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!

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.

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.