Patients perceptions of virtual reality therapy in the management of chronic cancer pain.

The management of chronic cancer pain remains challenging and complex, with the process often involving a variety of pharmacological and non-pharmacological approaches. Recent studies have shown virtual reality (VR) therapy to be successful in the management of acute pain. However, it remains unclear whether VR-based applications are effective as an adjunctive therapy for cancer patients with chronic pain. Moreover, there exists a gap in the current research landscape that address patient's perceptions of virtual reality therapy. This qualitative study enrolled patients from a larger ongoing randomized controlled clinical trial in two focus groups covering topics including patients experience with and perspectives on using VR for chronic pain control, both generally, and specific to their own circumstances. Five major thematic categories and 23 sub-categories emerged in the analysis process reflecting the participants' narrative. Similar to other research, this study found mixed results in the use of adjunctive VR therapy to manage chronic cancer pain, although a majority of respondents found it to be beneficial. This study confirms that pain management is a highly complex and individualized process. For maximum efficacy, it is recommended that future designs of VR interventions engage pain patients in the design process to ensure maximum efficacy of experiences to with individuals' preferences.

Magical beliefs and discriminating science from pseudoscience in undergraduate professional students.

Paranormal beliefs and magical thinking exist in the public, and amongst university students. Researchers have found that media can influence such beliefs. A 2012 study suggested pseudoscientific rationales can influence acceptance of reported paranormal phenomena. Using a paranormal belief survey and controlled experiment this work explores the paranormal beliefs and test the effects of three versions of a supernatural news story on undergraduate professional students. One version of the story presented a simple news article, another the same with a pseudoscientific rationale, and another gave a discrediting scientific critique. Results confirmed that many students do hold magical beliefs but discriminated between scientific and pseudoscientific narratives. However, pre-existing paranormal beliefs were associated with an increased likelihood of students finding paranormal reports scientific, believable and credible.

New sophistry: self-deception in the nursing academy.

In this essay, I advance an argument against the expansion and acceptance of postmodern metaphysical antirealist ideologies in the development of nursing theory in North America. I suggest mystical theoretical explanations of care, the rejection of empirical epistemology, and a return to divinity in nursing represent an intellectual dead end, as these ideas do little to help resolve real-world health issues and also negate the need for the academic discrimination of bad ideas. I examine some of the philosophical foundations of nursing theory and deconstruct some of the more preternatural theories that have become established as the dominant conventional wisdom in the academy. It is argued that this can be characterized as a form of self-deception, and overall has had a negative impact on advancement of the nursing profession and public health care. Reasons behind the widespread acceptance of these irrational theoretical stances in nursing and the ongoing support for mystical therapeutic interventions are explored.

Parents' Perspectives on Supporting Their Decision Making in Genome-Wide Sequencing.

PURPOSE: The purpose of this study was to explore parents' perceptions of their decisional needs when considering genome-wide sequencing (GWS) for their child. This is a partial report and focuses on how parents prefer to receive education and information to support their decision making about GWS. DESIGN: This study adopted an interpretive description qualitative methodological approach and used the concept of shared decision making and the Ottawa Decision Support Framework. METHODS: Participants were parents who had already consented to GWS, and had children with undiagnosed conditions that were suspected to be genetic in origin. Fifteen parents participated in a focus group or individual interview. Transcriptions were analyzed concurrently with data collection, iteratively, and constantly compared to one another. Repeat interviews were conducted with five of the parents to confirm, challenge, or expand on the developing concepts. FINDINGS: Participants felt that their decision to proceed with GWS for their child was an easy one. However, they expressed some unresolved decisional needs, including a lack of knowledge about certain topics that became relevant and important to them later and a need for more support and resources. Participants also had ongoing informational and psychosocial needs after the single clinical encounter where their decision making occurred. CONCLUSIONS: Participants expressed unmet decisional needs, which may have influenced the quality of their decisions. The strategies that participants suggested may help create parent-tailored education, counseling, decision support, and informed consent processes. CLINICAL RELEVANCE: Health care professionals who offer GWS for children should assess parents' values, priorities, and informational needs and tailor information accordingly. There are opportunities for nurses to become involved in supporting families who are considering GWS for their child.

Ways of knowing: realism, non-realism, nominalism and a typology revisited with a counter perspective for nursing science.

In this paper, we reconsider the context of Barbara Carper's alternative ways of knowing, a prominent discourse in modern nursing theory in North America. We explore this relative to the concepts of realism, non-realism and nominalism, and investigate the philosophical divisions behind the original typology, particularly in relationship to modern scientific enquiry. We examine forms of knowledge relative to realist and nominalist positions and make an argument ad absurdum against relativistic interpretations of knowledge using the example of Borge's Chinese Emporium of Benevolent Knowledge. We propose a contentious postpositivist practical classification for nursing knowledge that demonstrates and supports the idea that knowledge has both individual and subjective components. This classification supports the practical application of nursing knowledge within the paradigm of realist postpositivist science.

The value of prostate cancer support groups: a pilot study of primary physicians' perspectives.

BACKGROUND: In Canada, prostate cancer (PCa) is the most common male cancer, and prostate cancer support groups (PCSGs) have prevailed for more than 20 years providing support to men with PCa and their families. While the format, focus and benefits of attending PCSGs have been reported little is known about primary physicians' (PPs) perceptions of these groups. This article describes Canadian primary physicians' views about face-to-face and web-based PCSGs. METHODS: Canadian based primary physicians (n = 140) attending a 2012 Continuing Medical Education Conference participated in a pilot survey questionnaire study. The 56-item questionnaire used in this study included six sets of attitudinal items to measure primary physicians' beliefs about positive and negative influences of PCSGs, reasons for attending PCSGs, the attributes of effective PCSGs, and the value of face-to-face and web-based PCSGs. RESULTS: Results showed that PCSGs were positively valued, particularly for information sharing, education and psychosocial support. Poor inclusivity, privacy, and accessibility were identified as potential barriers, and recommendations were made for better marketing and web-based PCSGs to increase engagement with potential attendees. CONCLUSIONS: Findings suggest PPs highly valued the role and potential benefits of PCSGs. Information provision and an educational role were perceived as key benefits amid the need to improve local and provincial marketing of PCSGs. The potential for web-based PCSGs to help in the support of PCa patients was also recognized.

Evaluation of an eportfolio for the assessment of clinical competence in a baccalaureate nursing program.

This paper reports a study undertaken to evaluate the implementation of an electronic portfolio (eportfolio) tool for the assessment of clinical competence in a Bachelor of Science in Nursing program. Baccalaureate nursing programs increasingly use information and communications technologies to support student learning, assess and record progress. Portfolio based practice assessment and electronic portfolios represent growing trends to enhance learning via student reflection and self-identification of further learning needs. Using an action-research process, a mixed-methods evaluation strategy explored the efficacy of the eportfolio in its second year of use. Website tracking analytics and descriptive statistics were used to explore trends in eportfolio usage. Instructor and student surveys and focus groups were carried out at the end of the second year. Instructors valued the eportfolios convenience, improved transparency, an improved ability to track student progress, enhanced theory-practice links, and the competency based assessment framework. Students valued accessibility and convenience, but expressed concerns over assessment data openness and processes for standardization. Both groups felt that the eportfolio navigation required simplification. Electronic portfolios represent a technological evolution from paper-based clinical assessment systems. Although there appear to be many student and instructor advantages in using eportfolios, to maximize successful implementation, clinical teachers require additional training in this new pedagogic approach. Strategies to assist an institutional culture shift towards more transparent assessment processes may also need consideration.

Using social media to promote international student partnerships.

This paper describes a project to establish and evaluate online study partnerships, using social networking applications, between final year Canadian nursing students at the University of British Columbia (UBC) and second year undergraduate science education students at the University of Plymouth (UoP) in the UK. The project took place between 2009 and 2010 and evaluated the use of social networking applications with international interdisciplinary partnerships between Canadian and UK students. A multi-method evaluation strategy incorporating questionnaires, online focus groups and web analytics was used to explore the value of social media to promote the exchange of ideas and discussion of scientific philosophy in different contexts, between students working in disciplines with differing philosophical perspectives principally modern/post-modern, quantitative/qualitative, empirical/theoretical. This project resulted in a very successful collaborative partnership between UK and Canadian students.

Changing the game; some thoughts on future healthcare demands, technology, nursing and interprofessional education.

This editorial discusses the conclusions of a number of high-profile reports on the future of healthcare provision, and healthcare professional education. The need for the realignment of service provision, regulation, interdisciplinary healthcare and supporting education is discussed in the context of rapid technological and social change.

Implementing high-fidelity simulation in Canada: reflections on 3 years of practice.

This paper explores our experiences in implementing and using high-fidelity simulation (HFS) over the last three years, in the context of the results of the Canadian Association of Schools of Nursing (CASN) health 2006 simulation survey, which explored the use of simulation across Canada in professional health education. Considerations for the practical implementation of simulation based on evaluations at the University of British Columbia School of Nursing are discussed. The rapid increase in the uptake of simulation-based education in Canada is due in large part to the belief that these techniques offer a safe environment for learners to improve competence. Students and teachers have identified positive learning experiences with high-fidelity simulation, particularly with respect to complex patient care scenarios, multidisciplinary team scenarios, student team work (i.e., team-based learning), and reflective debriefing. Despite these benefits there have been significant resource implications from adopting these technologies. The use of team-based learning and reflective debriefing appeared to be a focal area for emphasis in the planning of clinical simulation experiences. A team focused learning approach may also offer a more cost-efficient strategy for clinical simulation.

High-fidelity patient simulation: considerations for effective learning.

This article explores a case of the implementation of high-fidelity simulation (HFS) in an undergraduate preregistration nursing program in a Canadian school of nursing. A small practice collaborative project to develop reusable simulation resources for team-based simulations is described, using HFS technology. Considerations for effective learning resulting from faculty and student evaluations of the project are discussed. Students identified positive learning experiences and indicated that real-time patient status changes proved valuable to them. Also, using these techniques offered a safe environment for improving competence. The use of reflective debriefing appeared to be a focal area for learning that requires emphasis in the planning of HFS experiences. This template, team-focused learning approach also appeared to offer a cost-efficient strategy for HFS.

Value of wireless personal digital assistants for practice: perceptions of advanced practice nurses.

AIMS AND OBJECTIVES: The aims were to explore advanced practice nurses' perceptions on wireless Personal Digital Assistant technologies, to establish the type and range of tools that would be useful to support their practice and to identify any requirements and limitations that may impact the implementation of wireless Personal Digital Assistants in practice. BACKGROUND: The wireless Personal Digital Assistant is becoming established as a hand-held computing tool for healthcare professionals. The reflections of advanced practice nurses' about the value of wireless Personal Digital Assistants and its potential to contribute to improved patient care has not been investigated. DESIGN: A qualitative interpretivist design was used to explore advanced practice nurses' perceptions on the value of wireless Personal Digital Assistant technologies to support their practice. METHODS: The data were collected using survey questionnaires and individual and focus group interviews with nurse practitioners, clinical nurse specialists and information technology managers based in British Columbia, Canada. An open-coding content analysis was performed using qualitative data analysis software. RESULTS: Wireless Personal Digital Assistant's use supports the principles of pervasivity and is a technology rapidly being adopted by advanced practice nurses. Some nurses indicated a reluctance to integrate wireless Personal Digital Assistant technologies into their practices because of the cost and the short technological life cycle of these devices. Many of the barriers which precluded the use of wireless networks within facilities are being removed. Nurses demonstrated a complex understanding of wireless Personal Digital Assistant technologies and gave good rationales for its integration in their practice. CONCLUSIONS: Nurses identified improved client care as the major benefit of this technology in practice and the type and range of tools they identified included clinical reference tools such as drug and diagnostic/laboratory reference applications and wireless communications. RELEVANCE TO CLINICAL PRACTICE: Nurses in this study support integrating wireless mobile computing technologies into their practice to improve client care.

A mobile clinical e-portfolio for nursing and medical students, using wireless personal digital assistants (PDAs).

This paper outlines the development and evaluation of a wireless personal digital assistant (PDA) based clinical learning tool designed to promote professional reflection for health professionals. The "Clinical e-portfolio" was developed at the University of British Columbia School of Nursing to enable students immediately to access clinical expertise and resources remotely, and record their clinical experiences in a variety of media (text, audio and images). The PDA e-portfolio tool was developed to demonstrate the potential use of mobile networked technologies to support and improve clinical learning; promote reflective learning in practice; engage students in the process of knowledge translation; help contextualize and embed clinical knowledge whilst in the workplace; and to help prevent the isolation of students whilst engaged in supervised clinical practice. The mobile e-portfolio was developed to synchronise wirelessly with a user's personal Web based portfolio from any remote location where a cellular telephone signal or wireless (Wi-Fi) connection could be obtained. An evaluation of the tool was undertaken with nurse practitioner and medical students, revealing positive attitudes to the use of PDA based tools and portfolios, but limits to the use of the PDA portfolio due to the inherent interface restrictions of the PDA.

A mobile clinical e-portfolio for nursing and medical students, using wireless personal digital assistants (PDAs).

This paper outlines the development and evaluation of a wireless personal digital assistant (PDA) based clinical learning tool designed to promote professional reflection for health professionals. The "Clinical e-portfolio" was developed at the University of British Columbia School of Nursing to enable students immediately to access clinical expertise and resources remotely, and record their clinical experiences in a variety of media (text, audio and images). The PDA e-portfolio tool was developed to demonstrate the potential use of mobile networked technologies to support and improve clinical learning; promote reflective learning in practice; engage students in the process of knowledge translation; help contextualize and embed clinical knowledge whilst in the workplace; and to help prevent the isolation of students whilst engaged in supervised clinical practice. The mobile e-portfolio was developed to synchronise wirelessly with a user's personal Web based portfolio from any remote location where a cellular telephone signal or wireless (Wi-Fi) connection could be obtained. An evaluation of the tool was undertaken with nurse practitioner and medical students, revealing positive attitudes to the use of PDA based tools and portfolios, but limits to the use of the PDA portfolio due to the inherent interface restrictions of the PDA.