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This review aims to explore instructional approaches employed in teaching complex procedural skills among caregivers.
Integrative Review.
Electronic searches were conducted across seven databases: CINAHL, PubMed, OVID, ScienceDirect, Web of Science, ProQuest Central and Google Scholar. Manual searches of references within relevant studies were also performed. Original, peer-reviewed studies published in English between 2014 and 2025 were reviewed.
The Whittemore and Knafl method of integrative review was utilised to comprehensively examine literature encompassing various methodological designs. 17 articles that examined the learning of procedural skills among caregivers were included.
The optimal approach to enhancing caregivers' knowledge, competence and confidence involves a learner-centric training model involving multiple phases. Effective caregiving begins with a thorough preparation of the caregiver, which is key to ensuring the success of the training programme. Next, knowledge can be imparted through diverse learning approaches and paradigms to cater to individual learning styles. Subsequently, the translation of knowledge gained to hands-on practice, deepens understanding and enhances caregivers' practical skills competency. Finally, confidence is built through providing opportunities and platforms for repeated practice, leading to mastery and increased confidence over time.
While specific learning pedagogies were not highlighted in the literature, the instructional approaches summarised in the existing literature closely resembled an existing teaching pedagogy: Peyton's Four-Step Approach. This approach is a stepwise teaching framework that has been widely used in healthcare teaching. The approaches used in the studies align with this approach and future interventions should consider designing their training accordingly to enhance its efficacy.
A well-designed training programme fosters caregiver resilience and preparedness, enabling them to navigate challenges effectively and sustainably. Future research could focus on creating an all-encompassing caregiver training that integrates the various approaches. Its feasibility and effectiveness in improving the caregiver preparation process could then be assessed.
No patient or public contribution.
This study aimed to explore the perceived preparedness and psychosocial well-being of general ward nurses prior to their deployment into the outbreak intensive care units (ICUs) during the COVID-19 pandemic.
With the surge in COVID-19 cases requiring ICU care, non-ICU nurses maybe deployed into the ICUs. Having experienced through SARS, hospitals in Singapore instituted upskilling programs to secure general ward nurses’ competency in providing critical care nursing. However, no studies have explored the perceptions of general ward nurses on deployment into the ICUs during the COVID-19 pandemic.
Qualitative descriptive study.
The study was conducted at Singapore’s epicentre of COVID-19 management. Five focus groups were conducted following purposive sampling of 30 general ward nurses identified for outbreak ICU deployment. Focus groups were audio-recorded, transcribed verbatim and data thematically analysed. This study was conducted and reported in accordance with the COREQ checklist.
Three salient themes arose, exemplifying the transition from clinical experts in the general wards to practising novices in the outbreak ICUs. Firstly, ‘Into the deep end of the pool’ described general ward nurses’ feelings of anxiety and stress associated with higher exposure risk and expanded responsibilities to nurse critically ill patients. Secondly, ‘Preparing for “war”’ illustrated deployed nurses’ need for clear communication and essential critical care nursing training. Lastly, ‘Call of duty’ affirmed the nurses’ personal and professional commitment to embrace this transition into the ICUs, and their desire for greater psychosocial support.
The study findings highlight that though general ward nurses perceived their impending ICU deployment positively, they require ongoing support to facilitate a smoother transition.
Findings provided an evidence base to improve the preparedness of general ward nurses deployed into the ICUs during the COVID-19 pandemic within key areas of training, information dissemination and psychosocial resilience.
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