Practice-based Issue Research Articles

Establishing a Community of Practice among Leaders Providing Technical Assistance: Lessons Learned before and during the COVID-19 Pandemic

The prevalence of youth behavioral health problems before and during the COVID-19 pandemic justifies continued investment in comprehensive school behavioral health systems that link education and behavioral health partners. Technical assistance (TA) providers typically build capacity among school-community partners to advance implementation of best practices in school behavioral health. The pandemic created major disruptions in the delivery of interventions and caused TA providers to adjust the what, where, when, why, and how they provided consultation and support to partners. The TA Community of Practice (TACoP) brought together seasoned TA providers to share knowledge and resources and engage in problem-solving as they struggled in their unique roles as change agents. This article describes the value of the TACoP in responding to immediate and novel challenges, such as collaboration, community-building, and practice-based issues, within

Getting Students to Talk: A Practice-Based Study on the Design and Implementation of Problem-Solving Tasks in the EFL Classroom

This study addresses a pedagogical practice-based issue, that is, difficulties with eliciting student–student co-constructed oral interaction in the EFL classroom. The study was conducted with a bottom-up approach to pedagogical research through the close collaboration of teachers and researchers who were equal partners in the research team. It was observed that students often engage in parallel monologues or unauthentic question–response sequences when accomplishing oral activities; thus, the research team aimed to design tasks providing opportunities for meaningful, co-constructed talk. The research design involved an iteration of task design and classroom testing in three cycles, and the student–student interaction was analyzed using conversation analysis. Findings show that the divergent problem-based task designed in this process did elicit purposeful and collaborative oral interaction, as the students engaged in co-constructed talk by visibly attending to each other’s turns-at-talk and by formulating fitting turns that fostered the progressivity of the activity. The task also included artifacts (i.e., material objects), the manipulation of which played an important role in the emerging collaborative interaction. These findings suggest that the implementation of open-ended problem-based tasks can develop students’ interactional competence, while the use of artifacts can help students make their reasoning tangible and visually accessible.

Between therapeutics and therapy: the continuum of therapeutic practice and the role of ethical blind spots in decision-making

ABSTRACT Therapeutic working has long been considered a fundamental part of the educational psychologist’s (EPs) role. Yet, little attention has been given to the ethical ambiguity which exists between the terms therapeutic practice and therapy, and the implications this has for practice. This paper starts with a definition of therapeutic practice, identifying three different approaches and exploring the practical and ethical differences between them. It is proposed that these approaches sit within a therapeutic continuum, which presents a range of nuanced, ethical complexities for consideration. Those issues are explored further, with a focus on ethical blind spots (EBS). The paper concludes with illustrative examples of EBS, bringing together dilemmas in initial decision-making along the therapeutic continuum and the practice-based issue of contracting with children and young people (CYP) and how these might be overcome.

Fabry Disease practice resource: Focused revision

Fabry Disease practice resource: Focused revision

Critical emancipatory reflection on a practice-based issue in relation to the working relationship between doctors and nurses in China

Abstract Objective Reflection is viewed as the most significant skill and should be advocated for lifelong learning. In order to grasp the process of reflection and embrace the reflective skill, one of the authors of this paper reflects on a practice-based issue in relation to the communication between doctors and nurses, to gain new understanding and thus improve the authors’ clinical practice. Methods Smyth’s framework with four stages is utilized as an ideal framework to guide the author’s reflection on the practice-based issue to free the author from her entrenched assumptions and the oppressive forces that limit her practice. Results The espoused and enacted theory, together with the critical reflection theory, are used to explore the values and beliefs that essentially govern the author’s practice and how these are distinct from the author’s worldviews. Following this, critical emancipatory reflection is undertaken to explore the dominant power structures within the author’s workplace. Furthermore, given the hegemonic and chaotic working context of this issue, hegemony and symbolic interaction theory are applied to unearth the various hidden constraining and oppressive forces. Additionally, socialization theory is utilized to help the author achieve professional identity. Conclusions Reconstructing the practice-based issue empowers the author to realize that in the future, she should act as a reflective practitioner, creating a daily habit, staying alert to practice, seeing things freshly, finding support systems, improving communication skills, conducting reflective research, and reifying reflective practice. Ultimately, the author will be sufficiently equipped to be able to transform her practice and change its outcomes.

Critical emancipatory reflection on a practice-based issue in relation to nurses’ communicative role with unsatisfied clients in Chinese hospitals

Abstract Objective This study aims to use reflective theory and critical emancipatory theory to explore nurses’ communicative role with unsatisfied clients. Methods This paper begins with the broad issue, and the analysis will engage Smyth’s cycle, which includes describing, analyzing, exploring, and reconstructing. Results Critical emancipatory reflection is essential to make changes in the professional practice of nursing, because it is of primary importance for the professional learning and development of a nurse. Conclusions Critical emancipatory reflection helps a nurse to analyze the constraints, including historical, sociocultural, political, and personal aspects.

Overcoming Challenges to Support Clinician-Scientist Roles in Canadian Academic Health Sciences Centres.

Clinician-scientists (CSs) make significant contributions to the healthcare system, yet their roles are not fully understood, supported or recognized by healthcare leaders or policy makers. CSs are healthcare professionals with advanced research training who continue to pursue clinical work and are considered an essential component of the research infrastructure in academic health sciences centres. The current literature supports the role of CSs but is also clear that there are multiple challenges in attracting and retaining clinicians to the role. To gain a comprehensive understanding of the current status of the CS role, two literature reviews were conducted. The findings reported here include an overview of: the education and training preparation for CS roles; the importance of the CS role; barriers and challenges to developing and implementing the CS role; and strategies for supporting and sustaining CS roles in practice. The paper further describes one Canadian academic health sciences centre's approach to supporting and increasing the number of CSs from nursing and allied health professions to support academic practice. Non-physician CSs may conduct research using multiple research designs across the research continuum from randomized controlled trials to grounded theory or qualitative descriptive approaches. Their research generally focuses on practice-based issues such as best practices for managing pain or frailty or evaluating the effectiveness of new approaches to care. Researchers and healthcare leaders in other organizations may find this work helpful for establishing their own structures to enhance research capacity and practice-based research, especially for non-physician CSs.

Preparing Students Towards the Complexity of Today’s Practice: Start-Up in a Multidisciplinary Assignment

Education in the Department of the Built Environment (Eindhoven University of Technology) aims to prepare students for multidisciplinary design teams. The Bachelor program offers a broad range incorporating essentials of urbanism, architecture, structure, building physics, real estate, construction, services et cetera. This broad BSc program lays a foundation for students and is followed by a Master program that focuses on specialization. There are six specializations: Architecture, Urban Design & Planning, Structural Design, Building Physics & Services, Real Estate Management & Development and Construction Management & Engineering. Multidisciplinary in the BSc is more than offering a variety of knowledge in courses and lectures. The Department also puts a lot of effort to train students to gain experiences in integral design teams. This takes shape in studios but is best expressed in the Multi-project (a semester assignment in the last year of the Bachelor). This assignment is organized by 9 coaches (from all specializations in the Master). The assessment is always a practice-based issue, and students have to cooperate as a design team during one semester. Developing the Multi-project has been a long route that took place over many years with several adjustments according to experiences and information gathered by student inquiries. This paper gives a very global overview of the present setup to contextualize this assignment. After that, the main part of this paper focuses on the kickoff (first 2-3 weeks). Here students start in parallel studios, meant to put them on track for integral design. Each studio combines two disciplines and compels students to precede design by analyzing all kind of issues in the light of the specific assignment. Because of the complexity of this assignment we frequently ask students to fill in an enquiry. Because of this we are now able to draw conclusions from major changes during the last 10-14 assignments (2007 – 2013).

A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment.

The practice guidelines of the American College of Medical Genetics and Genomics (ACMG) and the National Society of Genetic Counselors (NSGC) are developed by members of the ACMG and NSGC to assist medical geneticists, genetic counselors, and other health-care providers in making decisions about appropriate management of genetic concerns, including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recommendations within the ACMG and NSGC joint practice guidelines reflect the current scientific and clinical knowledge at the time of publication, are current only as of their publication date, and are subject to change without notice as advances emerge. In addition, variations in practice, which take into account the needs of the individual patient and the resources and limitations unique to the institution or type of practice, may warrant approaches, treatments, and/or procedures that differ from the recommendations outlined in this guideline. Therefore, these recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. Genetic counseling practice guidelines are never intended to displace a health-care provider's best medical judgment based on the clinical circumstances of a particular patient or patient population. Practice guidelines are published by the ACMG or the NSGC for educational and informational purposes only, and neither the ACMG nor the NSGC "approve" or "endorse" any specific methods, practices, or sources of information.Cancer genetic consultation is an important aspect of the care of individuals at increased risk of a hereditary cancer syndrome. Yet several patient, clinician, and system-level barriers hinder identification of individuals appropriate for cancer genetics referral. Thus, the purpose of this practice guideline is to present a single set of comprehensive personal and family history criteria to facilitate identification and maximize appropriate referral of at-risk individuals for cancer genetic consultation. To develop this guideline, a literature search for hereditary cancer susceptibility syndromes was conducted using PubMed. In addition, GeneReviews and the National Comprehensive Cancer Network guidelines were reviewed when applicable. When conflicting guidelines were identified, the evidence was ranked as follows: position papers from national and professional organizations ranked highest, followed by consortium guidelines, and then peer-reviewed publications from single institutions. The criteria for cancer genetic consultation referral are provided in two formats: (i) tables that list the tumor type along with the criteria that, if met, would warrant a referral for a cancer genetic consultation and (ii) an alphabetical list of the syndromes, including a brief summary of each and the rationale for the referral criteria that were selected. Consider referral for a cancer genetic consultation if your patient or any of their first-degree relatives meet any of these referral criteria.

Knowledge brokering in public health: a tale of two studies

ObjectivesA Knowledge Broker is one approach for facilitating the integration of evidence-informed decision making in public health practice. In this paper, the findings from two studies investigating a Knowledge Broker intervention as a means of enhancing capacity for evidence-informed decision making are presented. Contextual factors that facilitate this strategy are also identified. Study designThis paper describes work done through a single mixed-methods study (randomized controlled trial with a qualitative component) and a case study. MethodsThe Health Evidence team conducted two studies examining Knowledge Broker impact in Canadian public health departments. The effectiveness of knowledge translation strategies of varying intensities for promoting the use of research evidence in decisions related to child obesity prevention were explored via a randomized controlled trial with a fundamental descriptive component (2003–2007). In a case study (2010–2013), the authors partnered with three health departments to develop and implement tailored strategies targeted at the organization. Knowledge Brokers worked with designated staff in these studies via one-on-one consultations, small group meetings, and/or workshops and presentations. The Knowledge Broker role was assessed by analysing data from close-ended surveys, interviews, organizational documents, and reflective journals. ResultsIn this paper, the authors focus on findings from the qualitative analysis of implementing the Knowledge Broker role in both studies and explore several contextual factors that impacted study outcomes. Knowledge Brokers were shown to enhance individual capacity by improving knowledge and skill in searching for, critically appraising, and applying research evidence to practice-based issues. Organizational capacity was also enhanced with strong management support and policies. Effective Knowledge Broker attributes included both expertise in research methodology and public health, as well as intangible traits such as approachability and patience. Finally, optimal positioning and ways of working were identified, including the importance of in-person meetings and neutrality of the Knowledge Broker. ConclusionsKnowledge brokering is a potentially promising knowledge translation strategy for public health, though additional feasibility and cost-effectiveness data are still needed. The research presented here further highlights the importance of context and adopting a tailored approach to implement a Knowledge Broker strategy.

Seimo nutarimas: samprata ir istorinė raida

The article examines the concept of the Seimas (the parliament of the republic of Lithuania) resolution, its legal force, and practices of constitutional proceedings. Scientific research is undertaken with the goal to reveal its essential characteristics, as well as to detect possible legal regulation gaps and practice-based issues of implementation. While analyzing the evolution of centuries-old state parliamentarism, the state of the Seimas resolution and (or) of equivalent legislation was identified in times of the republic of both nations, the restoration of the state of Lithuania and of inter-war independent republic. Therefore, the Seimas resolution is the historical source of Lithuanian constitutional law. The concept of the Seimas resolution is enriched by its significance in march 1990, when the act of independence was adopted and published, as well as its direct provision in the constitution of 1992. This legal act addresses the relationship between the state authorities (distrust of government) and operational matters of the parliament itself (pre-term elections). The Seimas resolution is not an ordinary by-law. Having analysed more than twenty years of Lithuanian parliamentary experiences, the resolution should rather be considered as the primary means of expression of the political will of the Seimas. Depending on the importance of the issue, the will could be derived from the constitution itself and its principles, as well as from the representation of people“™s sovereignty. One of the most important areas of implementation of the Seimas resolution is the parliamentary oversight. By adopting respective resolutions, the Seimas may require reports from the accountable state authorities; it also may assess their performance or assign them various tasks. Some very important seimas resolutions (for example on elections results or impeachment petition to the constitutional court) could be voted with simple majority of participating members of seimas. The significance of such decisions requires renegotiating qualifications of voting to avoid unpredictable consequences in the Lithuanian politics. The Seimas resolutions also have a close relationship with the proceedings of the constitutional court of the republic of Lithuania. The Seimas can implement some of the court“™s judgments and conclusions by its resolutions. On the other hand, the constitutional court itself may assess whether the disputable Seimas resolution is in conformity with the constitution. It is possible in some cases that the court can examine the constitutionality of resolution on implementation of its own conclusions.

Molecular Testing for Cystic Fibrosis Carrier Status Practice Guidelines: Recommendations of the National Society of Genetic Counselors

To provide practice recommendations for genetic counselors whose clients are considering cystic fibrosis (CF) carrier testing or seeking information regarding CF molecular test results. The goals of these recommendations are to: 1) Provide updated information about the natural history, diagnosis, and treatment of CF and related conditions. 2) Supplement genetic counselors' knowledge and understanding of the available carrier screening and diagnostic testing options. 3) Describe the current state of genotype/phenotype correlations for CFTR mutations and an approach to interpreting both novel and previously described variants. 4) Provide a framework for genetic counselors to assist clients' decision-making regarding CF carrier testing, prenatal diagnosis, and pregnancy management. Disclaimer The practice guidelines of the National Society of Genetic Counselors (NSGC) are developed by members of the NSGC to assist genetic counselors and other health care providers in making decisions about appropriate management of genetic concerns; including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue, and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recommendations within the NSGC practice guidelines reflect the current scientific and clinical knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge.In addition, variations in practice, which take into account the needs of the individual patient and the resources and limitations unique to the institution or type of practice, may warrant approaches, treatments and/or procedures that differ from the recommendations outlined in this guideline. Therefore, these recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. Genetic counseling practice guidelines are never intended to displace a health care provider's best medical judgment based on the clinical circumstances of a particular patient or patient population.Practice guidelines are published by NSGC for educational and informational purposes only, and NSGC does not "approve" or "endorse" any specific methods, practices, or sources of information.

Emergency Nursing Resource: Non-Invasive Temperature Measurement in the Emergency Department

ENA's Emergency Nursing Resources (ENRs) are developed by ENA members to provide emergency nurses with evidence-based information to utilize and implement in their care of emergency patients and families. Each ENR focuses on a clinical or practice-based issue, and is the result of a review and analysis of current information believed to be reliable. As such, information and recommendations within a particular ENR reflect the current scientific and clinical knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge.

Emergency Nursing Resource: Wound Preparation

ENA's Emergency Nursing Resources (ENRs) are developed by ENA members to provide emergency nurses with evidence-based information to utilize and implement in their care of emergency patients and families. Each ENR focuses on a clinical or practice-based issue, and is the result of a review and analysis of current information believed to be reliable. As such, information and recommendations within a particular ENR reflect the current scientific and clinical knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge.

Book Review: The Handbook of Adult and Continuing Education

Kasworm, C., Rose, A., & Ross-Gordon, J. (2010). The Handbook of adult and Continuing Education. Thousand Oaks, CA: SAGE. 493 pp. ISBN 978-1-4129-6050-2 (hardcover) Adult and continuing education is an expansive and rapidly growing academic and practical field. The Handbook of adult and Continuing Education provides a comprehensive examination of the cutting edge research, theoretical developments, and practice-based issues that are important to the field. The field's top scholars and researchers offer critical and insightful perspectives on various topics in adult education, from social justice and diversity to adult education in a changing global society. In addition, this 2010 edition of the Handbook serves as a critical reference for adult educators, students, researchers, and professionals who are interested in adult and continuing education. The essays in this edition not only serve as a foundation for the field, but they also illuminate the progress that has been made in the field and new directions and developments for the future. The Handbook is organized into six distinctive sections that highlight the major areas of research and practice in adult and continuing education. These areas focus on (a) adult learning and the adult learner, (b) theoretical approaches to the field, (c) adult and continuing education as a field of practice, (d) diversity, (e) social justice, and (f) adult education in a global context. The book ends with critical reflections on the major developments in the field and conclusions that illuminate new directions for research and practice in adult and continuing education. A major strength of this handbook is the depth and breadth of content that illustrates the major areas of study and practice in the field as a whole. The opening section of the Handbook centers the general topic of adult learning and the adult learner in contemporary society. These authors highlight the changing face of formal and informal learning contexts, new research in adult development, and recent scholarship on group and organization learning. Following the opening section, adult education scholars reflect on the state of theoretical production in the field. More specifically, these essays speak to the place and importance of theorizing and knowledge production in the field with a focus on policy, international adult education, histories of adult education, and interdisciplinary theoretical frameworks. …

Facilitating Deep Learning in a Learning Community

The purpose of this study is to explore how the integration of online discussion into a mathematics methods course affected pre-service teachers’ learning. Students’ transcription of online discussion was analyzed using a mixed methods approach, combining computer-mediated discourse analysis and Chi-square test analysis. The data revealed that the online discussion helped pre-service teachers not only deepen their learning of mathematics methods, but also demonstrated their abilities to teach mathematics in different ways. It also indicated that the depth of their learning depended on the levels of threads and topics of discussion. Deep learning occurs 1) more often in the first level thread than subsequent level threads, and 2) in discussion topics, primarily those related to practice-based issues rather than theory-based topics.

Emergency Nursing Resource: Gastric Tube Placement Verification

ENA's Emergency Nursing Resources (ENRs) are developed by ENA members to provide emergency nurses with evidence-based information to utilize and implement in their care of emergency patients and families. Each ENR focuses on a clinical or practice-based issue, and is the result of a review and analysis of current information believed to be reliable. As such, information and recommendations within a particular ENR reflect the current scientific and clinical knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge.

Facilitating access to pre-processed research evidence in public health.

BackgroundEvidence-informed decision making is accepted in Canada and worldwide as necessary for the provision of effective health services. This process involves: 1) clearly articulating a practice-based issue; 2) searching for and accessing relevant evidence; 3) appraising methodological rigor and choosing the most synthesized evidence of the highest quality and relevance to the practice issue and setting that is available; and 4) extracting, interpreting, and translating knowledge, in light of the local context and resources, into practice, program and policy decisions. While the public health sector in Canada is working toward evidence-informed decision making, considerable barriers, including efficient access to synthesized resources, exist.MethodsIn this paper we map to a previously developed 6 level pyramid of pre-processed research evidence, relevant resources that include public health-related effectiveness evidence. The resources were identified through extensive searches of both the published and unpublished domains.ResultsMany resources with public health-related evidence were identified. While there were very few resources dedicated solely to public health evidence, many clinically focused resources include public health-related evidence, making tools such as the pyramid, that identify these resources, particularly helpful for public health decisions makers. A practical example illustrates the application of this model and highlights its potential to reduce the time and effort that would be required by public health decision makers to address their practice-based issues.ConclusionsThis paper describes an existing hierarchy of pre-processed evidence and its adaptation to the public health setting. A number of resources with public health-relevant content that are either freely accessible or requiring a subscription are identified. This will facilitate easier and faster access to pre-processed, public health-relevant evidence, with the intent of promoting evidence-informed decision making. Access to such resources addresses several barriers identified by public health decision makers to evidence-informed decision making, most importantly time, as well as lack of knowledge of resources that house public health-relevant evidence.

An introduction to ethics in nursing

Ethics is concerned with 'right and wrong', although agreeing what is 'right' can be challenging. An understanding of ethics is essential to the delivery of skilled professional care. It is vital that nurses appreciate the value of ethics in their work. Ethics is relevant to clinical, practice-based issues and affects all areas of the professional nursing role. To apply ethics effectively, nurses must develop reasoning skills and understand the concepts and principles that assist ethical analysis. This article, the first in a series of articles relating to ethics and nursing, offers an introduction to ethics, primarily focusing on their application in clinical nursing practice. Throughout the article, the terms 'ethical' and 'moral' are used interchangeably.