Factors that motivate RNs to return to school for the BSN and to remain in school to complete the degree

This exploratory descriptive study examined the factors that influence Registered Nurses (RNs) to return to school to pursue a Baccalaureate of Science in Nursing degree (BSN) and the factors that contribute to the decision to remain in school to complete the degree. Students (N = 226) enrolled in RN-BSN programs in three different universities in southeast Florida participated in the study by completing researcher developed questionnaires. The study group included 140 students who were newly enrolled in an RN-BSN program and 86 students who were preparing to graduate from an RN-BSN program. The instruments used in this study were two researcher developed questionnaires, the Corbett Nursing Educational Motivational Inventory - Form A (CNEMI-A), administered to the newly enrolled students, and the Corbett Nursing Educational Motivational Inventory - Form B (CNEMI-B), administered to the graduating students. The questionnaires included researcher-developed items in addition to items derived from a modified form of the Educational Participation Scale used by other researchers. Demographic data were also collected. Findings indicated that changes in health care, career goals, personal satisfaction, and flexible curriculum patterns are the major reasons why RNs return to school for the BSN. Less significant factors were social support, salary increase, and employer expectations. The factors considered most significant in the decision to remain in school to complete the degree were ranked in the following order: personal achievement, changes in health care, career change/advancement, enrollment options, faculty support, social support, and employer support. Implications for nurse educators related to the changing roles of RNs and the need to continue to assist RNs to adapt to new roles in health care. Recommendations for future research on RN-BSN nursing education included studies to identify the courses considered most useful by RN-BSN students as compared to courses considered repetitive of basic nursing programs. Studies were also recommended to examine the differences between the needs of RNs related to experience as an RN and recency of education. Additional studies were recommended to determine the feasibility of dual-enrollment ADN/BSN programs for last semester ADN students. ^

A systems model for community injury prevention

The purpose of this study was to develop, explicate, and validate a comprehensive model in order to more effectively assess community injury prevention needs, plan and target efforts, identify potential interventions, and provide a framework for an outcome-based evaluation of the effectiveness of interventions. A systems model approach was developed to conceptualize the major components of inputs, efforts, outcomes and feedback within a community setting. Profiling of multiple data sources demonstrated a community feedback mechanism that increased awareness of priority issues and elicited support from traditional as well as non-traditional injury prevention partners. Injury countermeasures including education, enforcement, engineering, and economic incentives were presented for their potential synergistic effect impacting on knowledge, attitudes, or behaviors of a targeted population. Levels of outcome data were classified into ultimate, intermediate and immediate indicators to assist with determining the effectiveness of intervention efforts. A collaboration between business and health care was successful in achieving data access and use of an emergency department level of injury data for monitoring of the impact of community interventions. Evaluation of injury events and preventive efforts within the context of a dynamic community systems environment was applied to a study community with examples detailing actual profiling and trending of injuries. The resulting model of community injury prevention was validated using a community focus group, community injury prevention coordinators, and injury prevention national experts. ^

A study of state and trait anxiety and perceived causes of anxiety identified by licensed practical nurses returning to an associate degree nursing program

The purpose of this study was to identify the state and trait anxiety and the perceived causes of anxiety in licensed practical nurses (LPNs) returning to an associate degree nursing program in order to become registered nurses (RNs). The subjects for this study were 98 students enrolled in a transitional LPN/RN associate degree nursing program in two community colleges in the state of Florida. The State-Trait Anxiety Inventory (STAI) developed by Spielberger (1983), was used as the measuring instrument for this study.^ In addition, a Q-sort technique was used to obtain information from the subjects regarding perceived causes of anxiety. Anxiety causes for the Q-sort cards used in the study were developed from the themes identified by a sample of LPN/RN students in a pilot study. The state and trait anxiety levels were obtained using the STAI for college students scoring key and scales. Descriptive statistics were used to determine the state and trait anxiety of the students. Correlational statistics were used to determine if relationships existed between the state and trait anxiety levels and perceived causes of anxiety identified by LPN students returning to an associate degree nursing program.^ The analysis of the Q-sort was performed by computing the means, standard deviations, and frequencies of each cause. The mean trait anxiety level of the students was 57.56, $SD=29.69.$ The mean state anxiety level of the students was 68.21, $SD=25.78.$ Higher percentile scores of trait anxiety were associated with higher ranks of the Q-sort category, "failing out of the program," $\rm r\sb{s}=.27,\ p=.008.$ Implications for future nursing research and application of the findings to nursing education are presented. ^

A study of the effects of a service-learning experience on student success at an urban community college

The purpose of this study was to explore the effects of a service-learning experience on student success as measured by class attendance, course completion, final course grades, and end-of-term evaluation data.^ Though many outcomes of service-learning experiences have been studied, including ethical values, self-esteem, student personal development, and career preparation, relatively few studies have been conducted on the effects of such experiences on academic achievement, and the studies that have been done have primarily studied students at traditional, four-year, residential universities.^ The study consisted of 286 students enrolled in six paired courses taught by five instructors at a community college in the Fall term 1996. One section of each pair (the control group) was taught using traditional subject matter and course materials and the other section of each pair (the treatment group) participated in a 20-hour required service-learning activity in addition to the regular course curriculum. The courses in the study included American History, Sociology, College Preparatory English, and Introduction to English Composition.^ The results of this study indicate that, overall, students who participated in a class in which service-learning was a requirement, achieved higher final course grades and reported greater satisfaction with the course, the instructor, the reading assignments, and the grading system, and the treatment section of one course pair had fewer absences. In addition, the faculty members reported that, in the treatment sections, class discussions were more stimulating, the sections seemed more vital in terms of student involvement, the students seemed more challenged academically, more motivated to learn, and seemed to exert more effort in the course. ^

A qualitative analysis of the lived experience of nursing staff developers in the process of changing to a new educational model

The purpose of this study was to document and critically analyze the lived experience of selected nursing staff developers in the process of moving toward a new model for hospital nursing education. Eleven respondents were drawn from a nation-wide population of about two hundred individuals involved in nursing staff development. These subjects were responsible for the implementation of the Performance Based Development System (PBDS) in their institutions.^ A purposive, criterion-based sampling technique was used with respondents being selected according to size of hospital, primary responsibility for orchestration of the change, influence over budgetary factors and managerial responsibility for PBDS. Data were gathered by the researcher through both in-person and telephone interviews. A semi-structured interview guide, designed by the researcher was used, and respondents were encouraged to amplify on their recollections as desired. Audiotapes were transcribed and resulting computer files were analyzed using the program "Martin". Answers to interview questions were compiled and reported across cases. The data was then reviewed a second time and interpreted for emerging themes and patterns.^ Two types of verification were used in the study. Internal verification was done through interview transcript review and feedback by respondents. External verification was done through review and feedback on data analysis by readers who were experienced in management of staff development departments.^ All respondents were female, so Gilligan's concept of the "ethic of care" was examined as a decision making strategy. Three levels of caring which influenced decision making were found. They were caring: (a) for the organization, (b) for the employee, and (c) for the patient. The four existentials of the lived experience, relationality, corporeality, temporality and spatiality were also examined to reveal the everydayness of making change. ^

A qualitative study of the impact of an educational intervention on older parents of adults with disabilities engaged in the phenomenon of future-care planning

This phenomenological study describes the impact of an educational intervention on the day-to-day experiences of older parent caregivers of adults with developmental disabilities who were engaged in the process of future-care planning. Qualitative strategies of individual and focus group interviewing were used with a purposive sample of older caregivers. Participants were members of an existing parent support group. Twenty-three caregivers representing 18 families were queried before and after the education program. The disabilities represented were mental retardation, cerebral palsy and autism. Parents whose children live at or away from home were included. The intervention was conducted on five Saturdays over a two month period; the duration of the study was five months. Findings used typical words of the respondents from their individual and focus group interviews to describe feelings, attitudes and experiences in making future-care plans. Data from verbatim transcriptions and researcher's field notes were coded, analyzed, sorted into themes, and subjected to interpretive analysis. Respondents showed a positive change in attitudes and actions after participating in the education program, regardless of their initial stage in care planning. Fears were replaced by hope and determination; hesitation and ineptitude by feelings of competence and confidence; and procrastination and delay by purposeful actions. Other key findings: use of a planning document greatly aided caregivers; barriers to planning were often intrinsic and amenable to education; residential plans were the most difficult aspect of planning; listening to the experiences of other parent caregivers was helpful; and making burial plans for their offspring was one aspect of planning parents wished to do themselves. ^

A case study of adults in college who developed an experiential learning portfolio

This single-case study provides a description and explanation of selected adult students' perspectives on the impact that the development of an experiential learning portfolio had on their understanding of their professional and personal lives. The conceptual framework that undergirded the study included theoretical and empirical studies on adult learning, experiential learning, and the academic quality of nontraditional degree programs with a portfolio component. The study employed qualitative data collection techniques of individual interviews, document review, field notes, and researcher journal. A purposive sample of 8 adult students who completed portfolios as a component of their undergraduate degrees participated in the study. The 4 male and 4 female students who were interviewed represented 4 ethnic/racial groups and ranged in age from 32 to 55 years. Each student's portfolio was read prior to the interview to frame the semi-structured interview questions in light of written portfolio documents. ^ Students were interviewed twice over a 3-month period. The study lasted 8 months from data collection to final presentation of the findings. The data from interview transcriptions and student portfolios were analyzed, categorized, coded, and sorted into 4 major themes and 2 additional themes and submitted to interpretive analysis. ^ Participants' attitudes, perceptions, and opinions of their learning from the portfolio development experience were presented in the findings, which were illustrated through the use of excerpts from interview responses and individual portfolios. The participants displayed a positive reaction to the learning they acquired from the portfolio development process, regardless of their initial concerns about the challenges of creating a portfolio. Concerns were replaced by a greater recognition and understanding of their previous professional and personal accomplishments and their ability to reach future goals. Other key findings included (a) a better understanding of the role work played in their learning and development, (b) a deeper recognition of the impact of mentors and role models throughout their lives, (c) an increase in writing and organizational competencies, and (d) a sense of self-discovery and personal empowerment. ^

The effects of the outdoor experiential ropes course on perceived team performance

The purpose of this quasi-experimental study was to explore the perceived effects of the Ropes Course on the performance of intact work teams. The dependent variable, team performance, was measured by the Team Performance Assessment, a 20 question inventory. The Ropes Course, the independent variable, was an outdoor experiential training program presently marketed as a highly effective team building training program. Issues the team addressed in the highly emotional and physical environment were purported to transfer back to the work environment and act as a catalyst for change The Ropes Course in this study consisted of a day long series of outdoor mental, emotional and physical exercises addressing the issues of goal-setting, role expectations, accountability, trust, respect, communication, problem-solving and decision-making. The 68 subjects, 37 in the treatment group and 31 in the control were employees of a large international financial institution. They were not chosen by random selection. The work teams' managers recognized a need to improve team morale, performance and functioning due to corporate reengineering and downsizing resulting in team members' job losses. Control teams were partially matched to the treatment teams on the basis of professional composition and similar job descriptions. The pretest of the Team Performance Assessment was given the morning of the Ropes Course treatment and the posttest was given three to five weeks later. The control teams received the pretests and posttests at about the same time intervals at their work location but received no Ropes Course treatment. The treatment teams' scores and the control teams' scores were statistically compared using the Multivariate Analysis of Variance (MANOVA) and the Multivariate Analysis of Covariance (MANCOVA) at the .05 level of significance. The statistical analysis revealed a significant difference between the control and experimental teams after the team building Ropes Course training as measured by the Team Performance Assessment (Gilbert, 1996). ^

A qualitative study of the clinical practice of graduates of a problem-based physical therapy program

The purpose of this study was to examine the perspectives of three graduates of a problem-based leaning (PBL) physical therapy (PT) program about their clinical practice. The study used the qualitative methods of observations, interviews, and journaling to gather the data. Three sessions of audiotaped interviews and two observation sessions were conducted with three exemplars from Nova Southeastern University PBL PT program. Each participant also maintained a reflective journal. The data were analyzed using content analysis. A systematic filing system was used by employing a mechanical means of maintaining and indexing coded data and sorting data into coded classifications of subtopics or themes. All interview transcripts, field notes from observations, and journal accounts were read, and index sheets were appropriately annotated. From the findings of the study, it was noted that, from the participants' perspectives, they were practicing at typically expected levels as clinicians. The attributes that governed the perspectives of the participants about their physical therapy clinical practice included flexibility, reflection, analysis, decision-making, self-reliance, problem-solving, independent thinking, and critical thinking. Further, the findings indicated that the factors that influenced those attributes included the PBL process, parents' value system, self-reliant personality, innate personality traits, and deliberate choice. Finally, the findings indicated that the participants' perspectives, for the most part, appeared to support the espoused efficacy of the PBL educational approach. In conclusion, there is evidence that the physical therapy clinical practice of the participants were positively impacted by the PBL curriculum. Among the many attributes they noted which governed these perspectives, problem-solving, as postulated by Barrows, was one of the most frequently mentioned benefits gained from their PBL PT training. With more schools adopting the PBL approach, this research will hopefully add to the knowledge base regarding the efficacy of embracing a problem-based learning instructional approach in physical therapy programs. ^

Facing a paradigm shift in professional credentialing: Preparedness of registered dietitians for Professional Development 2001

In the year 2001, the Commission on Dietetic Registration (CDR) will begin a new process of recertifying Registered Dietitians (RD) using a self-directed lifelong learning portfolio model. The model, entitled Professional Development 2001 (PD 2001), is designed to increase competency through targeted learning. This portfolio consists of five steps: reflection, learning needs assessment, formulation of a learning plan, maintenance of a learning log, and evaluation of the learning plan. By targeting learning, PD 2001 is predicted to foster more up-to-date practitioners than the current method that requires only a quantity of continuing education hours. This is the first major change in the credentialing system since 1975. The success or failure of the new system will impact the future of approximately 60,000 practitioners. The purpose of this study was to determine the readiness of RDs to change to the new system. Since the model is dependent on setting goals and developing learning plans, this study examined the methods dietitians use to determine their five-year goals and direction in practice. It also determined RD's attitudes towards PD 2001 and identified some of the factors that influenced their beliefs. A dual methodological design using focus groups and questionnaires was utilized. Sixteen focus groups were held during state dietetic association meetings. Demographic data was collected on the 132 registered dietitians who participated in the focus groups using a self-administered questionnaire. The audiotaped sessions were transcribed into 643 pages of text and analyzed using Non-numerical Unstructured Data - Indexing Searching and Theorizing (NUD*IST version 4). Thirty-four of the 132 participants (26%) had formal five-year goals. Fifty-four participants (41%) performed annual self-assessments. In general, dietitians did not currently have professional goals nor conduct self-assessments and they claimed they did not have the skills or confidence to perform these tasks. Major barriers to successful implementation of PD 2001 are uncertainty, misinterpretation, and misinformation about the process and purpose, which in turn contribute to negative impressions. Renewed vigor to provide a positive, accurate message along with presenting goal-setting strategies will be necessary for better acceptance of this professional development process. ^

Profile of Florida: Services in transitional housing programs for homeless women with children

Family homelessness is a disturbing social problem in the United States. This study was conducted to determine the scope of components that included services and programs available for homeless women with children in transitional housing programs in Florida and the effectiveness of these components in helping these women move towards independence. Primary data for this study were obtained through questionnaires sent to directors of homeless centers in Florida. Supportive services offered by these centers were evaluated to determine if they enabled homeless women with children to become self-sufficient. The findings of this research indicated that regardless of the size, length of participation, and scope of services provided by the centers, these women showed gains in their ability to move toward self-sufficiency. The results support the hypothesis that transitional housing programs have a positive effect on homeless women with children. ^

The impact of selected factors in nurses' attitudes toward bedside computers

The purpose of this study was to determine the impact of selected factors on nurses' attitudes toward bedside computers. Bedside computer systems, also referred to as point-of-care systems, are clinical information systems that allow documentation of patient care and retrieval of data at the patient's bedside, or in close proximity to where care is delivered. The adoption of bedside computer systems appears to be increasing among U.S. institutions. As healthcare institutions undertake automation projects, they face many challenges associated with implementing large-scale change. ^ The study explored four factors and their relationship to nurses' attitudes toward bedside computers. A pre-bedside implementation survey of 184 staff nurses did not demonstrate a relationship between previous computer experience and nurses' attitudes toward bedside computers (p > .05). The data did not indicate a relationship between nurses' formal education and their attitude toward bedside computers (p > .05). The data did support a relationship between nurses' previous computer experience and their comfort in the use of bedside computers (p < .0005). Using a quasi-experimental control group design, attitudes of nurses were studied over an 18 month period. The Pre versus Post Survey data indicated that nurses who used bedside computers, the experimental group, had more positive attitudes than the nurses who did not use bedside computers, the control group (p < .0005). ^ The findings are significant to institutions implementing bedside computers, to the human resource development staff overseeing bedside computer training, and to the practice of clinical nursing. ^

A study of dual cultures in dyadic relations

Elderly caregiving, a fact of life for millions of Americans, has gained significance with the increase in the elderly population. Over 25 million family caregivers in the US, most of whom are women rearing their own children, care for severely ill or disabled family members. The increased flow of women into the labor force has caused this traditional role to be entrusted to hired caregivers, mainly home health aides. ^ This case study describes and explains the dyadic experiences of elderly Jewish clients and their Jamaican home health aides in a mixed-culture environment. The inquiry was conducted with a purposive sample of four dyads, their case manager, and the placement officer, all of whom were selected through a home care agency in Fort Lauderdale, Florida. Strategies of data collection including non-participant observation, interviews, document analysis, and researcher's journals. Data from verbatim transcription of interviews and field notes were coded, sorted into emic categories, and reduced as linkages were identified via cross-case comparison. Three major themes—mixed-culture experiences, relationship building and maintenance, and agency role perceptions—emerged from the interpretative analysis of the data. ^ Assertions from these findings include that dyads have established a range of relationships to meet their personal needs, expectations, and desires in these goal-driven relationships. Relationally, they have reached interactional synchrony with some achieving the ideal family-type bond. Cultural difference is but one of the many contextual variables in the home care environment, which has its own cultural norms and expectations. Conflicts transcend cultural difference and seemed more a factor of individual relational disposition. ^

Selected psychosocial and demographic factors affecting levels of pre-retirement planning

In September 2002, the State of Florida implemented a new retirement structure for those employed in the Florida Public School System. Teachers were given the option to maintain their existing defined benefit plan or choose the newly offered defined contribution plan. The variables that affect planning for retirement are innumerable. Identifying the most significant variables is essential to understanding how one plans for retirement. ^ This study examined the relationship between hypothesized psychosocial and demographic factors and an individual's level of pre-retirement planning. The criterion variable, the level of pre-retirement planning, comprised two concepts. First, the time spent thinking about retirement was determined by the score an individual received on a pre-retirement planning scale. This scale included the concepts of information gathering, goals, anticipated resources, and long-range planning. Second, implementation of retirement plan procedures was determined by the percentage an individual annually deferred to retirement. ^ The survey used for data collection contained 50 close-ended items. It was distributed to all full-time teachers in nine randomly selected elementary, middle, and senior high schools throughout Miami-Dade County Public Schools. Multiple regression and crosstabulation indicated that math anxiety, general risk, years of service, and total family income were significant predictors of the level of pre-retirement planning, as measured by the pre-retirement planning scale. In addition, the statistical analysis indicated that math anxiety, internal locus of control, years of service, and total family income were significant predictors of the level pre-retirement planning, as measured by the amount deferred to retirement. An individual's level of math anxiety and family income were the two factors that were the most significant predictors for both concepts on the level of pre-retirement planning. ^ Based on the findings of the study, recommendations focused on assessing an individual's level of math anxiety and educating teachers, particularly pre-service candidates, about the factors that affect pre-retirement planning. Further research should investigate the benefit of such educational programs. ^

The theory of margin as a predictor of success on the National Council Licensure Examination for Registered Nurses

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the examination that all graduates of nursing education programs must pass to attain the title of registered nurse. Currently the NCLEX-RN passing rate is at an all-time low (81%) for first-time test takers (NCSBN, 2004); amidst a nationwide shortage of registered nurses (Glabman, 2001). Because of the critical need to supply greater numbers of professional nurses, and the potential accreditation ramifications that low NCLEX-RN passing rates can have on schools of nursing and graduates, this research study tests the effectiveness of a predictor model. This model is based upon the theoretical framework of McClusky's (1959) theory of margin (ToM), with the hope that students found to be at-risk for NCLEX-RN failure can be identified and remediated prior to taking the actual licensure examination. To date no theory based predictor model has been identified that predicts success on the NCLEX-RN. ^ The model was tested using prerequisite course grades, nursing course grades and scores on standardized examinations for the 2003 associate degree nursing graduates at a urban community college (N = 235). Success was determined through the reporting of pass on the NCLEX-RN examination by the Florida Board of Nursing. Point biserial correlations tested model assumptions regarding variable relationships, while logistic regression was used to test the model's predictive power. ^ Correlations among variables were significant and the model accounted for 66% of variance in graduates' success on the NCLEX-RN with 98% prediction accuracy. Although certain prerequisite course grades and nursing course grades were found to be significant to NCLEX-RN success, the overall model was found to be most predictive at the conclusion of the academic program of study. The inclusion of the RN Assessment Examination, taken during the final semester of course work, was the most significant predictor of NCLEX-RN success. Success on the NCLEX-RN allows graduates to work as registered nurses, reflects positively on a school's academic performance record, and supports the appropriateness of the educational program's goals and objectives. The study's findings support potential other uses of McClusky's theory of margin as a predictor of program outcome in other venues of adult education. ^