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Critical appraisal training for nurses

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Summary box - click on the headings to skip to the specific text
Background
Lunchtime journal club
Benefits
Mental health recovery model
Future development
Dedicated time


Background

An important function within nurse management is the development of nursing staff. The need to demonstrate evidence-based practice is a feature of every new health policy emanating from the Scottish Parliament and this concept requires that health staff determine best practice. Medical teaching, with its emphasis on research, has for some years included critical appraisal training (CAT). However, this has not been so in nursing to the same extent.

This article provides a reflective account of the benefits derived from the introduction of critical appraisal training and presentation skills within the context of a journal club.

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Lunchtime journal club

Here at the Adult Mental Health Directorate at Royal Cornhill Hospital in Aberdeen, we felt that the best way to review literature in relation to practice would be through a lunchtime journal club. The sessions were limited initially to ward managers, their deputies and directorate nurse managers and it was agreed that only those who attended the critical appraisal training would attend the monthly journal club.

The training was organised and sponsored by Eli Lilly and Company and delivered by colleagues from The Robert Gordon University over a two-day period. Though the training was focused on critical appraisal training, there was also a strong focus on team building.

The knowledge services manager at the hospital was very supportive of the initiative and in addition to providing education on the use of the e-library she provided a comfortable and private venue in the library for the ongoing monthly meetings.

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Benefits

As the members of the group needed to leave the ward for lunch anyway it seemed an ideal opportunity to enjoy lunch together in a social setting before the serious discussion got under way. Among the benefits identified by participants through the evaluation forms were:

  • Opportunity for interaction with colleagues and managers away from wards
  • Opportunity to review relevant articles
  • Opportunity to talk about experiences
  • Discussion and brainstorming ideas generated around topics

It was agreed that the events would run over a six-month period, after which there would be an evaluation. It is the evaluation that forms the basis of this paper.

Opportunities for nurses to have time out from their busy schedules to reflect are few. Often the pressures of ensuring that good and safe care is delivered can result in little time to explore whether there are better ways of working. In this climate, reflection and particularly reviewing literature is seen as a luxury.

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Mental health recovery model

It was anticipated that review of mental health nursing would result in some change in direction for mental health nurses. Indeed the product of that review? 'Rights, Relationships & Recovery? (locally referred to as the Three Rs) - proposes a new direction for mental health nurses and comes with a detailed action plan.

The journal club provided the opportunity to explore issues relating to the recovery model, least restrictive options particularly with regard to the locking of doors, and values-based services among other relevant topics.

The overwhelming view in relation to choice of topic was that it 'should be relevant to adult mental health? while one person also highlighted the benefit of self-development.

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Future development

There were mixed views regarding the future development of the journal club. While all members felt it was very worthwhile, some felt it should continue unchanged for a period while others felt that it should be extended to include new and possibly more junior members. That it has been beneficial was clear from all evaluations.

Journal clubs are one way of teaching critical appraisal skills, and letters to journals act as a forum for the critical appraisal of published articles. While letter writing and production of journal articles was not an original objective of the group, it may in turn be an option for the group to consider in its further development.

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Dedicated time

Reflective practice is an essential component of personal and professional development. If nurses are never able to find the time to reflect and review what is claimed as best practice then practice will not change. They need to have the opportunity to do this and it should be considered an important aspect of the work schedule rather than an added burden. But to do this there must be dedicated time otherwise it will always be an easy target in times of pressure in the ward environment.

This small initiative to introduce CAT had positive benefits professionally and personally while also having a social benefit. The initiative involved only a small number of nurses and over a relatively short period. Nevertheless, the enthusiasm with which people embraced the idea was refreshing and might be replicated in other settings with equally enthusiastic members.

Fiona F Parley is a clinical governance facilitator for NHS Grampian, Adult Mental Health Directorate, Royal Cornhill Hospital, Aberdeen. Email: fiona.parley@gpct.grampian.scot.nhs.uk

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