An exploration of the impact of role modelling on adult nursing students' professional development

Service users expect to be cared for by a nurse who is both competent and professional, a particularly pertinent point following the Francis and Keogh reports (DH 2013a, DH 2013b). Nursing students’ experience of education in practice strongly shapes their behaviour and knowledge but the ways in which this influences development of their professionalism is not yet fully understood. This study explored nursing students’ lived experience of role modelling aiming to understand the impact on their development as professional practitioners. In June 2013 twelve student nurses (4 first years, 4 second years, 4 third years) participated in in-depth interviews which were non-structured to allow exploration of the phenomenon that were most important to the participant. Using Interpretive Phenomenological Analysis, the information gathered from participants underwent several stages of thematic analysis. The influence of peers and service users on students’ professional development expands upon previously reported research. This is directly related to how students perceive their role model status and although not generalizable participants in this study found that reflecting on experiences with peers and observing the reaction by service users to care delivery had a positive influence on their professional development. Other principal findings include the importance to students of feeling valued as part of the team within their clinical placements and the potentially deleterious impact on students working with nurses who are displaying signs of burnout. Consequent to these findings, it would appear important for student nurse education to include acknowledgement of how clinical nurse observed behaviour may influence student development, facilitation of peer-to-peer interaction as appropriate to the clinical situation and the potential impact of fostering a ‘personal yet professional’ relationship with the student. A number of other issues are also identified. Given the potential influence of peers in enhancing students’ education, one way of optimising the effect of this novel finding could be to include a formal peer to peer mentoring system across all three years of a pre-registration programme. The findings indicate a limited awareness of the potential influence of academic staff as professional role models. This is a possible area for development. Students should also be guided to work with a number of staff in order to ensure exposure to a variety of practice behaviours

Information and Communication Technology (ICT) and International Business Travel: Mobility Allies?

Like forecasts about the paperless office, technological solutions to the problem of international business travel continue to be deferred. As with the increased use of office paper, international business travel is defying predictions of its decline. There is growing evidence to suggest that business sectors which seem ideally placed to substitute information and communication technology (ICT) for travel, are actually generating more physical travel than other sectors. This paper develops a case study of the Irish software industry to exemplify why international travel is not diminishing in importance how and the ICT and business travel relationship is changing in this sector. The paper presents research findings that suggest that a cycle of substitution, generation and modification relationships have occurred as mobility interdependencies have developed.Peer Reviewe

Dealing with disaffection: The influence of work-based learning on 14–16-year-old students’ attitudes to school

Abstract Background: Recent developments in policy concerned with raising achievement in schools have given rise to work-based learning as a mechanism for dealing with disaffection. Alongside this redress is the potential for promoting alternative pathways into further education and/or employment. This paper looks at the impact of a work-based learning programme on engagement/re-engagement for disaffected 14–16-year-olds. Drawing on data collected in a small borough in the north of England, it examines attitudes to learning in school and a vocational learning environment. Methods: Teachers’ and tutors’ attitudinal scoring of disaffected students was collected in school and a work-based learning provider, and interviews were conducted with a smaller sample of the students. Results: The retention of a strong school connection is identified as crucial in improving attitude to learning in disaffected students, while attitude and engagement is shown to be heavily interrelated. Students who solely attend a work-based learning provider are seen to further dissociate from school. Conclusions: This study explores the relationship between engagement and attitude to learning in disaffected 14-16-year-olds. Vocational learning is seen to be highly engaging and promotes an overall improvement in general attitude to learning. In relation to school, however, there is strong evidence of reinforced negative attitudes and further disaffection when students are fully removed from this environment. Thus, the most potent recipe for dealing with disaffection in this research is shown to be a mixture of environments where a connection with school is retained

INTERNATIONALIZATION OF BRAZILIAN FRANCHISE CHAINS: A COMPARATIVE STUDY

The primary goal of this paper is to comprehend the fundamental organizational differences between Brazilian franchise chains that only operate in the home market and Brazilian franchise chains that operate internationally. The sample chosen for this study comprehends 96 Brazilian franchises operating in the home market and 67 franchises with international operations; logistic regression was used to analyze data obtained from these sources. Our findings suggest that the development of a brand in international operations can be strategic for certain Brazilian franchise chains; this seems to be, however, a scarce resource for many franchises and it could be developed through international operations. With regard to the fees charged, the outcomes demonstrate that Brazilian franchises with international operations tend to charge lower fees from its franchisees to install new units. Regarding the monitoring and control of franchises, there is evidence that the monitoring capability is one of the determining factors in the development of Brazilian franchises international operations

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society