The purpose of this report of this article review is to describe and critique a peer-reviewed, scholarly article on the care of individuals (between the ages of 5 and 11) with special needs. The chosen article (Hall et al., 2014) was on the topic of training community nurses on how to support families with children who have developmental challenges. The article will be described and critiqued in detail, and a brief summary will highlight the main points of the article review.
Description and Critique
Hall et al. (2014) designed and delivered a training package to 19 nurses in the country of Macedonia. The training package was based on 9 modules that contained passive content (such as PowerPoint presentations, videos, and text) and that were also designed to be introduced and discussed by an expert. The training package was based around helping nurses better understand and work with children (and the families of children) with developmental challenges. The 9 modules were based on:

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Explaining why nurses’ values should include an appreciation of the developmental potential of children
Presenting theories related to the healthy development of children in social, physical, emotional, and cognitive domains
Teaching nurses how to identify children with possible developmental issues and how to refer such children
Educating nurses on how to interact with the parents of children with developmental difficulties
Educating nurses on how to better equip parents to assist children with developmental difficulties
Training nurses in empathetic support
Educating nurses in how to guide parents to appropriate community resources
Training nurses in interacting with physicians, social services providers, and other stakeholders in the interest of supporting children with developmental difficulties
Teaching nurses how to keep records of family needs and outcomes

As envisioned, the training was designed to equip senior nurses to improve the entire spectrum of care for younger children (most falling between 5 and 11), with the assumption being that nurses could add clinical value by (a) improving their ability to equip parents with information and techniques, (b) improving their ability to identify and service developmentally challenged children, and (c) improving their ability to work with other stakeholders in improving the outcomes of children with developmental problems.

The training approach taken by Hall et al. (2014) was aligned with recommendations in the existing nursing literature (Little, 2002; Park, 2011) pertaining to improving the care of developmentally challenged children by taking a systems view. However, despite the apparent quality of the training program, there were several flaws in Hall et al.’s empirical description of the training. To begin with, Hall et al. presented only a few sentences of discussion of trainees’ evaluation of the program. There were no descriptive statistics shedding light on the demographic, experiential, and other relevant qualities of the nurses exposed to the training program. Hall et al. did poll the nurses on how useful they found the training, but the use of a 5-point Likert scale for such a ranking was less useful than a 7-point scale or even a scale measure of training satisfaction might have been.

In terms of inferential statistics, Hall et al. (2014) measured changes in the nurses’ (a) knowledge of disability and (b) feelings of comfort with disabled people. Hall et al. did not, however, name the matched pairs t test as the procedure used for this calculation, and the introduction to the study also failed to state that one of the goals was to build nurses’ knowledge of disability while also reducing feelings of discomfort with disabled children. Given that the 9 modules of the training program were designed to achieve several goals, limiting the collection of attitudinal changes to data about discomfort and knowledge meant that the effectiveness of much of the training especially (modules 4-9) was not measured.

No research questions or hypotheses were specified. Readers should have been alerted to the goals of the study in terms of influencing an attitude change among nurses; instead, over 70% of the study was spent in describing the details of the training program, which left negligible space for other vital components of the study. There was an extremely brief literature review that was combined with an introduction, meaning that Hall et al. were unable to defend the design, content, and administration of their training program with reference to other training programs or even to appropriate nursing theories.

Conclusion
Although Hall et al.’s (2014) research topic is of clear interest to nurses involved in the care of young children with developmental difficulties, an while Hall et al.’s training program appeared to be promising, the study was of low quality. The absence of a literature review indicated a failure to engage with previous theories and empirical studies of nurse training related to the research topic. The cursory and arbitrarily use of statistical analysis meant that Hall et al. were not able to measure trainees’ perceptions of all aspects of the training program. The study was essentially a presentation about the content of the training program, which, while a crucial component of the study, should not have been presented at a length that pre-empted the other components (such as a literature review and a more thorough statistical analysis of program effectiveness) that the study should also have had.

    References
  • Hall, I., Soni, S., McConkey, R., Macdonald, S., Sinclair, M., & Veljkovik, I. (2014). Training community nurses on supporting families with children who have developmental difficulties: lessons from the former Yugoslavian Republic of Macedonia. Advances in Mental Health and Intellectual Disabilities, 8(6), 370-380. Retrieved from http://uir.ulster.ac.uk/32054/1/Training_Community_Nurses_McConkey_et_al_Final_draft.pdf
  • Little, L. (2002). Middle class mothers’ perceptions of peer and sibling victimization among children with Asperger’s Syndrome and nonverbal learning disorders. Issues in Comprehensive Pediatric Nursing, 25(1), 43-54.
  • Park, E.-J. (2011). An integrated ethical decision-making model for nurses. Nursing Ethics, 19(1), 139-159.