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. ^

Adult education directors' perceptions of performance indicators for adult education programs in the state of Florida

Current demands for accountability in education emphasize outcome-based program evaluation and tie program funding to individual student performance. As has been the case for elementary and secondary programs, demands for accountability have increased pressure on adult educators to show evidence of the benefits of their programs in order to justify their financial support. In Florida, recent legislation fundamentally changes the delivery of adult education in the state by establishing a performance-based funding system that is based on outcomes related to the retention, completion, and employment of program participants.^ A performance-based funding system requires an evaluation process that stresses outcome indicators over indicators that focus on program context or process. Although the state has adopted indicators of program quality to evaluate its adult education programs, these indicators focus mostly on program processes rather than student outcomes. In addition, the indicators are not specifically tied to workforce development outcomes, a priority to federal and local funding agents.^ Improving the accountability of adult education programs and defining the role of these programs in Florida's Workforce Development System has become a priority to policy makers across the state. Another priority has been to involve adult education practitioners in every step of this process.^ This study was conducted in order to determine what performance indicators, as judged by the directors and supervisors of adult education programs in the state of Florida, are important and feasible in measuring the quality and effectiveness of these programs. The results of the study indicated that, both statewide and by region, the respondents consistently gave the highest ratings on both importance and feasibility to the indicators of Program Context, which reflect the needs, composition, and structure of the programs, and to the indicators of Educational Gain, which reflect learner progress in the attainment of basic skills and competencies. In turn, the respondents gave the lowest ratings on both importance and feasibility to the indicators in the areas of Return on State's Investment, Efficiency, Retention, and Workforce Training. In general, the indicators that received high ratings for importance also received high ratings for feasibility. ^

Education and training in the use of physical agent modalities by occupational therapists practicing in the physical disabilities area

This study was conducted to examine how occupational therapists (OTs) practicing in the physical disabilities area received their training in the use of physical agent modalities (PAMs); to determine the frequency of PAMs usage by those therapists; and to obtain their opinions regarding the training of OTs and OT students in the administration of PAMs. Three hundred OTs practicing in physical diabilities (n = 194 returned) were surveyed. The most frequently used modalities were hot and cold packs, paraffin, and ultrasound. The least frequently used modalities were transcutaneous electrical stimulation (TENS) and whirlpool. On-the-job training was the most common educational method received by the respondents for PAMs usage. The respondents considered a combination of undergraduate education, fieldwork, continuing education and on-the-job training as the most appropriate educational setting for training in modalities. While few of the respondents received preparation in PAMs during entry-level academic programs, the majority felt that OT students should be trained in PAMs usage as part of their education curriculum. ^

The democratization of higher education in Jamaica: The role of the University of the West Indies

The University of the West Indies (UWI), established in the British colony of Jamaica in 1948, was mandated to serve the “brightest and the best” of the British colonies. Unfortunately, the austerity of Jamaica's economy has not helped to augment an “open door” access to higher education, and UWI is often criticized for not implementing policies to sustain the democratization of higher education; it is accused of functioning as an elitist institution. ^ The purpose of this qualitative study was to determine whether UWI functions democratically as an institution to influence the equity of higher education in Jamaica. A review of the literature reveals many interpretations of the democratization of higher education. Three of Spaulding and Kargodorian's four criteria were utilized to analyze this research. They were (1) equality of access to higher education, (2) equality of participation within the institution of higher education, and (3) equality of educational results. Multiple sources of written data augmented by interviews in Jamaica and Miami were utilized. ^ The analysis revealed that UWI functions in a collaborative relationship with Jamaica's Centralized Educational System as well as with the country's political, economic, and social realms to impact the democratization of higher education. Documentation suggests that, although strong traditional influences continue to exist, UWI has deviated from its original mandate and instead, flexible admittance policies and diversification of expanded programs have contributed to greater accessibility. ^ Despite UWI's reports of improvements which have contributed to more access, UNESCO and some interviewees have not been impressed. A World Bank report on enrollment ratio at the university level in English speaking Caribbean countries reflects less than one percent of the age cohort. The Jamaicans interviewed, especially those from the lower class, felt that their democratic right to receive higher education was not met. UNESCO regards UWI's efforts as just putting a “dent” in the problem. ^ Recommendations include continuing efforts towards developing curricula more relevant to the Jamaican society, increasing distance education in order to ease UWI's load, expanding financial partnerships with private sectors, and extending research in collaboration with large local and foreign private companies. ^

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. ^

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. ^

A hermeneutic phenomenology of graduate education students' understandings of instructor power in a higher education classroom

Higher education is a distribution center of knowledge and economic, social, and cultural power (Cervero & Wilson, 2001). A critical approach to understanding a higher education classroom begins with recognizing the instructor's position of power and authority (Tisdell, Hanley, & Taylor, 2000). The power instructors wield exists mostly unquestioned, allowing for teaching practices that reproduce the existing societal patterns of inequity in the classroom (Brookfield, 2000). ^ The purpose of this hermeneutic phenomenological study was to explore students' experiences with the power of their instructors in a higher education classroom. A hermeneutic phenomenological study intertwines the interpretations of both the participants and the researcher about a lived experience to uncover layers of meaning because the meanings of lived experiences are usually not readily apparent (van Manen, 1990). Fifteen participants were selected using criterion, convenience, and snowball sampling. The primary data gathering method were semi-structured interviews guided by an interview protocol (Creswell, 2003). Data were interpreted using thematic reflection (van Manen, 1990). ^ Three themes emerged from data interpretation: (a) structuring of instructor-student relationships, (b) connecting power to instructor personality, and (c) learning to navigate the terrains of higher education. How interpersonal relationships were structured in a higher education classroom shaped how students perceived power in that higher education classroom. Positive relationships were described using the metaphor of family and a perceived ethic of caring and nurturing by the instructor. As participants were consistently exposed to exercises of instructor power in a higher education classroom, they attributed those exercises of power to particular instructor traits rather than systemic exercises of power. As participants progressed from undergraduate to graduate studies, they perceived the benefits of expertise in content or knowledge development as secondary to expertise in successfully navigating the social, cultural, political, and interpersonal terrains of higher education. Ultimately, participants expressed that higher education is not about what you know; it is about learning how to play the game. Implications for teaching in higher education and considerations for future research conclude the study.^

Curricular perceptions of adult education at National Chun -Chin University, Chia -Yi, Taiwan

This research was conducted in Chia-Yi, Taiwan to study the needs of adult education participants to determine the factors necessary to provide direction for the development of university adult education curriculum and supportive government educational policies. Factors researched were characteristics of the adult learner, theories of adult learning, demands of adult education, and implications of university adult education as the theoretical foundation for the development of specific curriculum development efforts. The study investigated adult learning needs and their relationship with demographic variable. Analyzing the needs of adult education participant and the relative factors through a survey resulted in recommendations for the development of adult education program plans, content of curriculum, and teaching. Research questions were analyzed using descriptive statistics, frequencies, chi square, one-way analysis of variance (ANOVA), and post hoc analysis. ^ The study showed that most participants in these adult education activities were under forty, middle class, of above average educational levels, and either living or working in the city. People who were older, of lesser social and economic positions, with lower educational standards, and living/working in the country, did not participate as much in adult education opportunities. Recommendations included that in the planning or setting up of adult education activities, attention be given to all the possible barriers or problems that are likely to occur in people's participation, e.g., motivation, interests, content of courses, teaching methods, willingness of participation, qualification of teachers, time, funds, locations, and so on. It is suggested that the resolution of these problems can significantly increase the participation of adult education. ^

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. ^

Increasing nurse's knowledge of neonatal pain assessment through inservice education program

Recognizing neonatal pain is a challenge for nurses working with newborns due to the complexity of the pain phenomenon. Pain is subjective, and infants lack the ability to communicate, and their pain is difficult to recognize. The purpose of this study is to determine the effectiveness of education on the NICU nurses' ability to assess neonatal pain. With a better understanding of pain theory and the effects of pain on the newborn the nurse will be better able to assess newborns with pain. Designed as a quasi-experimental one-group pretest and posttest study, the data was collected on a convenience sample of 49 registered nurses employed in the neonatal and special care nursery units at a Childrens Hospital in the Miami area. The nurses were surveyed on the assessment of neonatal pain using the General Information and Pain Sensitivity Questionnaire. After the initial survey, the nurses were inserviced on neonatal pain assessment using a one hour inservice education program. One week after the intervention the nurse was asked to complete the questionnaire again. Data analysis involved comparision of pre and post intervention findings using descriptive methods, t test, correlation coefficients, and ANOVA , where applicable. Findings revealed a significant ( p=.006) increase in nurse's knowledge of neonatal pain assessment after completing the educational inservice when comparing the pre-test and post-test results.

Development of an education resource for families and clients navigating through end-of-life care with at-home palliation

Background: Community health nurses (CHNs) play a pivotal role in providing end-of-life care to clients diagnosed with a life-threatening illness. Providing quality end-of-life care is an ethical obligation. Eastern Health’s palliative end-of-life care program (PEOLC) offers nursing care, equipment, services, and support. However, the caregiver’s need for practical information about end-of-life issues is not addressed. Purpose: To develop an educational resource to assist clients and families during end-of-life and to provide a framework for new CHNs in home palliation. Methods: An informal Needs Assessment, a literature review, an environmental scan, and consultations with four CHNs involved with home palliation. Results: An educational resource was developed to address the practical end-of-life issues identified in the literature review and consultations. Conclusion: An improved delivery of care for at-home palliation in the community for clients and families, and a framework for new CHNs.

Compensatory Education: Approaching the Problem from the Wrong Direction

*Designated as an exemplary master's project for 2015-16*

From Where Do We Teach? Potential Positions in Public Education

This thesis is a conceptual examination of the positions from which we teach in public education. As it is philosophical in nature, it takes no qualitative or quantitative data. It offers a review of selected relevant literature and an analysis of personal and professional experience, with the intent to pose critical questions about teaching and learning. The framework of this thesis represents the following contentions: First, from its inception, public schooling served capital by preparing skilled labour for emerging industrial markets. This history is the hegemonic shadow that hangs over public education today. Second, movements toward the standardization of funding, curriculum, and evaluation support the further commodification of public schooling. The “accountability” that standardization offers, the “back to basics” that it aims for, is counter to the potential that public education might critically inform citizens and seek social justice. Third, movements toward the privatization of public schooling under the guise of “choice” and “mobility”, brought on by manufactured crisis, serve only to widen socio-economic inequities as capitalist neoliberal interests seek profit in both the product of public schools and in schooling itself. If we recognize and understand the power of public education to inform vast numbers of citizens who will, in turn, either maintain or reform society, we must ask: What do we want public education to be? What are the effects of continuing down historically conventional and increasingly standardized paths? What do progressive pedagogies offer? How might teachers destandardize their pedagogy and pursue equitable opportunities for marginalized students? How might students name themselves and their world, that they might play a part in its reimagining? For whom do we teach, and under what conditions? From where do we teach, and why? For educators to ask these questions, and to employ what they discover, will necessitate taking substantial risks. It will necessitate taking a stand and cannot be done alone. Teachers must seek out the collaboration of their students. They must offer students the time and the space to find their own voices, to create their own selves, and to envision previously uncharted paths on which we might walk together.

From teaching clinician to research academic- changing focus within UK nurse education; a discussion paper

The focus of this discussion paper is the need for effective professional socialisation of student nurses and the degree to which core values and culture are transferred through University schools of nursing, the academic teaching staff and to the student nurses.
UK schools of nursing had progressively transferred into university institutions more than two decades ago. Schools of nursing and the teaching academics within them, to a greater or lesser extent, impact on and help to professionally socialize student nurses. Professed core values of universities whilst including a focus on excellence and innovation, perhaps also include, collegiality, integrity and social commitment to care. These are all qualities, which should be core values and elements
of the transferable professional culture to student nurses. Notwithstanding the professed core values, at least in some areas of UK universities there is some evidence of increasing competition and a disproportionate research market driven focus. This can reflect back into schools of nursing and is inconsistent with nursing professional values.

This paper explores the degree to which the professed core values of universities and the institutional culture are necessarily enacted, and the degree to which
any dissonance in the institutions professed/enacted core values and culture reflect through the schools of nursing and impact in the professional socialisation of student nurses. The paper also explores the degree to which effective leadership in schools of nursing can help to maintain professional core values and a culture of nursing professional