The process of telepractice implementation during the COVID-19 pandemic: a narrative inquiry of preschool speech-language pathologists and assistants from one center in Canada

Background Many professional services were pressed to adopt telepractice in response to the global coronavirus SARS-CoV-2 (COVID-19) pandemic. The need to adopt a new service delivery approach quickly created different implementation challenges. This study explored the lived experiences of frontline clinicians who successfully transitioned their in-person speech-language therapy services to telepractice through an implementation science lens. Methods The study was conducted in partnership with one publicly funded program in Ontario, Canada that offers services to preschoolers with speech, language and communication disorders. Sixteen frontline speech-language pathologists and assistants at this organization shared their lived experience transitioning to telepractice during the pandemic during videoconference interviews. A narrative inquiry approach was used to analyze interview transcripts to identify the processes (or steps) this program took to implement telepractice and to understand the facilitators and barriers to telepractice implementation during the pandemic. Results The following six stages were identified from clinicians’ narratives: abrupt lockdown; weeks of uncertainty; telepractice emerged as an option; preparation for telepractice; telepractice trials; and finally, full implementation of telepractice. The stages of events offered significant insights into how government public health measures influenced clinicians’ decisions and their processes of adopting telepractice. In terms of barriers, clinicians reported a lack of knowledge, skills and experience with telepractice and a lack of technological support. The organization’s learning climate and team approach to transitioning services were identified as the main facilitator of implementation. Conclusions Findings suggest a need for better coordination of public health measures and professional services, which would have eased clinicians’ stress and facilitated an earlier transition to telepractice. Fostering an organization’s learning climate may improve organization’s resilience in response to emergency situations.

Silent voices of the midwives: factors that influence midwives’ achievement of successful neonatal resuscitation in sub-Saharan Africa: a narrative inquiry

Background In Tanzania, birth asphyxia is a leading cause of neonatal death. The aim of this study was to identify factors that influence successful neonatal resuscitation to inform clinical practice and reduce the incidence of very early neonatal death (death within 24 h of delivery). Methods This was a qualitative narrative inquiry study utilizing the 32 consolidated criteria for reporting qualitative research (COREQ). Audio-recorded, semistructured, individual interviews with midwives were conducted. Thematic analysis was applied to identify themes. Results Thematic analysis of the midwives’ responses revealed three factors that influence successful resuscitation: 1. Hands-on training (“HOT”) with clinical support during live emergency neonatal resuscitation events, which decreases fear and enables the transfer of clinical skills; 2. Unequivocal commitment to the Golden Minute® and the mindset of the midwife; and. 3. Strategies that reduce barriers. Immediately after birth, live resuscitation can commence at the mother’s bedside, with actively guided clinical instruction. Confidence and mastery of resuscitation competencies are reinforced as the physiological changes in neonates are immediately visible with bag and mask ventilation. The proclivity to perform suction initially delays ventilation, and suction is rarely clinically indicated. Keeping skilled midwives in labor wards is important and impacts clinical practice. The midwives interviewed articulated a mindset of unequivocal commitment to the baby for one Golden Minute®. Heavy workload, frequent staff rotation and lack of clean working equipment were other barriers identified that are worthy of future research. Conclusions Training in resuscitation skills in a simulated environment alone is not enough to change clinical practice. Active guidance of “HOT” real-life emergency resuscitation events builds confidence, as the visible signs of successful resuscitation impact the midwife’s beliefs and behaviors. Furthermore, a focused commitment by midwives working together to reduce birth asphyxia-related deaths builds hope and collective self-efficacy.

Reflections on the Concomitants of the Restrictive Visitation Policy During the COVID-19 Pandemic: An Ubuntu Perspective

Caregiving is a prominent concept in the Ubuntu philosophy, and caring and visitation of the sick is regarded as an example of Ubuntu. The restrictive visitation policy adopted in the hospitals during the coronavirus disease 2019 (COVID-19) pandemic affected the exhibition of this concept among patients, nurses, and families. The narrative inquiry was used to explore the reflections of the participants on the impact caused by the non-visitation policy experienced during the first and second waves of the COVID-19 pandemic in South Africa. The narrative inquiry approach allowed the participants to tell their story as it is unique to them. The study used purposive sampling technique to select five participants for the webinar. Three themes emerged from the narrated stories which are 1) moral anguish of the caregivers; 2) mental health instability, and 3) erosion of trust in health care practitioners (HCPs). The non-visitation hospital policy was intended to reduce the danger of spreading COVID-19 within and outside the hospital; however, the care provided was devoid of the values of Ubuntu such as mutual respect, relational, responsibility, reciprocity, and interconnectedness. In retrospect, a case-by-case application of the policy would reduce the non-desirable effect of the policy on the patients, nurses, and patients' family members.

A narrative inquiry into the resettlement of armed forces personnel in the Arabian Gulf: a model for successful transition and positive mental well-being

Background: The study sought to explore the lived experiences of individuals having served in the Armed Forces of Saudi Arabia, as they made the transition to civilian life and sought new employment opportunities. Methods: Researchers carried out qualitative research in the form of narrative inquiry. Narratives were collected from eleven in-depth interviews conducted in Saudi Arabia in 2021, allowed for insight into participant experiences. Existing literature on military retirement was also investigated. Results: Interviews were transcribed verbatim and analyzed concurrently using thematic analysis to identify patterns or themes. The researchers adopted thematic synthesis as an analytical framework though which descriptive themes from the literature on military retirement were generated. Overall, this approach allowed for the comparison of themes in literature with those of narrative interviews. Conclusion: The study identified challenges encountered by veterans during the resettlement and transitional phase from military to civilian life. There was a general consensus, however, that military life equips individuals with valuable skills that are transferrable to successful post-military employment, known as Positive Transferable Adaptability for Employability (PTAE), (Mottershead, 2019), which can greatly empower those making the transition. These findings led the researchers to develop a new model for veteran career paths that meet the contemporary employment needs of the Kingdom of Saudi Arabia: the REVERE Transition Model, which identifies six career paths.

Narrative Inquiry as a Relational Methodology

The authors present an overview of narrative research and focus primarily on narrative inquiry, highlighting what distinguishes this approach from other research methods. Narrative inquiry allows scholars to go beyond positivism and explore how research can be conducted based on participants' stories, rather than using a purely scientific methodological approach. This research method acknowledges and honors narrative truths and provides a scholarly framework that makes space for voices often marginalized or excluded when dominant narratives and/or data hold a prominent place in a research agenda. As such, narrative inquiry can be used in academic research to challenge the status quo, thus harnessing research to stretch beyond hegemonic ways of being and knowing. The authors provide a robust overview and conceptualization of this approach, along with foundational concepts and exemplars that comprise this method of research.

Double Dearth Effect

This chapter presents a narrative inquiry on the life experiences of three Filipino families who belong to each representation of socioeconomic status. Furthermore, it unpacks the temporal, social, and geophysical or spatial elements of their narratives in relation to the disruptive effects of the coronavirus pandemic on their resources, access, and literacy practices. Subsequent to securing their consent, each family was subjected to an online recorded semi-structured interview where they shared their life experiences. The recorded responses were later transcribed and analyzed using Montero and Washington's lens in exploring narratives. The researchers ultimately provide collaborative narratives of the three families' experiences and theorize on the specific experiences of poor or low-income families against the experiences of the middle class and the rich or high-income families. The researchers end the chapter by offering a working definition of their concept called the double-dearth effect.

ADAPTASI PEMBELAJARAN SANGGAR ANAK ALAM YOGYAKARTA DI MASA PANDEMI COVID-19

Pandemi membuat sejumlah institusi pendidikan menutup sekolah guna mencegah penyebaran virus. Secara global, Covid-19 mengubah pembelajaran secara tatap muka menjadi pembelajaran jarak jauh. Pandemi bukan hanya mengubah penyelenggaraan pembelajaran di sektor pendidikan formal, namun juga sektor pendidikan nonformal. Tujuan dari kajian ini yaitu untuk menganalisis bagaimana perubahan dan adaptasi proses belajar sebelum dan selama pandemi Covid-19 di Sanggar Anak Alam Yogyakarta. Proses adaptasi pembelajaran dikaji menggunakan pendekatan narrative inquiry. Data dikumpulkan melalui observasi dan wawancara. Hasil penelitian menunjukkan bahwa ada perubahan proses belajar di Sanggar Anak Alam Yogyakarta, yang sebelumnya kegiatan pembelajarannya diselenggarakan secara langsung di lingkungan luar menjadi kegiatan belajar dari rumah. Proses belajar sebelum pandemi berjalan setiap Senin sampai Jumat dengan proses belajar yang melibatkan proyek riset dengan model pembelajaran experiential learning, sementara di masa pandemi Covid-19 proses belajar mempertahankan proyek riset per semester dengan proses pendampingan yang sedikit berbeda. Experiential learning dan model pembelajaran berbasis proyek tetap dipertahankan sebagai strategi pembelajaran supaya apa yang dipelajari peserta didik relevan dengan kehidupan nyata dan proyek risetnya mampu diaplikasikan untuk memecahkan masalah di kehidupan sehari-hari. Penelitian ini menyarankan Sanggar Anak Alam Yogyakarta mengembangkan dan menggunakan teknologi pada proses pembelajaran agar peserta didik siap menghadapi Revolusi Industri 4.0.