Incorporating educational theory into critical care orientation

This article describes the development and implementation of a critical care total education system, which includes an orientation program. The educational process in this unit reflects Benner's model of novice to expert integrated with Schon's theory of reflective practice and Cranton's transformational learning theory. This program reflects an educational philosophy that facilitates learning on entry into the new workplace, and an established continuum of expected acquisition of knowledge, practice skills, attitudes, and critical thinking abilities promoting the transition from novice to expert.     

Moving forward with developmental care: Education and beyond

The philosophy of practice and research in neonatal developmental care is not new; however, the implementation and integration of the philosophy continues to lag behind in neonatal units. Successful integration of developmental care is multidimensional. A clear and concrete plan is needed to produce the desired change. A variety of educational options are available to prepare unit staff. These include comprehensive, formal, and continuing education programs. This article provides information on the available educational options and discusses an approach to incorporating developmental care principles into a specific unit's health care delivery culture. Copyright 2002, Elsevier Science (USA). All rights reserved.     

Nurse perceptions of the impact of nursing care on patient outcomes: an exploratory study

The aim of this research was to explore registered nurses' perceptions of the relationship between nursing care and clinical outcomes. We conducted an exploratory survey using a convenience sample of nurses attending a 3 day nursing practice conference. Nurses with postgraduate degrees and those with a clinical main work role had higher mean scores for the impact of nursing care on patient outcomes. Nurses reported that pressure ulcers and surgical wound infection were most affected by nursing care. Falls, medication errors, pain management, and patient education were some of the clinical indicators suggested as additional appropriate measures of nursing care. Our results suggest that nurses' educational background and work role may influence their perception of the impact of nursing care on patient outcomes.     

Lights, camera, education! The potentials of forum theatre in a learning disability nursing program

Learning disability nurse education, with a current emphasis on inclusive practice and a history of listening to the person with the disability, is well placed to take advantage of more 'experimental' forms of classroom teaching. In this article we argue for the use of forum theatre as a method of addressing topics from practice within an educational setting. Based on our emergent and exploratory work with students we detail at length the theoretical background that supports such an approach and contextualise the issues with reference to a short piece of drama we have used successfully with different student groups. We feel that the success of this method is due to the involvement of students in directing their own education as well as the inclusion of individuals labelled with learning disability as an integral part of the process.     

Partnership working between a higher education institution and NHS TRUSTS: developing an acute and critical care module

The underpinning philosophy of preparing nurses to work within a modern National Health Service (NHS) is to ensure patient safety and quality of clinical care. There is increasing recognition that post-registration education should become more clinically focused and adopt a more work-based approach. Critical to the success of such an approach is partnership working between education providers and NHS Trusts. Changes in the delivery of acute care in the NHS have resulted in an increased number of highly dependent patients in both critical and non-critical care areas. This article describes a partnership approach between a Higher Education Institution (HEI) and two NHS Trusts to deliver a degree level module to address the subsequent educational implications of these changes. This approach ensured module credibility and clinical focus. Student feedback confirms the clinical relevance of the module. Staff from the NHS had the opportunity to develop teaching skills by preparing teaching materials, delivering teaching sessions and receiving feedback on these. Areas of good practice were identified and there was sharing of skills, knowledge and expertise between both institutions. Joint working can enhance clinical relevance of educational provision and ensure consistency between theory and practice. In addition, there were a number of wider benefits to both institutions that resulted from this initiative.     

Fourth year nursing students' perceptions of their educational preparation in medication management: An interpretative phenomenological study

BackgroundMedication safety is an integral aspect of patient safety. Nurses, as advocates of patient safety, actively consider medication safety in the course of their daily work. Hence, it is important to consider the educational preparation of nursing students in medication management, as future caregivers. There are inherent links between nurses' undergraduate educational preparation in medication management and patient safety.ObjectiveThis research study identifies fourth-year nursing students' perceptions of their educational preparation in medication management.DesignAn interpretative phenomenological methodological approach underpinned this research study.SettingThis study was conducted at a University in the West of Ireland.ParticipantsParticipants were final year students of three undergraduate nursing programmes, Bachelor of Science in Nursing (General), Bachelor of Science in Nursing (Intellectual Disability) and Bachelor of Science in Nursing (Mental Health).MethodsFourteen semi-structured, face-to-face interviews were conducted with students on a one-to-one basis. Data were analysed using thematic content analysis.ResultsThe voices and interpretations of the participants in this study were fundamental to understanding nursing students' perceptions of their preparation in medication management and provided the foundation for this research. These perceptions were captured in the format of four themes: developing an understanding, embedding knowledge in practice, engaging in practice and accepting professional responsibility.ConclusionsFindings point to the important role of the university and the clinical placement settings in nursing students' medication management education and the need for further collaboration and development across both settings. Teaching and learning strategies which promote the integration of theory and practice throughout the four years of the undergraduate degree programme should be encouraged, such as technology enhanced learning and simulation.     

Students' views of enquiry-based learning in a continuing professional development module

The purpose of this study was to explore whether qualified nurses who had undertaken a continuing professional development module at a UK university, which utilised enquiry-based learning (EBL) as the educational strategy, believed that their nursing practice had been influenced by this educational approach. This study was underpinned by the assumptions of Gadamerian hermeneutic phenomenology; semi-structured interviews were conducted with eight nurses who had undertaken a continuing education module utilising an EBL approach. The responses in this study indicate that participants believed that their practice of nursing had been positively influenced by engaging in EBL. They felt that by becoming self-directed, critical, reflective practitioners, they were better able to deliver evidence-based practice/care. Self reports of practice change attributed to engaging in EBL were provided, with the patient identified as the principal beneficiary, echoing the espoused aims of continuing professional development. EBL was credited with being a motivating, energizing and enjoyable way of learning but participants were critical of the lack of preparedness of both the students and facilitators. Consideration needs to given as to whether EBL is viewed as a philosophy of learning or as a facilitative strategy used alongside other educational methods.     

An educational fair and poster approach to organization-wide mandatory education

BACKGROUND: An educational fair and poster approach was developed to meet organization-wide mandatory education requirements. METHOD: A multidisciplinary task force identified 25 mandatory topics. Task force members utilized posters to indicate key points (principles) and questions for each topic. Two interactive stations, body mechanics and fire safety, were developed to allow staff to actively participate and obtain immediate feedback on competency. This educational activity was presented in a fair-like atmosphere continuously over 3 days to reach a majority of staff. RESULTS: Ninety-three percent of the staff attended the educational activity. Department directors received immediate feedback on attendance, test scores, evaluation summaries and problem areas. Post-fair evaluation comments from department directors and staff were very positive. There was a major savings in both staff and staff development work hours. CONCLUSION: An educational fair and poster approach is an efficient method of providing organization-wide mandatory education. This approach can be adapted easily to any organization.     

Playing at research: methodological pluralism and the creative researcher

In its quest for acceptance by the scientific community, mental health nursing research has developed an unhealthy obsession with methodological rigour. This paper draws on the work of several writers from the philosophy of social science to argue that this focus on methodology stifles individual creativity and acts as a gatekeeper to the profession which excludes many of our brightest and most creative researchers. The author proposes a new approach to doing research that facilitates the creative process by encouraging a playful approach that temporarily abandons the accepted rules and methods of the research process in favour of an 'anarchistic epistemology' and a variety of unusual and not necessarily externally validated methods. It is only at the end of the research process that valid and generalizable methods are introduced, and the author calls for journals to open a creative dialogue by being more willing to publish papers describing the early, exploratory stages of research, based on a judgement of their creativity and innovation.     

The psychiatric educational experiences of advance beginner RNs

The nursing profession is in an extraordinary position to improve educational experiences of prospective nurses, particularly within psychiatric nursing. To acquire an enhanced understanding of the nurse's instructive learning process and skills regarding psychiatric nursing, this study described and explored the experiences of advance beginner nurses employed in mental health facilities. It also denoted the registered nurses' (RNs) educational preparedness to function in their new professional role. Reflection of the nurse's personal experiences was acquired by using a qualitative study with a phenomenological approach. Colaizzi's Frame work [Colaizzi, P., 1978. Psychological research as the phenomenologist views it. In: Valle, R., King, M. (Eds.), Existential Phenomenological Alternative for Psychology. Oxford University Press, NY, pp. 48-71] guided the mode of data analysis by enlisting 15 advance beginner nurses to participate in in-depth, audio-taped interviews. Results from this study indicated a need for educational improvements to accurately reflect trends of psychiatric patient care in order to emphasize interpersonal relationships as well as multi-diagnosis and co-morbidity. Additionally, increased contact with diverse patient populations and responsibilities congruent with other clinical placements in managing the patient's overall care were noted to be critical. This study suggests that some nursing educational programs can improve their curriculum, methods of teaching and approach used to introduce students to psychiatric mental health nursing.     

Approaches to gathering evidence for educational practices in nursing

There are many initiatives under way to teach nursing staff about evidence-based practice, but how many educators seek evidence as a basis for their teaching? Nursing education needs more higher quality research, teachers willing to question their current practices, and nurse educators who ask whether there is a better way of promoting learning and performance. This article provides a perspective of how nurse educators can develop an evidence-based approach to their teaching using the research that is available in nursing education.     

The impact of ''Project 2000'' educational reforms on the occupational socialization of nurses: an exploratory study

There is much in both nursing and sociological literature concerning the socialization of students into health care professions. In the case of nursing, concern has been expressed at the disparity between the values espoused by the educational establishment and those in the clinical areas. This study aimed to explore the changes in nursing occupational socialization since the implementation of recent educational reforms. Ethical approval was obtained from the local Research and Ethics Committee. The sample (n = 18) was drawn from qualified nurses working in a range of departments within three Welsh hospitals, half had undergone traditional training and half had received Project 2000 education. Data collection and analysis techniques were based on a grounded theory approach; this approach was deemed appropriate in that it allows the possibility of developing fresh perspectives on the subject without being too constrained by earlier studies. A strongly emerging theme from the data was that the nature of nursing socialization was related to the work contexts in which it was experienced; in particular respondents offered sharply contrasting accounts of nursing culture in 'acute' and 'chronic' areas of health work. The process of socialization was found to be harsher in acute areas with numerous instances of negative sanctions used to ensure compliance to ward culture, whilst in chronic areas occupational socialization was a more satisfactory process and nurses experienced less dissonance between ward and educational establishments. The size of this study mitigates against any firm conclusions; however, the early indications suggest that it would be a fruitful area for further research with a wider sample group drawn from diverse areas. This exploratory study suggests that the location of nursing work, in terms of whether it is in acute or chronic areas, is a determining factor in the experience of contemporary occupational socialization of nurses.     

Effects of 2 educational methods on the knowledge, attitude, and practice of women high school teachers in prevention of cervical cancer

Because of the increased emphasis on prevention and early detection of cervical cancer, we studied the effects of 2 educational methods on the knowledge, attitude, and practice, as regards prevention of cervical cancer, of women high school teachers in Tabriz. This study was a semiexperimental research. Samples were 129 female teachers divided in 3 groups: experimental 1 (educated by pamphlets), experimental 2 (educated by a lecture and flash cards), and control group (not manipulated). After doing pretest in the 3 groups, investigators used 2 educational methods for experimental groups. Data regarding the knowledge and attitude of 3 groups were gathered after 14 days and data regarding practice were gathered after 2 months. Chi-square and 1-way ANOVA were used for data analysis. Before education, knowledge, attitude, and practice of the 3 groups were the same, but after education there were significant differences in mean scores of knowledge and attitude of 2 experimental groups as compared with the control group and also between the 2 experimental groups (P < .001). Education by lecture and flash cards was more effective than by pamphlets. In regard to Pap smear practice, there was a significant difference between the 2 experimental groups as compared with the control group (P = .001), but there was no significant difference between the 2 experimental groups. Therefore, educational methods were effective on knowledge, attitude, and practice of teachers regarding prevention of cervical cancer and education by lecture and flash cards was more effective than by pamphlets in increasing knowledge and inducing a positive attitude but the 2 educational methods had the same effect on practice of teachers.     

Singapore nursing students' perceptions and attitudes about spirituality and spiritual care in practice: a qualitative study

Purpose: This exploratory study investigated nursing students' perceptions and attitudes about spirituality and spiritual care in practice. Study Design: A qualitative interpretative approach was used to investigate the research question. Method: In-depth interviews were conducted with 16 final-year preregistration nursing students from 3 different educational institutions offering a degree or diploma program in Singapore. Data were analyzed using the Miles and Huberman's method of thematic analysis. Findings: Thematic analysis identified three themes: (a) students' perceptions of spirituality, (b) spiritual care, and (c) factors influencing spiritual care in practice. Conclusions: The study informed that though young, spirituality matters to the nursing students. Accordingly, nursing is perceived to play an integral role in spiritual care. Enabling factors need to be systematically addressed both in the education and practice arenas before the perennial issue of disconnect between development and implementation of spirituality in practice can be bridged.     

The educational preparation and professional activities of occupational therapists

The professional activities of five groups of occupational therapists with different educational backgrounds were compared to examine the influence of education on career characteristics. Analysis of covariance, using length of professional experience as the covariate, revealed statistically significant differences in the areas of education, administration and supervision, leadership, oral presentations, publications, and research but not in clinical practice, public relations, products development, or professional recognition. The greatest differences emerged between the bachelor's, postbaccalaureate certificate, and basic master's groups and the advanced master's and other master's groups, thus supporting the association between increased education and increased professional involvement. No differences were detected between the bachelor's, certificate, and basic master's groups or between the advanced and other master's groups. The least involvement in professional activities occurred in the certificate group although the participation level for all groups was low. Although the findings highlight the important role of education in increasing therapists' involvement in professional activities, educational interventions more subtle than manipulating the entry level for practice or proliferating occupational therapy graduate programs may be needed to create a cadre of occupational therapists committed to advancing the stature of occupational therapy.     

Evaluating educational preparation for a health education role in practice: the case of medication education

Current health care policy and practice contexts in the UK point to the importance of nurses' ability to make an effective contribution to educating patients about medication, as part of their role in health education and health promotion. Nurses' potential contribution to this important activity will inevitably be dependent on knowledge and skills acquired during preregistration and postregistration programmes of education. Against this backdrop, changes in pre and postregistration nurse education in the UK in the past decade highlight the importance and timeliness of evaluating the adequacy of educational preparation for a medication role. This paper reports on the findings from an evaluation of UK educational preparation for a medication education role in practice. A case study design was used to investigate current educational preparation at three education institutions. Multiple methods of data collection at each site involved focus group discussions with lecturers and practitioners, individual interviews with key personnel, nonparticipant observation of teaching sessions, postobservation interviews with students and curriculum analysis. Findings highlighted the importance of a number of dimensions of preparation for practice of such a role: the need for sufficient taught pharmacology; opportunities for application and integration of prerequisite knowledge and skills; the importance of practice-based learning; the need for an evidence-based curriculum, and the importance of clarifying outcomes and competencies required for a medication education role within pre and postregistration curricula. The paper concludes with a discussion and implications of the findings.     

An evaluation of an educational programme to prepare family health nurses

In 1998 the World Health Organisation (WHO) Europe proposed a new type of community based nurse called the family health nurse (FHN). Although it was initially envisaged that 18 European countries would take part in the development of the FHN role through parallel processes of education and implementation, Scotland has been significantly ahead of other countries in enacting this plan. A pilot project involving community nurses from four remote and rural regions of Scotland was conducted between 2001 and 2003. A Scottish University was commissioned to provide a degree-level course for registered nurses with a minimum of two years post-registration qualifying experience. This paper summarises the main findings and issues arising from an external research evaluation of this educational programme. The programme was found to differ substantially in focus and format from other specialist community nursing programmes available in Scotland. Moreover there were key differences from the curriculum proposed by WHO Europe, in that there was more grounding in North American family nursing models and less focus on management and leadership. This customized degree programme provides a precedent for other educational providers in the UK to reconsider their approach to specialist practice degree level education.     

Developing a tool to measure holistic practice: a missing dimension in outcomes measurement within complementary therapies

Despite the wide and continuing debate over the relevance of particular research methods to evaluate complementary therapies, less attention has been given to what outcome criteria and measures to use and/or whether these have a sufficient breadth in perspective. While complementary and alternative medicine researchers have paid heed to the importance of measuring the subjective experience of therapy users, they have left unmeasured the notion of holism, in particular, the measurement of the effect of the interaction between therapist and therapy user, and its underlying philosophy of health and healing. This paper reports on an exploratory, qualitative study aimed at developing a measure of holism and holistic practice. It draws out some key features requiring measurement and provides insight into the emerging measure. Further development work is needed before the measure can be used within research or routine practice.     

不同学历护理人员的岗位分布状况及人力资源管理

目的 探讨不同学历护理人员的岗位分布工作状况,为医院合理配置护理人员提供依据.方法 统计我院不同学历护理人员的业务技术、岗位分布情况,并通过问卷调查评价高学历护理人员.结果高学历护理人员居管理岗位者多于中等学历者;高学历护理人员科研论文撰写水平、教学优秀率高于中等学历者;问卷评价用人单位偏重高学历护理人员.结论高学历护理人员在临床、科研及教学有其明显优势,是医院护理人力资源的必然选择,而加强在职人员继续教育是有效改善护理队伍素质的重要手段.