The Impact of a Simulated Clinical Experience on CEGEP Nursing Students’ Perceptions of Self-Efficacy and Achievement

Abstract : Providing high-quality clinical experiences to prepare students for the complexities of the current health-care system has become a challenge for nurse educators. Additionally, there are concerns that the current model of clinical practice is suboptimal. Consequently, nursing programs have explored the partial replacement of traditional in-hospital clinical experiences with a simulated clinical experience. Despite research demonstrating numerous benefits to students following participation in simulation activities, insufficient research conducted within Québec exists to convince the governing bodies (Ordre des infirmières et des infirmiers du Québec, OIIQ; Ministère de L’Éducation supérieur, de la Recherche, de la Science et de la Technologie) to fully embrace simulation as part of nurse training. The purpose of this study was to examine the use of a simulated clinical experience (SCE) as a viable, partial pedagogical substitute for traditional clinical experience by examining the effects of a SCE on CEGEP nursing students’ perceptions of self-efficacy (confidence), and their ability to achieve course objectives. The findings will contribute new information to the current body of research in simulation. The specific case of obstetrical practice was examined. Based on two sections of the Nursing III-Health and Illness (180-30K-AB) course, the sample was comprised of 65 students (thirty-one students from section 0001 and thirty-four students from section 0002) whose mean age was 24.8 years. With two sections of the course available, the opportunity for comparison was possible. A triangulation mixed method design was used. An adapted version of Ravert’s (2004) Nursing Skills for Evaluation tool was utilized to collect data regarding students’ perceptions of confidence related to the nursing skills required for care of mothers and their newborns. Students’ performance and achievement of course objectives was measured through an Objective Structured Clinical Examination (OSCE) consisting of three marked stations designed to test the theoretical and clinical aspects of course content. The OSCE was administered at the end of the semester following completion of the traditional clinical experience. Students’ qualitative comments on the post -test survey, along with journal entries served to support the quantitative scale evaluation. Two of the twelve days (15 hours) allocated for obstetrical clinical experience were replaced by a SCE (17%) over the course of the semester. Students participated in various simulation activities developed to address a range of cognitive, psychomotor and critical thinking skills. Scenarios incorporating the use of human patient simulators, and designed using the Jeffries Framework (2005), exposed students to the care of families and infants during the perinatal period to both reflect and build upon class and course content in achievement of course objectives and program competencies. Active participation in all simulation activities exposed students to Bandura’s four main sources of experience (mastery experiences, vicarious experiences, social persuasion, and physiologic/emotional responses) to enhance the development of students’ self-efficacy. Results of the pre-test and post-test summative scores revealed a statistically significant increase in student confidence in performing skills related to maternal and newborn care (p < .0001) following participation in the SCE. Confidence pre-test and post-test scores were not affected by the students’ section. Skills related to the care of the post-partum mother following vaginal or Caesarean section delivery showed the greatest change in confidence ratings. OSCE results showed a mean total class score (both sections) of 57.4 (70.0 %) with normal distribution. Mean scores were 56.5 (68.9%) for section 0001 and 58.3 (71.1%) for section 0002. Total scores were similar between sections (p =0.342) based on pairwise comparison. Analysis of OSCE scores as compared to students’ final course grade revealed similar distributions. Finally, qualitative analysis identified how students’ perceived the SCE. Students cited gains in knowledge, development of psychomotor skills and improved clinical judgement following participation in simulation activities. These were attributed to the « hands on » practice obtained from working in small groups, a safe and authentic learning environment and one in which students could make mistakes and correct errors as having the greatest impact on learning through simulation.

Ethical aspects of children’s perceptions of information-giving in care

The aim of this study was to identify key aspects in the exchange of information and to determine how nurses communicate news to hospitalised children. For this study, we applied the critical incident technique with 30 children aged between 8 and 14 years. Data were collected in paediatric units in a hospital in Alicante (Spain) using participant observation and semi-structured interviews. The analysis yielded three main categories: the children’s reaction to the information, nursing staff behaviour as a key aspect in the exchange of information and communication of news as well as children’s experience. This article emphasises the need to promote children’s consent and participation in nursing interventions. An analysis of these aspects will verify whether children’s rights are being respected and taken into account in order to promote children’s well-being and adaptation to hospitalisation.

Perceptions of New Principal Mentoring Programs in a Large Urban School District

The principalship has changed significantly over the past 20 years. Today’s principals must be effective instructional leaders, managers of large facilities, and experts at analyzing data to successfully meet the accountability demands of high-stakes testing, along with state, and federal mandates. The primary purpose of this quantitative study was to examine how 43 first- and second-year sitting school principals perceived their mentoring experiences and the degree to which a principal mentoring program—offered by their large urban school district—was effective in building their leadership capacity. A second purpose of this inquiry was to understand these principals’ perceptions of the most beneficial aspects of the mentoring program. The study used quantitative data gathered via an online questionnaire distributed during Fall 2015. The results indicated that respondents perceived that the components of the large urban school-mentoring program were generally effective in training principal mentees to become highly-effective school leaders. This study enriches the literature on mentoring by providing the voices of first and second year school leaders to add depth to the characteristics of successful mentoring programs.

Perceptions of Character Education in a Seventh-Day Adventist School

Character education has been viewed by many educators as having significant historical, academic, and social value. Many stakeholders in education argue for character development as a curricular experience. While understanding the degree to which character education is of worth to stakeholders of institutions is important, understanding students, teachers, and administrators perspectives from their lived experiences is likewise significant. The purpose of this phenomenological study was to gain a deeper understanding of character education within a Biblical framework environment by examining the lived experiences of students, administrators, and teachers of a Seventh-day Adventist School. Phenomenology describes individuals’ daily experiences of phenomena, the manner in which these experiences are structured, and focuses analysis on the perspectives of the persons having the experience (Moustakas, 1994). ). This inquiry was undertaken to answer the question: What are the perceptions of students, teachers, and an administrator toward character education in a Seventh-day Adventist school setting? Ten participants (seven students and three adults) formed the homogeneous purposive sample, and the major data collection tool was semi-structured interviews (Patton, 1990; Seidman, 2006). Three 90-minute open-ended interviews were conducted with each of the participants. Data analysis included a three-phase process of description, reduction and interpretation. The findings from this study revealed that participants perceived that their involvement in the school’s character education program decreased the tendency to violence, improved their conduct and ethical sensibility, enhanced their ability to engage in decision-making concerning social relationships and their impact on others, brought to their attention the emerging global awareness of moral deficiency, and fostered incremental progress from practice and recognition of vices to their acquisition of virtues. The findings, therefore, provide a model for teaching character education from a Seventh-day Adventist perspective. The model is also relevant for non-Seventh day Adventists who aspire to teach character education as a means to improving social and moral conditions in schools.

L'Intégration d'un Module d'Étude Internet Dans la Classe de Comptabilité: Perceptions des Élèves et les Résultats Académiques

Implemented in the context of Business Administration students enrolled in a college level three year technology program, this research investigated students’ perceptions and academic results concurrent with the implementation of an online web module designed to facilitate student self-study. The students involved in this research were enrolled in a program that, while offering a broad education in business disciplines, specialized in the field of accounting. As a result, students were enrolled in academically rigorous accounting courses in each of the six semesters of the program. The weighting of these accounting courses imposes a significant self-study component – typically matching or exceeding the time spent in class. In this context many of the students enrolled in the Business Administration Program have faced difficulties completing the self-study component of the course effectively as demonstrated in low homework completion rates, low homework grade averages and ultimately low success rates in the courses. In an attempt to address this situation this research studied the implementation of a web-based self-study module. Through this module students could access a number of learning tools that were designed to facilitate the self-study process under the premise that more effective self-study learning tools will help remove obstacles and provide more timely confirmation of learning during student self-study efforts. This research collected data from a single cohort of students drawn from the first three sequential accounting courses of the Business Administration Program. The web-based self-study module was implemented in the third of the three sequential accounting courses. The first two of these courses implemented a traditional manual self-study environment. Data collected from the three accounting courses included homework completion rates, homework, exam and final grades for the respective courses. In addition the web-study module allowed the automatic reporting of student usage of a number of specific online learning tools. To complement the academic data, students were surveyed to gain insight into their perceptions of the effectiveness of the web-based system. The research provided a number of interesting insights. First among these was a confirmation of the importance of the self-study process in the academic achievement of the learners. Regardless of the self-study environment, manual or web-enhanced, a significant positive correlation existed between the students’ self-study results, demonstrated in both homework completion rates and homework averages and the corresponding final grades. These results confirm the importance of self-study found generally in the prevailing academic literature regarding students enrolled in higher education. In addition, the web-enhanced learning environment implemented during the third accounting course coincided with significantly higher homework completion rates and corresponding homework averages: homework completion rates in particular increased from a combined average of 63% in the first two accounting courses to 93% in the web-enhanced context of the third accounting course. Moreover, the homework completion rates of the web-enhanced course were evenly distributed across the cohort of students. A quartile-based analysis was subsequently completed. Quartiles were constructed by ranking the students according to their combined average homework completion rates from the first two manual self-study courses, Accounting I and II. The quartile-based homework completion rates for the manual self-study courses Accounting I and II were subsequently compared to the results these same quartiles of students achieved in the web-based self-study within Accounting III. While the first two courses demonstrated significantly uneven homework completion rates across the quartiles ranging from 31% to 91% homework completion rates, the differences among the four quartiles within the web-enhanced module, with an average homework completion rate of 93%, were statistically insignificant. Congruent with the positive academic results observed in the third, web-enhanced course, through the corresponding survey, students expressed a strong attitude in favor of the online self-study environment. This research was designed to add to the existing research that studies the implementation of learning in an online setting. Specifically, the research was designed to explore a middle ground of online learning – a web-enhanced course – a context that supplements the classroom experience rather than replacing it. The web-enhanced accounting course demonstrated impressive favorable results, both academically and in terms of students' perception of the system; these results suggest that a web-enhanced environment can provide learning tools that facilitate the self-study process while providing a structured learning environment that can help developing learners reach their potential.

Development of an institutional framework to guide transitions into enhanced blended learning in higher education

The rapidly changing digital landscape is having a significant influence on learning and teaching. Our study assesses the response of one higher education institution (HEI) to the changing digital landscape and its transition into enhanced blended learning, which seeks to go beyond the early implementation stage to make the most effective use of online learning technologies to enhance the student experience and student learning outcomes. Evidence from a qualitative study comprising 20 semi-structured interviews, informed by a literature review, has resulted in the development of a holistic framework to guide HEIs transitioning into enhanced blended learning. The proposed framework addresses questions relating to the why (change agents), what (institutional considerations), how (organisational preparedness) and who (stakeholders) of transitions into enhanced blended learning. The involvement of all stakeholder groups is essential to a successful institutional transition into enhanced blended learning.

How should we measure online learning activity?

The proliferation of Web-based learning objects makes finding and evaluating resources a considerable hurdle for learners to overcome. While established learning analytics methods provide feedback that can aid learner evaluation of learning resources, the adequacy and reliability of these methods is questioned. Because engagement with online learning is different from other Web activity, it is important to establish pedagogically relevant measures that can aid the development of distinct, automated analysis systems. Content analysis is often used to examine online discussion in educational settings, but these instruments are rarely compared with each other which leads to uncertainty regarding their validity and reliability. In this study, participation in Massive Open Online Course (MOOC) comment forums was evaluated using four different analytical approaches: the Digital Artefacts for Learning Engagement (DiAL-e) framework, Bloom's Taxonomy, Structure of Observed Learning Outcomes (SOLO) and Community of Inquiry (CoI). Results from this study indicate that different approaches to measuring cognitive activity are closely correlated and are distinct from typical interaction measures. This suggests that computational approaches to pedagogical analysis may provide useful insights into learning processes.

University students and faculty have positive perceptions of open/alternative resources and their utilization in a textbook replacement initiative

This is contribution no. 16-114-J from the Kansas Agricultural Experiment Station. The Kansas State University Open/Alternative Textbook Initiative provides grants to faculty members to replace textbooks with open/alternative educational resources (OAERs) that are available at no cost to students. Open educational resources are available for anyone to access, while alternative educational resources are not open. The objective of this study was to determine the perceptions towards OAERs and the initiative, of students enrolled in, and faculty members teaching, courses using OAERs. A survey was sent out to 2,074 students in 13 courses using the OAERs. A total of 524 (25.3%) students completed the survey and a faculty member from each of the 13 courses using OAERs was interviewed. Students rated the OAERs as good quality, preferred using them instead of buying textbooks for their courses, and agreed that they would like OAERs used in other courses. Faculty felt that student learning was somewhat better and it was somewhat easier to teach using OAERs than when they used the traditional textbooks. Nearly all faculty members preferred teaching with OAERs and planned to continue to do so after the funding period. These results, combined with the tremendous savings to students, support the continued funding of the initiative and similar approaches at other institutions.

The role of networked learning in academics’ writing

This article explores academics’ writing practices, focusing on the ways in which they use digital platforms in their processes of collaborative learning. It draws on interview data from a research project that has involved working closely with academics across different disciplines and institutions to explore their writing practices, understanding academic literacies as situated social practices. The article outlines the characteristics of academics’ ongoing professional learning, demonstrating the importance of collaborations on specific projects in generating learning in relation to using digital platforms and for sharing and collaborating on scholarly writing. A very wide range of digital platforms have been identified by these academics, enabling new kinds of collaboration across time and space on writing and research; but challenges around online learning are also identified, particularly the dangers of engaging in learning in public, the pressures of ‘always-on’-ness and the different values systems around publishing in different forums.

The space for social media in structured online learning

In this paper, we explore the benefits of using social media in an online educational setting, with a particular focus on the use of Facebook and Twitter by participants in a Massive Open Online Course (MOOC) developed to enable educators to learn about the Carpe Diem learning design process. We define social media as digital social tools and environments located outside of the provision of a formal university-provided Learning Management System. We use data collected via interviews and surveys with the MOOC participants as well as social media postings made by the participants throughout the MOOC to offer insights into how participants’ usage and perception of social media in their online learning experiences differed and why. We identified that, although some participants benefitted from social media by crediting it, for example, with networking and knowledge-sharing opportunities, others objected or refused to engage with social media, perceiving it as a waste of their time. We make recommendations for the usage of social media for educational purposes within MOOCs and formal digital learning environments.

Sensitivity and specificity of machine learning classifiers for glaucoma diagnosis using Spectral Domain OCT and standard automated perimetry

PURPOSE: To evaluate the sensitivity and specificity of machine learning classifiers (MLCs) for glaucoma diagnosis using Spectral Domain OCT (SD-OCT) and standard automated perimetry (SAP). METHODS: Observational cross-sectional study. Sixty two glaucoma patients and 48 healthy individuals were included. All patients underwent a complete ophthalmologic examination, achromatic standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) imaging with SD-OCT (Cirrus HD-OCT; Carl Zeiss Meditec Inc., Dublin, California). Receiver operating characteristic (ROC) curves were obtained for all SD-OCT parameters and global indices of SAP. Subsequently, the following MLCs were tested using parameters from the SD-OCT and SAP: Bagging (BAG), Naive-Bayes (NB), Multilayer Perceptron (MLP), Radial Basis Function (RBF), Random Forest (RAN), Ensemble Selection (ENS), Classification Tree (CTREE), Ada Boost M1(ADA),Support Vector Machine Linear (SVML) and Support Vector Machine Gaussian (SVMG). Areas under the receiver operating characteristic curves (aROC) obtained for isolated SAP and OCT parameters were compared with MLCs using OCT+SAP data. RESULTS: Combining OCT and SAP data, MLCs' aROCs varied from 0.777(CTREE) to 0.946 (RAN).The best OCT+SAP aROC obtained with RAN (0.946) was significantly larger the best single OCT parameter (p<0.05), but was not significantly different from the aROC obtained with the best single SAP parameter (p=0.19). CONCLUSION: Machine learning classifiers trained on OCT and SAP data can successfully discriminate between healthy and glaucomatous eyes. The combination of OCT and SAP measurements improved the diagnostic accuracy compared with OCT data alone.

Assessment of Preclinical Learning on Oral Surgery Using Three Instructional Strategies

The purpose of this investigation was to evaluate three learning methods for teaching basic oral surgical skills Thirty predoctoral dental students without any surgical knowledge or previous surgical experience were divided Into three groups (n=10 each) according to instructional strategy Group 1, active learning Group 2, text reading only, and Group 3, text reading and video demonstration After instruction, the apprentices were allowed to practice incision dissection and suture maneuvers in a bench learning model During the students' performance, a structured practice evaluation test to account for correct or incorrect maneuvers was applied by trained observers Evaluation tests were repeated after thirty and sixty days Data from resulting scores between groups and periods were considered for statistical analysis (ANOVA and Tukey Kramer) with a significant level of a=0 05 Results showed that the active learning group presented the significantly best learning outcomes related to immediate assimilation of surgical procedures compared to other groups All groups results were similar after sixty days of the first practice Assessment tests were fundamental to evaluate teaching strategies and allowed theoretical and proficiency learning feedbacks Repetition and interactive practice promoted retention of knowledge on basic oral surgical skills

The interaction between technologies and society: Lessons learnt from 160 evolutionary years of online news services

In mapping the evolutionary process of online news and the socio-cultural factors determining this development, this paper has a dual purpose. First, in reworking the definition of “online communication”, it argues that despite its seemingly sudden emergence in the 1990s, the history of online news started right in the early days of the telegraphs and spread throughout the development of the telephone and the fax machine before becoming computer-based in the 1980s and Web-based in the 1990s. Second, merging macro-perspectives on the dynamic of media evolution by DeFleur and Ball-Rokeach (1989) and Winston (1998), the paper consolidates a critical point for thinking about new media development: that something technically feasible does not always mean that it will be socially accepted and/or demanded. From a producer-centric perspective, the birth and development of pre-Web online news forms have been more or less generated by the traditional media’s sometimes excessive hype about the power of new technologies. However, placing such an emphasis on technological potentials at the expense of their social conditions not only can be misleading but also can be detrimental to the development of new media, including the potential of today’s online news.

Undergraduate student experiences and perceptions of group projects

This paper reports the experiences and perceptions of student group projects of three cohorts of undergraduates: a 3rd year capstone course in professional communication (N = 54), a 3rd year elective in chemical engineering (N = 29), and a core 2nd-year course in chemical engineering (N = 74).