专科实习护生学业情绪与学业自我效能感的相关性研究

[目的]了解专科实习护生学业情绪、学业自我效能感现状,分析二者的相关性。[方法]采用便利抽样法,使用大学生一般学业情绪问卷、学业自我效能感量表对264名专科实习护生进行问卷调查。[结果]264名专科实习护生的消极高唤醒情绪(羞愧、焦虑、气愤)得分、消极低唤醒情绪(失望、厌烦)得分、积极高唤醒维度中的兴趣情绪得分均显著高于国内一般大学生,差异有统计学意义(P<0.05);学业情绪的4个维度得分与护理本科生相比差异有统计学意义(P<0.05)。研究对象的学业自我效能感总分为(79.42±10.08)分,其中,学习能力自我效能(40.38±5.99)分、学习行为自我效能(39.05±5.32)分,与国内专科护生大样本比较差异无统计学意义(P>0.05)。专科实习护生的积极高唤醒、积极低唤醒情绪与其学业自我效能感存在显著正相关(P<0.01);消极高唤醒和消极低唤醒情绪与其学业自我效能感存在不同程度的负相关(P<0.01)。[结论]专科实习护生的学业情绪有待提高,其学业自我效能感得分处于中等稍高水平;二者关系密切、相互影响。护理教育者应根据专科实习护生所处学习阶段的特殊性,采取针对性干预措施改善其学业情绪,进一步提升其学业自我效能感,提高护理专业人才培养质量。     

The academic writing experiences of a group of student nurses: a phenomenological study

AIMS: To investigate the academic writing experiences of a group of preregistration nursing students. To explore issues surrounding how academic writing skills were developed, integrated and received into the student's educational programme and how these skills impacted on various aspects of their educational and clinical experience. BACKGROUND: The development of an academic writing style is seen to be an integral skill that the student must be willing to learn and undertake within higher education settings. Academic styles of writing have been imported into nursing education as a consequence of its integration into higher education. I wanted to investigate the experiences of learning an academic style of writing for students early on in their nursing career. There is little, if any, research that seeks to investigate or measure these experiences of nursing students. METHODS: A phenomenological approach to investigate the academic writing experiences of a group of preregistration students. FINDINGS: There is an expectation that preregistration students will quickly acquire academic writing skills when most will have had little or no prior experience. There appeared to have been little emphasis placed on facilitating the development of these skills in the educational programme. The lack of emphasis and support proved to be problematical for these nursing students. The emergence of a theory-practice divide also figured strongly. Students were, however, able to appreciate the need and place for academic writing skills and most were able to identify the structural processes that were integral to acquiring such skills. CONCLUSION: A plethora of anecdotal evidence, supported by the findings in this study, suggests that most nursing students' struggle with the demands placed upon them when writing academic assignments. The need for greater emphasis and support throughout the whole period of training are highlighted in the findings of this study. It is known that nursing loses large numbers of its students to the academic rigors of its educational programmes. Where this is the case, the findings of this study support the need for nurse educationalists and curriculum planners to revise and reform the way that they approach and deliver the demands of an academic style of writing with their students.     

Academic Emergency Medicine Staffing Nonacademic Emergency Department Sites: A National Survey

Changing health care markets have threatened academic health centers and their traditional focus on teaching and research. OBJECTIVES: To determine the number of academic emergency medicine departments (AEMDs) that staff additional non-academic ED sites and to determine whether clinical reimbursement monies from those ED sites are used for academic purposes. METHODS: A two-part survey of all 119 academic EM programs listed in the 1997-1998 Graduate Medical Education Directory was conducted. Questionnaires were addressed to each AEMD chair. AEMDs and ED sites were characterized. Hiring difficulties, EM faculty academic productivity, and use of ED site reimbursement monies for academic activities were assessed. RESULTS: Ninety-nine of 119 (83%) AEMDs responded. Twenty-three (23%) AEMDs staffed 28 added ED sites. These sites tended to be urban (65%), with moderate volumes (25,000-35,000 patients/year), and had an equal or better reimbursement rate than the AEMD (89%). ED sites were commonly staffed by academic EM faculty (79%) and EM residents (29%). Ninety-six percent of the AEMDs had hired additional faculty; hiring new faculty was considered easy. Academic productivity at AEMDs with added ED sites was reported as unchanged. Reimbursement monies from these ED sites were commonly used for faculty salary support, faculty development, and EM research and residency activities. CONCLUSIONS: Academic EM departments are often affiliated with nonacademic ED sites. These additional sites are commonly staffed by academic EM faculty and EM residents. Academic productivity does not appear to decrease when additional ED sites are added. Reimbursement monies from these ED sites commonly supports academic activities.     

Academic stress, immunological reaction, and academic performance among students of nursing and physiotherapy

The associations among health status, health behavior, and changes in human cytomegalovirus (HCMV) specific salivary antibodies during academic stress were investigated in relation to academic achievement among nursing and physiotherapy students. Fifty-four first year students donated saliva samples and completed a pencil and paper questionnaire before (t1), during two term examinations (t2 and t3), and after grades were posted (t4). An increase in the level of specific salivary HCMV IgG and IgA antibodies from t1 to t2, and a decrease from t2 to t4 were related to academic success. Health status and health behavior remained fairly stable during the stress period. The results are congruent with the inverted U-shape model of stress and learning suggested by Yerkes & Dodson (1908).     

Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on Women in Academic Emergency Medicine

The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.     

Decreasing Barriers to Academic Rank for Advanced Practice Providers

The aim of this study was to reduce barriers to achieving academic promotion among advanced practice providers. Educational sessions, an online tutorial, and mentoring sessions were implemented. A survey was administered to all advanced providers after the interventions. Of the 168 surveys sent out, 117 (67%) were returned. Subsequently, 32% achieved academic rank (a 52% improvement), and 35% were active in the process. Reporting of the most frequently identified barriers “lack of mentorship” and “difficulty understanding the process” was reduced by 100% and 71%. Strategies to decrease barriers can be beneficial in improving the processes and achievement of academic promotion.     

基于影响因子分析我国护理学期刊学术影响力变化趋势

目的:从影响因子角度定量分析我国护理学期刊学术影响力变化趋势。方法:采用文献计量法、比较研究法,统计《中国科技期刊引证报告》核心版近10年收录护理学期刊的影响因子最大值、最小值和平均值等。结果:《中国科技期刊引证报告》核心版收录的护理学期刊影响因子平均值从2000年的0.1735上升到2009年的0.5621;最高值从2000年的0.373上升到2009年1.485,最低值从2000年的0.075上升到2009年的0.106;高影响力(影响因子≥1.0)期刊数量基本没变,但所占百分比逐渐减小。结论:我国护理学期刊质量和数量均逐年提高,且增长速度较快;学术影响力呈上升趋势,但仍然较弱,需加大期刊建设力度和提高护理人员的科研能力,以促进护理学科向纵深发展。     

Academic voice: On feminism,presence, and objectivity in writing

Academic voice is an oft‐discussed, yet variably defined concept, and confusion exists over its meaning, evaluation, and interpretation. This paper will explore perspectives on academic voice and counterarguments to the positivist origins of objectivity in academic writing. While many epistemological and methodological perspectives exist, the feminist literature on voice is explored here as the contrary position. From the feminist perspective, voice is a socially constructed concept that cannot be separated from the experiences, emotions, and identity of the writer and, thus, constitutes a reflection of an author's way of knowing. A case study of how author presence can enhance meaning in text is included. Subjective experience is imperative to a practice involving human interaction. Nursing practice, our intimate involvement in patient's lives, and the nature of our research are not value free. A view is presented that a visible presence of an author in academic writing is relevant to the nursing discipline. The continued valuing of an objective, colorless academic voice has consequences for student writers and the faculty who teach them. Thus, a strategically used multivoiced writing style is warranted.     

Funding and Publishing Trends of Original Research by Emergency Medicine Investigators over the Past Decade

Objectives: To update the profile of author‐reported funding of reports of original research published since 1994 in the four U.S. peer‐reviewed general emergency medicine (EM) journals. Methods: For the primary analysis, articles published in Academic Emergency Medicine, American Journal of Emergency Medicine, Annals of Emergency Medicine, and Journal of Emergency Medicine between 1994 and 2003 were reviewed by two emergency physicians trained in abstracting from the literature. Original research was identified; case reports, case series, abstracts, and meta‐analysis were excluded. Articles were classified by author report of extramural funding as government (public), private nonprofit (foundation), for profit (industry), or multiple. Data are reported as percent per year per journal. A secondary analysis of MEDLINE was performed to identify publishing trends by EM investigators outside of these four journals over the same period. Results: The primary analysis identified 5,728 articles; 3,278 (57%) were considered original research, with 32% of these reporting extramural funding. In 1994, there were 292 articles with 28% funded (28% public, 43% foundation, 17% industry, and 12% multiple). By 2003, there were 358 articles with 36% funded (42% public, 30% foundation, 18% industry, and 10% multiple). There was a trend toward increased extramural funding in all four journals (p = 0.007), with an estimated growth of 3.6% (95% confidence interval = 1.0% to 6.3%) per year over the past decade. The primary review identified 48% of all articles published by EM investigators. Conclusions: Author‐reported extramural funding rates for original research have increased in the EM literature over the past decade. Foundations have funded the largest number of studies, with public (government) sources increasing in 2003.     

Sabbatical Programs and the Status of Academic Emergency Medicine: A Survey

OBJECTIVES: The Society for Academic Emergency Medicine (SAEM) commissioned a survey in 1998 to describe sabbatical programs, academic rank, and tenure, and to shed light on factors affecting the continuum of faculty development, as a context for evaluating the potential importance of emergency medicine (EM) sabbatical programs. METHODS: The chairs of 120 EM residency programs were surveyed. RESULTS: The response rate was 90%. Of 108 responses, 44 were academic EM departments (AEMDs); ten were their affiliates. The setting was urban for 82%; 37% were publicly funded and 58% privately. AEMDs were more likely to have a tenure track and eligibility for a sabbatical program, but not more likely to use a sabbatical program. Among 2,042 ranked EM faculty, there were 121 professors and 346 associate professors. Mean sabbatical length was six months, provided at full pay requiring a mean of 5.7 years of employment. Among 39 programs reporting eligibility for an EM sabbatical, requirements included: tenure (43%), academic rank of associate professor (78%), an application with multiple approval levels (92%), and a formal report (75%). Thirteen EM programs used sabbaticals; only 40 faculty members altogether (9% of senior faculty) have taken sabbaticals. The mean value of sabbaticals (rated by users on a scale of 1 to 10) was 6.8. Reduced funding, lack of departmental status, difficulty retaining faculty, Health Care Financing Administration (HCFA) regulations, graduate medical education (GME) cutbacks, and no release time were identified as challenges for emergency physicians (EPs) wishing to participate in sabbaticals. Strategies proposed to overcome these obstacles include quality customer service, streamlined operations, outside contracts, computerization, hiring individuals with PhDs, collaboration, political activity, and faculty development. CONCLUSIONS: A sabbatical can be beneficial for individuals and their institutions, but presently EPs have not been able to maximize use of available opportunities. Some obstacles to successful participation of EM in sabbatical programs might be overcome with creative strategies and the active support of professional academic organizations.     

Academic freedom and academic duty to teach social justice: a perspective and pedagogy for public health nursing faculty

Public health nursing practice is rooted in the core value of social justice. Nursing faculty whose expertise is in public health are often the content experts responsible for teaching this essential, yet potentially controversial, value. Contemporary threats to academic freedom remind us that the disciplinary autonomy and academic duty to teach social justice may be construed as politically ideological. These threats are of particular concern when faculty members guide students through a scientific exploration of sociopolitical factors that lead to health-related social injustices and encourage students to improve and transform injustices in their professional careers. This article (a) reviews recent challenges to academic freedom that influence social justice education, (b) explores academic freedom and duty to teach social justice within the discipline of nursing, and (c) proposes a praxis-based approach to social justice education, which is grounded in transformative pedagogy.     

Differences between high- and low-achieving pre-clinical medical students: a qualitative instrumental case study from a theory of action perspective

BackgroundPoor academic performance and failure can cause undesired effects for students, schools, and society. Understanding why some students fail while their peers succeed is important to enhance student performance. Therefore, this study explores the differences in the learning process between high- and low-achieving pre-clinical medical students from a theory of action perspective.MethodsThis study employed a qualitative instrumental case study design intended to compare two groups of students—high-achieving students (n = 14) and low-achieving students (n = 5), enrolled in pre-clinical medical studies at the Universiti Malaya, Malaysia. Data were collected through reflective journals and semi-structured interviews. Regarding journaling, participants were required to recall their learning experiences of the previous academic year. Two analysts coded the data and then compared the codes of high- and low-achieving students. The third analyst reviewed the codes. Themes were identified iteratively, working towards comparing the learning processes of high- and low-achieving students.ResultsData analysis revealed four themes—motivation and expectation, study methods, self-management, and flexibility of mindset. First, high-achieving students were more motivated and had higher academic expectations than low-achieving students. Second, high-achieving students adopted study planning and deep learning approaches, whereas low-achieving students adopted superficial learning approaches. Third, in contrast to low-achieving students, high-achieving students exhibited better time management and studied consistently. Finally, high-achieving students proactively sought external support and made changes to overcome challenges. In contrast, low-achieving students were less resilient and tended to avoid challenges.ConclusionBased on the theory of action, high-achieving students utilize positive governing variables, whereas low-achieving students are driven by negative governing variables. Hence, governing variable-based remediation is needed to help low-achieving students interrogate the motives behind their actions and realign positive governing variables, actions, and intended outcomes.

Key Messages

• This study found four themes describing the differences between high- and low-achieving pre-clinical medical students: motivation and expectation, study methods, self-management, and flexibility of mindset.
• Based on the theory of action approach, high-achieving pre-clinical medical students are fundamentally different from their low-achieving peers in terms of their governing variables, with the positive governing variables likely to have guided them to act in a manner beneficial to and facilitating desirable academic performance.
• Governing variable-based remediation may help students interrogate the motives of their actions.

     

Derivation and Validation of a Methodology for Tracking Academic Stature of Medical Schools

Objective: To derive and validate a methodology for academic ranking of allopathic medical schools in order to track the development of emergency medicine (EM) at academic medical centers.
Methods: A methodology for institutional ranking according to NIH research grant funding was derived by using a well-known multiaxial ordinal ranking of all Liaison Committee on Medical Education (LCME)-accredited allopathic schools in 1990–91 as the criterion standard. This methodology was validated against the same annually updated criterion standard in 1995–96. Both ranking schemes were first stratified by quartile, then aggregated pairwise by contiguous quartiles to develop a 3 × 3 concordance matrix.
Results: Ranking by NIH grant funding produced concordance between all 126 schools in the derivation set and 123/124 schools in the validation set.
Conclusion: NIH research grant funding may be used as a valid methodology for broad categorization of allopathic medical school academic rank. This strategy should therefore serve as a suitable means of following the development of academic EM over time.
This project was supported by a grant from SAEM.     

Self-efficacy as a predictor of academic performance in science

Nursing students have traditionally experienced difficulties with the science subjects in nursing curricula, and irrespective of the institution conducting a nursing programme, this trend appears to be continuing. A satisfactory means of predicting academic performance in these subjects will facilitate the development of educational strategies designed to assist students overcome their difficulties. In this study, an instrument called the Self-Efficacy for Science (SEFS) was developed and tested. The SEFS was designed to predict academic performance in the science areas of a first-year undergraduate nursing course. A cohort of first-year students enrolled in a bachelor of nursing course were surveyed by questionnaire. Students' academic scores for two first-year science subjects were obtained and used as the criterion measure for the study. Principal component factor analysis revealed the SEFS contained six instead of the hypothesized four factors. These six factors could explain 70% of students' self-efficacy for science. Cronbach alpha of the SEFS was 0·9. The SEFS could predict 24% of the cohort's academic performance in a physical science subject and 18·5% for a bioscience subject. Studying science in the final year at high school was not statistically significantly related to the SEFS. Implications for students and future research are discussed.     

Changing Status of Academic Emergency Medicine (1991–1996)

Objective: An SAEM national task force previously concluded that academic departments and residencies in emergency medicine (EM) had preferentially developed outside of the academic mainstream. This study was designed to determine whether EM has made significant inroads into academic medical centers over the past 5 years. Methods: The baseline data set (7/1/91) contained all 126 Liaison Committee on Medical Education (LCME)-accredited schools, and all 87 Residency Review Committee (RRC)-accredited EM residencies. The comparison data set (7/1/96) contained all 124 LCME-accredited schools, and all 114 RRC-accredited EM residencies. The 1991–96 increment in academic departments and university-hospital residencies was examined in the aggregate, then stratified by medical schools grouped into quartiles and contiguous quartiles, according to academic ranking. A-priori and post-hoc comparisons were expressed with 95% and 99% confidence intervals (CIs), respectively.
Results: Over the past 5 years, the proportion of academic departments of EM increased by 23%, from 18% to 41% of all LCME-accredited schools (95% CI 12% to 34%). The largest increase (58%; 99% CI 40% to 77%) occurred among those schools academically ranked above the median. The proportion of EM residencies at university hospitals increased by 17%, from 40% to 57% (95% CI 5% to 30%). Again, the largest increase (25%; 99% CI 3% to 47%) occurred at university hospitals affiliated with schools academically ranked above the median.
Conclusion: EM has made substantial inroads into academic medical centers over the past 5 years. This is reflected in quantitatively and statistically significant increases in academic departments and university-hospital residency programs, both occurring largely within institutions whose academic rankings place them among the upper half of all LCME-accredited medical schools.     

Changes in Academic Attributes Associated with Establishment of Departments of Emergency Medicine

Abstract. Objective: To test the hypothesis that establishment of academic departments of emergency medicine (EM) is associated with improvements in attributes valued by traditional academic medicine.
Methods: Cross-sectional, observational analysis of academic departments of EM at all accredited allopathic medical schools, as of July 1, 1996. Nonre-spondents were mailed questionnaires three times, followed by phone contact. All variables were examined as before-after comparisons associated with department formation. Findings were reported as absolute differences, bounded by 99% confidence intervals (99% CIs), adjusted for multiple comparisons.
Results: Of 50 departments, 49 responded. Department formation was associated with a 25% (99% CI 5% to 46%) increase in accredited EM residencies, a 33% (99% CI 9% to 56%) increase in extramural grant funding, and 46% (99% CI 23% to 69%) and 34% (99% CI 8% to 58%) increases in departmental representation on medical school curriculum and promotions committees, respectively. The mean increase in academic faculty full-time equivalents (FTEs) was 6.7 (99% CI 3.3 to 10.1). There were average increments of 2.1 FTEs (99% CI 1.4 to 2.7) and 0.8 FTEs (99% CI 0.4 to 1.1) attaining senior ranks of associate professor and professor, respectively. With a top possible Likert scale score of 3, departmental status was associated with essentially identical improvements in the quality of faculty [2.6 (99% CI 2.4 to 2.8)], EM residents [2.6 (99% CI 2.4 to 2.8)], student teaching [2.7 (99% CI 2.5 to 2.9)], and overall academic productivity [2.8 (99% CI 2.7 to 3.0)].
Conclusion: Establishment of academic departments of EM at medical schools is associated with quantitatively and statistically significant improvements in many academic attributes that are mutually beneficial for both the institution and the specialty.