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Introduction: The significance of written feedback in students’ learning is well established in the literature; however, it is contingent on several factors, particularly the quality of written feedback. Many teachers are not formally trained to give feedback that could affect the student learning. Objective: This study was designed to investigate whether teachers modify their written feedback in response to a formal training workshop on written feedback. Methodology: Using a quasi-experimental design with pre and post within subject design, 94 teachers participated in this study. As a pre-test, participants were made to provide written feedback on a sample script at the beginning of the workshop. This was followed by a two-day interventional workshop that included discussions and hands on exercises on multiple aspects of written feedback. At the end of the workshop, the participants were again asked to provide feedback on the same script. Results: Comparisons between the pre- and post-intervention data revealed several differences. The quantity of feedback increased subsequent to the intervention. A rise in feedback on form and writing style was observed after the workshop, as opposed to a slight drop in feedback on content, leading to a more balanced focus. Although some of the desired differences, such as avoiding vague comments and criticism, were statistically insignificant, most of the other, differences in the pre-test and post-test were statistically significant. Conclusion: This study affirms that a formal training workshop could improve the quality of teachers’ written feedback.

Cancer is a growing health problem worldwide. Common treatments include surgery, chemotherapy and radiation therapy. Systemic anti-cancer medications often result in an array of physical and psychological side effects. Supportive care assists patients with cancer in managing multidimensional symptoms that result from treatment or the illness itself. This review discusses supportive care and examines patient counselling and mind-diversion activities, which are safe and cost-effective strategies. Improving cancer patients' health and wellbeing should be encouraged in oncology nursing practice and by teaching students the knowledge and skills needed to provide supportive care.

Nursing is considered both science and art. Artful nursing has been essential for holistic nursing practice since the time of Nightingale, but it is getting neglected and has been lately limited to nursing literature (Gramling, 2004). This qualitative study seeks to gain an understanding of the perceptions of active nurses in Pakistan about nursing art and yields four major themes: artful nursing is embedded in humane responsiveness, artful nursing has healing power, artful nursing is a satisfying experience, and artful nursing is invisible in nursing practice. Study participants valued nursing art, and their perceptions illuminate Watson's Theory of Human Caring (1988).

Background : Written Feedback (WFB) plays a significant role in student’s learning in terms of improvement of their academic writing skills. However, the quality of WFB may be affected by various personal and contextual factors. This study aimed to identify nurse teachers’ conceptions and practices of WFB on written assignments in nursing degree offering institutions in Karachi, Pakistan. Methods : A cross-sectional descriptive study design was used to answer the study questions. The study was conducted at 11 nursing schools in Karachi by recruiting those teachers who were teaching in nursing degree programs. The sample size of the study consists of 80 teachers. Universal sampling technique was used to select the subjects of the study. Results : The study result consists of demographic information of the participants, teachers’ conceptions and their practices of WFB. Although majority (92%) of the teachers believed that WFB is important for students’ learning, they acknowledged that they were not able to provide WFB at optimum level to their students. This gap in practice is attributed to various personal, contextual, and organizational factors; among them, the highest reported factors were teachers’ lack of training for provision of WFB (84%), distraction in the environment (78%), and constraints of time due to teacher’s workload (74%). Conclusions : The importance of WFB for students’ learning is well established in the literature. However, the preparation of teachers and an enabling environment to facilitate teachers for optimum practices of WFB needs considerable attention by educational institutions.

Background Students can experience multiple stressors during their academic life which have an impact on their emotional health and academic progress. Purpose This study sought to explore students' understanding of and factors affecting their emotional well-being in an undergraduate nursing programme at a private nursing institution in Karachi, Pakistan. Method In this qualitative study, data were collected through individual semi-structured interviews using a self-designed guide from 16 participants in total, drawn from various years of the selected undergraduate programme. Findings Participants noted that the quality of the ‘learning environment’ was a key influence on their emotional well-being. They highlighted faculty role and teaching approaches, academic expectations and availability of learning resources as important factors that affected their emotional well-being as well as their academic performance. Institutional support was also deemed important. Factors associated with a ‘hidden curriculum’ were found to be a threat to students' emerging sense of professionalism. Conclusion Suggestions are given as to how the learning environment in the nursing programme under study can be improved to take into account students' emotional well-being. Emphasis needs to be laid on developing supportive faculty role to provide conducive learning environment and professional development of students. Efforts to develop stress-free academic environment with supportive institutional policies need to be considered.

This mixed-methods research aimed to understand the practices and perceptions of teachers regarding writtenfeedback. For this purpose, a survey was administered to 150 teachers forming a non-probability sample, who wereworking in various universities in Karachi. The disciplines chosen for the study included nursing, applied linguistics,medicine and education departments in institutes of higher education situated in Karachi. Before sampling, initialscreening was done to obtain a list of institutes which provide written feedback on students’ assignments. Twohomogenous groups of teachers by discipline (nursing and education) were then selected for focus group discussions.It was found that most teachers consider written feedback an important tool for guiding and helping students improvetheir work. In fact, they consider written feedback as important as verbal feedback. Teachers also recognized theimportance of discussing the written feedback with the students but they rarely did so because of time constraints.Most teachers preferred to directly fix students’ errors instead of providing feedback to enable them to correct thoseerrors by themselves. While less than half of the participants used a checklist for grading, others used annotation.Several factors were found to have a great influence on the amount and quality of feedback. The most significantfactor was whether teachers had formal training in providing feedback. Only 17% of the participants in this study hadproper training to give written feedback. They also identified several environmental and personal factors that had animpact on their feedback practices including time, the relationship between the teacher and individual students, and,most importantly, the policies and culture of the institutes.

Background and Aim: Cancer is a daunting illness affecting a vast number of people globally. During the illness trajectory, cancer patients suffer from physical and/or psychosocial issues. These physical and psychosocial issues demand conscious actions by patients to maintain their well-being. Hence, the objective of the pilot study was to evaluate the level of self-care behaviors and satisfaction in women suffering from cancer after exposure to supportive care (education and mind diversion activities) delivered via a patient help group program. Methods: The study was conducted at the chemotherapy day care unit of one of the tertiary care hospitals located in Karachi, Pakistan. In this study, supportive care interventions were offered via the patient help group program over a 5-week period, and in the 6th week, data were collected. The total sample size of this pilot study was n = 17. Female cancer patients receiving weekly chemotherapy regimen and diagnosed with breast or gynecological cancers were a part of the study. Outcome variables, self-care behavior and satisfaction, were assessed via a self-developed questionnaire. Content validity index of the questionnaire was calculated on the basis of expert review and was found to be 96% for relevancy and 94% for clarity. Frequencies were calculated to evaluate outcome variables. Outcome variable satisfaction was also assessed via few open-ended questions. Results: Participants reported moderate-to-high self-care behaviors and satisfaction after exposure to supportive care interventions delivered via the patient help group program. Conclusion: Counseling and mind diversion activities are effective in producing a positive change in chemotherapy patients' self-care behaviors and satisfaction. Therefore, oncology nurses must utilize them in chemotherapy patient care. Future studies should evaluate the effectiveness of these interventions with larger sample size and comparative analysis.

Background There are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community. This research was aimed to determine the frequency of benzodiazepine use, along with its associations with socio-demographic and clinical characteristics among community dwelling adults, residing in two urban settlements of Karachi, Pakistan. Methods We performed a cross sectional study from August 2008 to December 2009, in 2 areas of Karachi, namely Garden and Sultanabad. We followed the systematic sampling strategy to randomly select the households, with an adult of either sex and of age 18 years or more. Data collection was carried out through interview, using a pre-tested questionnaire, with items on socio-demographic position, medical history and benzodiazepine use. Student's t-test and χ2 test was employed to determine the associations between socio-demographic and clinical characteristics, and their relationship with benzodiazepine use was determined using applied logistic regression. Results The overall percentage of benzodiazepine consumption was estimated to be 14%. There were significantly more benzodiazepine users in the peri-urban Sultanabad community to the urban community of Garden (p-value = 0.001). The mean age (± SD) for users was 51.3 (± 15.6) years compared to 37.1 (± 14.4) years among non-users. Bromazepam was the most widely used benzodiazepine (29%); followed by diazepam, with a median duration on primary use being 144 weeks (IQR = 48-240). The adjusted logistic regression model revealed that increasing age, location, female sex, unemployment and psychiatric consultation were associated with increased likelihood of benzodiazepine use. Conclusion We believe the unregulated over-the-counter sales of benzodiazepines and social conditions might be playing a role in this high consumption of benzodiazepines in the community.