Challenges and possible solutions for accessing scholarly literature among medical and nursing professionals and students in low-and-middle income countries: A systematic review

Factor Analytic Adaptation Study of the Groningen Reflection Ability Scale (GRAS) in Senior Nursing Students

BACKGROUND AND PURPOSE

Reflection is a cyclical and iterative learning process that incorporates critically analyzing experiences, deriving lessons, establishing learning objectives, and implementing newly acquired knowledge in similar situations. This study evaluated the psychometric properties of the Turkish version of the Groningen Reflection Ability Scale (GRAS) among nursing students.

METHODS

This study is a factor analytic investigation with a nested cross-sectional design. This study included 252 fourth-year nursing students and was carried out between 10 March 2024 and 10 May 2024. Data analysis was conducted using the Content Validity Index (CVI), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), Cronbach's alpha for internal consistency, test-retest reliability, and item-total score correlation.

RESULTS

The Turkish version of the GRAS consists of 23 items divided into three sub-dimensions: self-reflection, empathic reflection, and reflective communication. The internal consistency and reliability of the overall scale and its three sub-dimensions were acceptable. The three-factor construct validity of the Turkish version, identified through Exploratory Factor Analysis, was successfully confirmed with Confirmatory Factor Analysis.

CONCLUSION

The Turkish version of the GRAS is a valid and reliable instrument for evaluating reflective practice skills among fourth-year nursing students in Türkiye.

IMPLICATIONS

Nursing Practice: Evaluating reflective practice skills plays an important role in enhancing nursing students' critical thinking and their ability to provide patient-centered care. Policy Development and Implementation: Institutional policies should prioritize the standardized evaluation of reflective abilities within nursing education to maintain consistency and effectiveness. Education: Integrating reflection-based strategies into nursing curricula promotes self-awareness and professional growth.

FUTURE RESEARCH

Further studies should investigate the long-term influence of structured reflection on clinical competence and patient outcomes.

The State of Surgical Research in Sub-Saharan Africa: An Urgent Call for Surgical Research Trainers

Background

Surgery in low- and middle-income countries (LMICs) is poorly developed because of years of neglect. Sustained research on global surgery led to its recognition as an indivisible and indispensable part of primary healthcare in 2015. However, this has had little visible effect on surgical ecosystems within LMICs, especially in sub-Saharan Africa (SSA). SSA surgical research systems strengthening, which includes skills transfer, with local priority setting driving the research agenda, is needed to propel global surgery into the future.

Methods

The authors performed a literature review of the state of surgical research within SSA and also report the initial efforts of two research training nonprofits to empower young African surgeons with research skills.

Results

Surgical research in SSA is disadvantaged even before it is birthed, facing monumental challenges at every stage of development, from research agenda determination to funding, study execution, and publication. Compared with a global output of 17.49 publications per 100,000 population, SSA produces 0.9 (P < 0.0001). The Surgeons in Humanitarian Alliance for Reconstructive, Research, and Education and Enabling Africa Clinical Health Research programs are involved in the longitudinal research mentorship of surgical residents within SSA; the improved quality of research and successful publications by participants suggest nascent steps in growing young surgical scientists.

Conclusions

In the absence of an existing surgical research infrastructure within LMICs, global surgery research trainers should link up and collaborate to help develop a surgical research community that will provide the local data required to help transform the SSA surgical ecosystem.