Graduate competencies, employability and the transnational Radiography workforce shortage: A systematic literature review of current pre-registration Radiography education and training models.

INTRODUCTION: Transnational mobility of the Radiography workforce is challenged due to issues with standardisation of current education and training models which has added to the workforce shortage. To address the growing volume, scope and complexity of clinical Radiography service delivery, educational models need to be given a critical look for transnational relevance in modern times. This study aims to synthesise the characteristics of current pre-registration radiography educational programmes linked with effective knowledge, skill acquisition, and graduate employability to address the current workforce challenges through the development of newer training models. METHODS: Using a mixed methods systematic review approach, secondary data was obtained from an EBSCOhost search involving key databases including MEDLINE, CINAHL, Academic Search Ultimate, ScienceDirect, and SCOPUS. Themes were developed following a result-based convergent data synthesis. RESULTS: Forty articles met the predefined inclusion criteria following the study identification and screening phases. The included studies were conducted from across diverse settings including both low- and middle-income countries (LMIC) and high-income countries (HIC). Two broad themes were developed from the findings including: 1. Factors influencing graduate employability and 2) Radiography education and training programme characteristics. CONCLUSION: The findings highlight and advocate for an innovative model for Radiography education and underscores the significance of graduates possessing multi-modality skills, varied competencies, and effective accreditation processes for training. Prioritising alignment with industry needs and holistic skill development is vital to closing the employability gap, ultimately improving graduate skills and competencies to address workforce shortage while improving patient care outcomes. IMPLICATIONS FOR PRACTICE: Radiography training institutions should explore the development of new innovative models for multi-modality pre-registration education. This should offer adaptable routes that align seamlessly with the evolving regulatory, technological, and clinical trends.

Planning the transition of children with complex needs from hospital to home.

Planning and facilitating a high quality transition from hospital to home for children and young people with complex health needs is an important part of enabling them, and their families, to enjoy a good quality of life. This includes: identifying their health, social and education needs; what aspects of these needs their family can meet and what they will need assistance with; who should be involved in supporting them; the practicalities of what support and assistance they will need; how the funding required to meet their needs will be organised; and how their needs can be met in the context of their whole family.

Supporting children with complex health needs.

An increasing number of children have complex and continuing health needs. Caring for these children often requires nurses to develop a range of medical and technical skills and knowledge. It is equally important that children with complex health needs are supported in a way that enables them to enjoy the opportunities that other children do. This article explores the ways in which nurses can help children who have complex health needs to communicate, participate in play and leisure activities, socialise with their peers and access education.

Children with complex, continuing health needs and access to facilities.

AIM: To gain an understanding of parents' views regarding the social inclusion of their children who have complex and continuing health needs. METHOD: Semi-structured interviews were carried out with 14 parents whose children have complex health needs. FINDINGS: There are still significant gaps in the provision of transport, play, leisure and retail facilities for children who have complex and continuing health needs. This affects the lives of the children and their families. CONCLUSION: Suitable provision of accessible facilities for children with special needs makes a great difference to the lives of the children and their families. Also the attitudes and behaviours of individuals influence how much children and families feel included in and valued by society.

Children who have complex health needs: parents' experiences of their child's education.

BACKGROUND: An increasing number of children have complex and continuing health needs. These children have the same right to a full range of education opportunities as other children. METHODS: This paper reports on the findings from a small qualitative study of the experiences of parents whose children have complex heath needs, related to their experiences of their child's education. Interviews with parents were used to generate data. FINDINGS: Parents encounter a number of challenges to their children achieving equal opportunities in relation to education. The factors which influence their opportunities include: staffing issues, funding issues, the attitudes of individuals and organizations, staff confidence in meeting children's needs, clarity over responsibilities and funding. For parents, what seemed most important is not whether their child accesses mainstream education, but whether the school which they attend assists them to achieve their potential. Children who have complex health needs may have to make a greater effort than their peers to achieve educational goals, and may miss considerable school time. This can impact on their leisure time. Accessing pre-school education can be difficult for children who have complex health needs. CONCLUSIONS: Inclusion in education should include pre-school provision, and more work in this area would be beneficial. Inclusion in mainstream education is only beneficial if it enables the child to participate fully with their peers. This requires practical and organizational issues to be addressed, services to be well co-ordinated, responsibilities and funding to be clear, and staff to be enabled to be confident in meeting the child's needs. However, it is also vital that individuals and organizations have a positive attitude to children and to inclusion. The additional effort and time which children may have to spend on their school work because of their health needs should also be recognized and supported appropriately.

The CleanYourHandsCampaign: critiquing policy and evidence base.

Handwashing is considered to be the most effective way of reducing cross-infection. Rates of healthcare-associated infection and the incidence of meticillin-resistant Staphylococcus aureus are higher in the UK than in many other European countries. The government has responded by introducing the 'CleanYourHandsCampaign' throughout England and Wales, based on the success of the approach employed in Geneva. Alcohol hand rub is placed at every bedside in acute hospitals, ward housekeepers should replenish supplies and feedback on compliance is provided to health workers. Posters and other promotional materials are used to remind health workers and visitors to use the hand rub. Patients are encouraged to ask health workers if they have cleaned their hands before contact. In this paper we argue that the evidence base underpinning the CleanYourHandsCampaign is incomplete. Alcohol hand rub is acknowledged as a useful adjunct to hand hygiene but it is not effective in all circumstances. There is some evidence to support the use of feedback on performance to encourage compliance but no evidence that promotional materials such as posters or patient reminders are effective. The ethics of encouraging hospital patients to take responsibility for their own safety is questioned. Much of the success in Geneva must be attributed to the attention given to contextual factors within the organization that encouraged hand rub use, especially hospital-wide 'ownership' of the initiative by managers and senior health professionals. A customized intervention from another country that fails to consider local organizational factors likely to influence the implementation of the campaign is unlikely to be effective. It is concluded that although hand hygiene is of undoubted importance, undue emphasis should not be placed on it as a 'quick fix' to solve the unacceptably high rates of healthcare-associated infection in National Health Service hospitals.

Self-directed learning: views of teachers and students.

AIM: This paper reports the findings of an investigation into teachers' and students' understanding of the term self-directed learning (SDL), and their views concerning its value in paediatric intensive care (PIC) nurse education. METHODS: Qualitative methods of data collection and analysis were used. The findings from interviews with teachers and students across eight PIC nursing courses are reported. Local Research Ethics Committee protocols were followed. Data were analysed using constant comparative analysis. FINDINGS: Teachers and students appeared to experience some difficulty in articulating a precise definition of SDL. Both groups saw it as one teaching and learning method to be used alongside others, and focused their definitions on the observable events thought to demonstrate self-direction rather than the cognitive processes involved. Teachers and students considered SDL of some value, but only when used in conjunction with teacher-led methods. Both teachers and students felt that students take more responsibility for learning in SDL than in traditional teaching. However, there was a difference of opinion as to the manner in which responsibility was devolved and accepted, and neither party was completely convinced that the other respected them. LIMITATIONS: The study explored only PIC nurse education, and was not intended to be generalized beyond this field. CONCLUSION: The evidence from this study suggests that SDL has elusive qualities which defy precise definition. It appears that attempting such a definition and reducing SDL to an observable form may detract from its perceived value. It can be inferred from this study that in order to implement SDL issues of control and autonomy within the learning environment merit further exploration, rather than simply focusing on observable teaching and learning tools or methods.

Use of constant comparative analysis in qualitative research.

This article describes the application of constant comparative analysis, which is one method that can be used to analyse qualitative data. The need for data analysis to be congruent with the overall research design is highlighted.

Children in intensive care: physiological considerations.

The needs of critically ill children have been highlighted on many occasions in recent years. The specific physiological and psychosocial needs of critically ill children have resulted in the recommendation that they be cared for in specially designated units. It is essential that the anatomical and physiological differences between adults and children and how these affect them in health and illness be considered when providing care for this client group.

The education of registered nurses for practice in paediatric intensive care units in Australia and New Zealand.

This article summarizes a report on the findings of a study of the education and training of registered nurses for practice in Paediatric Intensive Care Units (PICUs) in Australia and New Zealand. The study was funded by the Florence Nightingale Foundation and Sandra Charitable Trust, and was carried out in late 1997. One element of the study was the exploration of four Paediatric Intensive Care Courses in Australia and New Zealand. The study firstly identified that these courses appeared to be valued by the PICUs linked with the institutes providing the courses. Secondly, the providers of PIC courses had, in some cases, adopted flexible approaches to the course to accommodate PICU needs. Thirdly, the use of adult learning principles as an issue in nurse education was raised. Fourthly, the use of Problem Based Learning and a Case Study approach appeared to be of value. In terms of clinical practice, the issue of assessment of competence, and the importance of clear delineation of the roles and responsibilities of those involved were identified. Assessor preparation were also discussed. Many of these issues have relevance in England, particularly in view of the identified need for increased provision of PIC courses.

Paediatric intensive care nursing education by distance learning: an example from Canada.

This paper follows a recent publication on the education of nurses for Paediatric Intensive Care (PIC) practice in Australia and New Zealand (Hewitt-Taylor 1998). It arises from the same issues of the identified need for exploration of alternative approaches to PIC education in England to address the shortfall in nurses with appropriate training and education to practice in this area. The exploration of one PIC course in Canada was of particular value, as it used a distance learning approach, which accords with some of the Department of Health (DoH 1997) recommendations for practice in England. The issues of theoretical input and assessment and practical experience and assessment will be addressed here. The course incorporated a case study/problem-based learning approach, which was discussed in the previous paper and will be revisited in this discussion. This paper contains exploration of these issues, and again highlights the perceived importance of PIC courses, as well as in service training.