Student Employment Models for Undergraduate Nurses and Midwives in Australia: A Scoping Review.

Introduction: Evidence has shown that throughout their undergraduate years, many nursing and midwifery students obtain paid employment in a wide variety of clinical and non-clinical positions. Across Australia, inconsistencies exist in the models of clinical employment available to these student groups. Previous Australian studies have described the employment of undergraduate nursing and midwifery students in regulated and unregulated clinical roles. No studies have reported on the various regulated roles available to both student nurses and midwives in Australia. The purpose of this scoping review is to identify and synthesize evidence related to nursing and/or midwifery students employed in regulated and unregulated clinical roles in Australia. Methods: This scoping review utilized published recommendations for data screening, abstraction, and synthesis. One of the authors, a librarian, undertook systematic searches in CINAHL Complete (1937-present), Emcare on Ovid (1995-present), Scopus (1969-present), and Ovid MEDLINE(R) (including Epub Ahead of Print, In-Process, and In-Data-Review & Other Non-Indexed Citations, 1946-present). The initial searches were completed in April 2019 and repeated in March 2021 and May 2022 to identify any new literature. Manual searching of reference lists in the included papers was also undertaken, together with selected organizational websites. The extracted data included the lead author, date, title, study design, study sample and location, and key findings. Results: From the 53 items retrieved, 23 peer-reviewed studies met the inclusion criteria and were included in the review. All items were published between 2011 and 2022. Only four of the studies focused upon student midwives. Undergraduate nursing and midwifery students in Australia obtain paid employment in a variety of regulated and unregulated clinical roles. Conclusion: The literature reported here demonstrates that there are differing models, nomenclature, educational requirements, and pay scales in place for student employment in clinical roles across Australian states and territories.

"Teaching Through Your Fingertips": A Descriptive Study to Understand the Experiences and Needs of Online Educators in Postgraduate Nursing Education in Australia.

Introduction: Even before COVID-19, enrolments in online postgraduate nursing and midwifery courses were growing globally. Teaching into planned online courses requires pedagogical considerations unique to the context. Objective: The objective of this descriptive mixed methods study was to understand the experiences and needs of Australian online educators who taught into planned online postgraduate nursing or midwifery courses. Methods: A 55-item online survey captured the experiences and needs of participants. This paper reports on the analysis of participants' qualitative responses in this survey, analyzed using a thematic analysis approach. Forty-nine postgraduate educators participated in this study. Results: Five core themes were identified: time is precious; redefining the educator role; understanding the pedagogical shift; online and alone; and learning to teach online. Many educators report lacking the skills and confidence to deliver high-quality education to postgraduate students through their fingertips. Conclusion: This research highlighted that online educators need support through resources, education, and professional development.

Exploring patient support by breast care nurses and geographical residence as moderators of the unmet needs and self-efficacy of Australian women with breast cancer: Results from a cross-sectional, nationwide survey.

PURPOSE: This study investigated whether use of services of a breast care nurse (BCN) at any time during treatment for breast cancer led to reduced unmet needs and increased self-efficacy among women with breast cancer. A secondary aim was to analyse comparisons between urban and rural and remote dwellers. METHOD: Participants were Australian women who completed treatment for breast cancer at least 6 months before the survey date, recruited through two national databases of women diagnosed with breast cancer. The cross-sectional online survey consisted of two well validated measures, the SCNS-SF34 and the CASE-Cancer Scale. Statistical data were analysed using SPSS, with chi-square used to measure statistical significance. RESULTS: A total of 902 participants responded to the survey. Unmet needs in the psychological domain were most prominent. Respondents who used the services of a BCN were significantly less likely to report unmet needs regarding tiredness, anxiety; future outlook; feelings about death and dying; patient care and support from medical staff; and provision of health systems and information. Scores of self-efficacy showed women using the services of a BCN had significantly higher self-efficacy when seeking and obtaining information (ρ ≤ 0.001) and understanding and participating in care (ρ = 0.032). Urban dwellers were more likely to have choice of health care service, but overall neither unmet needs nor perceived self-efficacy varied statistically significantly by remoteness. CONCLUSIONS: Women with breast cancer experience a range of unmet needs; however those using BCN services demonstrated positive outcomes in terms of decreased unmet needs and increased self-efficacy.

AN EXPLORATION OF THE AUSTRALIAN BREAST CARE NURSE ROLE IN SUPPORTING WOMEN WITH BREAST CANCER.

The lack of literature surrounding the role of the Australian Breast Care Nurse (BCN) and the well documented disparity between cancer survival in urban versus rural and remote areas has inspired an RN working in rural Australia to undertake doctoral research to further explore these issues.

Literature review: An exploration of the role of the Australian breast care nurse in the provision of information and supportive care.

Breast care nurses (BCNs) were introduced to the Australian health care system in the 1990s to facilitate better continuity of care and increase psychosocial support to women with breast cancer. Yet women with breast cancer, particularly those in rural and remote Australia have high levels of unmet supportive needs. The purpose of this literature review was to examine the role of the Australian breast care nurse in the provision of information and support to women with breast cancer. A literature review was conducted using a number of databases from January 2006 to November 2012. Pre-set criteria were used, and nine research papers were identified; one randomised control trial, five quantitative studies, two qualitative studies and one mixed method study. Of the nine studies identified, only one attempted to explore the national perspective, however participants from Tasmania were not used. Overall, the review revealed very few published Australian studies evaluating the role of the BCN since 2006. The results demonstrate a need for larger studies conducted on a national scale, using participants from diverse geographical areas to gain more insight into the level of access to BCN care experienced by Australian women from both urban and rural and remote areas. It is recommended that further research be undertaken in order to build up a body of quantitative data about the role of the Australian BCN in providing information and support to women.

A survey of the breast care nurse role in the provision of information and supportive care to Australian women diagnosed with breast cancer.

AIM: To explore the role of the Australian breast care nurse in the provision of information and support to women with breast cancer, with a focus on the differences experienced depending on geographic work context. DESIGN: A cross-sectional study. METHODS: This study conducted in 2013, involved surveying BCNs currently working in Australia, using a newly developed self-report online survey. RESULTS: Fifty breast care nurses completed the survey, 40% from major cities, 42% from inner regional Australia and 18% from outer regional, remote and very remote Australia. Patterns of service indicated higher caseloads in urban areas, with fewer kilometres served. Breast care nurses in outer regional, remote and very remote areas were less likely to work in multi-disciplinary teams and more likely to spend longer consulting with patients. Breast care nurses reported they undertook roles matching the competency standards related to the provision of education, information and support; however, there were barriers to fulfilling competencies including knowledge based limitations, time constraints and servicing large geographical areas. CONCLUSIONS: This was the first Australian study to describe the role of the breast care nurse nationally and the first study to investigate breast care nurses perceived ability to meet a selection of the Australian Specialist Breast Nurse Competency Standards. Important differences were found according to the geographical location of breast care nurses.

Geographical comparisons of information and support needs of Australian women following the primary treatment of breast cancer: a 10-year replication study.

BACKGROUND: In 2002, Raupach and Hiller examined the use of and satisfaction with information and support following treatment of breast cancer from a sample of participants in South Australia. In 2013 this study was replicated to include participants Australia wide and analyse comparisons based on geographical location. Statistical comparisons with the original study were also conducted. DESIGN: A 10 year replication study using a cross-sectional needs analysis survey. SETTING AND PARTICIPANTS: Women aged 18+ years diagnosed with breast cancer between 6 and 30 months ago were sourced from two national databases of women diagnosed with breast cancer. RESULTS: A total of 325 participants completed the survey. The Internet was the most commonly used source of information with 70% (n = 229 of 325) of women using the internet for information, a statistically significantly higher percentage compared with the 2002 study. The study found the top four information issues rated as moderately/extremely important by women in 2013 were identical in 2002. A comparison of sources of support used showed that women in outer regional, remote and very remote areas were statistically more likely to use the breast care nurse (BCN) for support (P = 0.044). CONCLUSIONS: The study provides useful, up-to-date data about information and support services used by Australian women with breast cancer. Comparisons with the earlier study show some of the needs of women have changed over time, but others have remained the same. Geographic comparisons overall, demonstrate many consistent findings regardless of location, however, the important work of the breast care nurse is an area in need of further research.

Development and interrater reliability testing of a telephone interview training programme for Australian nurse interviewers.

BACKGROUND: The final phase of a three phase study analysing the implementation and impact of the nurse practitioner role in Australia (the Australian Nurse Practitioner Project or AUSPRAC) was undertaken in 2009, requiring nurse telephone interviewers to gather information about health outcomes directly from patients and their treating nurse practitioners. A team of several registered nurses was recruited and trained as telephone interviewers. The aim of this paper is to report on development and evaluation of the training process for telephone interviewers. METHODS: The training process involved planning the content and methods to be used in the training session; delivering the session; testing skills and understanding of interviewers post-training; collecting and analysing data to determine the degree to which the training process was successful in meeting objectives and post-training follow-up. All aspects of the training process were informed by established educational principles. RESULTS: Interrater reliability between interviewers was high for well-validated sections of the survey instrument resulting in 100% agreement between interviewers. Other sections with unvalidated questions showed lower agreement (between 75% and 90%). Overall the agreement between interviewers was 92%. Each interviewer was also measured against a specifically developed master script or gold standard and for this each interviewer achieved a percentage of correct answers of 94.7% or better. This equated to a Kappa value of 0.92 or better. CONCLUSION: The telephone interviewer training process was very effective and achieved high interrater reliability. We argue that the high reliability was due to the use of well validated instruments and the carefully planned programme based on established educational principles. There is limited published literature on how to successfully operationalise educational principles and tailor them for specific research studies; this report addresses this knowledge gap.