1

Why we should welcome feedback and listen to those who raise concerns in both healthcare and research

Criticism and feedback can feel uncomfortable to both give and receive. It can be an awkward exchange, where both parties may be reluctant to let their guard down, concede to oversights, reveal any flaws and relinquish any feelings of responsibility. It can also be incredibly frustrating on both sides.

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But lets look at both sides of the coin rationally. Firstly, Why would someone offer feedback?

  • They want to make something better
  • They see an opportunity to improve something
  • They want to help you
  • They want something corrected
  • You, or someone else have asked them for feedback
  • They want to offer you their unique outsider/fresh eyes view of something that you may not be privy to.

These are all gifts, learning opportunities and avenues toward creating our best outputs. Here, we theorise that everyone who offers feedback has good intentions, which some may argue is unrealistic and naive. However, I am personally unwilling to lose out on the potentially invaluable gold dust of feedback for the sake of those who wish to meddle in mischief. The vast majority of those who enter both the healthcare and academic professions do so in order to contribute positively.

In order to feel valued and perform to the best of their abilities, healthcare staff must feel heard. This is the same for those in research. As such, whether we agree with the feedback we are given, it must be heard, examined, considered and then either acted upon or rebutted respectfully.

If you are doing your best, feel passionately about what you are trying to achieve and have worked hard to achieve something amazing, it can be hard to hear that there may be cracks in your work, despite all of your well intended efforts. You are also in the job to give your best and contribute positively. But you cannot know everything…so keep listening to those who have the ‘fresh eyes’ to see what you may not.

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Denial only denies you an opportunity to do better.

Lets look outside the box:

What is going on here?

Restaurant owner:

  • Wants her food to be good
  • Believes she has done her best
  • Defensive and protective about her achievements

Customer & Gordon Ramsey:

  • Wants good food
  • Wants mistakes corrected
  • Wants things to be better
  • Wants to be helpful and constructive
  • Has a new ‘Fresh eyes’ perspective from outside the organisation

The negative response to this feedback could mean:

  • The customer probably won’t return to the restaurant
  • The customer will avoid offering any further feedback
  • A missed opportunity to make things better
  • The expert will at some point back away from offering further assistance
  • The restaurant may fail to reach its full potential

FYI – These restaurant owners always achieve great things for their restaurants once they listen and act upon feedback

Reflection: Can we apply these roles to some of the roles active healthcare and research? (Including our own)!

Don’t despair!… If you get everything right, all of the time, you miss new opportunities to learn

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Some of my early academic papers were really very terrible. Some of the work I do now is muddled at first. I make mistakes, everyone does. I am in no way perfect, nor do I alone have all of the skills to change the world. I need help. I welcome help and input from those who can fill in for the skills I do not have and the knowledge I cannot yet see. This is why I welcome feedback and listen to those who raise concerns. In fact I grab every opportunity to do so.

In exchange for this, my work improves, I see new opportunities to thrive, new ideas are generated and collective collaborations make our outputs much stronger. Success.

If I had been steadfast in feeling that because I was so passionate about the work I was doing, nothing could possibly be wrong with it, then I would have missed the chance to create something better. Yes, it used to be frustrating to hear criticism. But this frustration can be turned around.

Once you see that a criticism is not a personal attack, it becomes a welcome guest.

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More recently, I had a paper accepted ‘No revisions required’. I was worried. I wanted feedback, I wanted changes made, I wanted other people to weigh in on my work and check for anything I may have missed. This is because I knew it would be a stronger paper having been ripped apart and then put back together again….made better.

Everything I have ever done has always been made better when others have offered their ‘fresh eyed’ feedback. Here are my top tips for making the most out of feedback.

  • Welcome and invite it
  • Listen to it, consider it and evaluate it
  • Let down your defenses (It is not an attack – people want to help)
  • Feedback on your feedback – Tell them how it was used
  • Actively search for those who can offer a ‘fresh eyed’ perspective on your project
  • Never attack those who offer you valuable feedback (They will avoid doing it again!)
  • Know that it is OK not to be perfect, you cannot do everything all of the time
  • Avoid blinkered approaches like ‘I know what is best’ & ‘Nothing can be wrong because I worked so hard for it not to be’.
  • Offer your own feedback to others – It will not only help them, but it will make you feel good and contribute toward the collective goal!

We all want to be the best we can be. We need to role-model and make things better for everyone. We need to lift each other up with support and praise.

Let go of your defenses and welcome new opportunities for success.

Free stock photo of typography, school, training, board

Until next time, look after yourselves and each other 💙💜💚

 

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3

A Guide to Literature Reviewing for Student Midwives & Student Nurses

Recently, I have had some midwifery (and nursing) students ask me about how to write their dissertation (Usually a literature review)…

Frequent questions included:

  • How to write a midwifery dissertation
  • How to write a nursing dissertation
  • How to structure a literature review
  • How to do research in midwifery
  • How to do research in nursing
  • How to bring the evidence together
  • How to make a well structured argument

This fairly long blog post may answer some of these questions for nursing and midwifery students…

See also my 15 Top Essay Writing Tips for Midwifery and Nursing Students here

Part of my work involves being a facilitator for problem based learning. Through this role, I enjoy supporting undergraduate health care students to study and develop their skills in evidence based practice. I do not claim to be an academic genius, and many of the rules in academia seem to be subjective in any case. However, in response to students asking for some suggestions and guidance, I hope that this simple and loose guide to literature reviewing may act as reference material for some student nurses and midwives working towards their dissertations or indeed any other essays and beyond.

Literature reviewing for dummies

(except you are not a dummy!)

Below I have written a very simplified example of a literature review. This is based upon a fictional subject which holds no relation to either midwifery or nursing practice. However, these methods may be applied to any subject in either nursing or midwifery practice.. you just need to replace my words with nursing or midwifery words as required.

Note: Although this may be a starting point to get you thinking about structuring an essay, literature review or dissertation please be mindful that one size may not fit all situations. Also, please do not take this example as a literal quick fix that will magically translate your work into A* material… always speak to your own tutors throughout the process of your writing in order to make sure that you are staying right on track.

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Title: Make sure it states clearly what your essay will be about, what it will do and explore, and how you went about doing what you have done:

How do 20 to 30 year old’s experience vintage tea parties? A narrative literature review.

With this title I am clearly setting up the parameters of what I am going to be looking at. I am also presenting a clear and answerable question which chooses a population of 20 to 30 year old’s to look at, and an ‘intervention’ or ‘interaction’ with a vintage tea party to explore. I am also telling my reader straight away that I will be exploring this topic and trying to answer my question by reviewing the relevant literature (a literature review).

Introduction: Make sure that you tell the reader exactly what this essay is going to do and produce. You will also want to set out a little bit about why you have chosen to look at your particular topic.

Introduction

Vintage tea parties are becoming increasingly popular among 20 to 30 year old’s (Vintage quarterly, 2016). This may suggest that populations within this age group enjoy hosting and attending tea parties, yet it is not yet known how this particular population experience vintage tea parties around the world. As 20 to 30 year old’s look to enjoy more social activities and enhance their social well-being, it will be important to understand how and why they may experience vintage tea parties as either a negative or positive social venture. This review aims to unite the evidence in relation to how 20 to 30 year old’s experience tea parties around the world. It will do this by reviewing the relevant literature and presenting it’s findings narratively in order to produce a global overview of current understanding.

Background: Give the reader a little bit of history to the topic in focus. Set the scene and entice your reader to learn more.

Background

Humans have enjoyed socialising with other humans for approximately 200,000 years (Human socialisation journal, 2014). Many of these social activities have often involved food and drink (Food and drink journal, 2013). They have also been used as a means to unify various groups of people, and allow new generations of humans to meet new tribes of people (Tribal weekly, 2015). Along with food and drink, social events in history have often involved music making, artworks and entertainments (Entertainment journal, 2013). More recently, these social events have introduced the concept of ‘themed’ social events where participants often enjoy a changed reality for a short period of time (Party time monthly, 2014). However, it is not yet known which particular components in combination enhance the experience of event participants.

Tea parties are one way that humans often come together in a bid to enjoy social interaction with food, drink and merriment (International Tea Party Journal 2015). The concept of a vintage themed tea party is a relatively new one, and is an activity currently most popular within social groups aged between 20 to 30 years old (Vintage parties quarterly, 2016). This age group is typically one which looks to enjoy a healthy work/life balance and frolic with similar social groups (Frolicking International, 2016). Vintage tea parties may be one way in which this group may enjoy a fruitful social life, yet it is not known which particular elements of a vintage tea party are most efficacious when brought together in unison. Therefore, it will be important to explore the literature in relation to how this particular age group experiences vintage tea parties, and which particular elements of a vintage tea party may come together to optimise this experience for future social occasions of this type.

Methodology: How did you search for your answers? Give as much detail as you can. What did you do? How? Where did your results and answers come from? How did you extract what you wanted from what you found? How are you going to share this and make your argument? Why?

Methodology

The literature in relation to how 20 to 30 year old’s experience vintage tea parties was reviewed narratively in order to gain a current overview of global understanding. The overriding question for this review was:

How do 20 to 30 year old’s experience vintage tea parties as a social activity?

You may want to use the SPIDER tool to formulate your own question: The SPIDER tool was developed by adapting the PICO tool, I will apply this hypothetical research question to this tool as follows:

  • (S) Sample: Populations aged between 20 and 30 year’s old.
  • (PI) Phenomenon of Interest: The experience of either attending or hosting a vintage tea party as a social activity.
  • (D) Design: Any study type (surveys/focus groups/cohort studies/interviews etc).
  • (E) Evaluation: The views, attitudes and opinions of 20 to 30 year old’s who either attend or host vintage tea parties as a social activity.
  • (R) Research type: qualitative, quantitative and mixed-methods research will be searched for.

Search strategy

Initially, the CINHAL, Medline and PsycINFO electronic databases were used to retrieve relevant papers in relation to the subject matter. Several key terms which were considered to be of relevance were entered into these databases simultaneously. These terms were entered together, and united using either the word ‘and’ or ‘or’. The search terms were used in the following format:

Vintage tea parties ‘and’ social occasions ‘or’ parties ‘and’ young people and’ tea ‘and’ cake ‘or’ lace doilies ‘or’ old fashioned ‘and’ antiques ‘or’ social gatherings ‘or’ cupcakes.

Inclusion criteria:

Papers were included if they specifically focused on the experiences of people aged between 20 and 30. Papers had to have a particular focus upon the experience of vintage tea parties in order to be included within this literature review. As the ‘vintage’ era was considered to be between the 1930’s and 1940’s, only papers published from 1960 onward were considered for this review. It was considered that from this period, the traditional tea party would indeed be classified as ‘vintage’ in retrospect.

(Please note that this is an extremely crude search strategy. These can be made much more efficient and systematic in more advanced papers – See an example here.)

This search strategy resulted in 27 separate searches and retrieved 1720 papers. Duplicate articles were then removed to reveal 808 papers. The abstracts of these remaining papers were then scanned reviewed and against the inclusion criteria, leaving 235 papers for further review. These remaining papers were read in their entirety and assessed for their suitability for inclusion. Following these assessments, 88 papers were removed as they did not focus upon the experience of tea parties, only the process of hosting them. Additionally, 92 papers were removed as they referred to the experiences of populations either over the age of 30 or under the age of 20. Lastly, 52 papers were removed as although they did refer to the experience of attending and hosting tea parties, these parties were not considered to be vintage in nature. This left 3 papers for inclusion. The reference lists of these papers were scanned for any further papers suitable for inclusion. Through this scanning, 1 further paper was included, resulting in a total of 4 papers to be included within this review. The paper selection process is represented within figure 1.

Figure 1: Paper selection process – This should leave the reader with no doubt about what you did, how you selected your papers for inclusion or exclusion and why. It also allows you to reflect upon your process.

Note (n=) Just means ‘number of’ ..e.g. (n=1).

Figure 1: Paper selection process

Records identified through database searching
(n =1720)

                                    ∇

Additional records identified through other sources
(n = 1)

                                    ∇

Records after duplicates removed
(n =912)

                                    ∇

Records screened
(n = 235)

                                    ∇

Records excluded
(n = 231)

                                    ∇

Studies included
(n = 4)

                                    ∇

Full-text articles excluded:

Paper does not focus upon the experience of tea parties (n =88)

Out of age range criteria (n=92)

Tea party not vintage in nature∇ (n=52)

Papers included: This should be some sort of table where you present which papers you are including within your review. You can go into further detail of each one as appropriate… But for this example it might look something like this:

Table 2: Study overview and characteristics

Paper  Sample number  Sample Type Study Design Findings
 

The mad Hatters tea party (Carroll, 2015)

4 Alice in wonderland (aged 21), The Mad Hatter, the March Hare, and the Dormouse  

Participants self reported their experiences to an interviewer.

 

Tea, iced cakes and singing are ‘enjoyable’. Can be enjoyed during either a birthday or an ‘un-birthday’.

 

Tea for two, and two for tea (Sinatra, 2012). 2 Doris Day (aged 25) and Frank Sinatra (aged 29). Focus group discussion Tea parties in solitude (2 people) with sugar cake make them ‘happy’. Also knee sitting is enjoyable in this context.
A tea party on the ceiling (Poppins, 1964) 2 adults aged 29. A nanny and a chimney sweep  

Questionnaire survey.

Laughing is key to a successful vintage tea party.
The queens tea party (Buckingham palace, 2010). 2500/8000 attendees aged between 20 and 30. A cross-section of honoured British society Online survey Cupcakes, doilies and finger sandwiches served with a variety of tea made the tea party ‘special’. Especially in the presence of queens and princesses.

 

At this point you may want to comment on the quality of the studies or papers you have selected. You can either do this by adding an extra column within the table above, or comment on the quality of studies within another subsection. If the quality of studies is poor, don’t worry…just acknowledge that the study is poor, and recognise that any results or recommendations you draw from those studies should probably be given less authority than the more rigorous studies.  

A basic guide as to which studies are considered to be academically superior is outlined within the pyramid below….

Image result for hierarchy of research studies

There are many published academic tools for assessing and appraising the quality of each particular study, and also for assessing any risk of bias that might be apparent. I have included a very basic quality assessment tool for assessing qualitative studies below. Feel free to use this or any more advanced ones you may find.

Image result for quality checklist for research studies systematic review

You may also want to report whether the studies that you have chosen to include are either qualitative or quantitative (or a mixture of both)

(sometimes called mixed method)!

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Image result for qualitative and quantitative research

(Images from: https://uxdesign.cc & http://www.slideshare.net/engelby/media-quantitative-and-qualitative-research-2012)

Data Extraction: Now that you have chosen the studies/papers with which you will address your own research questions, you will need to describe exactly how you have drawn out the knowledge or ‘data’ from those papers. This can be simple, or again, it can be a very detailed process with the use of complex data extraction tools.

Something like this tool below may help you to draw out knowledge from a paper…

Image result for research data extraction tools

(Tool from http://www.rrh.org.au/articles/subviewnthamer.asp?ArticleID=1523)

But equally, you may want to describe a simpler approach to your own data extraction method as follows…

Data Extraction

Each paper was read and re-read, whilst themes relating to the experience of either being a host or a guest at a vintage tea party were annotated throughout. Any numerical or ‘quantitative’ data was noted and will be reported narratively in order to build a broad picture of how 20 to 30 year old’s experience vintage tea parties.

Limitations: You may want to state what the limitations of your chosen studies were. Samples too small? only partial results available? not widely representative? – Bare in mind that some different types of essays will want the limitations section presented towards the end of the essay rather than just before the results section..

Limitations

This review has retrieved a small amount of papers, therefore the findings of this review may not be representative of a wider population. Also, due to the small amount of papers retrieved, it will not be possible to perform a meta-analysis of results (A meta-analysis is basically where you compare lots of similar data from a number of similar studies in order to see if the findings match closely or not. This will tell you if you can be really sure that what the evidence is telling you is really reliable and true… or not).

None of the studies selected used any verified tools to measure either a participants negative or positive experience of interacting with a vintage tea party. Therefore, these findings rely upon participant ratings, words and observations. Additionally, the studies retrieved can only be related to experiences of vintage tea parties within the western world, therefore we cannot be sure that this review is representative of other experiences around the world.

See here for a more detailed power point presentation on how to critique studies

You may also want to touch upon the limitations within your review….Did you really do everything you could have done to find all papers? What limited or prohibited you from creating the very best review of all time?

Results: Here you need to state what you actually found, what you interpreted from these findings and how these findings may related to each other.

Results

This literature review has retrieved 4 papers which illuminate how 20 to 30 year old’s within the western world experience both hosting and attending vintage tea parties as a social activity. These studies used a variety of data collection methods such as interviews (Carroll, 2015), focus groups (Sinatra, 2012), Questionnaires (Poppins, 1964), and online surveys (Buckingham palace, 2010). All studies reported that the experiences of 20 to 30 year old’s either attending or hosting vintage tea parties were positive overall. None of these studies reported any negative effects for any of their participants. Ultimately, vintage tea parties were found to be a jolly social activity for all attendees and hosts.

Synthesis of findings

(This is where you bring your results together and make sense of them, there are many different ways to synthesize your results: These methodologies can include meta-narrative, critical interpretive synthesis, meta-study, meta-ethnography, grounded formal theory, thematic synthesis, textual narrative synthesis, content analysis, qualitative metasummaries, framework synthesis and ecological triangulation) – Read more about this stuff here.

But let’s not over complicate things here. We will start by  examining all aspects of, and the context of each paper, whilst comparing and contrasting the results of each paper with the others. In doing so, we may use a mixture of the methodologies described above.

In terms of finding a suitable location for a vintage tea party, both Carroll and Buckingham palace chose to locate their vintage tea parties within a garden setting (Carroll, 2015 and Buckingham Palace, 2010). Although the setting of Carroll’s tea party was in a wooded clearing, it was set behind the mad hatters house, and therefore considered to be a back garden, in the same way that the queens garden party is hosted behind the queens properties. Conversely, Poppins (1964) explores the experiences of those present at a tea party hosted in a living room, and more specifically, upon a ceiling. Both of these settings were reported to be enjoyable for guests, as those interviewed following the Mad hatters tea party reported experiences of ‘merriment’, ‘joy’ and ‘enjoyment’ in response to being in these locations (Carroll, 2015). Equally, those who completed the surveys and questionnaires posed by Buckingham Palace (2010) rated their experiences of ‘merriment’, ‘joy’ and ‘enjoyment’ as “9 out of 10” on a positive rating scale when the tea party was held outdoors, with access to the garden rooms indoors. Sinatra (2012) did not specify a location for their tea party.

Opinions and experiences surrounding the display of appropriate etiquette appears to form some conflict within the studies. Sinatra (2012) encourages two guests to sit on one another’s knees, whilst serving tea. Whilst one guest at the tea party on the ceiling expressed some distaste at the ‘excessive laughter’ and the location of the tea party being hosted upon the ceiling (Poppins, 1964). The guests and hosts of the Mad Hatter’s tea party felt that it was very important to be officially invited to the tea party, rather than simply turn up unannounced (Carroll, 2015). Equally, the queen’s tea party hosted by Buckingham Palace (2010) requires all guests to present an official invitation before entry is permitted to the garden tea party. This tea party also requires its guests to wear a particular and suitable attire. Burping, belching, trumping and swearing is never permitted, and it is expected that one holds one pinky finger out whilst drinking tea (Buckingham Palace , 2010).

Food and other beverages form an important part of each of the tea parties referred to within this review. For the Mad Hatter’s tea party, it was a focus on tea and iced cake that contributed towards both the guests and hosts having a ‘jolly’ time (Carroll, 2015). Indeed, tea and cake feature heavily within each of the studies presented, and are often commented upon as a the source of an enjoyable experience (Sinatra, 2012, Poppins, 1964, Buckingham palace, 2010, Carroll, 2015). However, a variety of finger sandwiches, petit fours and other pastries were also rated highly (10 out of 10) as the ‘delight’ of the vintage tea party, making it more ‘special’ (Buckingham Palace, 2010, Poppins, 1964). Participants within each of these studies also reported that the presentation of this food is important, as the use of doilies, tea pots, cake tiers and napkins can enhance the experience of a vintage tea party (Sinatra, 2012, Poppins, 1964, Buckingham palace, 2010, Carroll, 2015).

The timing of hosting a vintage tea party was preferred in the afternoon as ‘afternoon tea’ by all studies (Sinatra, 2012, Poppins, 1964, Buckingham palace, 2010, Carroll, 2015). Additionally, the hosts and guests at the Mad Hatters tea party suggested that the vintage tea party could be enjoyed during either a birthday or an ‘un-birthday’ (Carroll, 2010). Those who completed the surveys and questionnaires posed by Buckingham Palace (2010) and Poppins (1964) rated their experiences more highly “9 out of 10” if a tea party hosted at any time included laughter, pleasant conversation and singing. These components were also apparent within the findings of  both the ‘Tea for Two’ tea party, and the Mad Hatters tea party (Sinatra, 2012, Carroll, 2015).

Discussion: This is an opportunity to interpret these results, and share what they might mean in a wider context.

  • What was interesting?
  • What was surprising?
  • Did you find what you expected to find?
  • How will this new knowledge change things in the future?
  • What are the implications of finding this new knowledge?
  • How will it affect your, and others practice?

Let’s shine a new light on things!…

SHINE A TORCH

Discussion 

(Start with a summary of your results)

Overall, participants aged between 20 and 30 reported positive experiences in relation to both hosting and attending vintage tea parties. Experiences were reported via a number of sentiments including ‘Joy’, ‘Merriment, ‘enjoyment’ and were described as being ‘special’. Questionnaires and surveys also highlighted that vintage tea parties were enjoyed both outdoors and indoors, mainly during the afternoon. Tea served from teapots with fine china, cake, sandwiches and pastries placed upon doilies and tiered plate displays can enhance ones experience of a vintage tea party, as can singing, laughing and pleasant conversation. As such, vintage tea parties can be considered a positive social activity for those aged between 20 and 30.

It was interesting to note that conversation and laughter in particular played a key factor in how this population enjoyed vintage tea parties. This would suggest that the success of such tea parties rely upon more than just the location of the event or the practicalities of hosting them. As such, part planners may wish to consider the implementation of conversation catalysts or ‘ice breakers’ to create the atmosphere required for success.

Etiquette is also an important factor to consider when creating an enjoyable vintage tea party, as gatecrashers can cause distaste among both hosts and guests. It is clear that invitations provide confidence and a certain formality to events as apposed to a spontaneous vintage tea party, which may become more informal as a result.

As many 20 to 30 year old’s already attend vintage tea parties, it was anticipated that they would indeed find these experiences to be enjoyable. The results of this review provide new and united evidence to strengthen this notion, and illuminate the particular reasons why these experiences may be enjoyable. This new evidence will be important to new hosts and party planners wishing to organise enjoyable vintage tea parties as social activity.

Implications for future practice

(What are you going to do or recommend in light of what you have found??)

Future tea parties would be enhanced by the application of these findings, as party hosts look to create enjoyable activities for those aged between 20 and 30. Party planners may wish to consider ‘vintage’ as a theme, and encourage guests to fully embrace this theme, concept and event as an alternative to the modern tea party. Future research may wish to explore these vintage tea parties in more detail with progression towards a large and adequately powered randomised controlled trial (RCT), as this would enable party planners and party goers to create the ultimate vintage tea party, as guided by a more rigorous evidence base.

“What is an RCT?” I hear you cry…

(See simplified info-graphic below)

Image result for what is a randomised controlled trial?

 

Conclusions: This is where you recap what you have done and found. It should match closely with the introduction in which stated what you were going to do. You should leave the reader with a final impact statement and your own final reflections.

In every day party creation, it is important to create an enjoyable social activity. As 20 to 30 year old’s seek to attend such activities, it is important to explore which social activities are experienced positively by this population group. This paper has reviewed the evidence in relation to how 20 to 30 year old’s experience vintage tea parties. Following a review of 4 academic papers, the evidence presented here suggest that vintage tea parties are indeed a jolly event for 20 to 30 year old’s.

As well as discovering that this population enjoy vintage tea parties as a social activity, this review has also unearthed which components may be most contributory to the success of such an event. As such, the hosts of future vintage tea parties should plan to include tea served from teapots with fine china, cake, sandwiches and pastries placed upon doilies and tiered plate displays, singing, laughing and pleasant conversation.

You may also want to include a subsection here that specifically outlines how you have met the learning outcomes set out by whichever module or dissertation/thesis it is that you are completing.

 

happy book

And there we are, a guide to writing a literature review. This guide is supposed to be a reference tool for you all to create your own masterpiece essays and dissertations. The review I present here may be much shorter than what you are required to produce, however, I hope it will serve as reference material as you progress in your academic writing. Although the subject matter here is vintage tea parties, I do hope that many nurses and midwives will easily be able to apply nursing and midwifery topics in place of the tea party.

The principles of writing a literature review are virtually the same within any subject matter. Here for instance, you just replace the vintage tea parties with diabetes, and boom…you have a literature review on how a certain population experiences diabetes or diabetic care. Whatever your academic question is, a literature review is a great way to help you find answers, improve your clinical practice and discover new evidence based practices to apply in the real world. Many clinical guidelines are constructed by reviewing the available literature. As you complete your literature reviews, you will also be able to make recommendations, based upon what you have found.

Although I have presented a loose structure for a literature review here, please be aware that there are many other structures, methodologies and reporting styles available. Yet I hope that this example will fit loosely around any essay topic if applied appropriately.

If you have any questions or comments, please feel free to add these to the comments section below. I really hope that this makes academia a little less scary for student midwives and nurses. For further hints and tips for essay writing, see my other article here.

Until next time…take care of yourselves, and each other ❤💚💜

 

 

 

 

 

 

 

 

 

 

 

 

5

15 Top Essay Writing Tips for Midwifery and Nursing Students

Every September will see a new intake of enthusiastic  &  embarking upon a new and exciting journey which will test their abilities in every sense. They will soon find out if they are suited to both complex and simple clinical tasks, compassionate care, skills drills, regulatory guidance, evidence based practice and the academic demands required to actually pass the course.

My experience as a midwife tells me that student midwives and nurses are more than capable of thriving in a clinical environment if they are afforded the provision of both effective and compassionate mentorship. To lead a student midwife or nurse into the profession with hope and optimism is an extremely rewarding task, and the bonds we can build within our profession will serve us all well as we continue to provide quality care throughout turbulent times.

Although there is undoubtedly effective leadership within the midwifery profession that prepares students for the clinical task of delivering excellence in maternity/nursing care, there is often a paucity of mentors who can spend time developing a student’s academic and research capabilities. This blog post is a response to those student midwives and nurses who have expressed to me their worry, concerns and a lack of knowledge in relation to the academic outputs required of them in order to pass the undergraduate courses.

I do not claim to be an academic genius, but I am a midwife with a passion for academia, evidence informed change and evidence based practice. I also cannot bare the fact that some clinically competent and compassionate student midwives/nurses may be lost to the profession due to the academic pressures they may face. Students may feel that these pressures are insurmountable. They are not.

Questions I have heard from students:

  • How do I write a student nursing essay?
  • How do I write a student midwife essay?
  • What does a good nursing essay look like?
  • What does a good midwifery essay look like?
  • What are the different types of essay?
  • Can you show me some essay templates?
  • How should I structure my essay?
  • I don’t know what they want from me?
  • How to do a literature review?

Part of my work involves being a facilitator for problem based learning. Through this role, I enjoy supporting undergraduate health care students to study and develop their skills in evidence based practice. As I was marking undergraduate essays recently, the same problems and conversations kept coming up. I was giving the same advice to each student. They were all having the same issues and were all in fact growing into wonderful academics and learning throughout the process.

It was magical to watch…. But what does this tell you? 

“You are not alone in your struggle…Be kind to yourself”.

Library books

15 Top Tips for Midwifery and Nursing Students on Essay Writing:

  1. Read around your subject before you start, and make sure you have the most up to date info on the topic before you begin.
  2. Use the online databases (You should have one made available to you in your university) to search for articles relevant to your topic.
  3. Read your learning outcomes and indicative content – address each one thoroughly, ticking them off as you go. Better still, explain how you have met each one within your essay. Its hard to fail someone who has demonstrated how they have met the goals they were set.
  4. Avoid making outright claims without a good reference to back it up. An example might be… “Diabetes affects millions of people worldwide” – Well yes, we know this to be true, but unfortunately, you are not a leading expert in diabetes (yet!)..and so you must instead quote the facts and figures in relation to diabetes and credit the expert who has published this knowledge….So instead you should perhaps write and cite… “Diabetes affects around 422 million people around the world” (Professor Diabetes, 2014) in your universities referencing style.
  5. If you want to be a fancy pants with your referencing (and make it easier and faster to reference your essay), you may want to consider using some academic referencing software such as Ref Works, Mendeley or EndNote. References should be restricted to within the last 5 years where possible.
  6. Look at examples of published papers. How do they present themselves? How are they structured? Your essay may not be too different from a published paper..learn from the best (or choose to emulate the academic style you like best)!
  7. Watch your grammar, spelling, punctuation and writing style throughout. Sentences should be short, clear and to the point. Each paragraph should focus upon a different point you are trying to make. They should not be too long either.
  8. Section headings make your essay easier to read and understand, it also helps you clarify what you are trying to say within each section.
  9. Know or decide on the type of paper you are writing before you begin. Is this a critical analysis? A literature review? Is it narrative? Descriptive? Look at your end goal. What do you want or need to produce?
  10. Take a fresh eyes approach to your essay every few days. Re read it. Does it still make sense to you? Have you missed anything out? Can you make it better or clearer in any way? Is it logical?
  11. Ask friends, colleagues and family to read it. Does it make sense to them? Use their fresh eyes too, they may help you improve it or spot mistakes.
  12. Use your tutors, that’s what they are there for. They can look at drafts for you, comment on the work you have already started and point you in the right direction. Don’t struggle alone. Always ask for help.
  13. Always relate your work back to how this would make you a better nurse or midwife. How do you reflect on what you find through your work? How does any new evidence you find change your practice? How might you relate it back to the NMC code?
  14. Lastly, start early. Do not leave anything until the last minute. You will need time to take a ‘fresh eyes’ approach every few days.
  15. As you regularly revisit your essay, make sure you also save your work regularly – email it to yourself to be extra safe!

pen writing

I hope that some student midwives and nurses can make use of these tips as they move forward in their academic journey. Please feel free to add more tips below in the comments section.

See here for my Guide to Literature Reviewing for Student Midwives & Student Nurses

Until next time…take care of yourselves, and each other ❤💚💜

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A summary of the #GreatMindsUW2016 Nursing & Midwifery conference at @worcester_uni

Yesterday I took a trip to Worcester University to attend and present my latest research at the #greatmindsUW2016 ‘Great Minds Don’t Think Alike’ nursing and midwifery conference at @worcester_uni.

Hearing ‘Re-energising Curiosity’ by Professor Tamar Thompson OBE, Visiting Professor University of Worcester speak, I was struck by the Institute for Health Improvement’s Triple Aim is a framework – an approach to optimising health system performance. This framework promotes the belief that new designs must be developed to simultaneously pursue three dimensions… “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care

I thought…I can easily fit an online intervention designed to support midwives in work-related psychological distress into this framework…right?IHI Triple aim

I guess I will just have to prove it first 🙂

Next I was privileged to hear my wonderful colleague…Diane Ménage (@Dianethemidwife ) Doctoral Research Student Centre for Technology Enabled Health Research, Coventry University talk about her vital work in Compassionate Midwifery: appreciating, supporting and sustaining compassion in practice. As I heard Diane speak about the importance of words, feelings and perspective in midwifery care, I was struck again by the importance of reflection in practice, taking time to step back and review…and of course be compassionate to one another. It is so clear that all midwives have the same vision for improved care and quality services. The room was definitely eager to follow Diane’s work (as am I!).

Diane Menage by Sally Pezaro

Next, I found myself enthralled by listening to Leadership in a changing landscape: the importance of values, culture and humanity by June Patel Care Director St Richard’s Hospice and Caring to care for people – working with senior acute nurses on a dementia leadership course run by the Association for Dementia Studies Christine Carter Senior Lecturer Mary Bruce Senior Lecturer Association of Dementia Studies, University of Worcester. Within both of these presentations, my focus gravitated towards the need to care for each other, before we are able to give good care to those using our health services. A recurrent theme…over and over…The best care just cannot happen without a healthy and cared for workforce.

Leadership in a changing landscape.jpg

Systems leadership

Next I was enthralled by Janet Davies – @janetRCN Nurse and Chief Executive & General Secretary of the . Again, we heard here how we all need to be change agents and make things happen.. We see a problem….we know the solutions. I just hope I can manage to remedy the well being of midwives and other healthcare professionals in distress!

Janet Davis#nursingcounts by sally pezaro

I was saddened to hear how poorly rewarded nursing is…I will be following the  hashtag from now on 🙂

Then it was my turn to share my research, and I am grateful to all that came to hear my presentation. It was great to be able to spark such a healthy and stimulating debate about the future of the online intervention I am looking to develop. I really felt that everyone in the room was really thinking and working through the moral and ethical dilemmas in making this project come to life. I would love to carry on this conversation, and I would welcome further comment and discussion as I too work through new obstacles and dilemmas in pursuit of changing health care for the better. Feel free to get in touch (we could have continued our debate for hours I am sure!) – Thank you 🙂

Sally Pezaro at #GreatMindsUW2016

Unfortunaltey, I was unable to hear my wonderful colleague ) speak, as she was scheduled to present her work at the same time time as myself. Please follow her work 

Hannah Matthews' work

Lastly I would like to thank my wonderful midwifery adviser, Dr. Elizabeth Bailey (@Liz8ailey ) for her great support to all of us yesterday at this great conference.

The thought that was left with me as I drove home…was..”Insanity is doing the same thing over and over again, expecting different results” 

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How might we apply Isaac Asimov’s “Three Laws of Robotics” to underpin the #NHS?

This week, as usual… my mind has been whirring with a multitude of issues relating to staff well being in the NHS. Except lately I have been trying to look at everything from a different angle. So, being a bit of a Sci-fi geek as well as a Tudor History fan and doctoral researcher, it suddenly dawned on me how I was, in my own mind, equating the professional duties of NHS staff with Isaac Asimov‘s “Three Laws of Robotics“.

This ‘Eureka moment’ happened whilst I was enjoying my morning dippy egg, and I shall translate my thoughts as follows:

In case you were unaware, Asimov’s laws were intended as a fundamental framework to underpin the behavior of robots in human society. These laws are intended to allow the safe use of robots as tools.

They were originally as follows:

  1. A robot may not injure a human being or, through inaction, allow a human being to come to harm.
  2. A robot must obey the orders given it by human beings, except where such orders would conflict with the First Law.
  3. A robot must protect its own existence as long as such protection does not conflict with the First or Second Laws.

I shall now rewrite these laws based upon the analogy of this being applied to NHS relationships in my own mind.

  1. Clinical professionals may not injure a patient or, through inaction, allow a patient to come to harm.
  2. Clinical professionals must obey the orders or ‘needs’ of patients, except where such orders would conflict with the First Law.
  3. Clinical professionals must protect their own existence as long as such protection does not conflict with the First or Second Laws.

In essence, clinical professionals are programmed in this same way to put patients first. I am not necessarily arguing that this is wrong. But again, in doing this we may paradoxically be putting patients at risk if we fail to value clinical professionals as humans too.

Are clinical professionals the subservient robots of humanity?

If clinical professionals obey the needs or ‘orders’ of patients at the expense of their own well being, then this may not be conducive to safe clinical care.

Later, Asimov added a “zeroth law”, that preceded the others in terms of priority:

0. A robot may not harm humanity, or, by inaction, allow humanity to come to harm.

Which in this analogy would become:

0. Clinical professionals may not harm humanity or, through inaction, allow humanity to come to harm.

If the well being of clinical professionals is not properly valued or addressed, the quality of patient care may be reduced through “malfunctioning” or “Decommissioned”  practitioners. Therefore, humanity is harmed twice – once in the harm of patients and once in the harm of clinical practitioners. Humanity suffers.

The three laws are intended for robots, and we need to remember that clinical professionals are not robots. We also need to ensure that the well being of NHS staff remains an issue of equal salience in the provision of safe care. If both NHS staff and patients are of equal societal value, then we must value #StaffExperience as much as we value #PatientExperience.

Should this happen, then we may see better quality outcomes for all.

Please let me know your thoughts… Until then, I shall be burying my head in an ethics paper and literature review!

Be kind to yourselves, and each other x

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#InternationalNursesDay celebrated during #MentalHealthAwarenessWeek… coincidence? #MHAW15

So… this will be a short blog for me today as I am working to get two new papers published so that I can do equally exciting, but different things next week 😀

I just wanted to sketch some quick thoughts down here about #InternationalNursesDay and  , as these events both fall within the same week and indeed #MentalHealthAwarenessMonth.

 celebrates self care and mindfulness this year, both extremely valuable tools (IMHO) to maintain ones own well being. The awareness week also brings our attention to the eternal war on stigma, which again IMHO is the biggest killer of all. This year was indeed an amazing #MentalHealthAwarenessMonth and I very much enjoyed reading and seeing the buzzing communities becoming involved on twitter.

Equally, #InternationalNursesDay  was celebrated with vigor, yet I saw this event in a different light.  saw those with mental ill health explain to the world how it feels to manage their mental health every day. They implore the world to take notice of their needs and  recognise mental ill health as being equal to physical health. They draw upon the importance of mental health awareness and the need for action. They are fighting for their rights and more. It was inspiring to see 😀

However, those celebrating #InternationalNursesDay seemed to share a different message. The main campaign which took my attention was the hashtag #whyInurse. This involved nurses from all over celebrating their work, acknowledging their privileged position and providing examples of the pride they share in nursing. It was really quite jovial. They were celebrating what they wanted to give, rather than anything they wanted to take for themselves.

This is seemingly a consistent pattern for health care professionals….they give all that they have….

Do they ever have time to look after themselves? Allow self care? practice mindfulness?

Many nurses celebrating their profession also celebrated #MentalHealthAwarenessWeek…Do they practice what they preach?

Although there is much to celebrate, I worry that health care professionals are placing themselves upon high ground. Through my research and the statistics I am seeing, I know that there are many health professionals who may be suffering in psychological distress. When these celebrations shout to the world that nurses are ‘having a ball’, it may make it that much harder for those in pain to speak out.

It may even make people think that health care professionals are much too happy in their jobs to be in psychological distress.

As it is #MentalHealthAwarenessWeek… I want to raise awareness about the healthcare professionals in psychological distress. They are dealing with horizontal violence, emotional and moral traumas, traumatic incidents, stigma, compassion fatigue and much more.

Remember that 1 in 4 people in the UK will experience a mental health problem each year. This figure also applies to health care professionals working within the NHS and all over the world.

I would like to bring #InternationalNursesDay and #MentalHealthAwarenessWeek together, so that healthcare professionals can become aware about their own mental health needs and the needs of their colleagues.

These are only my personal views. There is never any offence intended. Please see the support page of this blog if you have been affected by any of the content within this blog.

Thank you  for reading 🙂 

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Hospital Staff Absences for Mental Health Reasons Double – but do the Figures Add Up?

Today I was up early to watch Danny Mortimer NHSE_Danny (Chief Executive Employers) Speak on BBC Breakfast in light of new figures obtained via a Freedom of Information Act Request, that Hospital staff absences for mental health reasons has doubled across England in the last 4 years!

This information is obviously very relevant to my PhD study, and I will be reviewing it in time. However, the initial response that Danny Mortimer gave was that  staff feel comfortable talking about their . Hmm…

Has all of my research to date been wrong? Are #NHS staff comfortable talking freely about their mental ill health? (would love to hear your thoughts, but ironically you may feel unable to speak out – I tell myself this is the reason for a lack of comments on, and interactions with my blog all of the time :P)

Anyway, as you can imagine, I became worried that I was ‘missing something’ and asked Danny if he had any evidence for this? – See our conversation here

As you can see, he did not provide me with evidence for this statement, but agreed that we all need to do more to support our colleagues, and I know that we all share the same constructive goals. Unfortunately people don’t always have an answer, they just know that something needs to be done. I still believe that my PhD research could be the key to effective support, but this project is in its infancy and I will keep the readers of this blog as updated upon its progress as I am able.

So… the evidence provided by NHS Employers upon the mental health & well being of NHS staff is this:

MentalHealth Infographic WEB FINAL

A great infographic! However, one thing concerns me…. Apparently 76% of NHS trusts report that they monitor the well being of their staff (RCP, London). Yet 3 out of 4 people suffering from mental illness get NO TREATMENT AT ALL. (www.mentalhealth.org). So, are NHS trusts doing anything about the staff they find to be unwell? or are NHS staff fine? I think not. I worry that there is a lot of good rhetoric out there around NHS staff health and wellbeing, but not many interventions to support staff. The figures don’t add up, and seemingly only smarties have the answer.

I hope I have the answer coming… I hope its not too late.

http://www.mentalhealth.org.uk/content/assets/PDF/publications/fundamental_facts_2007.pdf?view=Standard

http://www.rcplondon.ac.uk/resources/nice-public-health-guidance-workplace-organisational-audit’