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Aleo G, Pagnucci N, Walsh N, Watson R, Lang D, Kearns T, White M, Fitzgerald C. The effectiveness of continuing professional development for the residential long-term care workforce: A systematic review. Nurse Education Today 2024; 137:106161. [PMID: 38493589 DOI: 10.1016/j.nedt.2024.106161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/23/2024] [Accepted: 03/10/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To investigate the effectiveness of continuing professional development in residential long-term care. DESIGN Systematic review. DATA SOURCES PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), and Web of Science. REVIEW METHODS Empirical studies published between 2003 and 2023 describing the effectiveness of continuing professional development in long-term care were selected according to PRISMA guidelines. The type, topic, and effectiveness of continuing professional development activities in long-term care were analysed, in addition to facilitators and barriers. The protocol of this review is registered in PROSPERO. RESULTS A total of 155 studies were selected, including over 17,000 participants the majority of whom were nurses. The most common topics were 'dementia care' (n = 22; 14.2 %), and restraint use (n = 14; 9 %). The impact of continuing professional development was mainly evaluated in terms of 'participant satisfaction with continuing professional development' (n = 5; 3 %), 'staff knowledge' (n = 57; 37 %), 'staff competencies and skills' (n = 35; 23 %), 'resident outcomes' (n = 45; 29 %), and 'staff wellbeing' (n = 12; 8 %). A total of 64 (41 %) studies evaluated if impact of continuing professional development was sustained over time. 'Good organisation', 'a supportive learning environment', 'expressing personal preferences', and 'management support' were described as facilitators of continuing professional development. CONCLUSIONS Increasing numbers of long-term care residents with complex health conditions require nurses with advanced skills, such as dementia care. To improve the effectiveness of continuing professional development, support from managers, who adopt relational leadership styles, is instrumental to integrate new knowledge and skills into practice. This needs to be linked to career progression, and consequently increase the attractiveness of working in the long-term care sector. This could meet the dual goal of improving outcomes for residents and nurses' job satisfaction.
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Affiliation(s)
- Giuseppe Aleo
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Nicola Pagnucci
- Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Via Savi 67, 56100 Pisa, Italy; European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Niamh Walsh
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | | | - Deirdre Lang
- Office of the Nursing & Midwifery Service Director (ONMSD), Clinical Programme Implementation & Professional Development, Room 250, Dr Steeven's Hospital, Dublin 8, Ireland.
| | - Thomas Kearns
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Mark White
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Catherine Fitzgerald
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Iscoe M, Socrates V, Gilson A, Chi L, Li H, Huang T, Kearns T, Perkins R, Khandjian L, Taylor RA. Identifying signs and symptoms of urinary tract infection from emergency department clinical notes using large language models. Acad Emerg Med 2024. [PMID: 38567658 DOI: 10.1111/acem.14883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Natural language processing (NLP) tools including recently developed large language models (LLMs) have myriad potential applications in medical care and research, including the efficient labeling and classification of unstructured text such as electronic health record (EHR) notes. This opens the door to large-scale projects that rely on variables that are not typically recorded in a structured form, such as patient signs and symptoms. OBJECTIVES This study is designed to acquaint the emergency medicine research community with the foundational elements of NLP, highlighting essential terminology, annotation methodologies, and the intricacies involved in training and evaluating NLP models. Symptom characterization is critical to urinary tract infection (UTI) diagnosis, but identification of symptoms from the EHR has historically been challenging, limiting large-scale research, public health surveillance, and EHR-based clinical decision support. We therefore developed and compared two NLP models to identify UTI symptoms from unstructured emergency department (ED) notes. METHODS The study population consisted of patients aged ≥ 18 who presented to an ED in a northeastern U.S. health system between June 2013 and August 2021 and had a urinalysis performed. We annotated a random subset of 1250 ED clinician notes from these visits for a list of 17 UTI symptoms. We then developed two task-specific LLMs to perform the task of named entity recognition: a convolutional neural network-based model (SpaCy) and a transformer-based model designed to process longer documents (Clinical Longformer). Models were trained on 1000 notes and tested on a holdout set of 250 notes. We compared model performance (precision, recall, F1 measure) at identifying the presence or absence of UTI symptoms at the note level. RESULTS A total of 8135 entities were identified in 1250 notes; 83.6% of notes included at least one entity. Overall F1 measure for note-level symptom identification weighted by entity frequency was 0.84 for the SpaCy model and 0.88 for the Longformer model. F1 measure for identifying presence or absence of any UTI symptom in a clinical note was 0.96 (232/250 correctly classified) for the SpaCy model and 0.98 (240/250 correctly classified) for the Longformer model. CONCLUSIONS The study demonstrated the utility of LLMs and transformer-based models in particular for extracting UTI symptoms from unstructured ED clinical notes; models were highly accurate for detecting the presence or absence of any UTI symptom on the note level, with variable performance for individual symptoms.
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Affiliation(s)
- Mark Iscoe
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Section for Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Vimig Socrates
- Section for Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, Connecticut, USA
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - Aidan Gilson
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Ling Chi
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Huan Li
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - Thomas Huang
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Thomas Kearns
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rachelle Perkins
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Laura Khandjian
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - R Andrew Taylor
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Section for Biomedical Informatics and Data Science, Yale University School of Medicine, New Haven, Connecticut, USA
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Odatzoglou P, Kearns T, Pittaway C, Dobson JM. Impact of palliative-intent radiotherapy with or without chemotherapy on lameness in flat coat retrievers with localised periarticular histiocytic sarcoma - a retrospective cohort, single institution study. Vet Comp Oncol 2024; 22:22-29. [PMID: 37935625 DOI: 10.1111/vco.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023]
Abstract
Histiocytic sarcoma (HS) is a common tumour in flat coat retrievers (FCRs) often affecting periarticular tissues and joints. Palliative-intent radiotherapy, seeks to achieve local tumour control, pain relief and improve limb function. However, the effect of palliative-intent radiotherapy on analgesic levels of dogs with localised HS has not been studied. We hypothesised that palliative-intent radiotherapy could improve lameness in dogs affected by localised HS. This study aimed to assess the impact of palliative-intent radiotherapy on lameness of FCRs with localised HS. A retrospective cohort single institution study was performed. Medical records of FCR dogs with HS that received external beam radiotherapy between 2003 and 2022 were reviewed and included demographic, staging, severity of baseline lameness, therapeutic management and outcome data. Descriptive statistics, McNemar's chi-squared test, Fisher's exact test and Kaplan-Meier analysis were used for statistical analysis. Thirty-nine dogs were included with a median age of 7.2 years, 25 were male and 14 were female. HS was most commonly located in the forelimb (29 dogs, 74.3%), affecting the shoulder joint (19 dogs, 48.7%). Staging was performed in all 39 dogs with 22 (56.4%) dogs having localised HS, six (15.3%) dogs had localised HS with node metastasis and 11 (28.2%) dogs had localised HS with systemic metastasis. All dogs received palliative-intent hypo-fractionated radiation therapy, 32 (82%) dogs showed improvement in lameness. In conclusion, palliative intent radiation treatment has an analgesic effect reducing lameness or clinical signs associated with affected tumour-bearing joints.
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Affiliation(s)
- Petros Odatzoglou
- Department of Veterinary Medicine, Queen's Veterinary School Hospital, School of Biological Sciences, University of Cambridge, Cambridge, UK
| | - Thomas Kearns
- Department of Veterinary Medicine, Queen's Veterinary School Hospital, School of Biological Sciences, University of Cambridge, Cambridge, UK
| | | | - Jane M Dobson
- Department of Veterinary Medicine, Queen's Veterinary School Hospital, School of Biological Sciences, University of Cambridge, Cambridge, UK
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Fitzgerald C, Pagnucci N, Kearns T, Hallissy M, Walsh N, Kelly C, Killeen C, White M, Aleo G. The experience and attitudes of long-term care workers with teaching and learning modalities for the delivery of continuing professional development activities: a mixed-methods study. Nurse Educ Pract 2023; 72:103774. [PMID: 37677990 DOI: 10.1016/j.nepr.2023.103774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
AIM to develop a better understanding of the attitudes and experiences of healthcare workers and managers with face-to-face, online asynchronous (pre-recorded), and online synchronous (live) modalities for Continuing Professional Development (CPD) working in the Long-Term Care (LTC) sector. BACKGROUND The recent global pandemic significantly interrupted the delivery and organisation of education and training for healthcare professionals internationally. As a result of the restrictions, healthcare professionals' access to CPD was limited, consequentially education and training activities were mostly delivered online. Research into the experiences of healthcare workers with the various teaching and learning modalities in the LTC setting is limited. DESIGN An explanatory mixed methods study using an exploratory sequential design. METHODS A two-phase study conducted from January 2022 to September 2022, in the Republic of Ireland. In phase one, researchers conducted four focus groups and in phase two 168 participants completed a survey to explore the results of phase one. RESULTS From the focus groups interviews five themes emerged regarding participants' experiences, attitudes and preferences with the three modalities of CPD education and training in the field of LTC: 1) Flexibility, 2) Networking, 3) Resources and Support, 4) Engaging and meaningful learning, and 5) Balancing online and face-to-face learning through Blended Learning. Results from the survey found the preferred modality was face to face (n = 54, 32.1%), followed very closely by blended learning (n = 51, 30.4%). Most of the respondents reported that synchronous online CPD education was convenient, flexible, offers the opportunity to interact with peers, and that its quality depends on educators' skills. The majority of respondents (n = 155, 92.3%) declared that they would require support in the workplace to implement their new knowledge and skills. CONCLUSIONS This study revealed the significance participants place on 'engagement' when taking part in education and training. Engagement was described as a key factor to improve the delivery of CPD in the LTC setting. In addition, regardless of the mode of delivery, participants reported that they need to be supported in the workplace to implement their new knowledge and skills. This requires the support and endorsement of employers and managers, who could ensure more protected time for learning, technical support and championing facilitators and mentors in the workplace to enhance the translation of new knowledge into clinical practice. TWEETABLE ABSTRACT In LTC settings, face-to-face CPD is the preferred mode of delivery. Although synchronous online CPD is very convenient, educators must be able to engage learners. LTC workers need support by managers to implement their new knowledge and skills in their workplace.
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Affiliation(s)
- Catherine Fitzgerald
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Nicola Pagnucci
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Thomas Kearns
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Michael Hallissy
- H2 Learning, The Digital Hub, 10-13 Thomas Street, Dublin, Ireland.
| | - Niamh Walsh
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Carmel Kelly
- Leading Healthcare Providers Skillnet, 2A Convent Road, Dun Laoghaire, Co., Dublin, Ireland.
| | - Clodagh Killeen
- Leading Healthcare Providers Skillnet, 2A Convent Road, Dun Laoghaire, Co., Dublin, Ireland.
| | - Mark White
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
| | - Giuseppe Aleo
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.
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Pagnucci N, Aleo G, Orlik W, Mahon P, Kearns T, Kelly C, Lordan T, Fitzgerald C. Teaching and learning modalities for continuing professional development in the long-term care: A rapid synthesis review. Nurse Educ Pract 2023; 70:103638. [PMID: 37104926 DOI: 10.1016/j.nepr.2023.103638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/07/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023]
Abstract
AIM To describe the various teaching and learning modalities for the delivery of Continuing Professional Development activities for health care professionals in the long-term care sector. BACKGROUND Continuing Professional Development is a key activity that organisations undertake to achieve effective workforce planning, recruitment, retention and upskilling strategies in long-term care settings. During the Covid-19 pandemic there was a rapid move to online modalities of Continuous Professional Development, but there is a paucity of evidence in relation to their effectiveness compared with face-to-face, or in-class learning. DESIGN A rapid synthesis review. METHODS MEDLINE, CINAHL and HEALTH BUSINESS ELITE databases were used to identify relevant articles that were published between 2016 and 2022. Original studies of any design investigating Continuing Professional Development activities, with or without a comparison between interventions or activities were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. The Kirkpatrick model was adopted as a globally recognised method for evaluating training programmes. RESULTS After a full text analysis, 34 papers were included in the review. Face to face was the most common method of delivery followed by online, while blended (a mix of face-to-face and online delivery) was the least common method used. The teaching modalities were not associated with specific learning contents, but were used for a range of content. Most studies obtained positive outcomes following implementation of the educational interventions. Kirkpatrick Level 4 (results) was the most commonly measured outcome. CONCLUSIONS While blended learning was the least common method of delivery, it was found to be more beneficial for learners than face-to-face or online exclusively. There are now new spaces to learn and new technologies that allow us to 'reimagine' where, when and how we teach. This requires Continuing Professional Development providers to design and tailor their courses according to health professionals' learning needs and the clinical contexts where they work. We recommend that Continuing Professional Development providers involve employers when designing teaching and learning activities for Long Term Care workers, to decide which modalities enable effective knowledge translation.
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Affiliation(s)
- Nicola Pagnucci
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132 Genoa, Italy; European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland
| | - Giuseppe Aleo
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland
| | - Witold Orlik
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland
| | - Paul Mahon
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland; Centre for Nursing and Midwifery Advancement, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
| | - Thomas Kearns
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland; Centre for Nursing and Midwifery Advancement, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland
| | - Carmel Kelly
- Leading Healthcare Providers Skillnet, 2A Convent Road, Dun Laoghaire, Co. Dublin A96 W7C5, Ireland
| | - Thomas Lordan
- Leading Healthcare Providers Skillnet, 2A Convent Road, Dun Laoghaire, Co. Dublin A96 W7C5, Ireland
| | - Catherine Fitzgerald
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St.Stephen's Green, Dublin, Ireland.
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Fitzgerald C, Aleo G, Affonso D, Orlik W, Grech P, García-Vivar C, Kilkku N, Wray J, Culhane A, Balogh Z, Lillo-Crespo M, Harrison N, Gazić M, Kearns T. Development of a European Centre of Excellence (Coe) for Research in Continuing Professional Development (UPGRADE). J CME 2023; 12:2160092. [PMID: 36969484 PMCID: PMC10031800 DOI: 10.1080/28338073.2022.2160092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/18/2023]
Abstract
The European Centre of Excellence (CoE) for Research in Continuing Professional Development (UPGRADE) is a pan-European network of researchers, clinicians, regulators, educators, and professional bodies, established in 2020 through a consensus group of experts, who defined its mission, vision, values, aims and objectives. The Centre's aim is to advance the science of Continuing Professional Development (CPD) for healthcare professionals through research and dissemination of best practices for CPD. Debate among UPGRADE partners and interchange of research data will yield best practices across countries to optimise quality CPD programmes. Collaboration, information exchange and communication among CPD experts will be facilitated through UPGRADE via an online Community of Inquiry (CoI). UPGRADE aims to evolve as a driving force network of academics and health professional leaders in research, education, professional regulation, and clinical practice whose collaborative work ensures quality and safe person-centred care. UPGRADE members are from 22 European countries, represented by strategic leaders in diverse sectors of health, policy, academia, and professional organisations. Three research-working groups constitute the pillars of UPGRADE, which addresses gaps in research, collect and create critical databases, and solidify the effectiveness of CPD.
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Affiliation(s)
- Catherine Fitzgerald
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Giuseppe Aleo
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dyanne Affonso
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Witold Orlik
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paulann Grech
- Department of Mental Health, University of Malta, MaltaMalta
| | | | - Nina Kilkku
- School of Social Services and Health Care, Tampere University of Applied Sciences, Tampere, Finland
| | - Jane Wray
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Aisling Culhane
- Department of Research and Policy Psychiatric Nurses’ Association Ireland, Station House The Waterways Sallins, Co Kildare, Ireland
| | - Zoltán Balogh
- College Professor Head of Nursing Department, Vice Dean for Clinical Relations, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | - Nigel Harrison
- Pro Vice Chancellor & Dean, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Mario Gazić
- President of Croatian Nursing Council, University of North, Zagreb, Croatia
| | - Thomas Kearns
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
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Bideau YM, Kearns T. A European Approach to Micro-credentials for Lifelong Learning and Employability. J Eur CME 2022; 11:2147288. [DOI: 10.1080/21614083.2022.2147288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yann-Maël Bideau
- European Commission, DG Education, Youth, Sport and Culture, Brussels, Belgium
| | - Thomas Kearns
- European Centre of Excellence for Research in Continuing Professional Development, Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
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Orlik W, Aleo G, Kearns T, Briody J, Wray J, Mahon P, Gazić M, Radoš N, García Vivar C, Lillo Crespo M, Fitzgerald C. Economic evaluation of CPD activities for healthcare professionals: A scoping review. Med Educ 2022; 56:972-982. [PMID: 35451106 PMCID: PMC9543361 DOI: 10.1111/medu.14813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
CONTEXT Continuing professional development (CPD) activities for healthcare professionals are central to the optimisation of patient safety and person-centred care. Although there is some evidence on the economics of healthcare professionals training, very little is known about the costs and benefits of CPD. METHODS This study aimed to review the research evidence on economic evaluations of CPD activities for healthcare professionals. CINAHL, MEDLINE/PubMed, Scopus, Econlit and Web of Science databases were used to identify articles published between 2010 and 2021. RESULTS Of the 6791 titles identified, 119 articles met the inclusion criteria and were included in this scoping review. The majority of articles were partial economic evaluations of CPD programmes (n = 70); half were from the USA. Studies that included multiple professions were most prevalent (n = 54), followed by nurses (n = 34) and doctors (n = 23). Patient outcomes were the most commonly reported outcome (n = 51), followed by change in clinical practice (n = 38) and healthcare professionals' knowledge gain (n = 19). CONCLUSIONS There is an urgent call for more evidence regarding the economic evaluations of CPD. This is particularly important in view of the rising costs of healthcare globally. The majority of studies included in this review did not provide detailed information on the evaluations and many focused exclusively on the cost of CPD activities rather than outcomes.
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Affiliation(s)
- Witold Orlik
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Giuseppe Aleo
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Thomas Kearns
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jonathan Briody
- Division of Population Health Sciences, Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jane Wray
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Paul Mahon
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | | | | | - Catherine Fitzgerald
- Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
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Kearns T. The impact of Continuing Professional Development on nurses' wellbeing and satisfaction. Prof Inferm 2021; 74:256. [PMID: 35363965 DOI: 10.7429/pi.2021.744256b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The European Centre of Excellence for Research in Continuing Professional Development (CPD) aims to develop a pan-European network of researchers, clinicians, regulators, and professional bodies to advance the science of CPD through research and foster knowledge exchange to promote best practices in CPD that can be translated across Europe. Currently, the Centre has members from 22 European countries. Three research-working groups have been established to develop key activities into CPD: 1) Evaluating the impact of CPD; 2) Digital Pedagogies for CPD; 3) The economics of CPD. One of its research activities focuses on exploring CPD needs of newly qualified nurses and midwives (NQNMs) and the impact on their "Intention to leave" and "Job satisfaction". However, information about the range and extent of CPD activities NQNMs participate in during the first 24 months following graduation is limited. It is also not well known how NQNMs' participation in CPD activities is associated with job satisfaction and intention to leave the organisation or the profession. AIM To develop a better understanding of the CPD needs of NQNMs and explore the impact on NQNMs' job satisfaction and intention to leave. METHODS A cross-sectional study using an online survey in four European countries: Ireland, UK, Italy, and Croatia. SAMPLE 2254 NQNMs. The questionnaire was developed using three validated sources: 1. The Q-PDN measures "motives", "conditions" and "importance" given to CPD and "CPD activities undertaken" by nurses. 2. The McCloskey/Mueller Satisfaction Scale (MMSS) assesses nurses' job satisfaction. 3. Four questions on Intention to leave current workplace (e.g., ward), organisation, or the nursing profession, adapted from Heinen et al. (2013). The last open-ended question, developed by the RCSI research team, asks the main motivation for leaving the profession. RESULTS Data collection will start by the end of September 2021. Expected outcomes are: 1) Create a database to inform a further pan-European wide survey of NQNMs and their CPD needs and 2) Provide recommendations to regulators, healthcare providers and policy makers about the CPD needs of NQNMs and factors associated with job satisfaction and Intention to Leave. CONCLUSIONS Previous research into CPD demonstrates its potential to improve job satisfaction and retention. Likewise, there is evidence that it is important to support NQNMs through appropriately designed CPD programs. The present European study intends to contribute to the scientific knowledge base on CPD needs and its impact on job satisfaction and retention in NQNMs.
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Affiliation(s)
- Thomas Kearns
- Executive Director, Faculty of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Clune Mulvaney C, Carney M, Kearns T. Leveraging momentum of 2020-Reflections from an International Conference. J Nurs Manag 2021; 29:609-612. [PMID: 33484028 DOI: 10.1111/jonm.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/19/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE This Commentary illustrates how innovative clinical and research initiatives highlight the ingenuity and creativity of nursing and midwifery professions thus leveraging the momentum of 2020 that commenced with the Year of the Nurse and Midwife and the Nursing Now Challenge. BACKGROUND Speakers demonstrated through vision, creativity and policy generation how the world is now in a different place due to COVID-19 and how the global crisis will change and shape the future of health care delivery. EVALUATION Speakers were invited because of their reputation as international leaders in global health and population. Participants evaluated content and its relevance to research, education and practice in group discussions. KEY ISSUES The current global crisis determines that the capabilities and capacity of nurses and midwives will become more crucial than ever to the delivery of universal health coverage (UHC) and population health by 2030. CONCLUSIONS Global leaders and policymakers must seek the knowledge and skills they need to support their work during a global crisis. IMPLICATIONS FOR NURSING MANAGEMENT Achieving population health and equitable access to health care is dependent on an adequate health workforce.
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Affiliation(s)
- Catherine Clune Mulvaney
- Faculty of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Marie Carney
- Faculty of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Thomas Kearns
- Faculty of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Abstract
A code of ethics for the practice of nursing seeks to capture, in a written document, the normative values, ethical principles and standards of good care to guide nurses - qua moral agents. A codification of the accepted collective values of nursing can play a constitutional and directional role for the profession. It can further stimulate discussions about nursing that reflect the dynamic essence of the profession. Consequently, there is merit to continually reflecting on a code's function and role especially when a new or revised code is introduced to the nursing profession and the wider public such as the European Nursing Council's Code of Ethics and Conduct for European Nursing. This paper examines codes of ethics in general and the European Nursing Council Code in particular using the framework of Gaumnitz and Lere. Although the European Nursing Council Code has all the ingredients of a contemporary professional ethics code, our position is that future iterations or addenda to this Code should be aligned to the UN Sustainable Development Goals and take a more radical step in becoming an exemplar of a nursing code that can be a catalyst for the advancement of the Sustainable Development Goals.
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Carney M, Kearns T, Greene K. Collaborative strategic initiative between a university and hospital network group: Advanced nurse/midwife practice forum. J Nurs Manag 2020; 28:1457-1460. [PMID: 32667682 DOI: 10.1111/jonm.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/03/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Faculty of Nursing and Midwifery, one of a few nursing and midwifery faculties worldwide, was established in 1974 by Ms Mary Frances Crowley, for postgraduate nursing education, and is situated within the Royal College of Surgeons in Ireland, University of Medicine and Health Sciences. The RCSI operates through a network group of university hospitals: Beaumont, Connolly, Drogheda, Cavan, Monaghan and the Rotunda. Combined these hospitals have 120 registered and candidate ANP/AMPs and caters for general, psychiatric, children and maternity patients/clients. The drive to establish the forum between the faculty and the six Dublin hospitals was to build capacity among advanced nurse practitioners and advanced midwife practitioners (ANP/AMPs) who are seen as intelligent consumers of evidence-based research and safe practice. The SCAPE report identified research as the single domain that was underdeveloped within the ANP role, in the study exploring the role of ANPs and CNSs. Latterly, the Nursing and Midwifery Board of Ireland highlighted research as a vital component of the ANP/AMP role in its standards for advanced nurse and midwife practice. The faculty acted collaboratively to introduce an ANP/AMP forum to support advanced practitioners working in the university hospital group in their education and professional development, support the expansion of their knowledge base through practice-based enquiry and research and act as a conduit for interactions between ANPs/AMPs by keeping them up to date with practice and research. METHODS The Initiation phase was undertaken through a survey of needs; Implementation phase by extensive literature review and research-based newsletters sent to individuals by the forum coordinator; and the Evaluation phase through focus groups.
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Affiliation(s)
- Marie Carney
- Faculty of Nursing and Midwifery, RCSI Network Group Hospitals, Dublin, Ireland
| | - Thomas Kearns
- Faculty of Nursing and Midwifery, RCSI, Dublin, Ireland
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Twigg M, Ilyas S, Kearns T, Zaki D, Grimes L. The provision of patient-centred care: A qualitative analysis of community pharmacists’ views after consultation skills training. Res Social Adm Pharm 2018. [DOI: 10.1016/j.sapharm.2018.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Foster SA, Wund MA, Graham MA, Earley RL, Gardiner R, Kearns T, Baker JA. Iterative development and the scope for plasticity: contrasts among trait categories in an adaptive radiation. Heredity (Edinb) 2015; 115:335-48. [PMID: 26243135 PMCID: PMC4815453 DOI: 10.1038/hdy.2015.66] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 06/02/2015] [Accepted: 06/04/2015] [Indexed: 01/19/2023] Open
Abstract
Phenotypic plasticity can influence evolutionary change in a lineage, ranging from facilitation of population persistence in a novel environment to directing the patterns of evolutionary change. As the specific nature of plasticity can impact evolutionary consequences, it is essential to consider how plasticity is manifested if we are to understand the contribution of plasticity to phenotypic evolution. Most morphological traits are developmentally plastic, irreversible, and generally considered to be costly, at least when the resultant phenotype is mis-matched to the environment. At the other extreme, behavioral phenotypes are typically activational (modifiable on very short time scales), and not immediately costly as they are produced by constitutive neural networks. Although patterns of morphological and behavioral plasticity are often compared, patterns of plasticity of life history phenotypes are rarely considered. Here we review patterns of plasticity in these trait categories within and among populations, comprising the adaptive radiation of the threespine stickleback fish Gasterosteus aculeatus. We immediately found it necessary to consider the possibility of iterated development, the concept that behavioral and life history trajectories can be repeatedly reset on activational (usually behavior) or developmental (usually life history) time frames, offering fine tuning of the response to environmental context. Morphology in stickleback is primarily reset only in that developmental trajectories can be altered as environments change over the course of development. As anticipated, the boundaries between the trait categories are not clear and are likely to be linked by shared, underlying physiological and genetic systems.
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Affiliation(s)
- S A Foster
- Department of Biology, Clark University, Worcester, MA, USA
| | - M A Wund
- Department of Biology, The College of New Jersey, Ewing, NJ, USA
| | - M A Graham
- Department of Biology, Clark University, Worcester, MA, USA
| | - R L Earley
- Department of Biological Sciences, University of Alabama, Tuscaloosa, AL, USA
| | - R Gardiner
- Department of Biology, The College of New Jersey, Ewing, NJ, USA
| | - T Kearns
- Department of Biology, The College of New Jersey, Ewing, NJ, USA
| | - J A Baker
- Department of Biology, Clark University, Worcester, MA, USA
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Kearns T, Wolfson AB. Metabolic acidosis. Emerg Med Clin North Am 1989; 7:823-35. [PMID: 2509197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This article reviews acid-base homeostasis and discusses the approach to the acidotic patient, with special reference to problems commonly encountered in emergency practice. General principles of therapy are presented, and their application to specific types of life-threatening metabolic acidosis addressed. By extension, recommendations are made concerning the treatment of the acidosis associated with cardiac arrest. Finally, preliminary information is presented on promising new approaches to the treatment of metabolic acidosis that are currently under investigation.
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Affiliation(s)
- T Kearns
- University of Pittsburgh Affilated Residency in Emergency Medicine, Pennsylvania
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Kearns T. The psychology of play. Australas Nurses J 1976; 5:25-6, 29. [PMID: 1051371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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