The standard life events methodology for the prediction of psychological symptoms was compared with one focusing on relatively minor events, namely, the hassles and uplifts of everyday life Hassles and Uplifts Scales were constructed and administered once a month for 10 consecutive months to a community sample of middle-aged adults It was found that the Hassles Scale was a better predictor of concurrent and subsequent psychological symptoms than were the life events scores, and that the scale shared most of the variance in symptoms accounted for by life events When the effects of life events scores were removed, hassles and symptoms remained significantly correlated Uplifts were positively related to symptoms for women but not for men Hassles and uplifts were also shown to be related, although only modestly so, to positive and negative affect, thus providing discriminate validation for hassles and uplifts in comparison to measures of emotion It was concluded that the assessment of daily hassles and uplifts may be a better approach to the prediction of adaptational outcomes than the usual life events approach

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Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events

Traditionally, professional expertise has been judged by length of experience, reputation, and perceived mastery of knowledge and skill. Unfortunately, recent research demonstrates only a weak relationship between these indicators of expertise and actual, observed performance. In fact, observed performance does not necessarily correlate with greater professional experience. Expert performance can, however, be traced to active engagement in deliberate practice (DP), where training (often designed and arranged by their teachers and coaches) is focused on improving particular tasks. DP also involves the provision of immediate feedback, time for problem-solving and evaluation, and opportunities for repeated performance to refine behavior. In this article, we draw upon the principles of DP established in other domains, such as chess, music, typing, and sports to provide insight into developing expert performance in medicine.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1553-2712.2008.00227.x

Deliberate practice and acquisition of expert performance: a general overview.

Background. Considerable financial and philosophical effort has been expended on the evidence-based practice agenda. Whilst few would disagree with the notion of delivering care based on information about what works, there remain significant challenges about what evidence is, and thus how practitioners use it in decision-making in the reality of clinical practice.

Aim.  This paper continues the debate about the nature of evidence and argues for the use of a broader evidence base in the implementation of patient-centred care.

Discussion.  Against a background of financial constraints, risk reduction, increased managerialism research evidence, and more specifically research about effectiveness, have assumed pre-eminence. However, the practice of effective nursing, which is mediated through the contact and relationship between individual practitioner and patient, can only be achieved by using several sources of evidence. This paper outlines the potential contribution of four types of evidence in the delivery of care, namely research, clinical experience, patient experience and information from the local context. Fundamentally, drawing on these four sources of evidence will require the bringing together of two approaches to care: the external, scientific and the internal, intuitive.

Conclusion.  Having described the characteristics of a broader evidence base for practice, the challenge remains to ensure that each is as robust as possible, and that they are melded coherently and sensibly in the real time of practice. Some of the ideas presented in this paper challenge more traditional approaches to evidence-based practice. The delivery of effective, evidence-based patient-centred care will only be realized when a broader definition of what counts as evidence is embraced.

What counts as evidence in evidence-based practice?

Nursing education programs across the country are making major capital investments in alternative learning strategies, such as human patient simulators; yet, little research exists to affirm this new innovation. At the same time, nursing programs must become even more effective in the development of students' clinical judgment to better prepare graduates to take on increasingly complex care management. This qualitative study examined the experiences of students in one nursing program's first term of using high-fidelity simulation as part of its regular curriculum. On the basis of these experiences, it seems that high-fidelity simulation has potential to support and affect the development of clinical judgment in nursing students and to serve as a value-added adjunct to their clinical practica.

High-fidelity simulation and the development of clinical judgment: students' experiences.

A renewed urgency has emerged in the qualitative health research community concerning the utility of qualitative research. This urgency is the result of several converging trends in health care research, including the elevation of practical over basic knowledge, proliferation of qualitative health research studies, and the rise of evidence-based practice as a paradigm and methodology for health care. Diverse conceptualizations of use and users exist, and these have different implications for understanding, demonstrating, and enhancing the utility of qualitative research findings. Issues affecting the utilization of these findings include the varied ways in which they are conceived, presented, synthesized, signified, and translated, and the complex repertoire of skills required to activate the knowledge transformation cycle in qualitative health research fully.

Using Qualitative Research

From novice to expert: excellence and power in clinical nursing practice

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The anatomy of self: the individual versus society

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Papers

From novice to expert: excellence and power in clinical nursing practice

The anatomy of self: the individual versus society

Systematic Treatment Selection: Toward Targeted Therapeutic Interventions

Sex roles and depression.

Enchantment and intervention in family therapy: training in ericksonian approaches