This paper describes a method for the creation of interactive software for safety training, with a focus on life-threatening situations encountered in the steel industry. This approach uses tools from the gaming industry to create photorealistic three-dimensional models and interactive situations that are typically encountered in steel production settings. Users interact with the models in real time through scripted scenarios in which they must carry out work-related tasks that require understanding and application of safety concepts. An example scenario that focuses on work at height and fall protection is discussed along with practical considerations for implementation.
Responsiveness is not new to the field of psychometrics. Responsiveness refers to the ability of an instrument to discriminate clinical changes as the result of an intervention.1,2 Responsiveness has been described as “an essential element of health status questionnaires”.3(p.1) It has been used in many areas, including depression, spinal cord injury, stroke, traumatic brain injury, cardiac rehabilitation and pain, to name a few.4-9 Over the years, there has not always been consensus about its place as a psychometric property. Although it has been viewed both as a unique psychometric property and a function of validity, it has always been held as part of the quantitative realm of research.3,10 If we are going to take time to define a psychometric property and subsequently measure it, then we should find a meaningful place for it in order to inform practice. We need to decide where and how responsiveness should be taken into account. We often see responsiveness reported in studies validating a new or revised instrument.6,11,12 In addition, it is reported when comparing instruments that measure the same construct or function.4 Quantifying responsiveness may also help researchers select the most robust instrument when planning an intervention study. Thus, the importance of selecting and using an instrument with strong psychometric properties cannot be stressed enough. Responsiveness has the potential to provide greater insight and understanding if we carefully consider the value and meaning of “clinically important change”. Statistically significant differences and clinically significant differences are distinctive entities; each has a role in measuring how an intervention can be viewed and evaluated. Statistical significance has been held as the gold standard when it comes to evaluating interventions. Statistical significance can tell us how sure we are that a relationship or difference exists, and whether to accept or reject the null hypothesis. By itself and without further information, statistical significance does not help us make clinical decisions. Therefore, if responsiveness can be used in clinical decsion-making, this would be a more practical approach to determine whether an effect truly exists. If an instrument has demonstrated that it is responsive and can detect clinical change, then results indicating clinical change tell us that the intervention has had an impact on the function being measured, whether it is depression, pain, motor movement or strength. We are continuously searching for interventions to improve the lives of others and need to consider if/how responsiveness findings help us make clinical decisions. Of course, we need to interpret findings in context, that is, an intervention may only be meaningful for the group being studied. In addition, we need to look at all study findings to see if clinical significance aligns with the overall study findings. By itself, responsiveness only tells us that an instrument has the ability to measure change. But when it does, we need to figure out if the measured change has meaning for clinicians/researchers and/or patients receiving the intervention, or both. What if we entertain the idea that responsiveness, by its own definition, is really giving us a glimpse of the patient's voice, in effect, informing qualitative inquiry? Are we merely looking at numbers or what those numbers represent? Does clinical change give us an inkling of that change from the patient perspective? What does this clinical change mean to these patients? Is change really saying that the intervention being tested is making a measureable difference in their life? If statistical significance tells us how sure we are that a relationship or difference exists as a result of an intervention, then maybe clinical significance can be considered a surrogate for “patient voice”, indicating that an intervention has made a difference in their life because, for example, they feel better, have less pain or have improved range of motion. This is different than shared decision-making because shared decision-making is an active exchange between a practitioner and patient, with the intention of making healthcare decisions.13 However, information gleaned from impactful clinical changes, as mentioned above, may lead to increased dialogue in shared decision-making regarding interventions or treatments. Treatments/interventions that have been studied and indicate promising outcomes may be considered in these collabrative encounters. As responsiveness is commonly reported and used in studies measuring physical or psychological function, we need to consider how we should interpret clinically important differences. Similarly, like other statistics, responsiveness cannot be viewed as a stand alone property but needs to be examined in the context of the study and overall study results. Therefore, if responsiveness can discriminate clinically important changes, as the result of an intervention and/or from the patient's perspective, then it may have a place in informing clinical decision-making.
The column concerns itself with mentoring as an evolving relationship between mentor and mentee. The collegiate mentoring model, the transformational transcendence model, and the humanbecoming mentoring model are considered in light of a dialogue with mentors at a Midwest university and conclusions are drawn.
The column concerns itself with mentoring as an evolving relationship between mentor and mentee. The collegiate mentoring model, the transformational transcendence model, and the humanbecoming mentoring model are considered in light of a dialogue with mentors at a Midwest university and conclusions are drawn.
Background Lateral/horizontal (LV/HV) violence is a widely reported phenomenon in nursing literature. There are a myriad of definitions but broadly it is defined as nurse-on-nurse aggression resulting in destructive behavior of nurses against each other. L/H violence is the demeaning and downgrading of others with unkind words and cruel acts often causing a wide array of negative effects. Objectives To synthesize the best available evidence on the experience of LV/HV in the profession of nursing, its impact on job satisfaction and retention, and the effectiveness of programs/strategies to decrease its prevalence or mitigate its negative effects. Inclusion criteria Types of participants This review considered studies that focused on licensed nurses and student nurses in any setting. Types of intervention(s)/phenomena of interest The qualitative component considered research on the experience of LV/HV in the profession of nursing. The quantitative component considered the impact of LV/HV on retention and job satisfaction, and the effectiveness of programs/strategies designed to decrease its prevalence or mitigate its negative effects. Types of studies The qualitative component of this review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, focus group and action research. The quantitative component of this review considered randomized controlled trials (RCTs); in the absence RCT's other research designs such as non-randomized controlled trials, experimental study designs, observational studies, and before and after studies were considered. We searched for and considered research reports and dissertations found in the grey literature. Types of outcomes The qualitative component of this review included experiential accounts of being a nurse or student nurse who had experienced LV/HV. The quantitative component of this review considered studies that reported the following: 1) The impact of LV/HV on job satisfaction and retention. 2) The effectiveness of programs/strategies to prevent LV/HV or mitigate its negative effects. Search strategy The search strategy aimed to find both published and unpublished English language primary research studies. We used a three-step search strategy in each component of this review. First we completed an initial limited search of MEDLINE and CINAHL followed by an analysis of the text words contained in the title and abstract and of the index terms used to describe the article. Second we searched across the following data basis using all identified keywords and index terms. Finally, we conducted a hand search of the references of key articles. Databases Databases searched include: BioMed Central CENTRAL (The Cochrane Library) CINAHL Conference Proceedings Health Source: Nursing/Academic Edition Elsevier Science Direct EMBASE Institute for Health & Social Care Research (IHSCR) New York Academy of Medicine Grey Literature Report ProQuest Digital Dissertations Psych ARTICLES PsychINFO PubMed (MEDLINE) Reference lists of identified studies and review papers SCOPUS Sociological Abstracts Methodological quality Two reviewers independently assessed articles meeting our inclusion criteria for methodological quality using the standardized appraisal tools from the Joanna Briggs Institute. Data collection For both the qualitative and quantitative components of the review we extracted including specific details about the phenomena of interest or interventions, populations, study methods and outcomes of significance to the review questions and specific objectives. Data were extracted using the standardized data extraction tools for the Joanna Briggs Institute. Data synthesis Qualitative research findings were pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). We could not undertake a meta-analysis of the quantitative papers because of lack of data for statistical pooling. Therefore, we synthesized the studies using a narrative summary. Results For the qualitative component of this review sixteen studies were included in the review. Ninety-five findings were extracted and grouped into sixteen categories which were synthesized into four meta-synthesis statements related to the experiencing a bullying environment, the complexity of the bullying environment, culpability in a bullying environment and coping in a bullying environment. For the quantitative component, we summarized and synthesized four descriptive correlational studies related to the impact of LV/HV. There were no relevant quantitative studies addressing the effectiveness of interventions. Conclusions The presence of LV/HV appears to be widespread throughout the nursing profession. LV/HV was reported more frequently by student nurses, new nurses, and older experienced nurses. Although a strong qualitative theme, this was not supported in the quantitative data. The experience of LV/HV causes intense distress in many of the victims. There is a paucity of research on the impact on job satisfaction and retention and the effectiveness of programs/strategies to decrease its prevalence and negative effects. There is a need for high quality qualitative and quantitative studies to further glean a better understanding of the phenomena its impact and in particular, effectiveness of interventions to affect job satisfaction and retention.
PURPOSE:To review the concepts of reliability and validity, provide examples of how the concepts have been used in nursing research, provide guidance for improving the psychometric soundness of instruments, and report suggestions from editors of nursing journals for incorporating psychometric data into manuscripts.METHODS:CINAHL, MEDLINE, and PsycINFO databases were searched using key words: validity, reliability, and psychometrics. Nursing research articles were eligible for inclusion if they were published in the last 5 years, quantitative methods were used, and statistical evidence of psychometric properties were reported. Reports of strong psychometric properties of instruments were identified as well as those with little supporting evidence of psychometric soundness.FINDINGS:Reports frequently indicated content validity but sometimes the studies had fewer than five experts for review. Criterion validity was rarely reported and errors in the measurement of the criterion were identified. Construct validity remains underreported. Most reports indicated internal consistency reliability (alpha) but few reports included reliability testing for stability. When retest reliability was asserted, time intervals and correlations were frequently not included.CONCLUSIONS:Planning for psychometric testing through design and reducing nonrandom error in measurement will add to the reliability and validity of instruments and increase the strength of study findings. Underreporting of validity might occur because of small sample size, poor design, or lack of resources. Lack of information on psychometric properties and misapplication of psychometric testing is common in the literature.
