Effects of an educational bereavement program on health care professionals' perceptions of perinatal loss

BACKGROUND: The purpose of this study was to examine the differences in health care professionals' perceptions of perinatal loss situations before and after an educational program on perinatal bereavement. METHOD: A quasi-experimental design was used in a pretest and posttest format. RESULTS: Scores were significantly higher (p = .000) on each of the posttest vignettes. Overall scores were lowest for the miscarriage pretest, whereas scores for the pretest vignettes for the stillbirth and neonatal loss were similar. A similar pattern occurred in the posttest vignette scores. CONCLUSION: Health care professionals' perceptions of the emotional care needs of families experiencing perinatal loss were significantly increased after an educational program. The miscarriage vignette had the largest change score and the lowest mean scores on the pretest and posttest, which indicates professionals do not view miscarriage as significant a loss as stillbirth and neonatal loss.     

Comparison of role conception and role deprivation in LPN-transition students and traditional ADN students in a specially designed associate program.

This study compared differences in role orientation and role deprivation between 41 LPN-transition students and 123 basic traditional associate degree nursing (ADN) students upon entry and exit to a specially designed ADN program. The Corwin Role Conception Scale was used to assess role conception and deprivation. Statistically significant differences were noted upon entry between LPN-transition students and traditional ADN students in professional and service role conceptions and in role deprivation, upon exit in professional role conception and role deprivation between LPN-transition and traditional ADN students, and in professional role conception within the LPN-transition students. No differences were found within traditional ADN students from entry to exit of the program.     

A spiritual education course to enhance nursing students’ spiritual competencies

The study aimed to determine the impact of an elective spiritual education course for nursing students on spiritual competencies. A convenience sample of nursing students (N = 92) was recruited from a baccalaureate school of nursing between February and July 2016. The intervention group (n = 45) was comprised of students enrolled in the elective spiritual education course which integrated non-Christian Eastern cultural beliefs; the control group was comprised of students not enrolled in the elective (n = 47). A quasi-experimental design examined pretest, posttest, and follow-up data from students' self-administered questionnaires. The intervention effect of the course was analyzed using generalized estimation equation. The results indicated posttest scores among nursing students in the intervention group were significantly better than the comparison group for spiritual health. Practicum stress and professional commitment were significantly better at follow-up. Spiritual care attitudes, caring behavior, and religious belief were significantly improved from pretest to posttest, and at follow-up for the intervention group compared with the control group. In conclusion, a spiritual education course should be considered as a regular course in the nursing curriculum, which could improve students’ spiritual competencies, individual spiritual growth, and the ability to care for patients.     

Immunization update: a community-based nursing education program

BACKGROUND: Nurses play key roles as advocates, educators, and researchers to eliminate barriers to access as well as educate the public on the importance of vaccines for children in the United States. METHOD: Fifty-four nurses attending a community-based immunization program completed a pretest questionnaire which included identification of related practice behaviors and general knowledge questions. Twenty-four responded to a similar posttest survey 6 months later. The investigators compared knowledge pretest and posttest scores with a t test. Behavioral changes were compared between the pretest and posttest group by analyzing the percentage of change between the time period. RESULTS: The mean score in the knowledge section increased significantly from a pretest mean of 52% to 75% during the posttest period (p < 005). Behavior change was not statistically significant because of the low number of posttest responses indicating actual immunization practices in the clinical setting. The investigators analyzed trends in practice by comparing percentages of responses. CONCLUSION: These findings suggest that a multifaceted, community-based nursing continuing education program including both local, ethnic community perspectives and information related to the latest standards of practice can impact knowledge levels and some practice behaviors.     

Continuing education outcomes related to pain management practice.

BACKGROUND: Nursing practice outcomes of continuing education need to be measured and reported as one indicator of the value of nursing continuing education. This article makes the case that knowledge gain, the traditional measure of continuing education effectiveness, is not necessarily sufficient to assess changes in nursing practice. METHOD: A pretest/posttest design was used to measure nursing practice outcomes of a continuing education program about pain management. A total of 50 attendees returned both the pretests and posttests and 68 attendees returned the follow-up evaluation. RESULTS: Ninety-four percent of the respondents had improved scores on the posttest. Ninety-one percent of the follow-up evaluation respondents stated they had an opportunity to use the new information and 98% stated the use of this information has improved patient care. CONCLUSION: This study found that a continuing education program triggered practice changes. The results of this study correlate with previous research that supports the need for practice outcome measurements.     

The effectiveness of feminist pedagogy in empowering a community of learners

The purpose of this study was to determine whether a pedagogy grounded in feminist ideals has the potential to empower students to make changes consistent with those ideals in their personal and professional lives. In Phase I, qualitative data were collected through e-mail questionnaires from students in two nursing schools, one in Canada and one in the United States. Findings were used to identify an appropriate tool to measure the empowering influence of feminist pedagogy. In Phase 2, a pretest-posttest design used Barrett's Power as Knowing Participation in Change Tool (PKPCT) to measure student empowerment. A clinical setting was added in a third baccalaureate nursing program. A total of 218 students participated in seven course offerings-four classroom and three clinical. One hundred one matched pairs were obtained, for an overall response rate of 46%. Repeated measures ANOVA revealed that overall empowerment scores, as measured by the PKPCT, and classroom empowerment (CE), as measured by the addition of a variable (i.e., the ability to contribute in class), increased significantly from pretest to posttest. Interaction between Sites 1 and 2 was also significant. Regression analysis indicated posttest CE scores added to pretest PKPCT and CE scores provided a strong model to predict overall empowerment scores, measured by the PKPCT at Time 2 (R2 = .703). Despite limitations related to loss of follow up and low response rates at one site, the results of this study supported both hypotheses: that empowerment would increase over the course of the class in which feminist pedagogical principles were used, and that classroom empowerment is likely to extend beyond the classroom to personal and work environments.     

A comparison of computer-based and instructor-led training for long-term care staff

Nursing facility administrators must find new and innovative ways to meet the training needs of their staff. The authors faced the challenge of teaching nursing facility staff about fire safety using computer-based training that had been adapted from a print-based/instructor-led (IL) program. This article discusses the effectiveness of the computer-based (CB) training as compared to the effectiveness of the traditional IL format. The CB and IL versions of a fire safety training program were presented to staff of a nursing facility. The 141 participants were randomly assigned to the CB, IL, or control groups. The control group completed a pretest and posttest, but received no training until the study was completed. Both the CB and IL groups significantly increased their knowledge scores from pretest to posttest and both significantly outperformed the control group. How the participants responded to the CB training was also important. Staff reported they enjoyed the CB training and had no difficulty using the computers. Computer-based training can be an effective alternative training technique for this population.     

Spinal cord injury computer-assisted instruction for medical students

OBJECTIVE: To determine if a computer-assisted instruction program would improve fourth-year medical students' knowledge base related to spinal cord injury, as determined by pretest and posttest scores. DESIGN: A multimedia computer-assisted instruction program was developed and offered on a volunteer basis to an entire class of fourth-year medical students (n = 168). Effectiveness of the instructional content was evaluated with pretests and posttests, and overall user satisfaction with the module was assessed with the courseware evaluation. RESULTS: The responses yielded 83 sets of completed pretest and posttest pairs and 80 sets of fully completed courseware evaluations. Mean posttest score was significantly higher than the mean pretest score (pretest, 6.65 +/- 1.44, vs. posttest, 7.36 +/- 1.38; df = 82, t = -4.74, P < 0.001). Courseware evaluations yielded positive ratings in all areas, including applicability and usability. CONCLUSIONS: The significantly increased posttest scores suggest that the students left the program with an expanded knowledge base in the content areas of spinal cord injury medicine covered in the computer-assisted instruction program.     

Evaluation of a simulation-based workshop on clinical performance for emergency physicians and nurses

BACKGROUND: Simulation-based medical education has been growing rapidly and becomes one of the most popular teaching methods for improving patient safety and patient care. The Simulation Subcommittee of the Hong Kong College of Emergency Medicine organized an educational program emphasizing the team training, clinical decision-making and communication skills. This study aimed to evaluate the attitude of the participants toward a new training program and the change in the knowledge on clinical performance in emergency physicians and nurses after attending the educational program.METHODS: A course evaluation form was filled in by the participants at the end of the workshop. An assessment of 20 multiple-choice questions with 5 options was administered to the participants before and after the 2-day simulation-based training workshop.RESULTS: A total of 72 doctors and nurses working in the Accident and Emergency Department were enrolled. The average pretest and posttest scores were 12 and 14.3 respectively. The percentage improvement in the mean score of the pretest and posttest was 11.5%. The Chi-square test showed signifi cant improvement in the pretest and posttest score grading(P=0.00). Paired t-test revealed signifi cant difference between the mean scores of the pretest and posttest(P=0.00).CONCLUSIONS: Participants had positive attitude toward this new training program. Significant improvement of the knowledge on clinical performance in healthcare professionals in the Accident and Emergency Department was observed after the participation in this simulation-based educational program.     

Socialization of R.N. to B.S.N.

The Nurse's Professional Orientation Scale and Schwirian's Six-Dimension Scale of Nursing Performance (Six-D Scale) were used in a five-year, longitudinal study of the professional socialization of the Registered Nurse/Bachelor of Nursing Science (RN/BSN) (n = 30) and generic baccalaureate students (n = 193) in a nursing program in the Southeast United States, Program exit socialization scores between RN/BSN and generic graduates were not significantly different. Using an ANCOVA, significantly higher socialization scores were found for the generic graduates. The scores for the RN/BSN graduates were significantly higher than the generic students at graduation on the teaching/collaboration, planning/evaluation and interpersonal communication subscales of the Six-D scale. When program entry Six-D subscales score were controlled, only the professional development subscale differentiated between RN/BSN and generic graduates. The program impact on the RN/BSN student/graduate as well as the means by which this process can be studied are questioned.     

The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial

AimThis study investigated the effect of flipped learning on first-year nursing students’ blood pressure knowledge levels and self-directed learning skills.BackgroundFlipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills.DesignThis study adopted a pretest-posttest open-label randomized controlled trial.MethodThe sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self-Directed Learning Skills Scale (SDLSS).ResultsThere was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009).ConclusionThe experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and “self-monitoring,” “motivation,” and “self-confidence” subscale scores than the pretest score.     

The affective outcomes of course work on computer technology in nursing.

At the University of Iowa, nursing students are introduced to computer technology as one unit in a course designed to explore nursing as a profession. A single group, pretest/posttest design was used to evaluate changes in attitudes associated with the course work. Relationships of attitudes scores and eight background variables were studied. Posttest attitudes scores were significantly higher than pretest scores. The attitudes scores were positively related to skills scores at a statistically significant level of .05, with no significant relationship between attitudes scores and knowledge base scores. Four of the eight background factors were related to the attitudes scores at a statistically significant level of .05.     

Effects of high-fidelity simulation on the critical thinking skills of baccalaureate nursing students: A causal-comparative research study

BackgroundCritical thinking has been identified as one of the standards for nursing school accreditation and a long-standing outcome of nursing education and nursing practice. High-fidelity simulation is one method currently used by nursing programs to increase critical thinking in nursing students. Despite these expectations, there is limited empirical evidence which compares the effects of simulation to other teaching strategies.ObjectivesThe purpose of this study was to examine whether statistically significant differences existed in mean critical thinking skill scores within groups (pretest to posttest) and between groups (simulation versus written case studies).DesignA quantitative causal-comparative methodology with a pretest/posttest design.SettingA private university in the midwestern United States which offers a four-year Bachelor of Science Nursing program.ParticipantsBaccalaureate junior nursing students (N = 69) were recruited from a convenience sample and divided into two groups which consisted of a simulation group (n = 36) and a written case studies comparison group (n = 33).MethodsThis research study consisted of a pretest, three weeks of being in either the simulation group or the written case studies group, and a posttest. The Health Science Reasoning Test (HSRT) was the instrument used for the pretest and posttest to measure critical thinking skills of all participants.ResultsA repeated measures mixed analysis of variance (ANOVA) indicated there was no statistically significant difference in participants' mean critical thinking scores within groups (pretest to posttest) or between groups (simulation versus written case studies).ConclusionsThe use of high-fidelity simulation as a teaching strategy versus written case studies to increase critical thinking skills of nursing students was not supported.     

Effect of a CVIS instructional program regarding therapeutic communication on student learning and anxiety

This quasi-experimental, pretest-posttest design study explored the effect of a computer video-interactive system (CVIS) instructional program regarding therapeutic communication on senior baccalaureate nursing students' learning and anxiety as they anticipated interaction with patients in psychiatric settings. The 75 subjects were randomly divided into two groups. Group I received a basic lecture and a supplementary CVIS instructional program on therapeutic communication, while Group II received the same lecture discussion on therapeutic communication and a videotape. Two hypotheses were tested, using analyses of covariance. Hypothesis I, that Group I would score significantly higher on a therapeutic communication posttest than would Group II, was supported (P less than .001). This finding validates previous observations that computer-video interaction programs do enhance learners' application of knowledge. Hypothesis II, that Group I would evidence significantly less state anxiety at posttest than would Group II, was not supported. Although there were no significant differences for state anxiety scores between the groups at either pretest or posttest, these scores remained higher than reported normative state anxiety scores. This finding suggests that anticipated interaction with psychiatric patients is an anxiety-inducing situation for nursing students.     

The effectiveness of a staff education program on the use of continuous EEG with patients in neuroscience intensive care units

Approximately a third of patients in neuroscience intensive care units (ICUs) experience subclinical seizures and, as a result, are at higher risk for poor outcomes. The use of continuous electroencephalography (cEEG) monitoring can help nurses detect seizure activity and initiate early prevention. Nurse competency in the use of cEEG is important to facilitate effective bedside monitoring. The objective of this study was to evaluate the effectiveness of a staff educational program aimed at improving the knowledge of nurses in the use of cEEG monitoring in adults. A quasi-experimental pretest/posttest 1-group design was utilized. Neuroscience ICU registered nurses, whose experience ranged from 2 months to 24 years, participated in the study. Participants completed a pretest on seizure knowledge and the use of cEEG monitoring. Participants received a 4-hour educational session on the use of cEEG monitoring. Immediately after the program and again 1 month later, they completed a posttest. Test scores improved significantly from pretest to the first posttest (t = -15.093, p < .001). Although there was a slight decline in the mean score from the posttest to the 1-month follow-up, posttest scores were significantly better than the pretest score (t = -12.42, df = 44, p < .001). Whereas years of experience correlated positively to the pretest score, after the intervention, no such correlation was evident. The results demonstrated that an educational program improved the competency of nurses in the use of cEEG with adult patients in a neuroscience ICU and that this knowledge was sustained over time. Further research is needed to demonstrate the effectiveness of this intervention in other settings.     

Environmental issues in patient care management: proxemics, personal space, and territoriality

Patient privacy issues play a significant role in healthcare policy. However, concern for patient privacy may not always carry over into patient care activities. An Association of Rehabilitation Nurses chapter research committee undertook a study to assess rehabilitation nurses' knowledge of proxemics, personal space, and territoriality and their application in rehabilitation nursing practice. The theoretical framework was Hall's 1966 theory of proxemics. A pretest-posttest design with a 1-hour educational intervention was used with a convenience sample of rehabilitation nurses (N = 43). The tests consisted of 12 multiple-choice questions and 1 open-ended question related to practice. Paired-samples t tests of pretest and posttest scores demonstrated improvement in posttest scores (p <.0005). Analyses of variance were conducted to determine whether there were any differences on the posttest scores when looking at education level, years of work experience, years of work experience in rehabilitation nursing, and certification. Higher education levels correlated with higher test scores (p < .005). Although findings are limited by sample size, results indicate that rehabilitation nurses are not familiar with the impact of proxemics. The nurses'application of these principles in the open-ended question indicates that a patient's personal space in a healthcare setting is determined by the nurse, not the patient. The implications that result from a call to action on these issues are discussed.     

A comparison of RN students in two types of baccalaureate completion programs

The purpose of this study was to compare perceptions of nursing programs and attitudes toward professional nursing behaviors in entering and exiting registered nurse students enrolled in generic and second step baccalaureate degree completion programs. The convenience sample of 233 registered nurse students was drawn from eight baccalaureate nursing programs in a metropolitan area. Data included a student profile, perceptions of program in which enrolled, a professional attitude scale, and demographics. Data were factor analyzed to cluster items into distinct empirical groups and then examined by analysis of variance using program type and entry/exit status as covariates. Factor analysis of program perception data delineated six principal factors. On two of the factors, overall nursing role attainment and communication ability, entering second step students held significantly higher expectations. However, responses of exiting students as to how well expectations had been met were similar between the two program types. Similar analysis of the professional attitude scale differentiated five factors. Results showed that among students entering both program types, second step entrants had significantly more professional attitudes (p less than .01). Differences between the exiting groups were not significant. This study suggests that professional attitude formation is not dependent upon type of baccalaureate completion program in which enrolled but may relate to type of prior nursing education.     

The effects of computer-based training on immediate and residual learning of nursing facility staff

Nursing facility administrators must find new and innovative ways to meet the training needs of their staff. In this article, researchers discuss the effectiveness of computer-based training compared with the traditional instructor-led format. The computer-based and instructor-led versions of a fire safety training program were presented to staff of nine nursing facilities. Participants (N = 1,294) were randomly assigned to the computer-based or instructor-led groups. Both groups significantly increased their scores from pretest to posttest. The computer-based group significantly outperformed the instructor-led group on the knowledge subtest at posttest. Participants reported that they enjoyed the computer-based training and had no difficulty using the computers. The researchers concluded that computer-based training can be an effective and efficient alternative training technique.     

Effect of a geriatric nurse education program on the knowledge, attitudes, and certification of hospital nurses

Although nurses are the primary care providers for hospitalized and vulnerable older adults living in the community, they are generally not prepared in geriatric care. This study examined the effect of a 21-hour nursing education program on nurses' knowledge and attitudes regarding care of older adults and the geriatric nursing certification of the participants. The program was offered to 92 nurses in three cohorts over a 1-year period. Participants completed pre- and posttest measures of geriatric knowledge and attitudes. Significant differences were found between pretest and posttest knowledge and attitudes. Program evaluation and success in achieving certification in gerontological nursing also indicated a positive effect of the program.