Band 3, Heft 1

The benefits obtained from properly managed clinical preceptorships cannot be underestimated. Nursing students benefit from clinical preceptors who exemplify the application of theoretical knowledge in actual clinical settings. Preceptorships, and the use of preceptors, remain a viable and important adjunct for faculty in US schools of nursing. This article reports on a portion of a study of undergraduate baccalaureate nursing programs and the use, selection, and evaluation of clinical preceptors. The results suggest that the design of most preceptorship programs does not consistently secure the use of qualified clinical preceptors. Today's clinical preceptors need to be more carefully selected, oriented, and evaluated to ensure quality education of nursing students. Benefits can be realized not only in nursing education, but also in nursing practice, patient care, and nursing administration. More research needs to be done in the area of clinical preceptorships and more specifically, selection and evaluation methods.

Many new faculty are being hired to fill the ever-increasing vacancies created by the attrition of current faculty members. To meet the diverse demands of today's educational climate, new faculty must develop an understanding of a variety of learning environments and skill in traditional and contemporary teaching strategies. This article presents storytelling as one strategy for educating potential new faculty in online instruction in an undergraduate nursing research course.

This study examined how nurses' personal and professional characteristics influenced their response to an educational intervention to improve their cultural knowledge and cultural competence. A one-group repeated measures design was used to evaluate the effectiveness of the intervention, which 76 public health nurses (PHNs) attended. Regression analysis showed that nurses with fewer years of nursing experience and higher level of education had a weak association with increased cultural knowledge and cultural competence but learning style and age were not associated with the outcomes.

Readings from two novels, Sandra Cisneros' The House on Mango Street and Toni Morrison's The Bluest Eye, were included in maternal-child clinical courses as part of a pilot project to identify potentially effective strategies for increasing student cultural sensitivity and reflective thinking skills. The authors analyzed student journals to determine student values and beliefs during maternal-child clinical experiences. The study sample consisted of 40 young women enrolled in a baccalaureate nursing program in a private, liberal arts university. These young women consistently interpreted `the other' in their own image. They responded most strongly to themes of belonging, including the struggles of immigrants to `fit in,' the ways of being acceptable and valued in U.S. society, and the process through which students as nurses learn to accept and care for others who are different.

Nurses work in complex health care systems, which today are based not only on medical treatment and cure, but also on enabling individuals and strengthening communities. This paper describes a curriculum approach to teaching nursing in an Australian university which seeks to prepare students for this environment. Underpinned by transformative education principles, and termed Solution Focused Nursing, specific teaching and learning strategies are discussed. A goal is to cultivate critical thinkers and knowledge workers, that is, nurses who are not only able to work skillfully, strategically, and respectfully with clients, but who also demonstrate discernment, optimism, and vision about nursing and health care.

A major component of the educative process in the professional disciplines is the field education/preceptorship experience in which students are afforded opportunities to develop professional competence under the tutelage of a practising professional and/or a university instructor. During this time students are exposed to competing discourses about what it means to think and act as nurses, teachers, doctors and social workers. Frequently, field teaching is characterized by conflictual situations involving students, field instructors and university faculty. Such conflict is poorly understood as indicated by the lack of literature available in the professional disciplines. The purpose of this study was to explore the phenomenon of conflict within the context of field teaching in professional education. Pivotal to this study was the issue of making sense of the conflict that prospective nurses, teachers, social workers and doctors experience in professional education within the practice realm and how such discourses shape their professional identities, practices and ultimate social values. At issue is the social construction of meaning that takes place within professional education. This study was conducted from the perspective of four professional programs including education, medicine, nursing and social work. The researchers focused on the final year of each program at a time when students were engaged in a major field / preceptorship experience in hospitals, schools, communities and social agencies. The experiences derived from the nursing data are presented in this paper.

The school of nursing faculty at a liberal arts university created an innovative group-mentoring course to support students' progression through the undergraduate nursing program. The foundation of the mentoring program is the dynamic relationship between novice and expert.Students are enrolled in this one-hour course for each of their four semesters in the upper division nursing curriculum. Group membership (faculty and students) is consistent throughout this time. The mentoring course requires faculty to lead a process-oriented group. Faculty are confident in teaching courses that are content-driven but have struggled with the unstructured nature of facilitating a process-oriented group. Therefore, the role of group mentor has been identified by faculty as very challenging.The purpose of this study was to explore faculty members' perceptions of assuming the role of a group mentor. Eight subjects participated in audio-taped interviews guided by open-ended questions. Four themes emerged including uncertainty, evolution, mutuality, and milieu.

This paper presents the research conducted in 2003 by the Nursing Division of the Israeli Ministry of Health regarding the level of and predictors of pain knowledge and attitudes of Israeli nursing students and certifying nurses, in the context of the Division's educational policy. Cross-sectional descriptive in design, the research included first and fourth year baccalaureate students and nurses beginning and completing certification programs (N= 1149).Knowledge and attitudes, educational level, experience and success in pain care were examined via a questionnaire based on the McCaffery and Ferrell and Riddell and Fitche tools. Student's t-test, Pearson correlations and ANOVA were used for data analysis.Educational level was the strongest predictor of knowledge and attitudes among nursing students and certifying nurses, contributing most of the 42.8% explained variance. Small significant contributions were made by other variables. This indicates that formal education is a good vehicle for enhancing knowledge and attitudes.

The purpose of this study was to describe the development and psychometric evaluation of the Eldercare Cultural Self-Efficacy Scale (ECSES). Bandura's Theory of Self-Efficacy provided the theoretical framework. The sample consisted of students (N=248) from seven schools of nursing in a northeast state. The psychometric evaluation included: item analysis, principal factor analysis (PFA) with orthogonal rotation, and internal consistency reliability using Cronbach's alpha. Descriptive statistics were used to determine levels of eldercare cultural self-efficacy among the sample. The PFA revealed a four factor structure (Assessing for Lifestyle and Social Patterns, Determining Cultural Health Practices, Determining Cultural Beliefs, and Dealing with Grief and the Losses Associated with Aging) that accounted for 61% of explained variance. The subscales alpha coefficients ranged from .82 to .95. Findings demonstrate the 28 item scale to be a reliable and valid instrument for use in nursing education to examine students' confidence in caring for ethnically diverse elders.

In this manuscript procedures for selecting and applying taxonomies using nursing-related examples are described. Bloom's taxonomy and Gagne's instructional theory are compared. The author concludes that both taxonomies have much in common and are appropriate for use in nursing education.

Nursing education recognizes the need for a framework of experiential learning that supports the development of professional roles. Action methods, originated by Jacob L. Moreno (1953), can be readily adapted to any nursing classroom to create the conditions under which students learn and practice professional nursing roles. While nurse faculty can learn to use action methods, they may not fully comprehend their theoretical underpinnings or may believe they are only used in therapy. This article explores Moreno’s ideas related to psychodrama and sociodrama applied in classroom settings, and presents many examples and tips for classroom teachers who wish to incorporate action methods into their classes.

A project planning group consisting of college and university representatives from a collaborative undergraduate nursing program developed an inclusive, process-oriented faculty development initiative to enhance the integration of clinical guidelines in clinical courses. In the first phase, results of a needs assessment were used to inform the development of a six-hour workshop for the third year clinical faculty in acute care, mental health, and community health. Pre-post surveys were conducted with students and clinical faculty during the first phase. Results from the workshop and surveys were used to develop a four-hour workshop for clinical faculty in all years of the program. The relatively short workshop process shows promise for initiating integration of clinical guidelines in undergraduate nursing education.

Nursing is at the cusp of a truly revolutionary time in its history with the emergence of electronic health (eHealth) technologies to support client care. However, technology itself will not transform healthcare without skilled practitioners who have the informatics background to practice in this new paradigm of client care. Nurse educators have been slow to react to the matter of the necessary knowledge, skills, and practice competencies required for nurses to function as eHealth practitioners. Specifically, undergraduate nursing education must take a proactive stance towards curriculum development in the areas of eHealth and informatics. The purpose of this paper, therefore, is to propose recommendations about the review and redesign of nursing curricula in relation to nursing informatics. Recommendations include increased information literacy education, interdisciplinary collaboration, and client-centred technologies. Recommendations for faculty development in nursing informatics are also provided.

Role theory was utilized in this descriptive study to investigate clinical faculty in baccalaureate nursing programs. The Clinical Faculty Role Questionnaire was developed and employed to study 134 full-time and part-time clinical faculty members. Theory derivation was used and the concept of role engagement was empirically supported. Pearson's correlation analysis was used to investigate the relationships among the variables. T-test results identified differences between full-time and part-time faculty members on role variables of status, role conception, and role engagement. The relationships between study concepts and areas of educational content related to the teaching role were explored and identified as supportive of the clinical educator role. Ancillary qualitative investigation resulted in the identification of several themes: the need for clinical competence; for part-time faculty, a desire to be included in program planning.

Delegation, an important concept for nursing students to learn and practice, is central to registered nurse (RN) performance, and important on the NCLEX-RN examination. Nursing faculty members from an ADN program designed a descriptive study to evaluate planned versus actual delegation in the curriculum, and a second study to evaluate an intervention on delegation.Study One assessed the presence of delegation in each nursing course. Statistical analysis compared the planned implementation with the results for student definitions of delegation, and identification of the five rights of delegation based on the National Council of State Boards of Nursing (NCSBN) definition and five rights. Study one results are shared.Study Two utilized a comparison of pre-to-post intervention measures. Students were asked to complete eight steps of a delegation exercise and determine what could be delegated to an unlicensed assistant, and what should be completed by the RN. Answers were coded and entered into SPSS. Statistical analysis compared each student's ability to correctly identify the five rights of delegation prior to the exercise, against the ability to correctly answer five questions two weeks post exercise. Significant improvement (p< 0.05) occurred on each measure. Recommendations are discussed.

Findings of a study of the impact of professional learning on Malaysian registered nurses are reported. The offshore delivery post-registration nursing degree programme is a formal aspect of professional learning, which enables Malaysian registered nurses to upgrade their hospital-based training or diploma of nursing qualification to a degree. Using a qualitative case study approach, data were collected from twelve programme graduates, through individual and focus group interviews. The programme promoted their personal professional growth and enhanced their professional development. It increased self-confidence, knowledge, self-fulfillment, critical thinking ability, interpersonal skills, interest in research and research utilisation, and life-long learning. There was evidence of career mobility and a raised awareness of their professional role and responsibility.

Nursing educators need to continue to explore ways that new pedagogies such as narrative pedagogy and reflective practice inform and extend students' thinking in classroom and clinical situations. The goal of instruction becomes creating an opportunity for learning that integrates content knowledge with knowledge of the context. Educational methodologies that incorporate the use of context in a reflective, dialogical approach over time hold much promise in developing a dynamic process of thinking in practice. Contextual learning is a reflective learning intervention that offers new possibilities for nurse educators to prepare nurses to think critically in practice. In this expository paper the design and instructional methodology of contextual learning is discussed, beginning with a brief overview of the nature of critical thinking and the use of narrative as major underpinnings in the development of this intervention. Examples of how the intervention was implemented with novice nurses in practice is provided. Finally, reflections on how the intervention could be refined for nursing students is offered.

There is an increased momentum to improve nurses' expertise in dealing with end of life issues via a standardized education program, ELNEC. This program has not been evaluated systematically. This quasi-experimental, longitudinal study's goal was to measure ELNEC Program's impact on registered nurses' death anxiety, death attitudes, and knowledge over time. General Systems Theory provided the foundation. Nurses completed surveys prior to and 3 times after the program. Research and control groups were similar. Research group's death anxiety scores increased immediately post- program, decreased 6 months later (t=-2.65, p=.02) and returned to pre-program levels at 12 months. Death attitudes varied. Knowledge levels improved significantly. The control group had steady increases in death anxiety scores. The program was associated with decreased death anxiety. Recommendations include timing evaluations after participants have time for reflection and planning "booster programs" to sustain effects. Future studies should include larger samples, incentives, and research method triangulation.

Hispanic/Latinos are the fastest growing minority group in the U.S. and the most underrepresented in the U.S. nursing workforce. Although a body of knowledge is growing regarding factors that foster academic success of undergraduate nursing students of color, there is limited information about Hispanic students in general, and Mexican American students in particular in BSN programs. Explored in this qualitative study, were perceived influences of institutional and interpersonal factors on retention and graduation of nine Mexican American students from a predominantly White BSN program. The key findings include adequate financial assistance, maintaining bicultural relations, and experiencing authentic caring relationships from institutional agents, family, and peers as crucial factors in academic success. Recommendations for nursing faculty and administrators are offered.

The "Collaborative Approach to Nursing Care" (CAN-Care) Model of practice-based education is designed to meet the unique learning needs of the accelerated nursing program student. The model is based on a synergistic partnership between the academic and service settings, the vision of which is to create an innovative practice-based learning model, resulting in a positive experience for both the student and unit-based nurse. Thus, the objectives of quality outcomes for both the college and Health Care Organization are fulfilled. Specifically, the goal is the education of nurses ready to meet the challenges of caring for persons in the complex health care environment of the 21st century.

The purpose of this study was to examine the effect of parent-child interaction on self-esteem as mediated by emotional support and self-perception among undergraduate nursing students in Thailand. This study recruited 307 Thai baccalaureate nursing students who completed the Rosenberg Self-Esteem Scale, Ross Parent-Child Interaction Questionnaire, Emotional Support instrument, and Self-Perception questionnaire. Results revealed that the students reported relatively high self-esteem. A path model demonstrated the positive effect of parent-child interaction on emotional support and self-perception, and the positive effects of emotional support and self-perception on self-esteem. Self esteem was powerfully predicted from emotional support and moderately predicted from self-perception. These variables account for 37% of the variance in self esteem.

Nursing students historically have struggled to learn a large amount of content in a short period of time. Reliance on intense memorization of endless facts from multiple textbook chapters is ineffective, exhausting, and generally does not result in knowledge retention. Nursing educators face the challenge of facilitating learning that promotes critical thinking through the use of strategies that actively engage the students. Creating an environment of learning where students come prepared to class and use the textbook material to enhance understanding and knowledge acquisition is imperative. This article presents active learning strategies that are flexible for varying class sizes, time availability, and topics. Classroom assessment techniques support the value of this teaching-learning approach.

Worldwide, at least two million people die annually from tuberculosis (TB), with projections of 36 million more global deaths between the years 2003 and 2020. To help nursing faculty strengthen TB curricula and standardize TB content in national and international undergraduate nursing programs, the Nurse Discipline Group of the National Tuberculosis Curriculum Consortium (NTCC) has developed comprehensive TB core competencies and specific student objectives for the classroom setting. These core competencies address the knowledge, ability, and/or skills required for an undergraduate nursing student to provide qualified holistic care for patients, families, and communities impacted by TB. The NTCC is comprised of a team of multidisciplinary health care educators in the United States, with the primary mission to instill knowledge, skills, and appropriate attitudes in the management of active and latent TB among undergraduate health care students.

There is an unprecedented shortage of registered nurses (RNs) in the United States of America. Efforts to educate more RNs have been limited by a shortage of both clinical placements and preceptors for nursing students. The purpose of this study was to examine nursing education issues associated with student clinical placement as experienced by hospital personnel who coordinate the placements with various schools of nursing. A qualitative study involving 15 state-wide participants directly associated with clinical placement of nursing students was conducted. Emergent themes from the data included lack of consistent terminology and definition of student and preceptor roles, preference of clinical scholars, process of site placements, rewards for supervision of students, dis-satisfiers to the supervision of students and suggested strategies for change. Recommendations which developed from the research are summarized and discussed.

Values are core to the practice of nursing, determining priorities in healthcare and forming the foundation of relationships with clients. Specific values have been recognized as essential to professional nursing practice and are considered central content within a baccalaureate nursing program. While these professional values are identified and defined, there is little guidance in nursing pedagogical literature as to teaching approaches, range and depth of content, and evaluative methods in this area. Clear discussion of an effective educational approach to professional values would be a significant contribution to the discipline of nursing.The paper expands on the brief summary of the five professional values identified by AACN as essential to professional nursing practice. It is easy to understand these values on a superficial level, but these values have many layers and are very difficult to live out in nursing practice. The discussion moves beyond definition and gives specific examples to lend clarity and depth to the topic. The discussion includes common areas in which students have difficulty, noting the inherent challenges for each of the values.

This paper highlights findings from a literature search to examine the role of nursing education in preparing nurses to meet healthcare demands. The review focused on nursing students’ perceptions of nursing and whether these views change during their nursing studies and impact workplace preferences. Nursing students often enter their program with preconceived ideas of where they want to work following graduation. Large urban hospitals were favored over community care because of the perceived opportunities for support. Of particular importance were the negative views relating to care of elderly patients. Unless attitudes are changed during their nursing studies, they may affect initial job selection. Implications for nursing education include provision of educational experiences that foster an optimistic career outlook in areas where there is a growing need for nursing services. More research is needed to determine how to enable appropriate learning experiences when there are limited resources and practice placements.

Today, the complexities in the health care system are challenging nurses to be skillful and knowledgeable critical thinkers and decision makers. To adequately prepare future nurses to meet the challenges, nurse educators must nurture and facilitate critical thinking. One strategy believed to promote critical thinking in nursing education is concept maps. The purpose of this pilot study was to determine the level of critical thinking in the clinical concept maps developed by second year baccalaureate nursing students. Students enrolled in a five-week clinical practicum course were asked to submit their final concept map and participate in a focus group. The data for the study included eighteen concept maps, 1 student focus group and 1 instructor focus group. The Holistic Critical Thinking Scoring Rubric (Facione & Facione, 1994) was used to measure levels of critical thinking, and content analysis was used to analyze focus group data. Results from this study indicated that developing concept maps in the clinical setting fostered critical thinking and improved clinical preparedness.

Constructivist and adult learning theory provided the theoretical framework for reusable learning units (RLUs) developed for a Southeastern University's family nurse-practitioner and nurse-midwifery distance educational programs. Reusable learning units are an organized series of learning events that satisfy one or more interrelated learning objectives that cannot be broken down to component parts without losing semantic and pragmatic meaning. This paper describes the conceptual framework, background and history of RLUs, and collaborative efforts for development and implementation.