Experts and Expertise in Organizations: An Integrative Review on Individual Expertise

Background: Rural and remote nursing has unique practice requirements that create a need for distinct education and practice preparation. Preparing registered nurses (RNs) to work in rural and remote communities is essential for the support and advancement of rural and remote health, as there is a shortage of rural and remote health care providers. Purpose: An integrative literature review was conducted to identify the current continuing education needs of rural and remote RNs internationally. Sample: Eight studies were included in the integrative review of the literature. Countries reported in the literature included Canada (n = 2), Australia (n = 2), Sweden (n = 1) and the United States (n = 3). Method: An integrative literature review on rural and remote nursing practice continuing education was conducted using Torraco’s (2005) guidelines, in addition to Whittemore and Knafl’s (2005) methodological strategies. A search strategy was created, tested, and approved by the research team.Themes were extracted, collated, analyzed, and knowledge synthesized. Findings: Rural and remote RNs identified areas requiring enhanced ongoing training. The identified training areas were summarized into the following four themes: 1) Comprehensive specialized nursing practice for direct patient care, 2) Unanticipated events, 3) Non-direct patient care, and 4) Advanced specialty courses. Conclusion: The autonomy, competency, and expertise that is expected of RNs working in rural and remote locations requires educational supports. Rural and remote nursing continuing education is required in the areas of: comprehensive specialized nursing practice for direct patient care, unanticipated events, non-direct patient care, and advanced specialty courses. Keywords: continuing education, integrative review, registered nurse(s), remote, rural Acknowledgements: The authors thank Saskatchewan Polytechnic for partial funding of this review through the Seed Applied Research Program. The authors also thank their research team member Chau Ha and research assistant Devendrakumar Kanani for their contributions to this integrative review.

Human resource development (HRD) academics and practitioners often speak of developing expertise in individuals and unleashing expertise in organizations. For individuals, expertise has professional and personal implications related to employment, work performance, career development, career transition, and resulting livelihood across the life span. For organizations, expertise has implications for training and development; for organizational development, as a competitive advantage; and for performance. Expertise presents challenges and opportunities for HRD and merits additional research to meet such challenges and leverage opportunities to benefit individuals, teams, organization, communities, nations, and humanity. The purpose of this integrative literature review was to examine the construct of expertise within the context of HRD. Findings included where, when, and how authors used expertise in the HRD literature. Major themes comprised expertise and assessment, workforce development, professional development, leadership development, redevelopment, and elicitation and transfer. Findings have implications for theory and practice and inform future research.

Despite growing demand for practicable methods of research evaluation, the use of bibliometric indicators remains controversial. This paper examines performance assessment practice in Europe—first, identifying the most commonly used bibliometric methods and, second, identifying the actors who have defined wide-spread practices. The framework of this investigation is Abbott’s theory of professions, and I argue that indicator-based research assessment constitutes a potential jurisdiction for both individual experts and expert organizations. This investigation was conducted using a search methodology that yielded 138 evaluation studies from 21 EU countries, covering the period 2005 to 2019. Structured content analysis revealed the following findings: (1) Bibliometric research assessment is most frequently performed in the Nordic countries, the Netherlands, Italy, and the United Kingdom. (2) The Web of Science (WoS) is the dominant database used for public research assessment in Europe. (3) Expert organizations invest in the improvement of WoS citation data, and set technical standards with regards to data quality. (4) Citation impact is most frequently assessed with reference to international scientific fields. (5) The WoS classification of science fields retained its function as a de facto reference standard for research performance assessment. A detailed comparison of assessment practices between five dedicated organizations and other individual bibliometric experts suggests that corporate ownership and limited access to the most widely used citation databases have had a restraining effect on the development and diffusion of professional bibliometric methods during this period.

OF THESIS MUSIC THERAPY INTERVENTIONS FOR END-OF-LIFE CARE: AN INTEGRATIVE LITERATURE REVIEW Music therapy plays an integral role in end-of-life care, positively impacting emotional, social, physical, cognitive and spiritual health. The purpose of this integrative review was to collect and compile studies (N= 55) between 2000 and 2016 on the topic of music therapy interventions in end-of-life care, in order to provide both music therapy students and therapists access to the most recent and commonly used music therapy interventions and goals. Results of the integrative literature review indicate that the most common intervention for all age groups in end-of-life care is songwriting and composition, with the most common therapeutic goal being emotional expression and catharsis. Details of music therapy interventions, goals and song details are written in tables for readers to refer to as a guide. Further research is needed with each specific age group and setting, in order to provide refined results beyond what is revealed through this review. Additionally, evaluating therapeutic outcomes of the interventions and goals obtained through this integrative review is another step that can be taken for future research.

To examine the literature exploring the current understanding of student nurse participation in clinical handover whilst they are enrolled in an undergraduate preregistration course. The importance of handing over the care of a patient to ensure continuity and safety of care is well-recognised. Effective preparation of student nurses to competently perform this critical task requires the use of appropriate teaching strategies to support this learning, within undergraduate preregistration nursing programs. An integrative literature review. An integrative literature review was conducted to establish what is known about student nurse participation in relation to clinical handover. This resulted in 18 articles for inclusion in the literature review. An analysis was then undertaken of these 18 articles to extract key themes. Learning and teaching strategies need to address a variety of methods of the clinical handover process including verbal and written handovers. Participating in clinical handover prior to being given the responsibility of patient care prepares students for the workplace. Key themes identified within the literature included: learning strategies, limitations and challenges involved in putting theory into practice, handover structure and issues regarding confidentiality. Simulation and clinical practice are commonly used to prepare students for this role during their undergraduate education. The use of simulation and structured handover techniques prior to clinical placement increases student confidence to engage in clinical handovers during their clinical placements. This article raises the awareness of both clinical staff and educators as to the need for student nurses to develop their skills in clinical handover practice and suggests strategies to prepare student nurses to conduct clinical handover competently in the clinical setting.

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search yielded more than 130 articles with 28 articles constituting the foundation of the review. This review is timely following the rapid increase in the scale, speed, and spread of immigration and its potential for changing NZ’s national health patterns and priorities. This integrative review led to the four primary conclusions. Firstly, migration in NZ is a gendered phenomenon, as there has been more women and girls arriving as migrants in NZ and being at risk of poor health in comparison with their male counterparts. Secondly, studies on infectious diseases take precedence over other health problems. Thirdly, research methodologies used to collect data may not be relevant to the cultural and traditional customs of the migrant populations. Furthermore, a number of research findings implemented have failed to meet the needs of NZ migrants. Lastly, policy initiatives are inclined more towards supporting health practitioners and lack a migrant centred approach.What is already known about this topic? Despite NZ becoming more ethnically and linguistically diverse, there is limited literature on the health of migrants living in NZ.What this paper adds? This integrative literature review provides a critical overview of refugee and migrant health in NZ through reviewing and critiquing the current literature available. This paper identifies research trends, the general health of migrants in NZ, recommendations that could inform future migrant and refugee health research and health policies and initiatives to ensure effective and relevant health service provision to migrants.

To examine the use of triage systems in primary care in the UK. Integrative literature review and narrative synthesis. PubMed, EMBASE, CINAHL and Cochrane Library were searched in October 2024. An integrative literature review was conducted following Whittemore and Knafl's (2005) five-step process. Of 1440 articles retrieved, 305 duplicates were removed, and 1086 excluded after title and abstract screening. Two additional articles were identified through citation and hand searches. Twenty studies were quality-assessed using the Mixed Methods Appraisal Tool, and data were extracted for narrative synthesis. Twenty studies were selected, including four randomised controlled trials, three quasi-experimental studies, eleven descriptive studies and two qualitative studies. The most common type of triage was telephone triage, most frequently performed by nurses. The most common health outcomes included subsequent patient re-contacts after triage, patient symptoms or complaints, current health status and patient safety. The benefits of triage included high patient satisfaction, workload redistribution, reduced GP workload and emergency department crowding, improved resource utilisation, access to care and communication. The challenges of triage included increased overall contact time, mis-triage issues, recruitment and retention challenges, the unsuitability of the decision support tool for the primary care setting and lower usage among older and less affluent groups. This review examined the current use of triage in primary care in the UK, identifying common patterns in triage processes and classifications. Several benefits were identified, though some ongoing concerns about triage remain. This paper provides essential evidence about the current use, effectiveness and challenges of triage in UK primary care. The findings can support healthcare policymakers, practitioners and researchers in planning and improving triage systems. Integrative review.

Adult community nursing services are evolving around the world in response to government policies and changing patient demographics. Amidst these changes, recruitment and retention of community nursing staff are proving a challenge. An integrative literature review has identified multiple factors that influence nurse retention in adult community nursing with sparse information on recruitment factors. Although factors impacting retention of community nurses have been identified, their generalisability around the world is a challenge as they are context and co-dependent. Indicating the need for this area of study to be explored at a local level, as the same factors present with different findings globally. To establish factors influencing recruitment and retention of registered nurses in adult community nursing services. Integrative literature review. Four electronic databases were searched in August 2019 from January 2008 to December 2018: CINAHL Complete, Web of Science, MEDLINE and PROQUEST. Both qualitative and quantitative studies focusing on factors influencing community nursing recruitment and retention were included. An integrative literature review methodology by Whittemore and Knafl (The integrative review: updated methodology. Journal of Advanced Nursing 52, 546-553) was followed, supported by Cochrane guidelines on data synthesis and analysis using a narrative synthesis method. The Center for Evidence-Based Management (CEBMa) critical appraisal tools were used for study quality assessment. Ten papers met the study inclusion criteria. Data synthesis and analysis revealed individual and organisational factors influencing the retention of community nurses with the following three dominant themes: (1) work pressure, (2) working conditions and (3) lack of appreciation by managers. The review identified context-dependent factors that influence adult community nurses' retention with limited generalisability. There is a lack of data on factors influencing recruitment into adult community nursing; further research is needed to explore factors affiliated to community nursing recruitment.

Increasing attention to engaging spinal cord injury (SCI) patients with their rehabilitation entails self-assessment of their functional status. The Spinal Cord Independence Measures Self-Report (SCIM-SR) was specifically developed to allow individuals with SCI to assess their functional status and report improvements or deficits. This review was done as a preliminary phase to examine the development process of the SCIM-SR and assess the advantages of using the SCI self-reported functional status measure in Qatar. An integrative literature review was conducted using Whittemore and Knafl’s framework, searching three databases: CINAHL, Embase, and Medline. The initial search yielded 793 articles published between 2010 and 2022. After further evaluation of the literature, 12 articles were included in the subsequent analysis. This integrative literature review identified two major themes: SCIM-SR tool development and the advantages of using SCIM-SR. Tool development involved tool translation, language and cultural adaptation, and psychometric testing. Reported advantages included increased patient engagement, independence and convenience. This integrative review identified the required processes for translation, language and culture adaptation, and psychometric testing to facilitate the adoption of SCIM-SR in Qatar. To develop an Arabic version of the SCIM-SR, following a specific guideline as described in this integrative review is recommended. Before implementing the Arabic SCIM-SR tool, it is critical to evaluate its validity and reliability.

This paper presents an integrative literature review of studies exploring the benefits and limitations of the recent expansion of the clinical role of nurses working in general practice in the United Kingdom. Similar clinical outcomes and high levels of satisfaction with consultations undertaken by nurse practitioners compared to general practitioners in primary care have been reported in a Cochrane review [Cochrane Database of Systematic Reviews (2004) vol. 5, p. CD001271]. Since then, nurse consultations have increased considerably as general practitioners have delegated part of their clinical workload to other general practice nurses. However, whether all general practice nurses can fulfil this extended role remains open to question. An integrative review was performed. Nine electronic databases were searched. UK studies were included if they were published after the previous Cochrane review, i.e. between 2004 and 2009. Eight studies were identified, most using qualitative methodology. The evidence suggested that the changes in nurses' role have been predominantly driven by the perceived increase in workload arising from the new general practitioner contract. Delegating work to nurses provided a means of organizing workload within a practice without necessarily allowing patient choice. Patients generally thought that all general practice nurses would be able to deal with simple conditions, but they would prefer to consult with a general practitioner if they thought it necessary. There were concerns about nurses' knowledge base, particularly in diagnostics and therapeutics, and their levels of training and competence in roles formerly undertaken by general practitioners. There have been few studies in this key area of healthcare policy. There is a need for better training and support for nurses undertaking roles in consultation and for patients' views to be better represented.

The aim of the present study focuses on presenting frenotomy as a therapeutic approach in the face of ankyloglossia in newborn patients and the benefits observed after performing the procedure. This is an integrative literature review. The inclusion criteria were applied to those articles that contemplated the proposed objectives, published between 2013 and 2023, in Portuguese and English and that dealt with the theme. As exclusion criteria, studies in editorial formats, studies in the format of letters to the editor, articles of integrative reviews or literature reviews, monographs, dissertations, theses and abstracts of annals were adopted. The searches resulted in a total of 466 articles that were indexed in the aforementioned scientific databases, of which 28 were in Bireme, 39 in Lilacs and 399 in PubMed. Among the identified studies, a quantitative of 13 studies were selected, 2 from Bireme, 4 from Lilacs and 7 from PubMed. During the analysis of the studies, it was identified that 54% of the studies were published between 2020 and 2023, despite the annual filter being applied to the last decade. In addition to the above, the majority of studies published by PubMed were observed in the selection, as well as the significant presence of studies associated with the journal: International journal of pediatric otorhinolaryngology. It is relevant to state that frenotomy may be a viable option to improve breastfeeding in cases of ankyloglossia and restrictive labial frenulum. However, it is necessary to carefully consider each individual situation, evaluate the long-term results and adopt a comprehensive and collaborative approach to ensure the effectiveness and safety of the procedure.

Building long-term and close customer relationships is an ever-salient function in business-to-business organisations and, especially, in expert organisations where high levels of trust and close customer interaction are needed in the production of the services. A key account management (KAM) system, an organised way for managing key customers, can be a useful tool for this purpose. However, there are many factors to consider when implementing such a system in this context. The aim of this article is to describe the specific and challenging characteristics of KAM implementation in expert organisations. In particular, this article aims to describe the kinds of organisational capabilities required for KAM system implementation and what kind of KAM organisation is appropriate to dovetail with particular organisational characteristics. This study is based on a qualitative single-case study in an expert organisation constructing its KAM practices for the first time.

Integrative reviews within healthcare promote a holistic understanding of the research topic. Structure and a comprehensive approach within reviews are important to ensure the reliability in their findings. This paper aims to provide a framework for novice nursing researchers undertaking integrative reviews. Established methods to form a research question, search literature, extract data, critically appraise extracted data and analyse review findings are discussed and exemplified using the authors' own review as a comprehensive and reliable approach for the novice nursing researcher undertaking an integrative literature review. Providing a comprehensive audit trail that details how an integrative literature review has been conducted increases and ensures the results are reproducible. The use of established tools to structure the various components of an integrative review increases robustness and readers' confidence in the review findings. Novice nursing researchers may increase the reliability of their results by employing a framework to guide them through the process of conducting an integrative review.

An online approach to teaching graduate nursing students to write integrative literature reviews: Examples from two published cases.

This workshop provides a high-level overview of the process for preparing an integrative literature review. An “integrative literature review is a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated” (Torraco, 2005, p. 356) This workshop first explains why integrative literature reviews are becoming increasingly popular in research circles, then contrasts integrative literature reviews with meta-analyses, meta-syntheses and other related forms of advanced literature reviews, as well as with more traditional literature reviews. Next, this workshop describes methodological considerations for finding, including, and excluding studies; processes for reviewing and classifying the literature, analyzing the resulting data, and the four types of findings that typical integrative literature reviews typically report. The workshop closes by directing participants to samples of integrative literature reviews and identifying considerations for submitting these reviews to peer-reviewed publications. To guide participants through this experience, this workshop is built around a sample literature review project. Participants will practice the skills taught by applying them to the sample project. For example, to illustrate methodological considerations, participants will identify characteristics for including and excluding studies in a search and, later, will receive a sample list of studies to determine whether or not to actually include them in the review.