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Poorer patient views of mental health inpatient treatment predict both further admissions and, for those admitted involuntarily, longer admissions. As advocated in the UK Francis report, we investigated the hypothesis that improving staff training improves patients' views of ward care. Cluster randomised trial with stepped wedge design in 16 acute mental health wards randomised (using the ralloc procedure in Stata) by an independent statistician in three waves to staff training. A psychologist trained ward staff on evidence-based group interventions and then supported their introduction to each ward. The main outcome was blind self-report of perceptions of care (VOICE) before or up to 2 years after staff training between November 2008 and January 2013. In total, 1108 inpatients took part (616 admitted involuntarily under the English Mental Health Act). On average 51.6 staff training sessions were provided per ward. Involuntary patient's perceptions of, and satisfaction with, mental health wards improved after staff training (N582, standardised effect -0·35, 95% CI -0·57 to -0·12, p = 0·002; interaction p value 0·006) but no benefit to those admitted voluntarily (N469, -0.01, 95% CI -0.23 to 0.22, p = 0.955) and no strong evidence of an overall effect (N1058, standardised effect -0.18 s.d., 95% CI -0.38 to 0.01, p = 0.062). The training costs around £10 per patient per week. Resource allocation changed towards patient perceived meaningful contacts by an average of £12 (95% CI -£76 to £98, p = 0.774). Staff training improved the perceptions of the therapeutic environment in those least likely to want an inpatient admission, those formally detained. This change might enhance future engagement with all mental health services and prevent the more costly admissions.

Background Fundamental motor skills (FMS) and physical fitness (FIT) play important roles in child development and provide a foundation for lifelong participation in physical activity (PA). Unfortunately, many children have suboptimal levels of PA, FMS, and FIT. The Active Learning Norwegian Preschool(er)s (ACTNOW) study investigated the effects of a staff-led PA intervention on FMS, FIT, and PA in 3–5-year-old children. Methods Preschools in Western Norway having ≥ six 3–4-year-old children were invited ( n  = 56). Of these, 46 agreed to participate and were cluster-randomized into an intervention ( n  = 23 preschools [381 children, 3.8 yrs., 55% boys]) or a control group ( n  = 23 [438, 3.7 yrs., 52% boys]). Intervention preschools participated in an 18-month PA intervention involving a 7-month staff professional development between 2019 and 2022, amounting to 50 h, including face-to-face seminars, webinars, and digital lectures. Primary outcomes in ACTNOW were cognition variables, whereas this study investigated effects on secondary outcomes. FMS was measured through 9 items covering locomotor, object control, and balance skills. FIT was assessed as motor fitness (4 × 10 shuttle-run test) and upper and lower muscular strength (handgrip and standing long jump). PA was measured with accelerometers (ActiGraph GT3X +). All measures took place at baseline, 7-, and 18-month follow-up. Effects were analysed using a repeated measures linear mixed model with child and preschool as random effects and with adjustment for baseline scores. Results Participants in the intervention preschools showed positive, significant effects for object control skills at 7 months (standardized effect size (ES) = 0.17) and locomotor skills at 18 months (ES = 0.21) relative to controls. A negative effect was found for handgrip strength (ES = -0.16) at 7 months. No effects were found for balance skills, standing long jump, or motor fitness. During preschool hours, sedentary time decreased (ES = -0.18), and light (ES = 0.14) and moderate-to-vigorous PA (ES = 0.16) increased at 7 months, whereas light PA decreased at 18 months (ES = -0.15), for intervention vs control. No effects were found for other intensities or full day PA. Conclusions The ACTNOW intervention improved some FMS outcomes and increased PA short-term. Further research is needed to investigate how to improve effectiveness of staff-led PA interventions and achieve sustainable improvements in children’s PA, FMS, and FIT. Trial registration Clinicaltrials.gov, identifier NCT04048967 , registered August 7, 2019. Funding ACTNOW was supported by the Research Council of Norway (grant number 287903), the County Governor of Sogn og Fjordane, the Sparebanken Sogn og Fjordane Foundation, and the Western Norway University of Applied Sciences.

Purpose: This study examined the extent to which teacher responsivity education affected preschoolers' language and literacy development over an academic year. Additional aims were to determine whether children's initial language abilities and teachers' use of responsivity strategies were associated with language outcomes, in particular. Method: In this randomized controlled trial, preschool centers were assigned to a responsivity education intervention (n = 19 centers, 25 teachers, and 174 children) or a \"business-as-usual\" control condition (n = 19 centers, 24 teachers, and 156 children). Teachers within the intervention centers received training focused on a set of strategies designed to promote children's engagement and participation in extended conversational interactions across the school day. Results: Hierarchical linear models showed no main effects on children's language skills, although moderating effects were observed such that the intervention appeared to have positive effects for children with relatively high initial language abilities. In addition, teacher use of responsivity strategies was positively associated with vocabulary development. With regard to children's literacy skills, there was a significant main effect of the intervention on print-concept knowledge. Conclusions: Although teacher responsivity education is viewed as benefitting children's language and literacy development, the impacts of this type of intervention on children's skills warrant further investigation. (Contains 6 tables and 1 figure.)

In this paper, I share my experience establishing a structured mentoring programme to benefit early-career academics and support staff at a research-intensive university in South Africa. In justifying the adopted process, the paper first clarifies what mentoring is and is not in higher education. It further justifies the benefits and importance of a structured mentoring programme in this chosen context. While the institution provides many support programmes, especially for academic staff, equal participation for all staff is yet to be realised. This autoethnographic qualitative analysis employs Nancy Fraser’s normative framework on social justice to explain how the programme was established to foster a socially just workplace and encourage participatory parity. The programme participants included three groups of permanent employees: those employed through the nGAP, other early-career academic staff, and early-career academic support staff. These groups had unequal access to career development resources. Mentors for the programme were recruited from lecturers who had completed the nGAP, while mentees were chosen based on recommendations from heads of departments (HODs). An 18-month stakeholder engagement process occurred in two phases to prepare for the programme’s implementation.

IntroductionPatient and staff experiences are strongly influenced by attitudes and behaviours, and provide important insights into care quality. Patient and staff feedback could be used more effectively to enhance behaviours and improve care through systematic integration with techniques for reflective learning. We aim to develop a reflective learning framework and toolkit for healthcare staff to improve patient, family and staff experience.Methods & analysisLocal project teams including staff and patients from the acute medical units (AMUs) and intensive care units (ICUs) of three National Health Service trusts will implement two experience surveys derived from existing instruments: a continuous patient and relative survey and an annual staff survey. Survey data will be supplemented by ethnographic interviews and observations in the workplace to evaluate barriers to and facilitators of reflective learning. Using facilitated iterative co-design, local project teams will supplement survey data with their experiences of healthcare to identify events, actions, activities and interventions which promote personal insight and empathy through reflective learning. Outputs will be collated by the central project team to develop a reflective learning framework and toolkit which will be fed back to the local groups for review, refinement and piloting. The development process will be mapped to a conceptual theory of reflective learning which combines psychological and pedagogical theories of learning, alongside theories of behaviour change based on capability, opportunity and motivation influencing behaviour. The output will be a locally-adaptable workplace-based toolkit providing guidance on using reflective learning to incorporate patient and staff experience in routine clinical activities.Ethics & disseminationThe PEARL project has received ethics approval from the London Brent Research Ethics Committee (REC Ref 16/LO/224). We propose a national cluster randomised step-wedge trial of the toolkit developed for large-scale evaluation of impact on patient outcomes.

Aim. To systematically map and identify key knowledge on organizational support for nurses’ career planning and development. Design. Scoping review. Methods. Systematic electronic searches were carried out with the CINAHL, PubMed, Scopus, and Web of Science databases in May 2022. The searches were limited to scientific, peer-review papers that were published in English from January 2012 to May 2022. Data were extracted and synthetized and are presented in tables and text. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results. We identified 1,400 papers and 28 met the inclusion criteria. Organizations recognized nurses’ career planning and development in relation to the individual’s professional development and the organization’s need to promote high-quality services and workforce engagement. The organizational support included strategic work to ensure there were adequate resources and purposeful vacancies and a structured framework based on objective qualification criteria and equal assessment. Organizations focused on sharing knowledge, structured career planning, and interpersonal support. Support within the nursing profession and multilayered interprofessional collaboration were also important. Conclusion. Nurses’ career planning and development was linked to their personal development and the organization’s aims and required support from both fellow nurses and other professionals. Implications for the Nursing Management. Identifying the organizational structures and methods that are needed to support nurses’ career planning and development can help nursing management to evaluate and develop strategies that improve the attractiveness of a nursing career and nurses’ engagement.

Purpose: This study explored gender differences in emotional intelligence (EI), leadership access, career development, and professional development among Jordanian nurses ( n = 186), aiming to identify institutional barriers affecting female nurses’ leadership trajectories. Methods: A quantitative cross‐sectional study was conducted across public, private, and military hospitals in Jordan using convenience sampling. Data were collected using validated scales for EI, career development, leadership access, and professional development. Statistical analyses included independent samples t ‐tests and multiple regression, with ethical approval obtained from the relevant institutional review boards. Findings: Female nurses scored significantly higher in EI ( M = 84.2, SD = 4.7) than males ( M = 78.5, SD = 5.1, t = −3.45, p = 0.001). However, males reported greater leadership access ( M = 6.2, SD = 1.8) than females ( M = 5.4, SD = 2.1, p = 0.034). Regression analysis showed that higher EI predicted leadership access ( β = 0.450, p = 0.001), yet gender remained a significant negative predictor for females ( β = −0.410, p = 0.030), indicating institutional barriers rather than an EI deficit. No significant gender differences were found in career development ( p = 0.442), and professional development scores showed only minor differences between genders without statistical significance. Discussion: Despite having higher EI, female nurses face structural challenges in accessing leadership positions. These findings underscore the need for gender‐inclusive leadership pathways and organizational reforms that address systemic inequities.

OBJECTIVES:The aim of this study was to examine outcomes from 10 years of research on a post-baccalaureate new graduate nurse residency program and to report lessons learned. BACKGROUND:Transition to practice programs are recommended by the Future of Nursing report, the Carnegie Foundation study, the Joint Commission, and the National Council of State Boards of Nursing. METHODS:Data from new graduate residents who participated in the University HealthSystem Consortium/American Association of Colleges of Nursing residency from 2002 through 2012 are presented. Analysis of variance results from the Casey-Fink Graduate Nurse Experience Scale and outcomes from the graduate nurse program evaluation instrument are provided. RESULTS:Retention rates for new graduates in the residency increased considerably in the participating hospitals. Residents’ perception of their ability to organize and prioritize their work, communicate, and provide clinical leadership showed statistically significant increases over the 1-year program. CONCLUSION:The recommendations for new graduate nurse residency programs are supported by the findings.

Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents’ functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU staff with education and support are discussed. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby.