Biomedical subjects
C Duffield
Publications and source records attributed to C Duffield.
Nurse managers in Australia: mentoring, leadership and career progression.
Identification of those leadership qualities which nurses believe led to their successful attainment of a nursing management position may help in understanding how to identify and foster leadership potential amongst nursing staff. This study asked nurse managers to indicate the important factors which influenced and facilitated their entry to management positions with a particular reference to the development of leadership characteristics. The results suggest that the leadership qualities we expect nurse managers to display evolve in a largely random way. Additionally, there is evidence that the development of leadership skills and attainment of management positions remains fragmented and random in nature. Because of this, individual nurse managers develop leadership skills almost by default using informal strategies to learn and develop. These findings should provide direction to educational providers and senior managers who seek to develop future leaders and managers.
Australian nurse educators identify gaps in expert practice.
In Australia, nurses face a double-barreled challenge to their role. With the rapid adoption of new health care technologies coupled with increasing economic constraints, they find themselves "doing more with less." In this context of continuous change, it is useful to determine what expert nurse clinicians deem the most essential skills, attitudes and knowledge required for practice in complex technological environments. Separate panels of 28 educators and 43 cardiac nurse clinicians participated in a national Delphi study rating the importance to the nursing role of 107 items drawn from the international literature on expert practice and technology. Indicating the importance of each item in both the "real" and "ideal" worlds of practice, educators identified 58 items where they felt actual practice was substantially far from the ideal. For 16 of these items relating to empowerment of patients, nursing research, and technology policy, the educators rated clinical behavior below the median of the real world scale, indicating substandard performance of a role or inadequate assimilation of a concept. The implications for the definition of expert practice and for curricula development are discussed.
Nurses' perceptions of their professional growth on completion of two years of postgraduate education.
In a climate of diminishing financial resources in service industries such as health care and education, it is not surprising that a focus on measuring and ensuring appropriate outcomes is widespread. Graduate education has the potential to make a significant difference to the professional behaviour of graduates. Postgraduate nursing coursework programs have been developed and offered in such a climate, many now charging full course fees, which no doubt stimulates participants and employers to look for value for money in terms of outcomes. A ten year longitudinal study began in 1992 and was designed to determine the impact of postgraduate coursework nursing education on the careers and the professional and personal development of graduates. This paper reports graduates' perception of their personal and professional growth in terms of professional activities such as writing for publication, research, mentoring, and involvement in professional organisations at the completion of their university course. Respondents indicated the course had contributed to increased professional behaviours in all aspects and to a marked improvement in their clinical confidence. Improved self esteem and increased participation in professional activities reflects changing attitudes towards nursing work that have important implications for improved quality of patient care.
It's all in a name. When is a 'Delphi study' not a Delphi study?
As nursing researchers we need to fully understand the origins of the methods we are using in research investigations. Without an in-depth understanding, we may find ourselves violating fundamental underpinning assumptions or conventions through ignorance, and the resulting studies are unlikely to stand up to tests of congruence and rigour. This paper is a discussion of some complexities encountered while exploring the literature on the Delphi technique, a research method we had believed to be straightforward. The Delphi method had been used extensively since its development in the 1950s, and its use in nursing research appears to be increasing. Our explorations revealed that, rather than a simple means of obtaining the judgments of experts, modifications and adaptations over the years have dramatically changed 'the' Delphi. Anyone wishing to use the method needs a sound knowledge of complex theoretical issues associated with its implementation.
Australian clinicians and educators identify gaps in specialist cardiac nursing practice.
Change is endemic in both the health care and higher education sectors in Australia. Consequently professional roles and educational pathways must also evolve and adapt, often catalysed by those in leadership positions. Two national Delphi panels, one of cardiac nurse educators and the other of cardiac nurses, were convened to answer the question 'What knowledge, skills and attitudes are required for an expert nurse practising in the highly technological cardiac care environment?' Respondents indicated on a Likert scale the importance of 107 items to the nurse's role in both the 'real' and 'ideal' worlds of practice. Overall there was very strong agreement between the two panels with results indicating that Australian nurses perform close to their ideal in many areas of practice. For 31 of the items, both panels identified that the reality of practice is quite far from their ideal. Both panels agree that 10 of the behaviours are carried out or valued very little in practice. Reasons why nurses are not carrying out these elements of the role to their satisfaction are discussed and remediation strategies suggested. The findings can inform both curriculum development and clinical practice. In the dynamic health care arena, the nursing profession continues to respond to community and professional needs, seeking to establish sound research-based practice and maintain a high quality of clinical care and nursing management. The development of competencies by the Confederation of Critical Care Nurses (1996) is a good example of professional groups taking the initiative both in defining the practice role and providing tools that assist educational bodies to develop programs appropriate for a practice based discipline. Specialty nursing practice is 'under the microscope' in Australia as the profession seeks the best methods to weight nursing activities, measure nursing outcomes and recruit, retain and justify the use of specialist practitioners.
The Delphi technique.
The Delphi technique is an easy-to-use research instrument which has become an accepted method of achieving consensus among individuals and experts. This paper describes its techniques, parameters for its successful application, variety of uses and some advantages and disadvantages.
Using the computer for clinical placements.
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Is there enough mentoring in nursing?
This paper examines the debate about the benefits of mentoring in nursing and argues that the evidence indicates that mentoring is a professional behaviour that contributes to career success and the development of professional leaders. Some strategies to facilitate mentoring are suggested. As well, the paper presents the findings from analysis of four studies which provided data on the incidence of mentoring among 317 nursing unit managers, 368 clinical nurse specialists, 478 RNs entering a graduate course and 235 of the latter group on completion of their course. The results show that, of those who reported their mentoring experience, more unit managers (45%) than clinical specialists (35%) experiencing mentoring and that 79% of graduating RNs reported that they had increased their mentoring of others since beginning their course. The overall incidence of mentoring was lower than that reported in the United States. Reasons for the findings are discussed.
Predictors of intention to study nursing among school students speaking a language other than English at home.
There is currently a shortage of bilingual nurses in New South Wales. It is important to include bilingual nurses in the workforce to meet not only the cultural and social needs of people speaking a language other than English at home, but also to facilitate the achievement of appropriate health outcomes for a multicultural population. The purpose of this study was to identify demographic and social factors which explain students' intention to study nursing. Respondents were 789 year 11 or 12 students speaking Arabic, Serbo-Croatian, Spanish, Turkish or Vietnamese from twenty-five schools in South Eastern, South Western and Western Sydney. Data were collected through a self-completed questionnaire. Chi square, t-test and logistic regression analysis were used for data analysis. Logistic regression analysis concluded that perceived parental income, years of settlement in Australia and father's occupation were significant factors. Bivariate analysis also revealed that significant differences were found in the intention to study nursing between male and female students and between students with a higher and lower Tertiary Entrance Rank (TER). Parental influence also affects students' intention. However, gender and TER were found to be insignificant after adjustment for other variables in the logistic regression model.
The impact of graduate education on the career paths of nurses.
This paper reports the findings of the first phase of a ten year longitudinal study of nurses graduating with higher degrees and diplomas. The higher education sector in Australia has been subjected to a variety of changes in the past decade. Amalgamations and restructuring, altered funding formulae, recognition of prior learning and credit transfer are some of the initiatives, many dictated by governmental bodies, which impact on the education system. Within this volatile context, graduate education in nursing has developed significantly in both quality and variety. These courses have been taken up vigorously by professionals who, until 1990, had limited opportunities for tertiary study in the discipline. Perhaps one of the most significant changes within education, and interestingly paralleled in the health sector, is the move to examine more carefully the outcomes of the process or service provided. The demographic profile, career movements and career plans of graduating students over a five year period from December 1992- December 1996 are presented.