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.

Predictors of feelings of depression among Asian American college students

The purpose of this study is to explore the relationship between various collegiate experiences including substance use, religiosity, campus climate, academic life, social life, self-concept, satisfaction with college, and perceived feelings of depression among Asian American college students compared to other racial groups. Employing Astin’s (1993) I-E-O model, the study utilized the 2008 Cooperative Institutional Research Program (CIRP) the Freshman Survey (TFS) and the follow up College Senior Survey (CSS) in 2012 with the final sample of 10,710 students including 951 Asian American students. Descriptive analysis, cross-tabulations, blocked hierarchical multiple regression analysis, the equality of the unstandardized beta coefficients from the regression analyses, and a one-way ANOVA were conducted for the data analysis. Asian American students who are female, from low SES backgrounds, academically less achieved, frequent substance users, less religiously involved, and less satisfied with overall college experiences showed higher levels of feeling depressed. For the rate of feeling depressed across racial groups, Asian American college students showed the highest rate of feeling depressed while White students reported the lowest rate of feeling depressed. For Asian American college students, feeling depressed in high school, hours spent per week on studying and homework, and self-confidence in intellectual ability were the most significant predictors of feelings of depression while drinking beer, drinking liquor, spirituality, failing to complete homework on time, hours spent per week on socializing, self rated self-confidence in social ability, and satisfaction with overall college experiences were significant predictors of feelings of depression. Asian American college students spent the longest hours on studying and homework, reported the highest GPA, but showed the lowest self-confidence on intellectual ability. For all four racial groups, feeling depressed in high school and self-confidence in intellectual ability were significant predictors of feelings of depression in common. Implications for practice and directions for future research emphasize the need for better understanding the unique cultural background and impact of academic life associated with feelings of depression among Asian American college students and developing customized psycho-educational and outreach programs to meet unique needs for psychological well-being for each racial group on campus.

Inclusão de crianças especiais em uma escola pública de Ribeira do Pombal, Bahia, Brasil : um estudo de caso

A inclusão de crianças com necessidades especiais nas escolas comuns é uma idealização voltada para a oportunidade e o respeito à diversidade. Com a Constituição Federal Brasileira (1988), no seu capítulo III, da Educação, da cultura e do desporto, Art. 205, rege que ―A educação, direito de todos e dever do Estado e da família [...]‖ denota que lugar de criança é na escola, independente de credo, deficiência, raça e cultura. O presente estudo de caso na escola pública Rui Barbosa, situada na cidade de Ribeira do Pombal, Bahia, Brasil, pretende conhecer a práxis educativa e o perfil dos profissionais sobre a proposta e a prática pedagógica inclusiva, como também analisar o espaço físico, observando se há ou não barreiras arquitetônicas e acessibilidade para os alunos com deficiência e também a participação da família, em inserir o filho no ambiente formal. Esta investigação tem como base a revisão da literatura sobre inclusão, com a utilização, no enquadramento teórico, da legislação brasileira, entre outros autores voltados ao tema. O desenvolvimento do estudo possui característica qualitativa, através de observação, questionário, entrevista, visitas, ou seja, uma construção através do diálogo e vivência diária realizada no turno matutino. Os participantes dessa investigação foram: gestores, coordenadora da Educação Especial e coordenadora do ensino comum, professores, agentes administrativos, representante da secretaria municipal, profissional da saúde (psicóloga), famílias e alunos do ensino comum e especial. A análise dos resultados obtidos revela que a proposta inclusiva encontra-se em processo de evolução humana e arquitetônica, mas também regista-se pontos positivos no aumento de número de matrículas, ou seja, os pais estão sendo conquistados e adquirindo confiança na instituição. Os professores, apesar da insegurança, da carência de auxílio, não tratam os alunos com desdém e buscam auxiliá-los como podem e sabem. Por fim, a escola aposta num trabalho que envolva o interpessoal e intrapessoal em busca da inclusão sem obstáculos.

THERE GOES THE ELECTORAL NEIGHBORHOOD: LOCAL NETWORKS, ATTRIBUTION OF RESPONSIBILITY, AND THE (UN) FAIRNESS OF ELECTIONS

During the last two decades there have been but a handful of recorded cases of electoral fraud in Latin America. However, survey research consistently shows that often citizens do not trust the integrity of the electoral process. This dissertation addresses the puzzle by explaining the mismatch between how elections are conducted and how the process is perceived. My theoretical contribution provides a double-folded argument. First, voters’ trust in their community members (“the local experience”) impacts their level of confidence in the electoral process. Since voters often find their peers working at polling stations, negative opinions about them translate into negative opinions about the election. Second, perceptions of unfairness of the system (“the global effect”) negatively impact the way people perceive the transparency of the electoral process. When the political system fails to account for social injustice, citizens lose faith in the mechanism designed to elect representatives -and ultimately a set of policies. The fact that certain groups are systematically disregarded by the system triggers the notion that the electoral process is flawed. This is motivated by either egotropic or sociotropic considerations. To test these hypotheses, I employ a survey conducted in Costa Rica, El Salvador, Honduras, and Guatemala during May/June 2014, which includes a population-based experiment. I show that Voters who trust their peers consistently have higher confidence in the electoral process. Whereas respondents who were primed about social unfairness (treatment) expressed less confidence in the quality of the election. Finally, I find that the local experience is predominant over the global effect. The treatment has a statistically significant effect only for respondents who trust their community. Attribution of responsibility for voters who are skeptics of their peers is clear and simple, leaving no room for a more diffuse mechanism, the unfairness of the political system. Finally, now I extend analysis to the Latin America region. Using data from LAPOP that comprises four waves of surveys in 22 countries, I confirm the influence of the “local experience” and the “global effect” as determinants of the level of confidence in the electoral process.

La oralidad en la administración de justicia ecuatoriana: código orgánico general de procesos

Los ciudadanos que en cualquier momento se ven involucrados en un proceso judicial deben conocer cómo se van a sustanciar y resolver sus causas, facilitándose mediante el sistema oral, brindando a los usuarios mayor confianza en la administración de justicia, que desempeña un rol trascendental e importante dentro del desarrollo de una sociedad. Las partes procesales buscan que sus pretensiones se vean reflejadas en una sentencia justa, considerando al Ecuador como un estado de derechos y de justicia garantizado en nuestra Carta Magna. Mediante esta monografía se pretende analizar la aplicación de la oralidad en el Código Orgánico General de Procesos. Revisando brevemente los antecedentes históricos: Egipto, Grecia, Roma hasta la actualidad, un análisis comparativo entre el sistema oral y escrito, pensamientos de autores a favor y en contra del sistema oral. Seanalizará la legislación en el ámbito nacional haciendo referencia a la Constitución del Ecuador, al Código Orgánico General de Procesos y al Código Orgánico de la Función Judicial, considerando a los principios del debido proceso. Se plasmará la opinión de juristas y profesionales de nuestro medio. Finalizando con las conclusiones de este trabajo. Ecuador como país, debe aprender de las experiencias pasadas y aprovecharlas adaptando la administración de justicia a las necesidades de nuestra colectividad, el sistema escrito no ha logrado solucionar satisfactoriamente los retos de la sociedad actual por ello ha sido sustituido y esperemos hayamos tomado el camino correcto.

Magnetic and Acoustic Investigations of Turbulent Spherical Couette Flow

Title of dissertation: MAGNETIC AND ACOUSTIC INVESTIGATIONS OF TURBULENT SPHERICAL COUETTE FLOW Matthew M. Adams, Doctor of Philosophy, 2016 Dissertation directed by: Professor Daniel Lathrop Department of Physics This dissertation describes experiments in spherical Couette devices, using both gas and liquid sodium. The experimental geometry is motivated by the Earth's outer core, the seat of the geodynamo, and consists of an outer spherical shell and an inner sphere, both of which can be rotated independently to drive a shear flow in the fluid lying between them. In the case of experiments with liquid sodium, we apply DC axial magnetic fields, with a dominant dipole or quadrupole component, to the system. We measure the magnetic field induced by the flow of liquid sodium using an external array of Hall effect magnetic field probes, as well as two probes inserted into the fluid volume. This gives information about possible velocity patterns present, and we extend previous work categorizing flow states, noting further information that can be extracted from the induced field measurements. The limitations due to a lack of direct velocity measurements prompted us to work on developing the technique of using acoustic modes to measure zonal flows. Using gas as the working fluid in our 60~cm diameter spherical Couette experiment, we identified acoustic modes of the container, and obtained excellent agreement with theoretical predictions. For the case of uniform rotation of the system, we compared the acoustic mode frequency splittings with theoretical predictions for solid body flow, and obtained excellent agreement. This gave us confidence in extending this work to the case of differential rotation, with a turbulent flow state. Using the measured splittings for this case, our colleagues performed an inversion to infer the pattern of zonal velocities within the flow, the first such inversion in a rotating laboratory experiment. This technique holds promise for use in liquid sodium experiments, for which zonal flow measurements have historically been challenging.

Effect of Metronidazole on Halitosis of 2 to 10 Years Old Children

Background: Regarding the fact that halitosis has social and personal aspects which can lead to social embarrassment and consequently low self-esteem and self-confidence in subjects suffering from the problem, especially children, its proper treatment is an important issue. Objectives: The aim of this study was to evaluate the effect of metronidazole as a nonspecific antimicrobial agent in the treatment of halitosis in children. Materials and Methods: In this study, 2-10 years old children with oral halitosis were enrolled. Children without H. pylori infection and parasitic infection were randomized in two interventional and control groups. Metronidazole was given 5mg/kg/day for one week. Information regarding the demographic characteristics of studied population and halitosis (duration and time of day with more halitosis and its severity) before and after intervention was recorded using a questionnaire Results: 77 children with halitosis were studied in two interventional (40 children) and control (37 children) groups. There was no significant difference between two groups before intervention. After intervention, halitosis improvement rate - according to the reports of mothers of studied children - was higher significantly in intervention group (P < 0.05). Conclusions: The results support the effectiveness of metronidazole in the treatment of halitosis. Moreover, it supports recent findings regarding the participation of specific bacteria specially unculturable ones in the pathogenesis of the disease.

Nível de confiança nas próprias memórias em estados emocionais negativos induzidos

Dissertação de Mestrado, Neurociências Cognitivas e Neuropsicologia, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2016

Liderança e coesão dos graduados instruendos no curso de Comandos

Este Trabalho de Investigação Aplicada incidiu sobre a “Liderança e Coesão dos Graduados Instruendos no Curso de Comandos”, cujo objetivo principal é a caracterização dos níveis de Liderança e Coesão durante as várias fases do Curso de Comandos. Para a realização deste estudo, foi feita uma intervenção em cada fase do Curso de Comandos (Estágio inicial, Fase Individual, Fase de Equipa, Fase de Grupo) com um Questionário de Competências de Liderança com seis dimensões de Liderança e três fatores critério (Rouco, 2012) inerentes à ação de comando e, um Questionário do Ambiente no Grupo com quatro aspetos (Carron, 1985). Estes Questionários foram aplicados a todos os Graduados Instruendos, Oficiais e Sargentos, que frequentaram o 124º Curso de Comandos, 1º Turno de 2015. Com base nas respostas, foi efetuado o tratamento dos dados num programa estatístico Statistical Package for Social Sciences. Os graduados instruendos no Curso de Comandos obtiveram comportamentos de liderança com valores médios mais elevados nas dimensões associadas à relação com as pessoas. A média com valores mais elevados regista-se na dimensão “Coesão, trabalho de equipa e cooperação”. Acrescenta-se o facto de que, os graduados instruendos, entre a fase inicial e a fase final, mostram grande vontade de cumprir a missão, grande capacidade de tomada de decisão e planeamento e desenvolver a coesão nos grupos. Os graduados instruendos, de um modo geral, percecionam que os níveis de coesão aumentaram desde a segunda fase até à última fase. Apesar da enorme queda de valores entre a primeira fase e a segunda fase, os valores na última fase são tão elevados que para além de compensarem a queda, atingem um limite superior a nove em todos os aspetos da coesão. Conclui-se que os graduados instruendos se sentem em todos os momentos, envolvidos com a interação, as tarefas, a produtividade e os objetivos do grupo. De um modo geral, os comportamentos dos graduados instruendos “Gestão de Conflitos” e “Liderança Participativa e Envolvimento” ao longo do curso de comandos contribuem para os três fatores critério. A capacidade dos graduados instruendos em tomar decisões com coragem e confiança em qualquer situação, a capacidade de avaliarem o ambiente externo e interno do grupo e a capacidade de influenciar e motivar através do exemplo, relaciona-se com a capacidade de obterem desempenhos superiores, com a competência adequada de estabelecer a capacidade de organização e motivação e, ainda, satisfazer o grupo em todo o curso. Podemos dizer que, de todas as fases do curso de comandos, a fase individual é a que apresenta os valores mais baixos nas dimensões da liderança, fatores critério e aspetos da coesão. Isto porque não existe prática de comando por parte do graduado instruendo, o que não permite a prática de liderança, e como nesta fase não existe equipa definida nem grupo, o graduado anda sozinho, o que não permite promover a coesão. Na última fase, a Fase de Grupo, todos os graduados instruendos trabalham pela primeira vez em conjunto, obtendo os valores mais elevados da coesão.

En/titled: The space where writing, editing and teaching intersect

Editing a literary magazine offers us a cultural space where our ideas and aesthetics can be expressed collectively and therefore be heard more effectively. This informs and frames our own writing by increasing our confidence in our own unusual voices. The sense of belonging Brand creates further breaks down the isolation of the writing life. The internationalism of Brand reinforces our own cultural identities as non-English writers. However, acting as a facilitator of others’ creativity can sometimes dissipate or even deplete creative energy. Editing and teaching can take over your writing to the point of annihilation. Further, in terms of external perceptions, you run the risk of disappearing as a writer. We shall look at how this can happen and explore ways that we can prevent it e.g. keeping the boundaries firm and clear.

Imagens da imparcialidade entre o discurso constitucional e a prática judicial

Tese (doutorado)—Universidade de Brasília, Faculdade de Direito, Programa de Pós-Graduação em Direito, 2016.

Améliorer la compréhension et la gestion des conflits d’intérêts des experts conseillant la prise de décisions en santé publique

Étude de cas / Case study

A perspectiva do cliente no processo de mudança em psicoterapia existencial

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção do grau de Mestre em Psicologia especialidade de Psicologia Clínica.

Améliorer la compréhension et la gestion des conflits d’intérêts des experts conseillant la prise de décisions en santé publique

Étude de cas / Case study

La confianza en las decisiones de presupuesto de capital: la TIR del comportamiento

En el presente artículo se desarrolla una investigación teórica que permite establecer un modelo matemático para cuantificar la influencia de la confianza de los gerentes en el proceso de presupuesto de capital, en particular sobre la Tasa Interna de Retorno. El Modelo permite concluir que el exceso de confianza es un factor que tiende a elevar esta tasa que esperan recibir los inversionistas tras invertir en determinados proyectos, generando así, en ciertas ocasiones, una toma de decisiones al interior de las empresas basada en cifras sesgadas, comprometiendo así los recursos de la misma.