Clinical evaluation — difficulties experienced by sessional clinical teachers of nursing: a qualitative study

Evaluation of nursing students in the clinical field requires the clinical teacher to make judgements regarding student progress in a number of areas In this study concepts of role theory, oppressed group behaviour and the ethics of caring emerged and were used as conceptual frameworks to interpret the data relating to the evaluation of undergraduate students The number of experienced faculty available for clinical teaching and evaluation has become inadequate and a large number of casual or sessional clinical teachers are employed to teach students in the clinical field Despite the well documented problems associated with clinical teaching and the use of inexperienced clinical teachers, sessional clinical teachers are nevertheless expected to evaluate student success in meeting the clinical requirements of the nursing course, often resulting in disparate decisions for students A phenomenological study was carried out using unstructured interviews and written clinical scenarios, to explore the evaluation process from the perspective of the sessional clinical teachers Research findings indicate that although the sessional clinical teachers were skilled at identifying student problems, they were reluctant to make difficult evaluation decisions, due to low self-esteem, role conflict and their ethic of caring It seems that gender socialization, patriarchal dominance and apprenticeship training had effected their confidence in their own decision making The implications of such findings are of concern for the ongoing credibility and integrity of nursing courses, as clinical teachers have an influence on the nursing profession through the preparation of its practitioners     

Stand magnifiers for low vision: description,prescription, assessment

Stand magnifiers are still one of the most commonly prescribed classes of low vision devices. Their performance can be difficult to understand because stand magnifiers usually do not give an image at infinity. This review summarises the methods of describing image enlargement for stand magnifiers, emphasising their relationship to equivalent viewing distance (EVD). This is done in terms of the underlying optical equations, and measurement methods, and methods of prescribing. In the past, methods of determining EVD have been somewhat indirect, requiring accurate measurement of lens power, and image position. The use of digital photography provides an alternative, more direct, simpler method of determining EVD, which can be accomplished in-office. This method is described and it is demonstrated how it gives comparable results to older methods with small, clinically non-meaningful differences, that may be due to differences in image distance reference planes. Describing the performance of stand magnifiers in terms of their dioptric power, or in terms of ‘nominal magnification’ or ‘trade magnification’, is imprecise and misleading. It is better to use indices such as equivalent viewing power and EVD, which take into account the magnifier dioptric power, the image position of the magnifier and the distance a patient is from the magnifier. While EVD is a useful index for prescribing stand magnifiers, manufacturers do not always provide sufficient technical details to determine EVD for their stand magnifiers, and available tables of EVDs are more than a decade old and are likely to need updating. Photographic comparison provides a method for determining EVD, and this method can also be applied to other low vision devices.