Explore the vast range of titles available.

The transition from student to novice is a difficult time. Although the novice nurse is excited to start working, the nurse struggles with acclimating to a new role with new responsibilities and the need to reconcile disparities between what was taught in school and what is practiced in the real world. To lessen the impact of the transition experience, health care organizations have implemented transition-to-practice programs including orientations, preceptorships, and residencies. Despite these efforts, if the novice nurse does not find these programs helpful, there is still a risk that the transition experience will not conclude with successful results. This integrative review examined qualitative studies that explored the transition-to-practice experience of novice nurses who participated in a transition-to-practice program provided by their place of employment. Thirteen articles met the criteria for this integrative review; seven themes emerged from the commonalities in the studies: socialization, professional growth, feeling supported, transition challenges, reflections, transition shock, and feelings. Though the transition period includes unique experiences for each novice nurse, the common feelings and needs identified in these studies require nurse educators and the healthcare organizations to ensure that novice nurses are prepared and given the tools to successfully transition to professional nursing practice. •Nursing students need preparation to overcome transition-to-practice challenges.•Mitigating the impact of non-clinical transition challenges is essential.•Research is needed to examine non-clinical transition-to-practice courses.

Background Undergraduate nursing internships are a critical phase in nursing education, where interns often face high levels of perceived stress due to the demands of clinical practice. This stress may contribute to the development of compassion fatigue, which can impair their professional performance and well - being. Resilience, as a psychological resource, has been suggested to buffer the negative effects of stress. However, the mediating role of resilience between perceived stress and compassion fatigue in undergraduate nursing interns remains understudied, highlighting the need for this investigation. Methods A cross - sectional study was conducted using a convenient sampling approach. From January to March 2025, 214 undergraduate nursing interns were recruited from three tertiary grade A general hospitals in Chengdu, China. Data were collected using four validated instruments: a General Information Questionnaire, the Chinese Version of the Compassion Fatigue Short Scale (CF - Short Scale), the Perceived Stress Scale (PSS), and the College Student Resilience Scale. Statistical analyses included descriptive statistics, Pearson correlation analysis, and structural equation modeling (SEM) to examine the mediating effect of resilience. The SEM was used to test the hypothesized model, with maximum likelihood estimation employed. Results Among the 214 undergraduate nursing interns, the mean total scores of compassion fatigue, perceived stress, and resilience were 57.53 ± 31.96, 39.33 ± 13.94, and 102.39 ± 13.94, respectively. Perceived stress was significantly and positively correlated with compassion fatigue ( r  = 0.289, P  < 0.01) and significantly and negatively correlated with resilience ( r  = − 0.378, P  < 0.01). Structural equation modeling showed an acceptable model fit (GFI = 0.842, CFI = 0.896, TLI = 0.854, IFI = 0.897). Perceived stress exerted a significant direct effect on compassion fatigue (standardized β = 0.388, P  < 0.001) and a significant indirect effect through resilience (unstandardized indirect effect = − 0.417, 95% CI [− 0.813, − 0.157]). The indirect effect accounted for approximately 23% of the total effect, indicating a partial mediating role of resilience. Conclusions This study demonstrates that resilience plays a partial mediating role in the relationship between perceived stress and compassion fatigue among undergraduate nursing interns. While higher resilience can attenuate the negative impact of perceived stress on compassion fatigue, perceived stress continues to exert a substantial direct effect. These findings indicate that resilience functions as a protective psychological resource but cannot fully offset the harmful effects of stress. Therefore, clinical nursing education programs should adopt dual-focused interventions that both strengthen resilience and prioritize stress management, in order to effectively reduce compassion fatigue and promote the sustainable professional development of nursing interns.

Introduction Microaggressions and their impact have been documented in minority college students; however, little is known about the experience of medical students. This study reports the prevalence and understanding of microaggressions among medical students at the University of Florida College of Medicine (UFCOM), while gaining insights into experiences of medical students dealing with microaggressions. Method A nine-question survey was sent out to all medical students at the UFCOM in the spring of 2017 to understand their experiences with microaggressions. The authors used simple statistics and chi-test to analyze the demographic data and an inductive thematic qualitative analysis was performed on the open-ended responses to study medical students’ understanding of the term, experiences, and impact of microaggressions. Results The response rate was 64% ( n  = 351/545). Fifty-four percent reported experiencing microaggressions, of those the majority were female students (73% compared with 51% among male students, p  = 0.0003); for female students from minority backgrounds this was 68% and for white female students 76% ( p  = 0.2606). Microaggressions are more common in the second year of medical school (30%), followed by the third year (23%). Most students were able to recognize and identify microaggressions, but some denied the concept existed, attributing concerns about microaggressions to a culture promoting oversensitivity and political correctness. Students described microaggressions related to sexism; religion; skin colour; and ethnicity. Students described indifference, emotional reactions and denial of the event as coping mechanisms. Conclusion Microaggressions are prevalent on a day-to-day basis among medical students with female students from a minority background as well as white female students experiencing more microaggressions. Further research is needed to explore interventions to counter microaggressions in order to ensure a healthy learning environment.

Background Occupational exposure to human papillomaviruses (HPV) poses a potential health risk to healthcare providers, yet preventive awareness and behaviors remain unclear. Therefore, this study aimed to investigate the knowledge, attitude, and practice (KAP) of healthcare providers toward occupational exposure to HPV. Methods This cross-sectional study was conducted between October 2023 and February 2024 at the First Affiliated Hospital of the Medical College of Shantou University. The participants included healthcare providers in gynecology, dermatology, or coloproctology departments. A self-designed questionnaire was employed to collect demographic characteristics and assess KAP toward occupational exposure to HPV. The exploration of the relationships between KAP was performed through Structural Equation Modeling (SEM). Results This study enrolled 1059 participants with a mean age of 34.76 ± 9.56 years. Most participants were female (77.90%), with a bachelor’s degree (46.55%). The mean KAP scores were 19.96 ± 6.20 (possible range: 0–28), 20.84 ± 2.62 (possible range: 6–30), and 24.43 ± 6.50 (possible range: 8–40). In the SEM analysis, knowledge positively influenced attitude (β = 0.171, P  < 0.001), and practice (β = 0.091, P  = 0.016). Attitude positively influenced practice (β = 0.254, P  = 0.001). Conclusions Healthcare providers demonstrated a moderate knowledge, attitude, and practice towards occupational HPV exposure. Educational and training activities should be implemented to enhance the KAP of healthcare providers toward occupational HPV exposure.

Background Assessing trainees is crucial for development of their competence, yet it remains a challenging endeavour. Identifying contributing and influencing factors affecting this process is imperative for improvement. Methods We surveyed residents, fellows, and intensivists working in an intensive care unit (ICU) at a large non-university hospital in Switzerland to investigate the challenges in assessing ICU trainees. Thematic analysis revealed three major themes. Results Among 45 physicians, 37(82%) responded. The first theme identified is trainee-intensivist collaboration discontinuity. The limited duration of trainees’ ICU rotations, large team size operating in a discordant three-shift system, and busy and unpredictable day-planning hinder sustained collaboration. Potential solutions include a concise pre-collaboration briefing, shared bedside care, and post-collaboration debriefing involving formative assessment and reflection on collaboration. The second theme is the lack of trainees’ progress visualisation, which is caused by unsatisfactory familiarisation with the trainees’ development. The lack of an overview of a trainee’s previous achievements, activities, strengths, weaknesses, and goals may result in inappropriate assessments. Participants suggested implementing digital assessment tools, a competence committee, and dashboards to facilitate progress visualisation. The third theme we identified is insufficient coaching and feedback. Factors like personality traits, hierarchy, and competing interests can impede coaching, while high-quality feedback is essential for correct assessment. Skilled coaches can define short-term goals and may optimise trainee assessment by seeking feedback from multiple supervisors and assisting in both formative and summative assessment. Based on these three themes and the suggested solutions, we developed the acronym “ICU-STAR” representing a potentially powerful framework to enhance short-term trainee-supervisor collaboration in the workplace and to co-scaffold the principles of adequate assessment. Conclusions According to ICU physicians, trainee-supervisor collaboration discontinuity, the lack of visualisation of trainee’s development, and insufficient coaching and feedback skills of supervisors are the major factors hampering trainees’ assessment in the workplace. Based on suggestions by the survey participants, we propose the acronym “ICU-STAR” as a framework including briefing, shared bedside care, and debriefing of the trainee-supervisor collaboration at the workplace as its core components. With the attending intensivists acting as coaches, progress visualisation can be enhanced by actively collecting more data points. Trial registration N/A.

Background New Zealand relies on International Medical Graduates (IMGs); however, the retention of IMGs is not optimal. This research uses a lens of cross-cultural code-switching to explore how professional and cultural differences impact on International Medical Graduates’ (IMGs’) journeys to practise effectively and remain in New Zealand. Methods Utilising theory-informing inductive analysis within a constructivist approach, framework analysis was conducted following 14 face-to-face interviews with IMGs. The analysis then explored the degree to which their experiences could be explained by cross-cultural code-switching’s psychological challenges (authenticity, competence, and resentment). Results Analysis showed there was an expectation for IMGs to code-switch. The greater the cultural and professional difference of IMGs (compared to New Zealand), the greater the intensity of psychological challenges experienced when switching. Moreover, IMGs received minimal support, making it difficult to overcome psychological challenges, especially the competence challenge. This led to feelings of frustration and vulnerability. Code-switching could also explain why complaints about IMGs were more likely when IMGs were stressed or tired. Conclusion Cross-cultural code-switching can be used to explain and identify how cultural differences cause psychological challenges. These findings inform how programmes can better support IMGs in orientation and ongoing training. Additionally, establishing, and allocating IMG cultural mentors would assist in addressing IMGs’ vulnerability and isolation. With this support, the journey may prove more manageable and encourage IMGs to continue practising in their adopted country.

Background To investigate the relationship between mindfulness and burnout in physicians and its underlying mechanisms. Methods Study 1 employed a multiverse-style analysis based on a large sample of 8,462 physicians to examine the robust relationship between mindfulness(MAAS) and burnout(MBIES). Study 2 conducted a 21-day intensive longitudinal assessment on 471 physicians to explore the internal mechanisms by which mindfulness affects burnout. Results Study 1 found that the negative association between mindfulness and burnout is robust. Study 2 discovered that Perceived Organizational Support(POS) and Psychological Safety(PS) play a sequential mediating role in the effect of mindfulness on burnout. Conclusions These findings provide a theoretical basis for formulating interventions at the organizational level and have important practical and theoretical significance for optimizing physicians’ work environments and improving the medical quality. Clinical trial number Not applicable.

Susan G. Butler Wake Forest University School of Medicine, Winston-Salem, NC Stephanie K. Daniels Michael E. DeBakey VA Medical Center, Houston, TX Roxann Diez Gross University of Pittsburgh School of Medicine, Pittsburgh, PA Susan Langmore University of California, San Francisco, CA Cathy L. Lazarus New York University School of Medicine, New York, NY Bonnie Martin-Harris Medical University of South Carolina, Charleston, SC Daniel McCabe Bath VA Medical Center, Bath, NY Nan Musson North Florida/South Georgia Veterans Healthcare System, Gainesville, FL John Rosenbek University of Florida, Gainesville, FL Contact author: JoAnne Robbins, VAMC GRECC 11G, 2500 Overlook Terrace, Madison, WI 53705. E-mail: jrobbin2{at}wisc.edu . Purpose: This review presents the state of swallowing rehabilitation science as it relates to evidence for neural plastic changes in the brain. The case is made for essential collaboration between clinical and basic scientists to expand the positive influences of dysphagia rehabilitation in synergy with growth in technology and knowledge. The intent is to stimulate thought and propose potential research directions. Method: A working group of experts in swallowing and dysphagia reviews 10 principles of neural plasticity and integrates these advancing neural plastic concepts with swallowing and clinical dysphagia literature for translation into treatment paradigms. In this context, dysphagia refers to disordered swallowing associated with central and peripheral sensorimotor deficits associated with stroke, neurodegenerative disease, tumors of the head and neck, infection, or trauma. Results and Conclusions: The optimal treatment parameters emerging from increased understanding of neural plastic principles and concepts will contribute to evidence-based practice. Integrating these principles will improve dysphagia rehabilitation directions, strategies, and outcomes. A strategic plan is discussed, including several experimental paradigms for the translation of these principles and concepts of neural plasticity into the clinical science of rehabilitation for oropharyngeal swallowing disorders, ultimately providing the evidence to substantiate their translation into clinical practice. KEY WORDS: rehabilitation, nervous system, swallowing treatment, dysphagia, evidence-based practice CiteULike     Connotea     Del.icio.us     Digg     Facebook     Reddit     Technorati     Twitter     What's this?

Transition from primary to secondary school is an often challenging milestone in the lives of all students. Although existing research provides insight into transition for students with autism spectrum disorder (ASD), research that considers transition from the perspective of students with ASD and concomitant intellectual giftedness (IG) appears scant. This paper contributes to narrowing this gap by providing insight into the experiences of 21 students with ASD and concomitant IG who had already transitioned to secondary school. Data gathered from focus group discussions revealed that this particular cohort of students experienced difficulties in gaining social acceptance by same-age peers and were unequipped to meet the expectations of secondary school teachers and an increased workload, which intensified their transition experience. These findings highlight that this cohort of students requires specific preparation and support to transition to secondary school, which was not occurring.

Despite the international growth of the service sector, an industrial paradigm defines the study of global labor. This is because analyses of service work typically focus on firms in the United States, while studies of global labor concentrate on manufacturing. I develop a framework for analysis of global service work by comparing ethnographic cases of labor in two global, luxury hotels in China. Each hotel is linked to the same U.S.-based global corporation, and both employ the same organizational template and recruit same-aged female workers. At the first hotel, workers silently cater to the preferences of guests, using recorded customer preference data and enacting imported feminized practices, a labor regime I call virtual personalism. At the second hotel, workers promote hotel products, displaying expertise to distinguish themselves from sex workers who frequent the hotel, a labor regime I call virtuous professionalism. Why do distinctly gendered labor practices emerge in the two settings? To explain the divergent regimes of labor, I show that firms institutionalize localized consumer status struggles through the gendered organization of interactive labor. Workers' interactive strategies and local workplace legacies mediate the forms institutionalism takes. I call the entwining of consumer markets and labor practices \"market-embedded labor.\"