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.

An interpretative phenomenological analysis of the lived experience of suicidal behaviour

Background: In Scotland, suicide prevention is a major public health challenge, with two people, on average, dying every day due to suicide. Any efforts to prevent suicide should be aided by research. Existing research on suicide is dominated by quantitative research that has largely focused on providing explanatory accounts of suicidal phenomena. Research providing rich and detailed accounts of suicidal behaviour among individuals who have directly experienced it is growing but remains relatively embryonic. This study sought to supplement existing understanding of attempted suicide specifically by exploring the processes, meaning and context of suicidal experiences among individuals with a history of attempted suicide. Methods: The study used a retrospective qualitative design with semi-structured in-depth interviews. Participants were patients (n=7) from a community mental health service in Glasgow, Scotland who had attempted suicide within the previous 12-month period. The interviews were transcribed verbatim and were analysed for recurrent themes using interpretative phenomenological analysis (IPA). Results: Three super-ordinate themes, each with inter-related sub-themes, emerged from the analysis. 1) “Intentions”: This theme explored different motives for suicide, including providing relief from upsetting feelings; a way of establishing control; and a means of communicating with others. 2) “The Suicidal Journey”: This theme explored how individuals’ thinking can change when they are suicidal, including feeling overwhelmed by a build-up of distress and a narrowing of their perspective. 3) “Suicidal Dissonance”: This theme explored how people can feel conflicted about suicide and can be fearful of the consequences of their suicidal behaviour. Conclusion: Participants’ accounts were dominated by experience of significant adversity and psychological suffering. These accounts provided valuable insights into the suicidal process, highlighting implications for clinical practice and future research.

Government management of tourism in fostering residents support for sustainable tourism development: Evidence from a Portuguese historic town

This study proposes a conceptual framework that explores the correlations between economic dependence (ED), local government management of tourism (GMT), perceived tourism benefits and costs, and support for sustainable tourism development (STD). A quantitative research design was adopted. Data collection was carried out by personal survey applied to 300 residents of the small historic town of Lamego, located within the Douro Valley World Heritage Site. Structural equation modelling methods were employed to analyse the proposed model. Results suggest that GMT has a significant effect on the perceived impacts of tourism, both in the positive and in the negative. The effect of GMT in fostering residents’ support to STD was also empirically supported. Additionally, it was also determined that positive perceptions of the impacts of tourism directly influence support to STD. Nevertheless, ED does not have a significant effect either on perceivedbenefits, nor on perceived costs or on residents’ support to STD. Likewise, perceptions of the negative impacts do not predict residents’ support to STD.

Analysis and Visualisation of Crowd-sourced Tourism Data

C3S2E '16 Proceedings of the Ninth International C* Conference on Computer Science & Software Engineering

The commodification of culture in the Thai tourism context: a study of culinary experiences in touristic traditional markets

The purpose of the thesis is to examine the relationship between tourism and the local culture expressed in culinary experiences offered in the traditional, nostalgic-themed markets that have arisen as popular attractions in the 21 st century. Central to the thesis is an examination of how the traditional cultural values are articulated in the production, promotion and consumption of culinary experiences in order to understand the value of culture when embedded in the process of commodification, as well as to understand influential socio-cultural factors. The thesis investigates the potential of traditional markets to promote food as the main attraction in the market. Field studies were conducted from December 2012–March 2014 in eight traditional markets in the central region of Thailand. Based on the ethnographic approach in studying the narratives in the markets, a variety of methods were implemented in the process of data collection. Besides observational analysis of the venue, semi-structured interviews and the self-administered questionnaires were used to collect data from actors who engage in food experiences, including management team members, food traders and visitors. Data was also collected from interviews with officers working for Tourism Authority of Thailand (TAT).  Keys findings of the thesis reveal that the cultural expressions of food experience in each market is an outcome of both the interactions of worldviews expressed by actors involved in the traditional market and the socio-cultural condition of Thailand. The relationships between stakeholders’ attitudes towards food experiences and the commercial potentials and limitations of food were analysed. The analysis of the cultural value of culinary experiences demonstrates that the existing academic discussions of the authenticity of tourism are insightful in explaining the character of food experiences offered in this tourism scenario. Most importantly, authenticity in tourism experiences, being a desirable element in culinary experiences, is a reflection of the how the pre-modern aspect of Thai society is embraced in a contemporary context. In addition, the commodification of culinary culture generates multidimensional consequences on the value of traditional culture and local lives. Moreover, the performance of culinary experiences can be viewed from the perspective of how Thai society interacts with globalization. The thesis also points out that it is possible to compare the situation of the traditional markets with the marketing positioning of food in Thai tourism marketing policy.

Applying Platform Design to Improve Product-Service Systems Collaborative Development

Part 3: Product-Service Systems

A MORE COMPLETE STREET A STREET FOR EVERYONE TO ENJOY, NORTH EAST STREET, FREDERICK, MARYLAND – A DESIGN INVESTIGATION OF DIFFERENT STREET DESIGN THEORIES

This design-research thesis suggests that the improvement of North East Street performances by using Complete Streets, Green Street, Place Making and Context Sensitive Solution principles and practices. Heavily used by a variety of users, often conflicting with one another, University of Maryland Campus Drive would benefit from a major planning and design amelioration to meet the increasing demands of serving as a city main street. The goal of this thesis project is to prioritize the benefits for pedestrians in the right-of-way and improve the pedestrian experience. This goal also responds to the recent North East Street Extension Phrase I of economic renaissances. The goal of this design-research thesis will be achieved focusing on four aspects. First, the plans and designs will suggest to building mixed use blocks, increase the diversity of street economic types and convenience of people’s living. Second, design and plans will propose bike lanes, separate driving lanes from sidewalks and bike lanes by street tree planters, and narrow driving lanes to reduce vehicular traffic volume and speed in order to reduce pedestrian and vehicle conflicts. Third, plans and designs will introduce bioswales, living walls and raingardens to treat and reuse rain water. Finally, the plans and designs will seek to preserve local culture and history by adding murals and farmers market. The outcome of the design-research thesis project is expected to serve as an example of implementing Complete Streets, Green Street, Place Making and Context Sensitive Solution principles and practices in urban landscape, where transportation, environment and social needs interact with each other.

A HUMAN-CENTERED APPROACH TO IMPROVING THE USER EXPERIENCE OF SOFTWARE UPDATES

Software updates are critical to the security of software systems and devices. Yet users often do not install them in a timely manner, leaving their devices open to security exploits. This research explored a re-design of automatic software updates on desktop and mobile devices to improve the uptake of updates through three studies. First using interviews, we studied users’ updating patterns and behaviors on desktop machines in a formative study. Second, we distilled these findings into the design of a low-fi prototype for desktops, and evaluated its efficacy for automating updates by means of a think-aloud study. Third, we investigated individual differences in update automation on Android devices using a large scale survey, and interviews. In this thesis, I present the findings of all three studies and provide evidence for how automatic updates can be better appropriated to fit users on both desktops and mobile devices. Additionally, I provide user interface design suggestions for software updates and outline recommendations for future work to improve the user experience of software updates.

Design gráfico alternativo

Dissertação de Mestrado para obtenção do grau de Mestre em Design de Comunicação, apresentada na Universidade de Lisboa - Faculdade de Arquitectura

Role of tourism in local communities’ attitudes toward biodiversity conservation: case study of Golestan National Park, Iran

Dissertação de Mestrado, Economia do Turismo e Desenvolvimento Regional, Faculdade de Economia, Universidade do Algarve, 2016

Design de comunicação

Dissertação de Doutoramento para obtenção do grau de Doutor em Design, dissertação apresentada na Universidade de Lisboa - Faculdade de Arquitetura.

Adaptive lighting design as a holistic approach to public lighting

Dissertação para obtenção do grau de Doutor em Design, apresentada na Universidade de Lisboa - Faculdade de Arquitetura.

DESIGN OF EFFICIENT IN-NETWORK DATA PROCESSING AND DISSEMINATION FOR VANETS

By providing vehicle-to-vehicle and vehicle-to-infrastructure wireless communications, vehicular ad hoc networks (VANETs), also known as the “networks on wheels”, can greatly enhance traffic safety, traffic efficiency and driving experience for intelligent transportation system (ITS). However, the unique features of VANETs, such as high mobility and uneven distribution of vehicular nodes, impose critical challenges of high efficiency and reliability for the implementation of VANETs. This dissertation is motivated by the great application potentials of VANETs in the design of efficient in-network data processing and dissemination. Considering the significance of message aggregation, data dissemination and data collection, this dissertation research targets at enhancing the traffic safety and traffic efficiency, as well as developing novel commercial applications, based on VANETs, following four aspects: 1) accurate and efficient message aggregation to detect on-road safety relevant events, 2) reliable data dissemination to reliably notify remote vehicles, 3) efficient and reliable spatial data collection from vehicular sensors, and 4) novel promising applications to exploit the commercial potentials of VANETs. Specifically, to enable cooperative detection of safety relevant events on the roads, the structure-less message aggregation (SLMA) scheme is proposed to improve communication efficiency and message accuracy. The scheme of relative position based message dissemination (RPB-MD) is proposed to reliably and efficiently disseminate messages to all intended vehicles in the zone-of-relevance in varying traffic density. Due to numerous vehicular sensor data available based on VANETs, the scheme of compressive sampling based data collection (CS-DC) is proposed to efficiently collect the spatial relevance data in a large scale, especially in the dense traffic. In addition, with novel and efficient solutions proposed for the application specific issues of data dissemination and data collection, several appealing value-added applications for VANETs are developed to exploit the commercial potentials of VANETs, namely general purpose automatic survey (GPAS), VANET-based ambient ad dissemination (VAAD) and VANET based vehicle performance monitoring and analysis (VehicleView). Thus, by improving the efficiency and reliability in in-network data processing and dissemination, including message aggregation, data dissemination and data collection, together with the development of novel promising applications, this dissertation will help push VANETs further to the stage of massive deployment.

Life design counseling: A study on client's operations for meaning construction

This study evaluated the adequacy of the micro-theory of client operations to explain meaning construction during Life Design Counseling. Four adolescents were interviewed about their second counseling session. Their recollections were stimulated through the replay of counseling videotapes. The resulting transcribed interviews were qualitatively analyzed. Results confirmed a sequence of client operations evolving from the symbolic representation of experience and reflexive self-examination towards making new realizations and revisioning self. Moreover, clients reported negative and positive session moments evidencing that clients' attention and activity during the session was not restricted to meaning construction operations. Practical implications for life design counseling are derived from the results and discussed.

Using Research Methods in Human Computer Interaction to Design Technology for Resilience

Research in human computer interaction (HCI) covers both technological and human behavioural concerns. As a consequence, the contributions made in HCI research tend to be aware to either engineering or the social sciences. In HCI the purpose of practical research contributions is to reveal unknown insights about human behaviour and its relationship to technology. Practical research methods normally used in HCI include formal experiments, field experiments, field studies, interviews, focus groups, surveys, usability tests, case studies, diary studies, ethnography, contextual inquiry, experience sampling, and automated data collection. In this paper, we report on our experience using the evaluation methods focus groups, surveys and interviews and how we adopted these methods to develop artefacts: either interface’s design or information and technological systems. Four projects are examples of the different methods application to gather information about user’s wants, habits, practices, concerns and preferences. The goal was to build an understanding of the attitudes and satisfaction of the people who might interact with a technological artefact or information system. Conversely, we intended to design for information systems and technological applications, to promote resilience in organisations (a set of routines that allow to recover from obstacles) and user’s experiences. Organisations can here also be viewed within a system approach, which means that the system perturbations even failures could be characterized and improved. The term resilience has been applied to everything from the real estate, to the economy, sports, events, business, psychology, and more. In this study, we highlight that resilience is also made up of a number of different skills and abilities (self-awareness, creating meaning from other experiences, self-efficacy, optimism, and building strong relationships) that are a few foundational ingredients, which people should use along with the process of enhancing an organisation’s resilience. Resilience enhances knowledge of resources available to people confronting existing problems.