768 resultados para Education, Nursing, Graduate


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A qualitative study was conducted to detennine 5 nursing educators' perceptions about the online application of a problem-based learning strategy in undergraduate nursing education. The question asked in the study was: Can the essential elements of face-to-face problem-based learning be supported in an online format? The data for this study came from 2 individual tape-recorded interviews with each of the 5 participants over a 3-month period and from a researchjournaI. The educators felt that student-centered learning and critical thinking could be supported within an online format. However, they noted that challenges could exist in terms of developing tutor roles, fostering student self-direction, facilitating group process and connections, and incorporating a nursing philosophy of online learning. The importance of tailoring an online problem-based learning course to reflect educators' philosophies and values in nursing emerged as an important theme from the interview responses. Overall, the participants suggested that an ideal environment would blend both face-to-face and online elements and that fewer elements would be offered in the first 2 years of the nursing program. They described a hybrid model of problem-based learning in which the online component could be used to support face-to-face sessions.

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The effectiveness of various kinds of computer programs is of concern to nurse-educators. Using a 3x3 experimental design, ninety second year diploma student nurses were randomly selected from a total population at three community colleges in Ontario. Data were collected via a 20-item valid and reliable Likert-type questionnaire developed by the nursing profession to measure perceptions of nurses about computers in the nursing role. The groups were pretested and posttested at the beginning and end of one semester. Subjects attending College A group received a computer literacy course which comprised word processing with technology awareness. College B students were exposed to computer-aided instruction primarily in nursing simulations intermittently throughout the semester. College C subjects maintained their regular curriculum with no computer involvement. The student's t-test (two-tailed) was employed to assess the attitude scores data and a one-way analysis of variance was performed on the attitude scores. Posttest analysis revealed that there was a significant difference (p<.05) between attitude scores on the use of computers in the nursing role between College A and C. No significant differences (p>.05) were seen between College B and A in posttesting. Suggestions for continued computer education of diploma student nurses are provided.

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This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.

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As a result of the current changes taking place in the delivery of acute care services, the emergence of acute ambulatory care (AAC) settings is expanding. According to a literature review, the volume, acuity, and complexity of patient care in these settings is increasing while the time the patients spend under the care of nurses is decreasing. Two forces, hospital downsizing and advancing technology, are identified as the major contributors to the shift in acute care delivery. The effects that these changes are having on the clinical nursing practice of registered nurses working in AAC settings are not known. Given that AAC settings are rapidly expanding, it can be anticipated that the delivery of nursing care will continue to be compressed into a shorter time frame. Therefore, the following qualitative research question was formulated: What are the problems and issues related to clinical nursing practice in acute ambulatory settings? The purpose of this study was to explore the problems and issues associated with change and clinical nursing practice including the educational needs of nurses working in MC settings. Specific objectives of the study included the following: (a) to explore the problems and issues related to nursing practice in select AAC settings; (b) to explore the similarities and differences in perspectives related to role expectation between nurse managers, nurse educators, and staff nurses; and (c) to develop a conceptual framework that will guide the construction of an instrument needed for further research. This study used semistructured individual interviews and focus group sessions to collect data from the three categories of registered nurses. More specifically, data were collected from one nurse manager, two charge nurses, two nurse educators and fifteen staff nurses, working in three different MC settings of a major teaching hospital. Collected data were separately analyzed by the researcher and an external rater following grounded theory methodology. By using open and axial coding, the problems and issues identified by nurses were grouped into several major and minor themes. In final analysis, by using selective coding, the four core themes (intensification, moderation, frustration, and adaptation) were extracted. Each core theme was presented and discussed in relation to hospital downsizing and advancing technology. The relationships among the four core themes were discussed and depicted in a model termed the "Impact and Consequence Model on Nursing Practice in MC Settings." Implications for further research are discussed and research hypotheses, based on the research findings, are presented.

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The purpose of this study was to assess the effects of changing a nursing documentation system, developed from King's Conceptual Framework, on the use of the nursing process. The null hypothesis was that there would be no significant increase in the reflection of the use of the nursing process on the nursing care plan or nurses' notes, as a result of using a nursing documentation system developed using King's Conceptual Framework (1981). The design involved the development of a questionnaire that was used to review health records pre and post implementation of a documentation system developed based on King's Conceptual Framework and Theory of Goal Attainment (1981). A Record Completeness Score was obtained from some of the questions. The null hypothesis was rejected. The results of the study have implications for nursing administration and the evaluation of nursing practice. If the use of a documentation system developed from a conceptual framework increases the reflection of the nursing process on the patient's health record, nursing will have the means to measure patient outcomes/goal attainment. All health care organizations and levels of government are focusing on methods to monitor and control the health-care dollar. In order for nursing to clearly determine the costs associated with nursing care, measurement of patient outcomes/goal attainment will need to be possible. In order to measure patient outcomes/goals attainment nurses will need to be able to collect data on their practice. It will be critical that nursing have a documentation system in place which facilitates the reflection of the nursing process within a theoretical framework.

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This study developed a new, valid and reliable evaluation instrument to measure the level, type and pattern of management decisions of fifteen nursing students. The management decision score achieved using this instrument was correlated with two psychological determinants of management decision making: creativity and problem-solving ability. The instrument was a written patient management problem in case format, answered by a free form written response. The student responses were classified for type of management decision according to the sub-categories of technical, inter-personal, environmental and unique. Using statistical analysis a significant difference was found in the type of management decisions most frequently selected by the study sample. The students predominantly selected technical type decisions. This preference for one type of management decision may be due to a number of psychological and environmental factors. These factors may program and mold the type of management decisions student nurses make early in their career. Low but positive correlations were found between the total management score and the two psychological tests. This finding supports the authors cited in the literature who state that although creativity augments the type of management decision making, it is not present or encouraged widely in the nursing profession. These factors are worth considering when the profession becomes concerned over ritualization and lack of individuality in patient care. The tool is easy to administer, lends itself to a variety of professional settings and shows promise with further refinement for computer application.

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The recent reengineering within the health care industry has challenged many assumptions regarding traditional structures and roles. Within a product-line management structure, the traditional viewpoint that those who manage patient care areas must have a nursing background, is an example of one such assumption being challenged. The nursing profession is often seen as the greatest obstacle to the implementation of a product-line management structure and generic manager positions (does not require a nursing background), due to the perceived loss of professional identity. This qualitative study focused on how nursing staff within a chronic care and rehabilitation facility perceived a generic service manager position. Focus groups were conducted in three phases, over a 14 month period of time. The data collected from the focus groups were then coded according to common themes. Each phase was analyzed independently, with the study concluding with an analysis and interpretation of the collective results. The results of this study revealed a significant shift in how the nursing staff perceived their professional identity and accountability in light of the implementation of the generic Service Manager position. Initial reactions of personal and professional vulnerability and resentment were seen to transform into an increased ability to explicitly articulate the role of nursing. Changes in behavior that were described included: increased consultation and collaboration with other

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This correlational study investigated the psychological types, learning style preferences, readiness for self-directed learning, demographic and continuing education participation data of 154 registered nurses at two different Southern Ontario hospitals. One hospital was a large tertiary care university-affiliated teaching centre (Cityview) and the other was a smaller secondary care community hospital (Waterview). The instruments used in the study were the PET Type Check, Kolb's Learning Style Inventory, the Self-Directed Readiness Scale (SDLRS), and a Nursing Survey developed by the researcher. Descriptive statistics, crosstabulations and correlational analyses were calculated. The most common psychological types identified among this sample of nurses were extraverted thinking, introverted intuitive and extraverted intuitive. There were no significant differences between the two hospitals. The accommodator learning style was preferred overall, with more nurses at Waterview Hospital preferring the diverger learning style, and more nurses at Cityview Hospital preferring the accommodator learning style. The majority of nurses scored in the average and above average categories on the SDLRS, indicating that they perceive themselves as ready to engage in self-directed learning. At Cityview Hospital there were more nurses in the average and high readiness categories, whereas at Waterview Hospital more nurses scored in the below average category. No significant correlations were found for learning style with psychological type, or for learning style with SDLRS scores. A positive correlation was found to exist between SDLRS scores and each of the psychological types extraverted feelings, extraverted thinking, and introverted intuitive.The only significant correlation for psychological type and continuing education activity was a positive correlation between extraverted thinking types and participation in informal discussion or study groups. Positive correlations were found for SDLRS scores with each of the following continuing education activities; number of hours per month spent reading journals; journal reading; attendance at credit courses; watching videos; using reference texts. Further details of the results are included as well as a discussion of the findings and implications for future research.

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This was a study designed to identify and explore the assumptions that Registered Nurses have about their current nursing role and practice. A qualitative case study approach was used to gather descriptive data. Thirteen study participants completed the indicators of critical thinking exercise and participated in a group session in which they identified positive and negative critical incidents in their clinical practice. The analysis of the anecdotes that were generated from the critical incident exercises revealed ten assumptions held by the Registered Nurses about their nursing practice. The ten assumptions were reflected back to the study participants to determine their level of agreement with each assumption. The ten assumptions were supported by the majority of the respondents. The Registered Nurses in this study appraised themselves affirmatively on eight out of nine indicators of critical thinking.

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The study was undertaken to identify what motivates registered nurses to participate in continuing education activities. The primary questions were whether basic nursing education, employment status, clinical area, and position, as well as readiness for selfdirected learning influenced Canadian nurses' motivational orientations when deciding to participate in continuing education activities. Other individual differences (e.g., age) were also examined. The sample included 142 registered nurses employed at an urban community hospital. Three instruments were used for data collection: the Education Participation Scale, the Self-Directed Learning Readiness Scale, and a nursing survey consisting of demographic questions. Basic nursing education and employment status did not effect motivational orientation or self-directed learning readiness. Clinical area and level of position significantly influenced nurses' decisions to participate in continuing education activities. Motivational orientation had a significant relationship with selfdirected learning readiness. Implications for practice as a result of this study involves program planning and delivery. The identification of the motivational orientations of participants may assist in the development and delivery of continuing education programs that are beneficial, relevant, and address the identified learning needs of participants. Implications for future research also exist in relation to studying different groups of nurses, for example, registered nursing assistants, and investigating related issues, for example, what are the deterrents to participation in continuing education?

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This qualitative study explores 8 gifted adults' perceptions of their own giftedness and how those perceptions influenced their pursuit of graduate education as revealed by retrospective interviews. This study serves to inform the existing literature surrounding giftedness especially as it relates to gifted individuals across the lifespan and their experiences and perceptions of education at all levels. This study also provides insight into the emotional impact being labeled gifted has on an individual's self-concept and academic identity. The major themes that emerged using the interpretive phenomenological analysis method (Smith & Osborn, 2003) were discussed under five main headings: Evolution of Giftedness, Success and Failure, Expectations, Effort, and Doubt and Proof. An adaptation of the listening guide method (Gilligan, Spencer, Weinberg, & Bertsch, 2003) was used to provide a unique and personal perspective of the phenomenon of giftedness and revealed the feelings behind the themes that emerged in the interpretive phenomenological analysis method. Specifically; this study illuminates the lack of evolution that an individual's understanding and perception of giftedness undergoes across the lifespan, and the impact such a static and school-bound understanding has on gifted adults' self-concept. It also reveals the influence that gifted individuals' innate need to achieve has on their academic aspirations and their perceptions of themselves as gifted. Furthermore, it reveals how important the understanding and internalization of failure can be on the self-concept of gifted individuals, and that this issue needs immediate attention at all levels of education.

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In this hermeneutic phenomenological study, we examined the experience of interprofessional collaboration from the perspective of nursing and medical students. Seventeen medical and nursing students from two different universities participated in the study. We used guiding questions in face-to-face, conversational interviews to explore students’ experience and expectations of interprofessional collaboration within learning situations. Three themes emerged from the data: the great divide, learning means content, and breaking the ice. The findings suggest that the experience of interprofessional collaboration within learning events is influenced by the natural clustering of shared interests among students. Furthermore, the carry-forward of impressions about physician–nurse relationships prior to the educational programs and during clinical placements dominate the formation of new relationships and acquisition of new knowledge about roles, which might have implications for future practice.

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The potential of formative assessment (FA) for informing learning in classroom-based nursing courses is clearly established in the literature; however, research on FA in clinical courses remains scarce. This inquiry explored the lived experience of nursing students using transcendental phenomenology and described the phenomenon of being assessed in clinical courses. The research question guiding the study was: How is the phenomenon of assessment experienced by nursing students when FA is formally embedded in clinical courses? Inherent in this question were the following issues: (a) the meaning of clinical experiences for nursing students, (b) the meaning of being assessed through FA, and (c) what it is like to be assessed when FA is formally embedded within clinical experiences. The noematic themes that illuminated the whatness of the participants’ experience were (a) enabled cognitive activity, (b) useful feedback, (c) freedom to be, (d) enhanced focus, (e) stress moderator, and (f) respectful mentorship. The noetic themes associated with how the phenomenon was experienced were related to bodyhood, temporality, spatiality, and relationship to others. The results suggest a fundamental paradigm shift from traditional nursing education to a more pervasive integration of FA in clinical courses so that students have time to learn before being graded on their practice. Furthermore, this inquiry and the literature consulted provide evidence that using cognitive science theory to inform and reform clinical nursing education is a timely option to address the repeated calls from nursing leaders to modernize nursing education. This inquiry contributes to reduce our reliance on assumptions derived from research on FA in nursing classrooms and provides evidence based on the reality of using formative assessment in clinical courses. Recommendations for future research are presented.

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