An effective learning environment is one which provides opportunities for meaningful learning experiences that contribute to a student meeting their learning outcomes. Learning in the clinical environment has traditionally formed an integral part of nursing education programs in the country. In tertiary-based nursing courses today, students can spend equal or more hours learning in the clinical workplace as they do in their classroom-based studies. Developing ways to improve teaching and learning in the clinical environment can help to develop a more positive workplace culture, which in turn, has been identified as producing more effective learning outcomes for students.
D and is recommended by NICE as a primary treatment (NICE, 2018). It is seen as a cognitive-behavioural treatment combined with aspects of exposure therapy (Boudewyns & Hyer, 1996) and it works by the participant recalling the traumatic events that they experienced whilst simultaneously having their attention directed to a physical bilateral stimulation they are receiving, such as hearing tones in alternating ears, moving eyes rapidly from side to side, or tapping sensations of either side of the body. Similarly to ET, this therapy works by allowing the mind to safely experience traumatic events, letting the mind process them fully in order to heal appropriately (Shapiro, 1996). A systematic narrative review was carried out on the effectiveness of EMDR for PTSD from four randomized control trials and two meta-analyses. It was found that the therapy was able to reduce the symptoms as well as symptoms that were trauma related, and also appeared more effective than other treatments for trauma as well as effective across different cultures. However, there was a consistent limitation which was the small sample sizes. It also did not take into account the amount of people who were withdrawn from the trials. Despite this, EMDR is shown to be able to reduce the symptoms of PTSD by treating the cause of the problem (Wilson, Farrell, Barron, Hutchins, Whybrow & Kiernan, 2018). This, in turn, leads to a lessening of symptoms.
Although the above mentioned therapies may be effective at treating the psychological damages, there is evidence to show that people who suffer with PTSD have physiological changes too. A meta-analysis studied brain regions of PTSD participants compared to controls and found that the hippocampus and left amygdala volumes as well as the anterior cingulate cortex were all significantly smaller compared to controls and trauma-exposed participants (Karl, Schaefer, Malta, Dorfel, Rohleder & Werner, 2006). Other studies have made observations that there are differences in grey matter volumes, hypothalamus, and even the prefrontal cortex between PTSD participants and controls (Flemingham et al, 2009). Multiple types of medication can be prescribed to alleviate the symptoms of PTSD, and these can include anti-depressants, anti-anxiety medication and anti-psychotics (Ipser & Stein, 2012), however the most commonly used in the U.K. as a treatment for PTSD are antidepressants (De Vries, De Jonge, van den Heuvel, Turner & Roest, 201
