The enablers and barriers to facilitating the development of reflective practice skills of third level allied health professional students through technology: A scoping review

BACKGROUND: The ability to reflect on one’s own performance, attitudes, and knowledge is an essential attribute of a competent allied health professional (AHP). Traditionally, reflective practice skills have been fostered during clinical placements via dyadic or narrative means (e.g. face-to-face supervision, journal writing, and observational assessment). However, with the onset of the Covid-19 pandemic, students face reduced opportunities for traditional clinical learning experiences, and embraced telepractice, simulation-based learning and other technology-based learning opportunities. OBJECTIVE: Research is limited regarding the use of digital technologies to facilitate the development of students’ reflective practice skills, therefore the best ways to facilitate this novel learning are not fully known and students may be disadvantaged as a result. As such, a scoping review was conducted to identify studies addressing the enablers and barriers to facilitating reflective practice skills of third level healthcare students, including speech and language therapy students, through technological means. METHODS: Five electronic databases were searched for studies published between 2016 to 2020. Identified records were imported into Covidence and titles and abstracts were screened by two independent reviewers. Data charting and critical analysis was completed by both authors independently. RESULTS: Six studies were ultimately included in data charting. These were of heterogeneous design and mixed quality. Four themes and a range of subthemes were identified regarding enablers and barriers to the facilitation of reflective practice via technological means. CONCLUSIONS: This research has provided critical information which may support the future use of technology in facilitating reflective practice among students. Competency in reflective practice is crucial to the professional development of students, yet Covid-19 and resultant restrictions present challenges to implementing the processes traditionally involved in developing such skills. This research highlights potential avenues for future developments in higher education which may overcome these barriers and augment the professional development of students.

Effects of computerised clinical decision support systems (CDSS) on nursing and allied health professional performance and patient outcomes: a systematic review of experimental and observational studies

ObjectiveComputerised clinical decision support systems (CDSS) are an increasingly important part of nurse and allied health professional (AHP) roles in delivering healthcare. The impact of these technologies on these health professionals’ performance and patient outcomes has not been systematically reviewed. We aimed to conduct a systematic review to investigate this.Materials and methodsThe following bibliographic databases and grey literature sources were searched by an experienced Information Professional for published and unpublished research from inception to February 2021 without language restrictions: MEDLINE (Ovid), Embase Classic+Embase (Ovid), PsycINFO (Ovid), HMIC (Ovid), AMED (Allied and Complementary Medicine) (Ovid), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (Wiley), Cochrane Database of Systematic Reviews (Wiley), Social Sciences Citation Index Expanded (Clarivate), ProQuest Dissertations & Theses Abstracts & Index, ProQuest ASSIA (Applied Social Science Index and Abstract), Clinical Trials.gov, WHO International Clinical Trials Registry (ICTRP), Health Services Research Projects in Progress (HSRProj), OpenClinical(www.OpenClinical.org), OpenGrey (www.opengrey.eu), Health.IT.gov, Agency for Healthcare Research and Quality (www.ahrq.gov). Any comparative research studies comparing CDSS with usual care were eligible for inclusion.ResultsA total of 36 106 non-duplicate records were identified. Of 35 included studies: 28 were randomised trials, three controlled-before-and-after studies, three interrupted-time-series and one non-randomised trial. There were ~1318 health professionals and ~67 595 patient participants in the studies. Most studies focused on nurse decision-makers (71%) or paramedics (5.7%). CDSS as a standalone Personal Computer/LAPTOP-technology was a feature of 88.7% of the studies; only 8.6% of the studies involved ‘smart’ mobile/handheld-technology.DiscussionCDSS impacted 38% of the outcome measures used positively. Care processes were better in 47% of the measures adopted; examples included, nurses’ adherence to hand disinfection guidance, insulin dosing, on-time blood sampling and documenting care. Patient care outcomes in 40.7% of indicators were better; examples included, lower numbers of falls and pressure ulcers, better glycaemic control, screening of malnutrition and obesity and triaging appropriateness.ConclusionCDSS may have a positive impact on selected aspects of nurses’ and AHPs’ performance and care outcomes. However, comparative research is generally low quality, with a wide range of heterogeneous outcomes. After more than 13 years of synthesised research into CDSS in healthcare professions other than medicine, the need for better quality evaluative research remains as pressing.