Implications of a theoretical framework on stress and burnout for the development of graduate nursing education curricula

This study had two purposes: (a) to develop a theoretical framework integrating and synthesizing findings of prior research regarding stress and burnout among critical care nurses (CCRNs), and (b) to validate the theoretical framework with an empirical study to assure a theory/research based teaching-learning process for graduate courses preparing nursing clinical specialists and administrators.^ The methods used to test the theoretical framework included: (a) adopting instruments with reported validity, (b) conducting a pilot study, (c) revising instruments using results of the pilot study and following concurrence of a panel of experts, and (d) establishing correlations within predetermined parameters. The reliability of the tool was determined through the use of Cronbach's Alpha Coefficient with a resulting range from.68 to.88 for all measures.^ The findings supported all the research hypotheses. Correlations were established at r =.23 for statistically significant alphas at the.01 level and r =.16 for alphas.05. The conclusions indicated three areas of strong correlation among the theoretical variables: (a) work environment stressor antecedents and specific stressor events were correlated significantly with subjective work stress and burnout; (b) subjective work stress (perceived work related stress) was a function of the work environment stressor antecedents and specific stressor events, and (c) emotional exhaustion, the first phase of burnout, was confirmed to be related to stressor antecedents and specific stressor events. This dimension was found to be a function of the work environment stressor antecedents, modified by the individual characteristics of work and non-work related social support, non-work daily stress, and the number of hours worked per week. The implications of the study for nursing graduate curricula, nursing practice and nursing education were discussed. Recommendations for further research were enumerated. ^

Public school administrators' knowledge of special education law

The purpose of this study was to assess the knowledge of public school administrators with respect to special education (ESE) law. The study used a sample of 220 public school administrators. A survey instrument was developed consisting of 19 demographic questions and 20 situational scenarios. The scenarios were based on ESE issues of discipline, due process (including IEP procedures), identification, evaluation, placement, and related services. The participants had to decide whether a violation of the ESE child's rights had occurred by marking: (a) Yes, (b) No, or (c) Undecided. An analysis of the scores and demographic information was done using a two-way analysis of variance, chi-square, and crosstabs after a 77% survey response rate.^ Research questions addressed the administrators' overall level of knowledge. Comparisons were made between principals and assistant principals and differences between the levels of schooling. Exploratory questions were concerned with ESE issues deemed problematic by administrators, effects of demographic variables on survey scores, and the listing of resources utilized by administrators to access ESE information.^ The study revealed: (a) a significant difference was found when comparing the number of ESE courses taken and the score on the survey, (b) the top five resources of ESE information were the region office, school ESE department chairs, ESE teachers, county workshops, and county inservices, (c) problematic areas included discipline, evaluation procedures, placement issues, and IEP due process concerns, (d) administrators as a group did not exhibit a satisfactory knowledge of ESE law with a mean score of 12 correct and 74% of responding administrators scoring in the unsatisfactory level (below 70%), (e) across school levels, elementary administrators scored significantly higher than high school administrators, and (f) a significant implication that assistant principals consistently scored higher than principals on each scenario with a significant difference at the high school level.^ The study reveals a vital need for administrators to receive additional preparation in order to possess a basic understanding of ESE school law and how it impacts their respective schools and school districts so that they might meet professional obligations and protect the rights of all individuals involved. Recommendations for this additional administrative preparation and further research topics were discussed. ^

A comparative analysis of school satisfaction and dropout risk of middle school students attending programs for students with emotional handicaps, severe emotional disturbance and general education students attending center schools and satellite schools

This study evaluated school satisfaction as an indicator of dropout risk of students with Emotional Handicaps (EH) and students with Severe Emotional Disturbance (SED). The students attended two different kinds of middle schools in a largely urban school district in South Florida. One hundred eight students in grade 8 (ages 13-16) participated in this study. Participants were administered the National Dropout Prevention Assessment (NDPA). Forty participants with EH and SED attended a special center school. Thirty-one participants with EH and SED attended satellite programs in a regular middle school. Thirty-seven general education participants attended the same regular middle school. Overall school satisfaction scores were generated, as well as three primary factors (school, environment and personal) and 16 subscales (school atmosphere, future income, difficulty level of classwork, teacher relationships, peer relationships, intrinsic interest in classwork, school hours, classwork stress, general attitude towards school, family influence, perceived opportunity for career, future goals, travel distance, leisure time, self-appraisal of performance, and self-esteem).^ Comparison of students with EH and SED revealed that both groups of students were rated at "low risk" of becoming dropouts on the Environmental factor and the Difficulty of Schoolwork subscale. Students with EH were rated at "caution risk" risk on the Travel Distance subscale. Students with SED were rated at "high risk" on this subscale.^ There were no significant differences in school satisfaction and dropout risk between different program delivery models. There were also no significant differences for category of students (EH, SED) by school type (center school, satellite program). All students were rated at "low risk" of dropping out of school.^ There were significant differences between general education students and students with EH and SED attending satellite programs. Students with EH and SED were rated at "caution risk" for dropping out on the Travel Distance and the Leisure Time subscales. Discussion of results, implications for practice and recommendations for further research are included. ^

An examination of parental opinions regarding the inclusion of disabled students in regular education classes

This study investigated the opinions regarding inclusion of parents of both disabled and nondisabled elementary children from a large suburban county. An opinion survey combining Wilczenski's Attitudes Toward Inclusive Education Scale with additional questions was distributed to 1170 children from 24 schools. Three research questions focused on differences between mean parental responses as they related to the inclusion and disability status of the parent's child. Results from the 270 respondents indicated that parents with disabled children had more favorable opinions about inclusion than did those with nondisabled children. Parents with included children were more favorable toward inclusion than were parents whose children were not included. Parents with included disabled children were more accepting of inclusion than were those with nondisabled children in inclusive settings. Parents' answers differed depending on the type of disability being included. Regardless of their child's disability or inclusion status, the ranking for disability types from most acceptable for inclusion to least acceptable were: social, sensory, motor, academic and behavioral. Results across types of questions, including questions relating to acceptance and general inclusion issues, indicated consistently more favorable opinions of parents with disabled children, included children and disabled children in inclusive classes. Two additional research questions examined parental responses as they related to demographic characteristics of the parents and of the schools their children attended. Analysis of Variance found only one significant main effect for any parental demographic variable. This difference was for the number of parents' elementary children when comparing parents with and without disabled children. The only significant main effects of demographics of schools the parents' children attended were for the area of the county and for schools with differing percentages of severely disabled students when comparing responses of parents with disabled and nondisabled children. For all research questions, tests indicated low effect sizes and moderate to high power levels. These results, and the fact that means for all groups were in the middle range of response choices, indicate that there may be little practical significance to the overall results. Further studies should investigate the trends found in this study. ^

A distance education case study: A comparison of instructional delivery methods practiced by higher education faculty and emerging standards

The purpose of this research was to compare the delivery methods as practiced by higher education faculty teaching distance courses with recommended or emerging standard instructional delivery methods for distance education. Previous research shows that traditional-type instructional strategies have been used in distance education and that there has been no training to distance teach. Secondary data, however, appear to suggest emerging practices which could be pooled toward the development of standards. This is a qualitative study based on the constant comparative analysis approach of grounded theory.^ Participants (N = 5) of this study were full-time faculty teaching distance education courses. The observation method used was unobtrusive content analysis of videotaped instruction. Triangulation of data was accomplished through one-on-one in-depth interviews and from literature review. Due to the addition of non-media content being analyzed, a special time-sampling technique was designed by the researcher--influenced by content analyst theories of media-related data--to sample portions of the videotape instruction that were observed and counted. A standardized interview guide was used to collect data from in-depth interviews. Coding was done based on categories drawn from review of literature, and from Cranton and Weston's (1989) typology of instructional strategies. The data were observed, counted, tabulated, analyzed, and interpreted solely by the researcher. It should be noted however, that systematic and rigorous data collection and analysis led to credible data.^ The findings of this study supported the proposition that there are no standard instructional practices for distance teaching. Further, the findings revealed that of the emerging practices suggested by proponents and by faculty who teach distance education courses, few were practiced even minimally. A noted example was the use of lecture and questioning. Questioning, as a teaching tool was used a great deal, with students at the originating site but not with distance students. Lectures were given, but were mostly conducted in traditional fashion--long in duration and with no interactive component.^ It can be concluded from the findings that while there are no standard practices for instructional delivery for distance education, there appears to be sufficient information from secondary and empirical data to initiate some standard instructional practices. Therefore, grounded in this research data is the theory that the way to arrive at some instructional delivery standards for televised distance education is a pooling of the tacitly agreed-upon emerging practices by proponents and practicing instructors. Implicit in this theory is a need for experimental research so that these emerging practices can be tested, tried, and proven, ultimately resulting in formal standards for instructional delivery in television education. ^

The knowledge and use of critical thinking teaching strategies of faculty in associate degree nursing education programs

The purpose of this study was to determine the knowledge and use of critical thinking teaching strategies by full-time and part-time faculty in Associate Degree Nursing (ADN) programs. ^ Sanders CTI (1992) instrument was adapted for this study and pilot-tested prior to the general administration to ADN faculty in Southeast Florida. This modified instrument, now termed the Burroughs Teaching Strategy Inventory (BTSI), returned reliability estimates (Cronbach alphas of .71, .74, and .82 for the three constructs) comparable to the original instrument. The BTSI was administered to 113 full-time and part-time nursing faculty in three community college nursing programs. The response rate was 92% for full-time faculty (n = 58) and 61% for part-time faculty (n = 55). ^ The majority of participants supported a combined definition of critical thinking in nursing which represented a composite of thinking skills that included reflective thinking, assessing alternative viewpoints, and the use of problem-solving. Full-time and part-time faculty used different teaching strategies. Full-time faculty most often used multiple-choice exams and lecture while part-time faculty most frequently used discussion within their classes. One possible explanation for specific strategy choices and differences might be that full-time faculty taught predominately in theory classes where certain strategies would be more appropriate and part-time faculty taught predominately clinical classes. Both faculty types selected written nursing care plans as the second most effective critical thinking strategy. ^ Faculty identified several strategies as being effective in teaching critical thinking. These strategies included discussion, case studies, higher order questioning, and concept analysis. These however, were not always the strategies that were used in either the classroom or clinical setting. ^ Based on this study, the author recommends that if the profession continues to stress critical thinking as a vital component of practice, nursing faculty should receive education in appropriate critical teaching strategies. Both in-service seminars and workshops could be used to further the knowledge and use of critical thinking strategies by faculty. Qualitative research should be done to determine why nursing faculty use self-selected teaching strategies. ^

Teacher efficacy of special education teachers of English language learners with disabilities

This research examined the perceived teacher efficacy of special education teachers of English Language Learners (ELLs) with educational disabilities by surveying 202 elementary special education teachers using the EXCEL Teacher Inventory. EXCEL consists of 20 teacher efficacy items, three open-ended questions, and participant demographic items. ^ Overall participant teacher efficacy scores were high. Of the variables assessed, a statistically significant difference in perceived efficacy was found with self-reported proficiency in the language of the target students. No statistically significant differences in teacher efficacy scores were found for (a) levels of teacher preparation; (b) number of years of teaching experience; or (c) socioeconomic status of the students. A multiple regression analysis indicated that, of the variables listed above, proficiency in the language of the target students accounted for significant variance in predicting the level of teachers' perceived efficacy. ^ Responses to the open-ended questions about what was most helpful when working with ELLs with disabilities yielded two major themes: organizational issues and teacher issues. Participants wrote numerous comments about the value of support from educational professionals and parents. Many participants recommended individuals in preservice programs take ESOL content specific courses. ^ The results demonstrate the positive correlation between proficiency in the language of the target students and teacher efficacy. This suggests that teachers of ELLs with disabilities have proficiency in the ELLs' native language (or have support from others who are language proficient) that allows them to distinguish between language difference and language disability and provide instruction in the native language when needed. Further, results from open-ended questions suggest that special education teacher preparation programs should include courses related specifically to strategies for teaching ELLs with disabilities, not just ELLs. ^

Private higher education policy in Ohio, 1980--2006: A case study demonstrating the usefulness of Zumeta's public policy posture model

This study describes the case of private higher education in Ohio between 1980 and 2006 using Zumeta's (1996) model of state policy and private higher education. More specifically, this study used case study methodology and multiple sources to demonstrate the usefulness of Zumeta's model and illustrate its limitations. Ohio served as the subject state and data for 67 private, 4-year, degree-granting, Higher Learning Commission-accredited institutions were collected. Data sources for this study included the National Center for Education Statistics Integrated Postsecondary Data System as well as database information and documents from various state agencies in Ohio, including the Ohio Board of Regents. ^ The findings of this study indicated that the general state context for higher education in Ohio during the study time period was shaped by deteriorating economic factors, stagnating population growth coupled with a rapidly aging society, fluctuating state income and increasing expenditures in areas such as corrections, transportation and social services. However, private higher education experienced consistent enrollment growth, an increase in the number of institutions, widening involvement in state-wide planning for higher education, and greater fiscal support from the state in a variety of forms such as the Ohio Choice Grant. This study also demonstrated that private higher education in Ohio benefited because of its inclusion in state-wide planning and the state's decision to grant state aid directly to students. ^ Taken together, this study supported Zumeta's (1996) classification of Ohio as having a hybrid market-competitive/central-planning policy posture toward private higher education. Furthermore, this study demonstrated that Zumeta's model is a useful tool for both policy makers and researchers for understanding a state's relationship to its private higher education sector. However, this study also demonstrated that Zumeta's model is less useful when applied over an extended time period. Additionally, this study identifies a further limitation of Zumeta's model resulting from his failure to define "state mandate" and the "level of state mandates" that allows for inconsistent analysis of this component. ^

The effect of a clinical practicum on elementary education preservice teachers' development of reading expertise

The purpose of the study was to measure gains in the development of elementary education teachers’ reading expertise, to determine if there was a differential gain in reading expertise, and last, to examine their perceptions of acquiring reading expertise. This research is needed in the field of teacher education, specifically in the field of reading. A quasi-experimental design with a comparison group using pretest-posttest mixed-method, repeated measures was utilized. Quantitative data analysis measured the development of reading expertise of elementary preservice teachers compared to early childhood preservice teachers; and, was used to examine the differential gains in reading expertise. A multivariate analysis of variance (MANOVA) was conducted on pre- and posttest responses on a Protocol of Questions. Further analysis was conducted on five variables (miscue analysis, fluency analysis, data analysis, inquiry orientation and intelligent action) using a univariate analysis of variance (ANOVA). A one-way ANOVA was carried out on gain scores of the low and middle groups of elementary education preservice teachers. Qualitative data analysis suggested by Merriam (1989) and Miles and Huberman (1994) was used to determine if the elementary education preservice teachers perceived they had acquired the expertise to teach reading. Elementary education preservice teachers who participated in a supervised clinical practicum made significant gains in their development of reading expertise as compared to early childhood preservice teachers who did not make significant gains. Elementary education preservice teachers who were in the low and middle third levels of expertise at pretest demonstrated significant gains in reading expertise. Last, elementary education preservice teachers perceived they had acquired the expertise to teach reading. The study concluded that reading expertise can be developed in elementary education preservice teachers through participation in a supervised clinical practicum. The findings support the idea that preservice teachers who will be teaching reading to elementary students would benefit from a supervised clinical practicum.

Toward understanding the study experience of culturally sensitive graduate students in *American distance education programs

The purpose of this research was to gain an understanding of the study experience of non-American graduate students living outside of the United States and formally engaged in graduate studies in an American Distance Education (DE) Program. These students have been labeled “culturally sensitive.” The nature of this study dictated a qualitative case study methodology using in-depth interviews to collect the data and the hermeneutic approach to understanding and description. This study aims at generating questions and hypotheses that will lead to further investigations that explore the need for cultural and contextual sensitivity in order to provide more equitable and accessible higher education for all. ^ The study attempted to answer the question: What is the study experience of “culturally sensitive” graduate students in American DE Programs? The underlying issue in this study is whether education designed and provided by educators of different socio-cultural backgrounds from that of the students could be content relevant and instructionally appropriate, resulting in educational enhancement and/or prepare students to function adequately in their own communities. ^ Participants in this study (n = 12) were engaged in Master's level (n = 2) and Doctoral level (n = 10) DE programs at American Universities, and were interviewed by E-mail, face-to-face, or using a combination of the two. Data analysis compared interviews and highlighted repetitive patterns. Interview data was triangulated with recent related literature and data from document reviews of archived E-mail conversations between students and their professors. The patterns that emerged were coded and categorized according to generative themes. The following themes were identified in order to analyze the data and confirmed through participant check-back: program benefits, communication, technology, culture and methodology, and reflectivity. ^ Major findings in this study indicate that culture plays an important role in cross-cultural encounters for students in American DE programs vis-à-vis student perceptions as to whether their study needs were being met. Most notably, it was found that the coupling of cultural perceptual differences with transactional distance created a potential barrier to communication that could affect short-term success in American DE programs. To overcome this barrier, students cited good communication as essential in meeting student's needs, especially those communications that were supportive and full of detail and context and from a primary source (ex. directly from the professor). Evaluation was a particularly sensitive issue, especially when students were unaware of their professor's cultural and contextual intricacies and therefore were uncertain about expectations and intended meaning. CSGS were aware of their position and the American rather than global context in which they were participating. Students appear to have developed “extended identities”, meaning that they acculturated in varying degrees in order to be successful in their program but that their local cultural identity was not compromised in any way. For participants from Venezuela access to higher DE has been a limiting factor to participation, due to the high cost of technology and telephone lines for communication. ^

Characteristics of the Commission on Accreditation of Allied Health Education Programs or National Athletic Trainers' Association -accredited athletic training programs associated with first -attempt passing rates on the NATABOC examination

Athletic training is an allied health profession recognized by the American Medical Association requiring certification by examination. There are two routes towards certification as an athletic trainer: attending a university with an accredited athletic training program or with an internship program By 2004, the only route towards certification will be by attending a Commission on Accreditation of Allied Health Education Programs (CAAHEP) or National Athletic Trainers' Association (NATA) accredited athletic training program. CAAHEP looks at passing rates on the NATA Board of Certification (NATABOC) examination when granting accreditation. This study examined characteristics of programs associated with first time passing rates. ^ Directors from 39 CAAHEP or NATA accredited athletic training programs completed a descriptive 17-question survey regarding academic characteristics, faculty characteristics, and program characteristics. Analysis used Spearman's rho correlation coefficient, with significance of p = <.05. Four program directors were interviewed to gather additional insight. ^ There were three program characteristics that showed a significant positive association with first attempt passing rates: the number of full-time and part-time approved clinical instructors (ACIs), and the number of students in the program. Further investigation found a statistically significant association between a low ratio of ACIs to athletic training students and first time passing rates. ACIs are certified athletic trainers (ATCs) who have received special training in order to supervise athletic training students. CAAHEP mandates a 1:8 ratio of ATCs to athletic training student. This study showed that a smaller ratio of ATC to student in combination with ACI training was significantly associated with higher first time passing rates. The number of courses above the required 13 delineated by the Education Council showed a significant negative association with first attempt passing rates. ^ Universities seeking or maintaining accreditation should incorporate characteristics associated with a higher passing rate on the NATABOC examination. Characteristics include utilizing a large number of full-time and part-time ACIs, admitting a large number of students into the program while maintaining a low ACI to athletic training student ratio, and offering curricula that focuses on the 13 courses that have been deemed relevant to the athletic training curriculum by the Education Council. ^

The effects of health education on student health -related behaviors

During their transitional period from childhood to adulthood, adolescents engage in risk-taking behaviors that become public health concerns. It is important for school health education professionals to design instructional programs that focus on adolescents' developmental needs and foster healthier lifestyles. The goal of health education is to help students acquire health skills that are necessary to succeed in school and in life. This is especially important because the increase in teenagers' risky behaviors can affect their health, well being, and eventually the course of their lives. ^ This study examined the effects of health education on health-related behaviors of public high school students. A multivariate analysis of variance was conducted to determine whether the comprehensive approach based on The Jessors' Problem Behavior Theory (PBT) had a greater impact on adolescents' risk-taking behaviors than the traditional approach. After 18 weeks of health instruction using one of these approaches, the Youth Risk Behavior Survey (YRBS) was administered to measure the level of subjects' self-reported behaviors in six categories of adolescent risky behaviors: the use of tobacco; the use of alcohol and other drugs; engagement in injurious activities; consumption of unhealthy diet; an inadequate level of participation in physical activities; and engagement in risky sexual activities. ^ The results of this study did not support the hypothesis that using the comprehensive health education approach was more influential than the traditional health education approach in improving students' health-risk behaviors. Further research studies based on bio-psychosocial theories are needed to develop and evaluate methods of instruction and delivery of health skills. ^

The contribution of higher education to economic *development in a globalized environment

Amidst concerns about achieving high levels of technology to remain competitive in the global market without compromising economic development, national economies are experiencing a high demand for human capital. As higher education is assumed to be the main source of human capital, this analysis focused on a more specific and less explored area of the generally accepted idea that higher education contributes to economic growth. The purpose of this study, therefore, was to find whether higher education also contributes to economic development, and whether that contribution is more substantial in a globalized context. ^ Consequently, a multiple linear regression analysis was conducted to support with statistical significance the answer to the research question: Does higher education contributes to economic development in the context of globalization? The information analyzed was obtained from historical data of 91 selected countries, and the period of time of the study was 10 years (1990–2000). Some variables, however, were lagged back 5, 10 or 15 years along a 15-year timeframe (1975–1990). The resulting comparative static model was based on the Cobb-Douglas production function and the Solow model to specify economic growth as a function of physical capital, labor, technology, and productivity. Then, formal education, economic development, and globalization were added to the equation. ^ The findings of this study supported the assumption that the independent contribution of the changes in higher education completion and globalization to changes in economic growth is more substantial than the contribution of their interaction. The results also suggested that changes in higher and secondary education completion contribute much more to changes in economic growth in less developed countries than in their more developed counterparts. ^ As a conclusion, based on the results of this study, I proposed the implementation of public policy in less developed countries to promote and expand adequate secondary and higher education systems with the purpose of helping in the achievement of economic development. I also recommended further research efforts on this topic to emphasize the contribution of education to the economy, mainly in less developed countries. ^

The knowledge and use of critical thinking teaching strategies of faculty in associate degree nursing education programs

The purpose of this study was to determine the knowledge and use of critical thinking teaching strategies by full-time and part-time faculty in Associate Degree Nursing (ADN) programs. Sander's CTI (1992) instrument was adapted for this study and pilottested prior to the general administration to ADN faculty in Southeast Florida. This modified instrument, now termed the Burroughs Teaching Strategy Inventory (BTSI), returned reliability estimates (Cronbach alphas of .71, .74, and .82 for the three constructs) comparable to the original instrument. The BTSI was administered to 113 full-time and part-time nursing faculty in three community college nursing programs. The response rate was 92% for full-time faculty (n = 58) and 61 % for part-time faculty (n = 55). The majority of participants supported a combined definition of critical thinking in nursing which represented a composite of thinking skills that included reflective thinking, assessing alternative viewpoints, and the use of problem-solving. Full-time and part-time faculty used different teaching strategies. Fulltime faculty most often used multiple-choice exams and lecture while part-time faculty most frequently used discussion within their classes. One possible explanation for specific strategy choices and differences might be that full-time faculty taught predominately in theory classes where certain strategies would be more appropriate and part-time faculty taught predominately clinical classes. Both faculty types selected written nursing care plans as the second most effective critical thinking strategy. Faculty identified several strategies as being effective in teaching critical thinking. These strategies included discussion, case studies, higher order questioning, and concept analysis. These however, were not always the strategies that were used in either the classroom or clinical setting. Based on this study, the author recommends that if the profession continues to stress critical thinking as a vital component of practice, nursing faculty should receive education in appropriate critical teaching strategies. Both in-service seminars and workshops could be used to further the knowledge and use of critical thinking strategies by faculty. Qualitative research should be done to determine why nursing faculty use self-selected teaching strategies.