Incorporating the views of obstetric clinicians in implementing evidence-supported labour and delivery suite ward rounds: a case study

Objectives: To implement evidence‐supported delivery suite ward rounds using strategies to overcome barriers. Design: Qualitative case study to identify barriers and a quantitative assessment of outcomes on ward rounds. Method: After an introduction to the proposed evidence‐supported delivery suite ward round reactions were elicited from 15 clinicians. Responses were categorized into barriers related to knowledge, skills, attitudes and behaviour. Using strategies to overcome these barriers, a weekly evidence‐supported ward round was established. During patient‐centred discussions, clinical questions were formulated. Following literature searches, evidence was acquired and appraised. Results: Clinicians had limited awareness about the potential benefits of a clinical librarian's support during ward rounds. They were unsure of their skills in evidence‐based practice. There was scepticism, fear of loss of autonomy, poor motivation and resistance to change. Clinicians identified several factors that could impinge on their practice. Using appropriate strategies when evidence‐supported ward rounds were conducted, 67 questions were raised. However only seven articles were appraised in time to affect decisions on that ward round. Conclusions: Knowledge of barriers was helpful in developing plans for implementation of evidence‐supported ward rounds. The pilot study indicates the feasibility of this approach.     

Audience support and choking under pressure: a home disadvantage?

This paper highlights the not-so-obvious but compelling reasons why the same supportive audiences that can help performers attain their highest potential also may increase performers' risk of choking under pressure. Drawing primarily from social psychology research and theory, we conclude that audience support magnifies performance pressure and induces performers to avoid failure rather than seek success during the most critical moments of performance contests. Although supportive audiences can inspire performers to excel when motivation would otherwise be lacking, audiences may also lead performers towards maladaptive self-monitoring and overcautiousness when the stakes are highest. The increased self-focus that supportive audiences induce can disrupt the automatic execution of the skills performers possess. Dispositional and situational moderators of the relationship between audience support and performance are reviewed.     

Not that different in theory: Discussing the control-value theory of emotions in online learning environments

This commentary investigates the extent to which the control-value theory of emotions (Pekrun, 2006) is applicable in online learning environments. Four empirical studies in this special issue of The Internet and Higher Education explicitly used the control-value theory as their theoretical framework and several others have components of the theory implicitly described. Thus, for each article we examined what emotions were expressed, the antecedents of the emotions, and their academic outcomes in relation to the control-value theory of emotions. In general, the results from these studies parallel those in traditional classrooms, suggesting there are few differences in emotions experienced in online learning environments relative to face-to-face classrooms. A primary reason for the observed similarities in emotions may be that control and value appraisals play consistent roles as antecedents of specific emotions even though students’ learning environment is dramatically different. We conclude with suggestions for future research.