Catherine Fetherston

Research on transformative learning (Mezirow, 1991), particularly within the context of higher education, has demonstrated the significant impact university learning can have on a wide range of cohorts across diverse learning contexts. However, the extensive body of literature pertaining to transformative learning remains largely silent on the experiences of Aboriginal and Torres Strait Islander university students and the extent to which their engagement with academia can be transformative. Nevertheless, Nakata’s (2007b) cultural interface theory has shaped policy, practice and thought in Indigenous higher education, elucidating the nuances, complexities and challenges that confront Indigenous students in their journey through university. In bringing together these two critical theories, this study investigated the journeys of three undergraduate Indigenous university students finding that university can indeed be a site of positive personal transformation. Such changes were fostered through critical peer support relationships, relationships with family and loved ones as well as a growing confidence and pride in their cultural identities. These findings have important implications for the way institutions support and teach Aboriginal and Torres Strait Islander students and provides a nuanced insight into their university journeys at the cultural interface.

Background: Insufficient wound care knowledge in nursing students affects confidence and competence. Scarce research on wound care content and delivery leads to curriculum disparities. Integrating essential content is vital for improved wound care education.

Aims: This study aimed to determine Australian wound care curriculum content for a 3-year Bachelor of Nursing program and identify the optimal year for introducing each topic, as recognised by experts.

Methodology: A three-round Delphi survey involved 17 wound care experts in Australia. The survey used the Standards for wound prevention and management to identify 74 wound care topics within the three categories of anatomy and physiology (A & P), assessment and treatment/therapies, requiring >70% agreement on the year of introduction for each topic.

Results: The Delphi process established consensus on the initial introduction year for 65 of the 74 wound care topics. A total of 19 topics garnered consensus exceeding 70% in the first year, 19 in the second year, 15 in the third year, and 12 for postgraduate study. Expert consensus enabled a progressive development of knowledge and skills in wound theory, assessment, care planning, patient education and prevention over the 3-year program.

Conclusion: The gathering of this data has allowed for conceptual scaffolding of these topics according to the stage at which wound care topics are recommended for introduction into nursing curricula.

Many formalised breastfeeding supports have been implemented in Australia, however breastfeeding duration still falls well short of national and global targets. A re-exploration of how women currently seek, interact with and respond to the support provided them can assist in informing further change. We used 'narrative inquiry' to examine the stories of seven women's lived experiences of support whilst establishing breastfeeding and collected data through audio-recorded conversations, transcribed verbatim stories, retold narratives, and researcher reflexive journaling. Clandinin and Connelly's framework (2000) was used to inform analysis by enabling an understanding of the relational aspects and the changeable nature of mothers' experiences. Thematic data analysis revealed four themes: 'trusting in the "natural"', 'navigating the complexity of the breastfeeding journey', 'battling others' assumptions', and 'finding strength in supportive environments'. All mothers found strength in the supportive interactions they experienced from professional, peer and family support. However, mothers also encountered many barriers, indicating remaining deficits in the support offered to breastfeeding mothers. The support experienced could be improved by encouraging more positive societal attitudes and developing a more knowledgeable, non-judgemental health system that delivers anticipatory, rather than reactive support responses. This will encourage the recognition of individuality, and support breastfeeding self-efficacy and the role of family support in overcoming breastfeeding difficulties.

Background: Information literacy (IL) skills are essential for the translation of current knowledge into evidence-based practice (EBP) in healthcare, which in turn improves patient outcomes. However, students enter pre-registration nursing programs with variable IL skills, which can present challenges when preparing research-literate nursing graduates. Objectives: To develop an online module for nursing students to learn the IL skills they require to effectively implement EBP. Project design: A self-paced, interactive online module was developed for final year pre-registration nursing students at an Australian university and launched in late January 2019. Four different digital tools, including screen-capture videos, split-screen tutorials, e-portfolio/learning journey platforms, and digital badges, were integrated to create an interactive module on database searching and systematic reviews. A student feedback survey was added to collect information on the students’ learning experience. Results: Students reported the online module was challenging but engaging and that its self-paced interactive nature assisted their learning. Digital badges were reported as a motivating factor by students, and their attitudes toward EBP were positive. Students were able to complete the module on their own, but a handful required face-to-face assistance. Conclusion: This project successfully integrated screen-capture videos, split-screen tutorials, e-portfolios and micro-credentialing into one online learning module to assist nursing students with developing the IL skills required for effective EBP.

Problem A lack of understanding of the challenges that Enrolled Nurses experience as they transition to Registered Nurse may prevent the development of resources and strategies necessary to ensure their success in the program. Question What are the experiences of nursing students who are enrolled in a Bachelor of Nursing program as they transition from Enrolled Nurse to Registered Nurse? Methods A qualitative interpretive approach, influenced by phenomenology and underpinned by Schlossberg’s Transition theory, was used in this study. Data was collected from Enrolled Nurses (n = 7) using individual interviews and enriched with additional context from a focus group of nursing academics (n = 4). Findings Five themes were identified: ‘Standing out from the crowd’, ‘struggling with the academic demands’, ‘seeking personal and professional balance’, ‘moving beyond the constraints of being an EN’ and ‘growing within the program’. Discussion The challenges experienced by the Enrolled Nurses, such as adapting to the requirements of the tertiary program and balancing study with their other life responsibilities, were identified as being exacerbated by the 12 months of advanced standing that they receive. Strategies to overcome these challenges included accessing academic and personal resources. Success within the program was discussed by these students as empowering their personal and professional lives. Conclusion The challenges the Enrolled Nurses encountered and strategies they employed to succeed in the program are identified in this study. Recommendations to improve the transition of Enrolled Nurses through a Bachelor of Nursing program are proposed.

Problem/Background Perinatal death has far reaching emotional effects for all involved in this devastating event. The opportunity for learning as a result of this catastrophe, however, remains unexplored. Aim To explore midwives’ experiences of caring through, and learning from, perinatal death, to better inform the effective planning and delivery of education that optimises both midwifery and self-care. Methods A naturalistic interpretive multiple case study design. Seventeen midwives, located in Australia, participated in an online group activity hosted as a blog, followed by telephonic focus groups and in-depth email interviews. Findings Thematic data analysis revealed seven major themes: Grappling with the reality of perinatal death; Struggling with personal and professional heartache; Seeking the space to grieve as a professional; Being with the woman and her family; Finding a new purpose; Strengthened through support; and Developing the courage to care. Discussion The initial turmoil and impact of loss reflected the catastrophic nature of perinatal death. Midwives uncovered a journey to acceptance and learning, realising a determination to enhance expertise and discovering value in experiential knowledge. Insecurity regarding competence and confidence to manage perinatal death and bereavement care was highlighted. However, sharing their stories revealed professional fulfilment, personal strength, and solidarity amongst midwives who have endured similar experiences. Conclusion A coordinated approach to support and the dissemination of experiential knowledge and learning could be developed within an online model of narrative sharing and discussion. Debriefing, support and sharing of expertise in this way may foster engagement within and beyond the workplace.

Academic work environments are becoming progressively more digitalised and focused on performativity and commodification, increasing the potential to force an unwanted merge of the boundary between work and non-work domains. This study aimed to explore academic wellbeing and the role played by factors related to work-life merge. Data were collected from a cross sectional survey of 605 Australian and 313 UK academics, who were found to have a short version Warwick-Edinburgh Mental Wellbeing Score of 21.47 ± 4.11 and 21.35 ± 4 respectively, which is significantly below population norms. Australian men’s scores were significantly lower than Australian women (20.7 ± .31, p = .007). Job strain was evidenced by excessive work hours, high levels of intrusive work-related thoughts, reduced physical activity and a self-perception that work-life merge adversely affected psychological and physical health, and mostly only occurred to meet work demands. Action by government education and university leaders is urgently required to identify policy and management practices that are contributing to this ongoing health concern. The establishment of national and university based advisory groups and consideration of a data warehouse to curate a public dataset on the wellbeing of staff within universities could assist in ensuring the outcomes of any action are continually assessed.

Objective: This review aims to identify and synthesize the best qualitative evidence on the experiences of Chinese immigrants receiving palliative care in their country of residence where the culture is predominantly Western, and the experiences of their family carers. Introduction: The recent increase in international immigration has led to challenges in providing culturally appropriate palliative care. Chinese populations have particular beliefs, values and practices surrounding death and filial piety. These differ considerably from those in Western cultures and have significant implications for palliative care service provision. This review will explore the experiences and perceptions of Chinese immigrants and how their cultural beliefs shape their acceptance and decision making related to palliative care. Inclusion criteria: The review will include studies on the experiences of Chinese immigrants over 18 years of age with a terminal medical condition receiving palliative care in outpatient units, hospitals, hospices, specialist palliative care units, homes and community settings in their country of residence where the culture is predominantly Western. Methods: Eligible studies will be studies with qualitative data including designs such as phenomenology, grounded theory, ethnography, narrative research, qualitative description, action research and feminist research published in English and Chinese. CINAHL, PsycINFO, MEDLINE, Scopus and Web of Science Core Collection will be used and grey literature will be searched using ProQuest Dissertations and Theses, OpenGrey and Caresearch. Appraisal of selected studies will be done with the Joanna Briggs Institute Qualitative Assessment and Review tool. Findings will be synthesized through a meta-aggregative approach to produce a comprehensive set of synthesized findings that can be used as a basis for evidence-based practice.

Background: A range of supports are required to protect and promote breastfeeding and although Australia boasts high initiation rates, these supports have not yet been able to increase duration of breastfeeding to achieve national and global targets. Aim: To explore the current literature describing the range of formalised supports being implemented to assist Australian breastfeeding mothers and better enable understanding of where the future focus is required to improve support and ensure breastfeeding success. Method: A search for relevant peer-reviewed and grey literature published after 1989 was undertaken using CINAHL, PubMed, Cochrane Library, Proquest, Scopus and Google Scholar. Findings: Breastfeeding support in Australia exists as globally influenced, policies and directives that inform a range of recommended management procedures, clinical practice and community support. Despite this broad approach, unsupportive societal attitudes still exist and breastfeeding prevalence remains suboptimal. There is also uncertainty regarding how support, from an individual to community health level, is implemented effectively for improved sustainability. Conclusion: Strengthened support at all levels is needed to see the cultural change needed for improvement. Further research into how women interact with support may prove valuable in revealing ways in which current breastfeeding supports can be strengthened to avoid early cessation.

Problem Where misperceptions and a lack of understanding of the realities of the Nursing profession exist, this can result in students entering into Nursing degrees without understanding the academic knowledge, behavioural and physical attributes and other inherent requirements necessary to undertake and succeed in their studies and subsequent career. Question Can an ‘Assessment for Learning’ approach result in enhanced student understanding of inherent requirements and their relationship to registered nurse attributes? Methods This interpretive study analysed students’ written reflections on two Bachelor of Nursing inherent requirement statements using latent content analysis. Purposive sampling of all 165 students enrolled in an introductory professional nursing unit was undertaken with 162 (98.2%) consenting to provide demographic data and have their reflections analysed following completion of their unit. Findings Four themes were identified: Eye opening, responding to self-examination, setting goals and effecting change, and affirming beliefs and attributes. Discussion Analysis of the students’ reflections on the nursing inherent requirements showed they exhibited enhanced awareness, understanding and acknowledgement of personal areas to be addressed, as well as goal setting and the beginnings of acculturation and movement along the pre-professional identity to professional identity continuum. Conclusion An assessment for learning approach enhanced beginning students understanding of requirements inherent in undertaking a Bachelor of Nursing degree, enabling them to set goals for their development as they linked the BNIRs to the attributes required of a registered nurse.