Biomedical subjects

Moira Attree

Publications and source records attributed to Moira Attree.

3 recordsLinked to original sources

PubMed2006

Evaluating healthcare education: issues and methods.

This paper analyses the methodological issues inherent in evaluating healthcare education and considers approaches for addressing these. Recent policies have exhorted practitioners to base their practice on evidence; however in healthcare education the evidence base is not extensive. Whilst educational evaluation has advanced in the last decades, standardised designs and toolkits are not available. Each evaluation has different aims and occurs in specific contexts, thus the design has to fit the circumstances, yet meet the challenge of scientific credibility. Indicators of educational processes and outcomes are not scientifically verified; no toolkit of standardised 'off-the-shelf' valid, reliable and sensitive measures exists. The evidence base of educational practice is largely derived from small-scale, single case studies; the majority of measures are self-devised, unvalidated tools of unproven reliability, thus meta-synthesis is not appropriate and results are not generalisable. Healthcare educational evaluators need valid and reliable assessments of both knowledge acquisition and its application to practice. The need to establish and explain attribution, i.e. the relationship between educational inputs and outcomes is complex and requires experimental/quasi-experimental design. In addition, educational evaluators face the pragmatic challenge of practice in healthcare contexts, where confounding variables are hard to control and resources are scarce.

Confounding Factors, Epidemiologic↗

PubMed2005

Patient safety: do nursing and medical curricula address this theme?

In this literature review, we examine to what extent patient safety is addressed within medical and nursing curricula. Patient safety is the foundation of healthcare practice and education both in the UK and internationally. Recent research and policy initiatives have highlighted this issue. The paper highlights the significance of this topic as an aspect of study in its own right by examining not only the fiscal but also the human costs such events invite. In the United Kingdom patient safety issues feature prominently in the (Department of Health, 2000a. An organisation with a memory. The report of an expert group on learning from adverse events. The Stationery Office, London, Department of Health, 2000b. Handling complaints: monitoring the NHS complaints procedures (England, Financial year 1998-99). The Stationery Office, London.) policy documentation but this is not reflected within the formal curricula guidelines issued by the NMC and GMC. Yet if healthcare educational curricula were to recognise the value of learning from errors, such events could become part of a wider educational resource enabling both students and facilitators to prevent threats to patient safety. For this reason, the paper attempts to articulate why patient safety should be afforded greater prominence within medical and nursing curricula. We argue that learning how to manage errors effectively would enable trainee practitioners to improve patient care, reduce the burden on an overstretched health care system and engage in dynamic as opposed to defensive practice.

Clinical Competence↗

PubMed2005

Nursing agency and governance: registered nurses' perceptions.

AIM: To explore registered nurses' perceptions of standards of nursing practice and factors that affect nursing practice standards. BACKGROUND: Nursing governance affects nurses' ability to manage nursing practice standards. Lack of nursing professional autonomy has been associated with occupational dissatisfaction, stress, turnover and low morale, which impact upon care quality. METHOD: Grounded theory was used. Data, gathered by semistructured interviews with 142 nurses, theoretically sampled from three National Health Service hospitals were analysed using constant comparative analysis. FINDINGS: Nurses were dissatisfied with their governance over factors that they believed had most influence on nursing practice standards. Perceived lack of control over factors that affect practice standards generated dissatisfaction, frustration and demoralization. CONCLUSIONS: Nurses' perceived lack of governance over their practice requires investigation and attention if occupational dissatisfaction, stress, turnover and low morale, which impact on quality care, are to be reduced. Dissatisfaction with nursing governance indicates a need to review nurses' professional involvement in clinical governance.

Adult↗