Factors influencing nursing students' preference for a hybrid format delivery in a pathophysiology course

A growing number of courses in higher education are adopting a hybrid format of course delivery. Hybrid courses use both online learning activities with traditional classroom teaching and thus offer the efficiency and flexibility of online delivery without the complete loss of face-to-face contact. This paper explores students' satisfaction with a hybrid course delivery format, where students were required to attend the traditional tutorial session as well as complete the prescribed web-based learning activities. The study also sought to determine if age, part-time employment or academic performance were associated with satisfaction levels of the hybrid format. Participants were 143 undergraduate nursing students enrolled in a final year pathophysiology course at a university in Sydney, Australia. A survey design was used to evaluate hybrid versus traditional face-to-face classroom instruction, resulting in a high overall satisfaction with the hybrid course delivery format. Students' age and the hours they spent in part-time employment were not associated with satisfaction levels of the hybrid format. Students who achieved higher marks in the final examination expressed stronger preference for the traditional format of course delivery indicating a perceived reliance on teacher-based instruction. It is recommended that additional support be provided to students while they make the shift to a more active independent mode of learning when using web-based formats.     

Graduating nursing students' perceived preparedness for working in critical care areas

halcomb e.j., salamonson y., raymond d. & knox n. (2012)?Graduating nursing students perceived preparedness for working in critical care areas. Journal of Advanced Nursing68(10), 2229-2236. ABSTRACT: Aims. This article reports a study examining the relationships between undergraduate students' demographics, educational preparation and clinical experience and their self reported preparedness for employment in critical care. Background. Increasing demand for critical care services internationally, creates a need to grow the critical care nursing workforce. Limited data are available on factors affecting new graduate nurses' career choices. Methods. Final year nursing students from a multi-campus Australian university were surveyed during 2009. Results. Over half of the participants were interested in seeking employment in critical care following graduation. Main reasons for choosing critical care nursing were: (i) like varied and challenging work; (ii) opportunities for professional development; and (iii) like working one-on-one with patients. The main barriers identified by participants were related to the lack of knowledge and clinical skills required to work in critical care. Using the 9-item Confidence and Interest in Critical Care Nursing scale, the study revealed that male participants and those who spent more than 1 week clinical placement in critical care were significantly more likely to report greater confidence and interest in seeking employment in critical care areas. Conclusions. The value of placing nursing students in critical care areas for more than 1 week during undergraduate clinical placements is affirmed. Whilst most final year students report feeling prepared to work in critical care areas, the next step is to explore the transition of students as new graduates in critical care to identify professional and educational issues that impact on their retention.     

Factors predicting therapeutic efficacy of combination treatment with sitagliptin and metformin in type 2 diabetic patients: the COSMETIC study

Objective We assessed the predictive parameters for therapeutic efficacy of initial combination therapy with sitagliptin and metformin in drug‐naïve type 2 diabetic patients. Design, Patients, and Measurements In this 52‐week treatment study, 150 patients (mean age, 54·9 ± 12·5 years) with type 2 diabetes and HbA1c of 7·0–10% were treated with sitagliptin 100 mg once and metformin 500 mg twice daily. To assess the predictive parameters for therapeutic efficacy, a multivariate regression analysis was performed with baseline fasting glucose, insulin, C‐peptide, and glucagon levels, homoeostasis model assessment‐insulin resistance (HOMA‐IR) and β‐cell function (HOMA‐B), insulinogenic index (IGI, defined as 30–0 min insulin/30–0 min glucose), and area under the curve for glucose, insulin, and C‐peptide obtained after 75‐g oral glucose tolerance test. Results After 52 weeks, mean HbA1c levels and fasting and postload 2‐h glucose were significantly decreased from 8·7 ± 1·4% to 7·2 ± 1·3%, 9·2 ± 3·0 to 7·2 ± 1·8 mm , and 17·5 ± 5·1 to 10·9 ± 3·6 mm , respectively (P < 0·01). HOMA‐B and IGI increased significantly from 50·3 ± 33·5 to 75·1 ± 32·8 and from 11·3 ± 1·3 to 35·0 ± 6·3 at 52 weeks, respectively (P < 0·01). Multivariate regression analysis indicated that the reduction in HbA1c was significantly associated with high baseline HbA1c, low IGI, and short duration of diabetes after adjusting for age, sex, body mass index, blood pressure, triglycerides, creatinine, high‐sensitivity CRP, glucagon, C‐peptide, HOMA‐B, and HOMA‐IR. No severe adverse events were observed. Conclusion These results suggest that drug‐naïve type 2 diabetic patients with low β‐cell function would benefit the most from early initial combination therapy of sitagliptin and metformin.