of maternal and newborn assessment. Institutions and practitioners can draw on Carper's work to facilitate focusing on the whole person and expanding the epistemological underpinnings of HFS in nursing and other disciplines.

The use of socially assistive robots for dementia care.

Innovative solutions for dementia care are required to address the steady rise in adults living with dementia, lack of adequate staffing to provide high-quality dementia care, and the need for family caregivers to provide care for their loved ones in the home. This article provides an overview of the use of socially assistive robots (SARs) to offer support as therapists, companions, and educators for people living with dementia. Social, ethical, and legal challenges associated with the use of robotic technology in patient care and implications for the use of SARs by nurses are discussed. These items considered, the authors conclude that SARs should be considered as a viable way to assist people living with dementia to maintain their highest possible level of independence, enhance their quality of life, and provide support to overburdened family caregivers. Further research is needed to evaluate the merits of this technological approach in the care of adults with dementia.

Considering place in community health nursing.

When a geographic location is assigned meaning, it becomes a place. The authors argue that place matters as both geographical location and lived experience.They extend the current conceptualization of nursing geography to encompass community health nursing and address intricacies of community nursing practice and research that often go unnoticed. They do so by exploring the notion of place in home and community, including the structural/spatial dimensions of the nurse-client relationship. The authors review the health geography literatures, then discuss the implications for practice and research in community health. They invite community health nurses to critically examine their practice and research with reference to such issues as the power of the nurse, marginalized places as determinants of health, and how best to care for clients living in diverse community settings.

Considering place in community health nursing.

When a geographic location is assigned meaning, it becomes a place. The authors argue that place matters as both geographical location and lived experience. They extend the current conceptualization of nursing geography to encompass community health nursing and address intricacies of community nursing practice and research that often go unnoticed. They do so by exploring the notion of place in home and community, including the structural/spatial dimensions of the nurse-client relationship. The authors review the health geography literatures, then discuss the implications for practice and research in community health. They invite community health nurses to critically examine their practice and research with reference to such issues as the power of the nurse, marginalized places as determinants of health, and how best to care for clients living in diverse community settings.