Hegemony of printed books in Australian tertiary education a concept under challenge

This paper is about challenges to the hegemony of printed books in Australian tertiary education and the potential demise of that hegemony. Not because the book in its traditional form is considered by some to be outdated and not because ofcompeting products that might put the use of the traditional book under threat - our Australian 'book-industry' might well rise to such challenges given that competitiveness is a driving feature of business. This paper is about challenges to the hegemony of printed books in tertiary education because of forces entirely outside the 'book-industry's' control.

The function of traditional printed books within tertiary education is changing. Education is a user-pays product, and competitive pressures ensure students are given greater voice in the types of learning resources provided, with the evolution of electronic and communication technologies allowing student learning resources to be made available in a myriad of ways. Thus a traditional printed book may be an inflexible tool in a dynamic environment.

'Moral distress'-time to abandon a flawed nursing construct?

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains.

Real time, perceived time and time online : a review of student experiences of time over thirty years of distance and online education

This paper examines how students use and perceive time when studying in distance education modes and what affects this perception of time and the reality of time. We examine 30 years of student involvement on distance and online education, their comments on both their learning experiences, and the technology requirements of distance education/online learning. Our University has been involved in distance education since its formation in 1974. The online technologies offer increasingly sophisticated and immersive experiences for our students, both on campus and off campus, but many of our students continue to complain of time squeeze, and fail to predict the time it will take them to complete our subjects. We research how the technologies we use for online learning are contributing to this time squeeze perception and the student's "real" time to learn.
Research is drawn from both the Australian Bureau of Statistics and surveys of our students' experiences (we have 32,000 students online, with single online classes of over 1300 students), to examine student use and perceptions of their available time to study and how the technologies used in online learning affect this.

Young children learning about evaporation: a longitudinal perspective

This paper traces the learning pathways over a 4-year period of 12 children learning about evaporation. The findings show the complexity and dependence on context of children's understandings. Detailed transcripts for 2 children are used to demonstrate how understandings of phenomena are framed within a network of personal narratives of self that reflect children's different subjectivities as learners and school children, It is argued that the longitudinal methodology opens up a more complex and nuanced view of children's conceptual learning in school settings than is afforded by cross-sectional studies and that the focus on individuals over time compels a very different construction of the learner than is represented in mainstream conceptual-change literature. [ABSTRACT FROM AUTHOR]

Undergraduate pre-registration nursing education in Australia: a longitudinal examination of enrolment and completion numbers with a focus on students from rural and remote campus locations

Introduction: There is much evidence to indicate a shortage of Registered Nurses (RNs) in Australia and to suggest that the shortage may be more pronounced in rural and remote locations. Attracting RNs to work in rural and remote areas may not be as simple as increasing the intake of students into university undergraduate pre-registration nursing courses. There is some evidence indicating that student nurses may be more likely to enter the nursing workforce in rural and remote locations if they have existing associations with rural and remote areas and/or their undergraduate education provides opportunities to undertake supported placements in rural and remote settings. Two important difficulties have been associated with measuring outcomes in relation to rural and remote pre-registration nursing students. One is defining what constitutes a rural or remote location and the other is suspect data on the number of nursing students enrolled in, and completing, nursing courses. The aims of this study were to provide a longitudinal profile of the number of domestic students studying and completing undergraduate pre-registration nursing courses in Australia, with a particular emphasis on identifying those at rural and remote university campuses, and to compare results across States and Territories.
Method: This study presents the combined findings from two investigative reports. Data on undergraduate pre-registration nursing student numbers were collected via electronic survey instruments completed by staff at all Australian educational institutions offering undergraduate pre-registration nursing education programs in 2001 and 2002. Australian domestic students were the focus of this study. Data included the total number of domestic students enrolled in undergraduate pre-registration nursing courses in 2001 and 2002, the number of domestic students who successfully completed courses in 1999, 2000 and 2001, and estimates for the number expected to complete in 2002. Surveys were sent to course coordinators or other staff nominated by heads of divisions of nursing at each institution.
Results: There was a 100% response rate. Twenty-four rural and remote campus locations were identified using an adjusted form of the Rural, Remote and Metropolitan Areas (RRMA) classification system. The Australian Capital Territory and the Northern Territory did not have any rural or remote campus locations. In contrast, undergraduate pre-registration nursing in Tasmania was offered at a rural campus only (for the first 2 years). From 2001 to 2002, there was an increase of just over 5% in the total number of domestic students enrolled in undergraduate pre-registration nursing courses in Australia (2002 total = 22 811 students). Rural and remote location students accounted for slightly more than 25% of these students in 2001, and almost 27% in 2002. The States Victoria, New South Wales and Queensland had the highest percentage of students enrolled at rural and remote campus locations, greater than the Australian average for both years. In contrast, South Australia and Western Australia had less than 11% of students enrolled at rural and remote campus locations for each year. Total undergraduate pre-registration course completions increased by approximately 16% across Australia between 1999 (n = 4868) and 2002 (n = 5667), although for 2002, the figure was projected. Of these total course completions, the percentage of students completing at rural and remote campus locations increased from almost 23% to nearly 28% during the same period. Of the States/Territories with both metropolitan and rural/remote campus locations, only Victoria and Queensland had more than 25% of their total student completions consisting of students enrolled at rural and remote campus locations for each year. In contrast, South Australia and Western Australia had approximately 6% of student completions consisting of students enrolled at rural and remote campus locations in 1999, increasing to approximately 12% projected for 2002.
Conclusion: In this study, the authors attempted to improve the accuracy of data collection in relation to the number of domestic undergraduate pre-registration nursing students in Australia, which is representative of the potentially new Australian domestic RN workforce. There was a trend towards an increasing number of students being enrolled in undergraduate pre-registration nursing courses, and also toward an increasing number of course completions. From the perspective of the rural and remote RN workforce, the percentage of students enrolled and completing courses at rural and remote campus locations was found to be increasing. However, there may be some areas of concern for education and workforce planners in States and Territories that are providing a smaller percentage of their undergraduate pre-registration nursing courses in rural and remote areas. Several study limitations are discussed and suggestions made for future research.

Design, format, validity and reliability of mutiple choice questions for use in nursing research and education

Multiple choice questions are used extensively in nursing research and education and play a fundamental role in the design of research studies or educational programs. Despite their widespread use, there is a lack of evidence-based guidelines relating to design and use of multiple choice questions. Little is written about their format, structure, validity and reliability of in the context of nursing research and/or education and most of the current literature in this area is based on opinion or consensus. Systematic multiple choice question design and use of valid and reliable multiple choice questions are vital if the results of research or educational testing are to be considered valid. Content and face validity schould be established by expert panel review and construct validity should be established using ‘key check’, item discrimination and item difficulty analyses. Reliability measures include internal consistency and equivalence. Internal consistency should be established by determination of internal consistency using reliability coefficients while equivalence should be established using alternate form correlation. This paper reviews literature related to the use of multiple choice questions, current design recommendations and processes to establish reliability and validity, and discusses implications for their use in nursing research and education.

Making decisions: nursing practices in critical care

This article reports the types and complexity level of decisions made in everyday clinical practice by critical care nurses. It also reports factors that influence the complexity of those decisions. A combination of methods were chosen for the two phase study. In the first phase, 12 qualified critical care nurses documented decisions (over a 2 hour period) on a clinical decision recording form designed by the researcher. In the second phase, participants attended a semi-structured focus group.

From the analysis, five types of decisions were identified; assessment, intervention, organisation, communication and education. In addition to these documented decisions, three factors that influenced decision complexity were identified from a thematic analysis of the transcribed interviews; communication, patient related and properties of the decision. Nurses reported that communication decisions were the most difficult to make. However, the concept of nurses knowing the patient reduced the level of decision complexity. It is suggested that this has important implications for decision making practices of nurses working in the area of critical care and potentially for patient outcomes.

The diversity of critical care nursing education in Australian universities

A range of critical care nursing educational courses exist throughout Australia. These courses vary in level of award, integration of clinical and academic competence and desired educational outcomes; this variability potentially leads to confuson by stakeholders regarding educational and clinical outcomes. The study objective was to describe the range of critical care nursing courses in Australia. Following institutional ethics approval, all relevant higher education providers (n=18) were invited to complete a questionnaire about course structure, content and nomenclature. Information about desired professional and general graduate characteristics and clinical competency was also sought.

A total of 89% of providers (n=16) responded to the questionnaire. There was little consistency in course structure in regard to the proportion of each programme devoted to core, speciality or generic subjects. In general, graduate certificate courses concentrated on core aspects of critical care, graduate diploma courses provided similar amounts of critical care core and speciality content, while master's level courses concentrated on generic nursing issues. The majority of courses had employment requirements, although only a small proportion specified the minimum level of critical care unit required for clinical experience. The competency standards developed by the Australian College of Critical Care Nurses (ACCCN) were used by 83% of providers, albeit in an adapted form, to assess competency. However, only 60% of programmes used personnel with a combined clinical and educational role to assess such competence.

In conclusion, stakeholders should not assume consistency in educational and clinical outcomes from critical care nursing education programmes, despite similar nomenclature or level of programme. However, consistency in the framework for speciality nurse education has the potential to prove beneficial for all stakeholders.

Nursing education and graduates : profiles for 1999 and 2000, with projections for 2001

An analysis of DEST statistical data on nursing education had suggested that there were issues with the classification of undergraduate data and new initiatives, such as combined degrees, which were poorly captured. This project had two distinct aims. First, to explore and map exhaustively the range of undergraduate programs offered by tertiary education providers across Australia leading to an initial qualification and entry into nursing practice. Second, to explore and map in detail specialist nursing education courses offered by tertiary and other education providers across Australia. This research was funded under the Evaluations and Investigations Programme (EIP).

Nursing education and graduates in Victoria : profiles for 2000, 2001, and 2002 with projections for 2003

This project is the second of two projects commissioned by the Nurse Policy Branch, Victorian Department of Human Services (VDHS). The project investigated nursing education at the undergraduate and postgraduate levels in the university sector and in the VET sector. The data gathered from the project provided VDHS with a better understanding of nurse labour force issues.

Clinical education : a challenging component of undergraduate nursing education

Clinical education is an essential part of every undergraduate nursing curriculum. The main benefits are that it allows students to put theory into practice and experience the realities of the practice- based nursing profession. Limitations include the unstable nature of the clinical area as a learning environment and the challenges this produces with students' assessments. This article reviews the literature and concludes there is room for significant improvement in the area of clinical education and numerous strategies can be implemented to do so.

The tri-focal model of care : Advancing the teaching-nursing home concept

Providing residential aged care is challenging because of the complexity of residents' health status, difficulties recruiting and retaining skilled staff, and financial and regulatory constraints. This paper discusses some of these challenges and describes an innovative model of care, termed 'The Tri-focal model of care'. This model was developed based on the concepts of 'partnership-centred care', 'positive work environment' and the need for evidence-based practice to underpin all aspects of care. It is envisaged that the implementation of this model will provide a rich learning environment that advances the teaching-nursing home concept and the quality of residential aged care.

Securing the oral tradition : reflective positioning and professional conversations in midwifery education

We postulate that positioning is a powerful tool in guiding and transforming student professional learning and practice development. In our experiences with students enrolled in he Graduate Diploma of Midwifery, we determined that positioning elaborates individual scholarship and identity formation of the learner midwife in practice settings. Positioning Theory, developed by Harré and other authorities, is a psycho-sociological 'ontology' or concept of how individuals metaphorically position or locate themselves, and others, within institutions and societies. Three key components of positioning theory include 'position', 'speech act' and 'storylines', developing from the everyday social interactions of professional conversations. Reflective positioning can be applied as an analytical tool for the moment-to- moment exchanges inherent in practice related conversations, occurring between midwives and midwifery students. These moment-to-moment interactions of professional conversations can be used by students to complete or fill their learning gaps. Positioning therefore, provides a novel, contemporary theoretical framework to 'unpack' or understand the complexity of midwifery practice and yet is complementary with reflective practice. Excerpts are used to demonstrate reflective positioning applications by students. Midwives are encouraged by health services and by the University to provide student support through a 'preceptorship' program to supervise, work with and assess students for competence in midwifery practices. We claim that reflective positioning by students within professional conversations with their preceptor/midwives, are the construction sites for learning and where identity formation of each student as a future midwife is both shaped and transformed. Both academics and managers of health services need to embrace the value of workplace conversations, the sites of rich oral traditions of nursing and midwifery. Thus, in seeking claim to our rich oral traditions, all students will benefit from engagement in reflective positioning to promote their professional learning and practice development.