Dr Heidi Singleton
- 01202 961573
- hsingleton at bournemouth dot ac dot uk
- http://orcid.org/0000-0002-3487-1029
- Senior Lecturer in Children and Young Peoples Nursing
- BGB
Biography
Heidi's route through academia has led her to Children’s and Young People’s Nursing, a research field that she feels passionate about. Having joined BU as Lecturer of Children’s and Young People’s Nursing, Heidi brings a range of experience to the role. Having trained as a CYP Nurse at the University of Surrey, she worked as a Research Assistant at the University of Southampton School of Nursing. Next, obtaining a Post Graduate Certificate of Education and a Master’s Degree in Education, she completed her PhD at BU. Her PhD focused on how technology can engage and improve student nurses’ understanding of complex concepts including diabetes. She believes that blending evidence based practice with innovative ideas to engage and keep pace with the changing nursing landscape should be at the heart of nurse education.
In addition to exploring how technology can be used for education, her other main research areas focus on how technology can be used both therapeutically, and for service improvement in the areas of dermatology (including the psychological impact of eczema and nurse led skin cancer clinic service innovation), mental health (improving early intervention service innovation) and anxiety (vaccination and hospital appointment anxiety) predominantly in children and young people...
Heidi is the academic lead for a Cochrane Review entitled: Psychological and educational interventions for atopic eczema in children. She is the PI for a £39K funded HEIF Project which aims to explore how an “eczema igloo” can help distract children from scratching and improve quality of life for children and families.
In her spare time, Heidi enjoys walking, yoga, and musical theater.
moreResearch
Heidi has conducted a research study comparing the use of a virtual reality training simulation to traditional nurse education methods. The study was chosen as a Fusion Case study and the link can be found here: https://www.bournemouth.ac.uk/why-bu/fusion/using-virtual-reality-train-nurses Together with diabetes expert Dr Janet James and diabetes specialist nurse Simone Penfold, Heidi focused on developing a patient case study to teach student nurses how to effectively treat a diabetic emergency – hypoglycaemia. Hypoglycaemia is a medical emergency experienced by diabetics where their blood sugar drops too low. Hypoglycaemia was chosen as the focus of the work because an increasing number of patients admitted to hospital also have diabetes as a secondary condition so it’s becoming ever more important that nurses understand how to treat hypoglycaemia. In the case study, a patient is admitted to hospital and then experiences hypoglycaemia. The patient’s condition deteriorates and throughout the scenario the student is given a number of choices and their decision affects the patient’s outcome. Technology company Daden worked closely with the BU team to create an app based on the case study that simulates the emergency. The software can be used on computers, immersive technology including Oculus Rift and mobile phones with virtual reality (VR) headsets to really bring the experience to life. The simulation was carefully created to be both accurate and realistic – the setting is based on wards at Royal Bournemouth Hospital that the student nurses have worked in and the software has replicated the same equipment used within the wards so the experience is familiar to the student nurses... When using the software, students go through the scenario and must make choices on what care to give the patient. The exercise instantly provides feedback on the choice, allowing students to ascertain what the correct treatment options are.
moreHeidi's doctoral thesis was entitled Singleton, H., 2020. Virtual technologies in nurse education: the pairing of critical realism with partial least squares structural equation modelling as an evaluation methodology. Doctoral Thesis (Doctoral).
Abstract:
Background: Virtual technologies have been, and continue to be, of significant interest to Higher Education (HE) educators. There have been many research studies carried out into the efficacy and acceptability of these technologies. But, this research (via a systematic literature review) found that there are significant methodological shortcomings in many of those studies, particularly with respect to understanding the mechanisms of the effect of virtual technologies on learning. Most papers were superficial and concentrated on the Technology Acceptance Model (TAM) of usability and ease of use. Some carried out perfunctory assessments of learning effect, but predominantly by measuring student enjoyment via subjective self-reporting. This thesis responded to this gap in the literature by implementing a non-immersive virtual reality (VR) (accessed via a laptop), educational simulation of a deteriorating diabetic patient and creating a novel and powerful method to evaluate the effect of that simulation on nurse education. Method: The systematic review of the literature led to the creation of a diabetes VR simulator. A novel approach was designed to evaluate this simulator which consisted of the pairing of a randomised controlled trial (RCT) (n=171), analysed via Partial Least Squares-Structural Equation Modelling (PLS-SEM)... The conceptual pathway model for this PLS-SEM approach was drawn from a Critical Realist (CR) review. Hence the main aim was to assess the effectiveness of CR paired with PLS-SEM as a method to evaluate the impact of VR simulations on undergraduate nurse education. The RCT enabled comparison of the VR simulation with normative teaching methods which addressed the two objectives: to determine the effect of pairing CR with PLS-SEM as an evaluative method, and to determine how using this novel evaluative method can inform our understanding of the impact and future use of VR simulations for undergraduate nurse education. Findings: The effect of pairing CR with PLS-SEM was that deep insight was gained into how VR simulations can benefit student nurses. VR was found to be significantly (P=<.001) better in terms of hypoglycaemia knowledge than normative methods. Moreover, the novel method also enabled identification of the key point of action of the simulation, via analysis of the conceptual model which evidenced that the “engagement to immersion” pathway was responsible for leading to higher knowledge scores in the VR group. This thesis is claiming addition to knowledge about how the novel methodological approach taken has the potential to deepen understanding of how virtual technologies can affect learning. Recommendations for policy, practice, and further research have been made on this basis. Future studies could use PLS-SEM combined with CR in order to ascertain both measurable and rich data about how new technologies can improve nurse education.
moreEczema Igloo (A BU Heif funded project): Immersive virtual reality to distract from itch for children with moderate to severe eczema.
Atopic eczema, (atopic dermatitis (AD) is a long-term inflammatory skin condition and one of the commonest childhood illnesses. It is a debilitating disease with high levels of disease burden for the patient (Blakeway 2020). The main symptoms are itch and dryness. AD is the most common long-term disorder, affecting up to 20% of children in industrialised countries (Tsakok 2019). Standard treatment is trigger/irritant avoidance and regular application of emollients and topical steroids/calcineurin inhibitors (Wollenberg 2020). There have been concerns around steroid withdrawal amongst some patients who have very severe AD. Hence, non-pharmacological treatments are being sort.
In addition to educational programmes, a range of psychological therapies are used to treat children. These include mindfulness, relaxation, and guided imagery techniques to distract children from the scratch itch cycle that contributes to insomnia and impacts on quality of life (LeBovidge 2021). The last Cochrane review of Psychological and Educational interventions revealed no robust interventions to enhance effective guided imagery in this context (Ersser et al 2014). Furthermore, virtual reality (VR) has not been sufficiently applied to intervention development in dermatology.
Traditionally, guided imagery has been used in the form of audio scripts spoken to the patient to guide their imagination away from any stress and the itching sensation (Vagnoli 2019)... The use of VR works to focus attention, distracting the patients in relation to different environmental stimuli (Carrougher 2009). Whilst we have found no previous studies that have evaluated VR to treat eczema, it has been used to treat anxiety, burns and pain (Barros 2014; Scapin 2018). Since itch and pain can be triggered from the same receptive fields in the skin (Behrang 2020), it is proposed that VR could be used as a more sophisticated and immersive version of guided imagery. VR displaces a person to an imagined ‘other’ location, with complete immersion as the goal (Brigham 2017), physically blocking out the real world and replacing it with a computer-generated world which includes visual, auditory, and haptic stimuli. VR may potentiate the distractive effect, building on what would be the more limited reach of existing guided imagery interventions. Therefore, our hypothesis is that VR would provide immersive diversion from unpleasant symptoms of eczema. Heidi is leading a Cochrane review of the evidence base, due for publication in 2023.
Through gathering perspectives from key stakeholders’- families, we aim to develop a prototype eczema igloo (with eye tracking, breath, and heart rate control features) that will distract children from their itchy eczema and reduce stress. The aims of this project align with the NHS long term plan, which encourages innovation and technological revolution in clinical practice.
This is a collaborative HEIF funded project working with the following experts:
-Professor Steven Ersser, FHSS- Professor of Nursing & Dermatology Care
-Professor Debbie Holley, FHSS Professor of Learning Innovation
-Dr Xiaosong Yang, FMC, Associate Professor of Computer Animation
-Dr Emily Arden-Close, SCITECH, Senior Lecturer
-Dr Sarah Thomas, BCRU
-Richard Glithro- SCITECH, Demonstrator
-John Moran, FHSS, Simulation Lead Technician
-Amanda Roberts- Nottingham Support Group for Carers of Children with Eczema
moreFavourites
- Singleton, H., Porter, S., Beavis, J., Falconer, L., Hernandez, J.P. and Holley, D., 2023. Accounting for complexity in critical realist trials: the promise of PLS-SEM. Journal of Critical Realism, 22 (3), 384-403.
- Singleton, H., James, J., Falconer, L., Holley, D., Priego-Hernandez, J., Beavis, J., Burden, D. and Penfold, S., 2022. Effect of Non-Immersive Virtual Reality Simulation on Type 2 Diabetes Education for Nursing Students: A Randomised Controlled Trial. Clinical Simulation in Nursing, 66, 50-57.
- Singleton, H., Holley, D., Arden-Close, E., Yang, X., Cui, Y. and Ersser, S., 2022. Virtual reality used to distract eczematous children from distressing symptoms: A pilot evaluation. Dermatological Nursing, 21 (1), 39-44.
- Singleton, H., Ersser, S.J. et al., 2021. Psychological and educational interventions for managing eczema. Cochrane Database of Systematic Reviews, 2021 (11).
- Singleton, H., James, J., Penfold, S., Falconer, L., Priego-Hernandez, J., Holley, D. and Burden, D., 2021. Deteriorating Patient Training Using Nonimmersive Virtual Reality: A Descriptive Qualitative Study. CIN - Computers Informatics Nursing, 39 (11), 675-681.
- James, J., Singleton, H., Penfold, S. and Holley, D., 2020. Virtual reality can improve nursing students' knowledge of hypoglycaemia: Do students prefer immersive virtual reality to non-immersive virtual reality? DIABETIC MEDICINE, 37, 107.
Expertise related to UN Sustainable Development Goals
In 2015, UN member states agreed to 17 global Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all. This person's work contributes towards the following SDGs:
Good health and well-being
"Ensure healthy lives and promote well-being for all at all ages"
Quality education
"Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all"
Peace, justice and strong institutions
"Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels"
Partnership for the Goals
"Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development"
Journal Articles
- Singleton, H., Davis, C., Cui, Y., Glithro, R., Arden-Close, E., Holley, D., Ersser, S., Thomas, S., Yang, X. and Roberts, A., 2023. The use of an Eczema Gaming Igloo to distract children with eczema from distressing symptoms: a pilot study. Dermatological Nursing.
- Singleton, H., Porter, S., Beavis, J., Falconer, L., Hernandez, J.P. and Holley, D., 2023. Accounting for complexity in critical realist trials: the promise of PLS-SEM. Journal of Critical Realism, 22 (3), 384-403.
- Brown, H. and Singleton, H., 2022. Barriers that Influence Treatment Adherence for Children and Young People with Atopic Eczema: A Literature Review. Nursing Children and Young People.
- Singleton, H., James, J., Falconer, L., Holley, D., Priego-Hernandez, J., Beavis, J., Burden, D. and Penfold, S., 2022. Effect of Non-Immersive Virtual Reality Simulation on Type 2 Diabetes Education for Nursing Students: A Randomised Controlled Trial. Clinical Simulation in Nursing, 66, 50-57.
- Singleton, H., Holley, D., Arden-Close, E., Yang, X., Cui, Y. and Ersser, S., 2022. Virtual reality used to distract eczematous children from distressing symptoms: A pilot evaluation. Dermatological Nursing, 21 (1), 39-44.
- Singleton, H., Ersser, S.J. et al., 2021. Psychological and educational interventions for managing eczema. Cochrane Database of Systematic Reviews, 2021 (11).
- Singleton, H., James, J., Penfold, S., Falconer, L., Priego-Hernandez, J., Holley, D. and Burden, D., 2021. Deteriorating Patient Training Using Nonimmersive Virtual Reality: A Descriptive Qualitative Study. CIN - Computers Informatics Nursing, 39 (11), 675-681.
- McDonald, H. and Rushforth, H., 2006. Children's views of nursing and medical roles: implications for advanced nursing practice. Paediatr Nurs, 18 (5), 32-36.
- Rushforth, H., Burge, D., Mullee, M., Jones, S., McDonald, H. and Glasper, E.A., 2006. Nurse-led paediatric pre operative assessment: an equivalence study. Paediatr Nurs, 18 (3), 23-29.
- Rushforth, H. and McDonald, H., 2004. Decisions by nurses in acute care to undertake expanded practice roles. British Journal of Nursing, 13 (8), 482-490.
Books
- Allen, S. et al., 2022. Fusion Learning Colloquium 2022 - Proceedings. Poole, UK: Bournemouth University.
Conferences
- Singleton, H., Holley, D., Moran, J., Rolfe, U. and Collins, E., 2023. Child and Adolescent Mental Health Simulations filmed in 360. In: AHSN Virtual Reality Seminar 17 March 2023 online.
- Singleton, H., Holley, D., Moran, J., Bancroft, A., Collins, E. and Rolfe, U., 2023. Child and Adolescent Mental Health Simulations filmed in 360 presented at the AHSN Virtual Reality Seminar. In: AHSN Virtual Reality Seminar 17 March 2023 online.
- Pask, S., Staples, J., Singleton, H., Moran, J., Collins, E., Bancroft, A., Holley, D., Rolfe, U. and Snowden, J., 2022. Child and Adolescent Mass Casualty Simulations Filmed in 360- Healthcare Practitioners Working Together. In: Pier Wessex 17-18 October 2022 Winchester.
- Bancroft, A., Rolfe, U., Singleton, H., Holley, D. and Moran, J., 2022. Simulation: Creating and sharing reusable learning resources with our students. In: Fusion learning, Innovation and Excellence Colloquium (FLIE), Bournemouth University 28 June 2022 Bournemouth University.
- James, J., Singleton, H., Penfold, S. and Holley, D., 2020. Virtual reality can improve nursing students' knowledge of hypoglycaemia: Do students prefer immersive virtual reality to non-immersive virtual reality? DIABETIC MEDICINE, 37, 107.
- Singleton, H., James, J., Penfold, S. and Priego-Hernandez, J., 2019. Assessing student nurses' knowledge of hypoglycaemia: The first step to improvement. DIABETIC MEDICINE, 36, 116.
Internet Publications
- Holley, D. and Singleton, H., 2021. Breaking the Zoom gloom for students: hi-tech to lo-tech solutions. Available from: https://aldinhe.ac.uk/playful-and-creative-learning/take5-61-breaking-the-zoom-gloom-for-students-hi-tech-to-lo-tech-solutions/.
Theses
- Singleton, H., 2020. Virtual technologies in nurse education: the pairing of critical realism with partial least squares structural equation modelling as an evaluation methodology. PhD Thesis. Bournemouth University, Faculty of Health and Social Sciences.
Posters
- Staples, J., Edwards, R., Pask, S., Singleton, H., Moran, J., Holley, D. and Rolfe, U., 2021. 360 Simulation: Assessing baby Robin. In: Moving upstream using simulation to improve systems.
Others
- Singleton, H., Holley, D., Arden-Close, E., Yang, X., Ersser, S. and Cui, Y., 2022. Developing and evaluating a novel interactive virtual reality intervention for children with eczema.. Sigma Phi-Mu Chapter. Published online.
PhD Students
- Andy Sweetmore. Early Intervention service improvement for Children and Young People's mental health
- Leila Kattach. Service improvement for nurse led skin cancer clinics
Profile of Teaching PG
- Heidi is the CYP link teacher for the Return to Nursing Practice Course
Profile of Teaching UG
- Heidi teaches a range of level 4 to level 6 UG units for the Department of Nursing and more widely across the FHSS Faculty.
Grants
- Efficacy of technology-supported approaches within nurse-led skin cancer clinics for patients requiring rapid diagnosis and follow-up support: development and exploration of a resource efficient novel model (UHD Match Funded, 18 Sep 2022). Awarded
- Developing a toolkit of early interventions for young people with mental health difficulties (Dorset HealthCare NHS Trust, 18 Sep 2022). Awarded
- Eczema Igloo (BU Internal Bid, 10 Apr 2022). In Progress
External Responsibilities
- Sigma Phi Mu, Chair of Leadership and Sucession Commitee (2023-)
- Sigma Phi Mu, Research committee member (2021-)
Internal Responsibilities
- Panel Member, Academic Quality
- Programme Lead, CYP Nursing
- Member, Public Engagement in Research Network
- Member and Conference 2024 organiser for exhibition, SIGMA BU
- Student Representative Link for CYP, Student Representatives
Journal Reviewing/Refereeing
- Journal of Clinical Nursing, Anonymous peer review, 06 Oct 2020
- British Journal of Educational Technology, Anonymous peer review, 03 Sep 2018
Public Engagement & Outreach Activities
- ESRC Festival of Social Science
Conference Presentations
- ASPIH Virtual Conference, 360 Simulation: Assessing baby Robin, 08 Nov 2021, Online
- Café Scientifique, Singleton, H. Holley, D. Falconer, E. . A ‘wicked challenge’: supporting our students’ learning with new technologies, 01 Jan 2019, Bournemouth
- Diabetes UK Professional Conference 2019, H Singleton, Dr J James, S Penfold and Dr J Priego-Hernandez . Assessing student nurses’ knowledge of hypoglycaemia- the first step to improvement., 01 Jan 2019, Liverpool
- UCISA Conference, Singleton, H. Falconer, E. Holley , D. Engage and Educate with Virtual Reality: sharing our experiences of VR Deteriorating Patient, 05 Dec 2018, Birmingham
- BU PGR Conference 2018, Singleton, H. Evaluation of the effectiveness of virtual, augmented and mixed reality technologies for learning, in higher education: a systematic review of the literature, 02 Dec 2018, BU
- OER18 Bristol, Falconer, L. King, D. Singleton, H. Holley, D. Virtual Reality: the implications for open educational resources, 18 Apr 2018, Bristol
Attended Training
- BU-Certificate in Programme Leadership, 07 Oct 2022, Certificate in Programme Leadership
- BEEs- Best evidence for dermatology-Nottingham, 14 Mar 2022, Statistics module
- PhD Supervisor Training, 01 Jan 2021
Qualifications
- PhD in Virtual technologies in nurse education: the pairi (Bournemouth University, 2020)
- Return to Nursing Practice (Nursing) in Children's Nursing (NMC, 2019)
- MA in Education (2015)
- PGCE in Education (2003)
- BSc (Hons) in Children's Nursing (2001)
- RNC in Children's Nursing (RCN, 2001)
Honours
- Emerging Research Award 2023 (Sigma Nursing, 2023)
- Travel Award to attend Dermatology & Venereology at the EADV Congress in Berlin (British Dermatology Nursing Group, 2023)
- Travel Bursary (NIHR/BAD, 2022)
- Recognition for Excellence in Nursing Education during Covid-19 pandemic. Nursing (SIGMA Nursing, 2021)
- Senior Fellow of HEA (HEA, 2021)
- Vice Chancellor Scholarship for PhD Studies (BU, 2017)
- Morgan Prize-Highest clinical and academic results (University of Surrey, 2001)
- Pergamon Prize-Best academic research project (A study into the presence of microorganisms in neonatal incubators). (University of Surrey, 2001)
Memberships
- British Dermatology Nursing Group, Member (2021-),
- Cochrane, Member (2021-2024),
- CYP Nurse Academics UK, Member (2020-),
- NMC, Member (2020-),
- RCN, Member (2020-),
- Sigma Nursing Phi Mu Chapter, Member (2020-),
- Nursing for Long Term Health Research Centre, Member (2019-),
- UK Dermatology clinical Trials Network: Nottingham, Member,
Social Media Links
- Twitter, @N4LTH
- Twitter, @CypBu
- Twitter, @blueprintteach