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Reflective Practice IS Nursing Practice
By: Arvinder Aulakh, Jessica Brooks
“Let us never consider ourselves finished nurses…we must be learning all of our lives.”
Clearly, Florence Nightingale had early insights into the importance of continual professional growth and development. Reflective practice is foundational within pediatric hematology/oncology nursing, enhancing team collaboration, improving care standards, and supporting nurses’ emotional well-being. This offers multifaceted benefits for nurses, their young patients, and the families they care for.
Pediatric hematology/oncology nursing is a profession that embraces collaboration through reflecting on shared experiences and challenges. Reflective practice allows nurses to contribute to the collective knowledge base by critically evaluating their current practices to drive evidence-based practices. Engaging with nurses with different experiences allows for dialogue that contributes to holistic patient care, team learning, and improved communication.
Patient care outcomes are improved through reflective practice. Personal values and beliefs can indirectly and unknowingly affect patient care. Reflective practice provides insights into nurses’ strengths and challenges contributing to better clinical acumen, empathetic communication, and emotional resiliency. Through this, professional growth and development are achieved, allowing for higher standards of patient care.
It is well understood through literature and lived experience that caring for seriously ill children can lead to burnout and compassion fatigue. Reflective practice empowers nurses by enhancing their self-awareness through professional reflection, facilitating peer support through group discussion, and promoting empathy and compassion by providing a safe and non-judgmental environment. Supporting nurses’ well-being through group self-reflection promotes enhanced job satisfaction.
There are many guidelines and frameworks that can be used when doing a reflective practice. When engaging in reflection, nurses should consider these key aspects:
- Description of experience: Recall the important events and features by giving a clear, non-judgmental and comprehensive account of the experience. Experiences may include describing a challenging patient interaction, a successful teamwork experience, or any other significant event.
- Evaluation: Take a “look back” and think about the importance of that experience. What went well? What were the challenges? How did these moments impact patient care, team dynamics, or your personal feelings about work?
- Analysis: An opportunity to critically think about the experience using theory and research. This could include analyzing communication strategies, ethical dilemmas, or case studies that highlight successes and challenges.
- Future action: The experience is summarized to help gain personal insights and determine any next steps. What will you continue to do? What will you change? Setting specific and measurable goals can guide your growth.
Consider incorporating reflective practice into staff meetings, evaluations, and group discussions. Through this, professional development is enhanced because reflective practice IS nursing practice!
About the Authors
Arvinder Aulakh and Jessica Brooks are POGO Interlink Nurses working at SickKids. Learn more about the POGO Interlink Nursing Program.
Highlights from the 2024 POGO Symposium: Through a Nurse’s Lens
By Denise Mills
This year, the POGO Multidisciplinary Symposium on Childhood Cancer took an exciting road trip to Niagara-on-the-Lake, where Ontario’s pediatric oncology community gathered to connect, collaborate, and learn. POGO partner hospitals were well represented, including the five centres with specialized childhood cancer programs and eight POGO Satellite Clinic locations. Over 60 nurses participated in this impactful event! While we can’t relive the Symposium, here are a few key takeaways from the sessions.
Lee Dupuis: The Power of the Patient’s Voice in Symptom Management
Lee Dupuis delivered a powerful closing presentation on the critical role of the patient’s voice in improving symptom management. She explained how we define the “patient’s voice,” how to elicit it from pediatric patients, and why it’s essential to listen and respond effectively to improve care. Lee shared compelling results from a recent trial conducted in the US and Canada, which randomized symptom screening against usual care.
The findings were clear and will be shared in an upcoming publication. For more insights into symptom assessment tools, explore SSPedi and Spark here: Symptom Assessment Tools.
Lee also emphasized the importance of implementing clinical practice guidelines (CPGs) in our clinical practices, such as the Spark Clinical Care Pathways. For more information on CPGs, visit the POGO Clinical Practice Guidelines.
Nicole Culos-Reed: Exercise and Fatigue Management in Pediatric Oncology
Nicole Culos-Reed’s session highlighted POGO’s updated CPG recommending physical activity as an effective intervention for fatigue in children and adolescents with cancer. Nicole explored the benefits of exercise during treatment, such as protecting muscle strength, improving immune function, and managing common side effects. She also discussed the long-term importance of physical activity after treatment, including its impact on cognitive function, cardiac health, bone mineral density, and the risk of metabolic syndromes.
To learn more about her POEM program (Pediatric Oncology Exercise Manual) and the IMPACT intervention for physical activity during treatment, visit POEM & IMPACT.
Agnes Wong: The Art and Science of Compassion
Agnes Wong led an inspiring session that guided us through the components of compassion, emphasizing the importance of mental and emotional training for healthcare providers. Agnes also underscored the need for self-compassion as a prerequisite for effectively caring for others. She challenged us to consider how compassion training should be integrated at a systems level, in institutions, and in professional training programs.
For those interested in further developing their compassionate practices, Agnes shared a valuable resource: the Mindfulness & Compassion Training Program at the Sarana Institute.
We hope you find these highlights inspiring and insightful. Thank you to all who attended and contributed to the success of the 2024 POGO Symposium!
Evaluating Healthcare Simulation Escape Rooms as an Educational Tool in Nursing Continuing Education: A Fellowship Journey
By: Brennah Holley
Fellowship Overview
Brennah Holley, Clinical Nurse Educator at CHEO in Ottawa (and former Co-Chair of the POGO Nursing Committee), recently completed an Advanced Clinical Practice Fellowship (ACPF) through the Registered Nurses Association of Ontario and is now conducting an exciting research project (directly related to her fellowship) to explore the potential of Healthcare Simulation Escape Rooms (HSER) as an innovative educational tool in nursing. With the nursing profession facing pressing challenges such as staffing shortages and varied learning needs, her research aims to assess whether HSERs can enhance knowledge acquisition among nursing staff.
“HSERs merge gamification with traditional learning, creating engaging team-based experiences,” Brennah explains. As defined by Anderson et al. (2020), HSERs infuse healthcare themes into interactive escape room settings, offering a fresh platform for education and assessment.
Research Objective and Methodology
At the heart of Brennah’s research is the objective to evaluate HSERs’ effectiveness in nursing education. The study, which began in early 2024, will investigate whether engaging in an HSER focused on anaphylaxis leads to better knowledge retention and application compared to traditional lecture formats.
In a randomized controlled trial, nurses at CHEO will be divided into two groups: Group A will receive a lecture, while Group B will experience both the lecture and the HSER. “This approach allows us to gather vital data on the impact of immersive learning,” she notes.
Learning Experience and Skill Development
Brennah’s journey through the fellowship has been rich with learning. She acquired essential skills in research design, ethics submissions, and statistical analysis. Working alongside the Clinical Research Unit (CRU) at CHEO, she navigated the complexities of ethics applications, completing necessary training and developing vital documentation like consent forms.
Addressing knowledge gaps in statistical analysis was a significant focus for Brennah. By collaborating with a co-investigator from CHEO’s CRU, she enhanced her research capacity. “This partnership has been instrumental in refining my project,” she emphasizes.
Brennah also developed her skills in survey design and literature reviews, both critical for creating effective educational tools.
Outcomes and Future Directions
Data collection for her research will extend until early 2025, with plans to draft a manuscript by fall 2025. The implications of Brennah’s research could be profound, providing evidence to support the integration of HSERs into nursing curricula and continuing education programs. “Ultimately, we want to enhance patient care through improved educational strategies,” she states.
Reflections
Reflecting on her ACPF experience, Brennah describes it as transformative, filled with opportunities for professional growth. Presenting at international conferences and collaborating with nurse educators worldwide have enriched her journey. As she begins her master’s in Nursing, she is eager to further explore innovative educational methodologies, with HSERs leading her efforts to improve nursing practice.
In summary, Brennah Holley’s fellowship at CHEO highlights the promise of innovative educational approaches in nursing, paving the way for advancements in continuing education and enhanced patient care.
“We are on the brink of a new era in nursing education,” she concludes, optimistic about the future.
To learn more about Brennah’s fellowship experience or research endeavours, feel free to reach out to her.
Congratulations to the 2024 POGO Recognition Awards Recipients
On Friday, November 8, the Pediatric Oncology Group of Ontario (POGO) honoured the recipients of the 2024 POGO Recognition Awards at a Celebratory Dinner. Established in 1999, the awards acknowledge significant contributions of Ontarians to the field of childhood cancer care in Ontario and beyond. Award recipients work in POGO partner hospitals and demonstrate POGO’s core values of partnership, collaboration and excellence.
POGO Champion Award
Lee Dupuis, RPh, PhD
Pediatric Oncologist, Senior Scientist, Professor, Division of Haematology/Oncology, The Hospital for Sick Children
In recognition of her dedication to improving the lives of childhood cancer patients, exceptional leadership in supportive care, and commitment to those she mentors and all with whom she collaborates, in Ontario and beyond.
POGO Visionary Award
Ian M. Wilson, MD
Pediatrician, Grand River Hospital
In recognition of his integral role in shaping the vision for the POGO Satellite Clinic Program, bringing childhood cancer care closer to home for families in communities across Ontario.
POGO Nursing Leadership Award
Tina Hamalainen, RN, BScN
POGO Interlink Team Leader, The Hospital for Sick Children
In recognition of her commitment to a patient-centred approach to childhood cancer care that improves the lives of young people and their families, and to a culture of learning in support of pediatric oncology teams.
POGO Community Partner Impact
The Slaight Family Foundation
In recognition of their exceptional and longstanding commitment to childhood cancer care, and landmark investment of $1,000,000 in the POGO School and Work Transitions Program.
Premier Ford and Minister Jones join POGO to launch new roadmap to strengthen Ontario’s world-class childhood cancer care system
Ontario’s new five-year Childhood Cancer Care Plan, produced by the Pediatric Oncology Group of Ontario (POGO) and its partners, builds on strong, province-wide coordination to deliver wrap-around care and support for children, youth, survivors and families at every step of the childhood cancer journey.
September 23, 2024, Toronto, ON – Premier Doug Ford and Minister of Health Sylvia Jones recently joined POGO to launch the Childhood Cancer Care Plan: A Roadmap for Ontario 2024-2029. Published by POGO and its partners, the Plan leverages strong collaboration and coordination across the province to ensure wrap-around care and support for children and youth with cancer, survivors and families at every step of the childhood cancer journey. With support from the Government of Ontario, this new roadmap will continue to strengthen the province’s world-class childhood cancer system.
“Unfortunately, too many families here in Ontario are faced with the harsh reality of childhood cancers,” says Premier Doug Ford. “It’s a terrible disease that impacts not just the children, but their entire family. We’re incredibly grateful for the outstanding work that POGO does to support these families, ensuring they have access to the care they need, when and where they need it.”
“We thank POGO for your dedication, for your leadership and collaboration, for everything you do to support children and their families facing a cancer diagnosis,” says Health Minister Sylvia Jones. “I look forward to our continued work to ensure families have access to the best possible treatment and care throughout their journey.”
POGO works to ensure that everyone affected by childhood cancer has access to the best care and support. Informed by diverse voices from across the childhood cancer community, the Plan has priorities which focus on bringing care closer to home, ensuring survivor well-being, harnessing data, improving access to drugs and therapies, and enhancing the availability of mental health and financial supports for families.
Sam Taylor’s daughter, Ellie, was diagnosed with rhabdomyosarcoma, a soft tissue cancer, at age 10. “Shortly after Ellie’s diagnosis, we were connected with a POGO Interlink Nurse, an invaluable resource who guided us through the hospital system and helped us understand the unfamiliar world of childhood cancer,” says Sam Taylor. “Through her visits to our home and Ellie’s school, we knew we were in good hands. And when the time was right, the nurse helped us with the transition to care closer to home at the POGO Satellite Clinic at our local community hospital. This meant more time for Ellie with her friends and brother and a lot less time on the road. The POGO Satellite quickly became a second home for our family—an inviting place with an incredible staff where Ellie felt safe and relaxed, and where we, as her parents, felt reassured that she was receiving the best possible care.”
“Ontario’s childhood cancer care system is considered one of the best in the world, and we have the opportunity to make it even better by addressing current challenges and thinking ahead to navigate future demands,” says James Scongack, Chair of the POGO Board of Directors. “On behalf of POGO and our partners, I want to thank the Government of Ontario for its support, and its commitment to improving the lives of thousands of kids and families across Ontario dealing with this devastating disease.”
“There is exceptional pride in the quality and accessibility of Ontario’s childhood cancer care system. This is made possible by a shared vision of excellence across our incredible community,” says Lauren Ettin, Chief Executive Officer of POGO. “Working together, we can continue building on our collective success, so that children and youth with cancer, survivors and families can count on having the treatments, resources and supports they need, now – and for life.”
Download and share the Childhood Cancer Care Plan: A Roadmap for Ontario 2024-2029.
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About Pediatric Oncology Group of Ontario (POGO)
Pediatric Oncology Group of Ontario (POGO) works to ensure that everyone affected by childhood cancer has access to the best care and support. We partner to achieve an excellent childhood cancer care system for children, youth, survivors, and their families and healthcare teams, in Ontario and beyond. POGO champions childhood cancer care, and as the collective voice of this community, is the official advisor to Ontario’s Ministry of Health on children’s cancer control and treatment. POGO is a non-profit organization with charitable status, here for kids with cancer, for now, for life.
Media Contact
Jacqui DeBique
Senior Manager, Communications
Pediatric Oncology Group of Ontario (POGO)
416-592-1232 ext. 266