ObjectivesTo understand from a patient and carer perspective: (1) what features of the discharge process could be improved to avoid early unplanned hospital readmission (within 72 hours of acute care discharge) and (2) what elements of discharge planning could have enhanced the discharge experience.DesignA qualitative descriptive design was used. Study data were collected using semi-structured interviews that were transcribed verbatim and analysed using inductive thematic analysis. Data related to participant characteristic were collected by medical record audit and summarised using descriptive statistics.SettingThree acute care hospitals from one health service in Australia.ParticipantsPatients who had an early unplanned hospital readmission and/or their carers, if present during the interviews and willing to participate, with patient permission.FindingsThirty interviews were conducted (23 patients only; 6 patient and carer dyads; 1 carer only). Five themes were constructed: ‘experiences of care’, ‘hearing and being heard’, ‘what’s wrong with me’, ‘not just about me’ and ‘all about going home’. There was considerable variability in patients’ and carers’ experiences of hospital care, discharge processes and early unplanned hospital readmission. Features of the discharge process that could be improved to potentially avoid early unplanned hospital readmission were better communication, optimal clinical care including ensuring readiness for discharge and shared decision-making regarding discharge timing and goals on returning home. The discharge experience could have been enhanced by improved communication between patients (and carers) and the healthcare team, not rushing the discharge process and a more coordinated approach to patient transport home from hospital.ConclusionsThe study findings highlight the complexities of the discharge process and the importance of effective communication, shared decision-making and carer engagement in optimising hospital discharge and reducing early unplanned hospital readmissions.
In tertiary education, generic professional skills should be developed along with discipline-specific knowledge and skills. Team-Based Learning (TBL), an active learning strategy, creates deep learning and enhanced student engagement; however, its effects on the development of generic learning outcomes are unknown. The aim of this study was to evaluate postgraduate specialty nursing students’ perspectives of how TBL impacts the acquisition of skills defined by the university’s eight Graduate Learning Outcomes (GLOs). A descriptive exploratory design was used in this study. Postgraduate nursing students in 2016-2017 at one university were invited to participate. Data were collected via demographic survey, a ranking tool, and written reflections. Data were analysed using descriptive statistics and content analysis. The response rate was 97.2 per cent (172/177). Participants were mostly females (n=152, 88.4%) aged 25–34 years (n=115, 66.9%). Student (n=156) rankings showed TBL contributed to the acquisition of critical thinking (n=90, 57.7%) and problem solving skills (n=56, 35.9%) the most. Students (n=144) made 2719 comments regarding how TBL led to the acquisition of GLOs in written reflections. Almost 98 per cent (n=2657) of all reflective comments were positive. All students mentioned at least one GLO positively due to TBL. Most positive reflections related to self-management (n=520, 19.6%) and communication (n=434, 16.3%).Postgraduate specialty nursing students perceived TBL classes contributed to the acquisition of their university’s GLOs, particularly critical thinking, problem solving, and self-management skills. The active learning strategy of TBL facilitates learning and engagement, and the attainment of essential professional attributes which are highly valued by employers.
Aims and objectives To explore the use and student outcomes of Team‐Based Learning in nursing education. Background Team‐Based Learning is a highly structured, evidence‐based, student‐centred learning strategy that enhances student engagement and facilitates deep learning in a variety of disciplines including nursing. However, the breadth of Team‐Based Learning application in nursing education and relevant outcomes are not currently well understood. Design A scoping review of international, peer‐reviewed research studies was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews. Methods The following databases were searched on 7 May 2020: Cumulative Index of Nursing and Allied Health Literature, MEDLINE Complete, PsycINFO and Education Resources Information Center. Search terms related to nursing, education and Team‐Based Learning. Original research studies, published in English, and reporting on student outcomes from Team‐Based Learning in nursing education programmes were included. Results Of the 1081 potentially relevant citations, 41 studies from undergraduate (n = 29), postgraduate (n = 4) and hospital (n = 8) settings were included. The most commonly reported student outcomes were knowledge or academic performance (n = 21); student experience, satisfaction or perceptions of Team‐Based Learning (n = 20); student engagement with behaviours or attitudes towards Team‐Based Learning (n = 12); and effect of Team‐Based Learning on teamwork, team performance or collective efficacy (n = 6). Only three studies reported clinical outcomes. Conclusions Over the last decade, there has been a growing body of knowledge related to the use of Team‐Based Learning in nursing education. The major gaps identified in this scoping review were the lack of randomised controlled trials and the dearth of studies of Team‐Based Learning in postgraduate and hospital contexts. Relevance to clinical practice This scoping review provides a comprehensive understanding of the use and student outcomes of Team‐Based Learning in nursing education and highlights the breadth of application of Team‐Based Learning and variability in the outcomes reported.
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