A qualitative study of the impact of an educational intervention on older parents of adults with disabilities engaged in the phenomenon of future-care planning

This phenomenological study describes the impact of an educational intervention on the day-to-day experiences of older parent caregivers of adults with developmental disabilities who were engaged in the process of future-care planning. Qualitative strategies of individual and focus group interviewing were used with a purposive sample of older caregivers. Participants were members of an existing parent support group. Twenty-three caregivers representing 18 families were queried before and after the education program. The disabilities represented were mental retardation, cerebral palsy and autism. Parents whose children live at or away from home were included. The intervention was conducted on five Saturdays over a two month period; the duration of the study was five months. Findings used typical words of the respondents from their individual and focus group interviews to describe feelings, attitudes and experiences in making future-care plans. Data from verbatim transcriptions and researcher's field notes were coded, analyzed, sorted into themes, and subjected to interpretive analysis. Respondents showed a positive change in attitudes and actions after participating in the education program, regardless of their initial stage in care planning. Fears were replaced by hope and determination; hesitation and ineptitude by feelings of competence and confidence; and procrastination and delay by purposeful actions. Other key findings: use of a planning document greatly aided caregivers; barriers to planning were often intrinsic and amenable to education; residential plans were the most difficult aspect of planning; listening to the experiences of other parent caregivers was helpful; and making burial plans for their offspring was one aspect of planning parents wished to do themselves. ^

A case study of adults in college who developed an experiential learning portfolio

This single-case study provides a description and explanation of selected adult students' perspectives on the impact that the development of an experiential learning portfolio had on their understanding of their professional and personal lives. The conceptual framework that undergirded the study included theoretical and empirical studies on adult learning, experiential learning, and the academic quality of nontraditional degree programs with a portfolio component. The study employed qualitative data collection techniques of individual interviews, document review, field notes, and researcher journal. A purposive sample of 8 adult students who completed portfolios as a component of their undergraduate degrees participated in the study. The 4 male and 4 female students who were interviewed represented 4 ethnic/racial groups and ranged in age from 32 to 55 years. Each student's portfolio was read prior to the interview to frame the semi-structured interview questions in light of written portfolio documents. ^ Students were interviewed twice over a 3-month period. The study lasted 8 months from data collection to final presentation of the findings. The data from interview transcriptions and student portfolios were analyzed, categorized, coded, and sorted into 4 major themes and 2 additional themes and submitted to interpretive analysis. ^ Participants' attitudes, perceptions, and opinions of their learning from the portfolio development experience were presented in the findings, which were illustrated through the use of excerpts from interview responses and individual portfolios. The participants displayed a positive reaction to the learning they acquired from the portfolio development process, regardless of their initial concerns about the challenges of creating a portfolio. Concerns were replaced by a greater recognition and understanding of their previous professional and personal accomplishments and their ability to reach future goals. Other key findings included (a) a better understanding of the role work played in their learning and development, (b) a deeper recognition of the impact of mentors and role models throughout their lives, (c) an increase in writing and organizational competencies, and (d) a sense of self-discovery and personal empowerment. ^

The effects of the outdoor experiential ropes course on perceived team performance

The purpose of this quasi-experimental study was to explore the perceived effects of the Ropes Course on the performance of intact work teams. The dependent variable, team performance, was measured by the Team Performance Assessment, a 20 question inventory. The Ropes Course, the independent variable, was an outdoor experiential training program presently marketed as a highly effective team building training program. Issues the team addressed in the highly emotional and physical environment were purported to transfer back to the work environment and act as a catalyst for change The Ropes Course in this study consisted of a day long series of outdoor mental, emotional and physical exercises addressing the issues of goal-setting, role expectations, accountability, trust, respect, communication, problem-solving and decision-making. The 68 subjects, 37 in the treatment group and 31 in the control were employees of a large international financial institution. They were not chosen by random selection. The work teams' managers recognized a need to improve team morale, performance and functioning due to corporate reengineering and downsizing resulting in team members' job losses. Control teams were partially matched to the treatment teams on the basis of professional composition and similar job descriptions. The pretest of the Team Performance Assessment was given the morning of the Ropes Course treatment and the posttest was given three to five weeks later. The control teams received the pretests and posttests at about the same time intervals at their work location but received no Ropes Course treatment. The treatment teams' scores and the control teams' scores were statistically compared using the Multivariate Analysis of Variance (MANOVA) and the Multivariate Analysis of Covariance (MANCOVA) at the .05 level of significance. The statistical analysis revealed a significant difference between the control and experimental teams after the team building Ropes Course training as measured by the Team Performance Assessment (Gilbert, 1996). ^

A qualitative study of the clinical practice of graduates of a problem-based physical therapy program

The purpose of this study was to examine the perspectives of three graduates of a problem-based leaning (PBL) physical therapy (PT) program about their clinical practice. The study used the qualitative methods of observations, interviews, and journaling to gather the data. Three sessions of audiotaped interviews and two observation sessions were conducted with three exemplars from Nova Southeastern University PBL PT program. Each participant also maintained a reflective journal. The data were analyzed using content analysis. A systematic filing system was used by employing a mechanical means of maintaining and indexing coded data and sorting data into coded classifications of subtopics or themes. All interview transcripts, field notes from observations, and journal accounts were read, and index sheets were appropriately annotated. From the findings of the study, it was noted that, from the participants' perspectives, they were practicing at typically expected levels as clinicians. The attributes that governed the perspectives of the participants about their physical therapy clinical practice included flexibility, reflection, analysis, decision-making, self-reliance, problem-solving, independent thinking, and critical thinking. Further, the findings indicated that the factors that influenced those attributes included the PBL process, parents' value system, self-reliant personality, innate personality traits, and deliberate choice. Finally, the findings indicated that the participants' perspectives, for the most part, appeared to support the espoused efficacy of the PBL educational approach. In conclusion, there is evidence that the physical therapy clinical practice of the participants were positively impacted by the PBL curriculum. Among the many attributes they noted which governed these perspectives, problem-solving, as postulated by Barrows, was one of the most frequently mentioned benefits gained from their PBL PT training. With more schools adopting the PBL approach, this research will hopefully add to the knowledge base regarding the efficacy of embracing a problem-based learning instructional approach in physical therapy programs. ^

Facing a paradigm shift in professional credentialing: Preparedness of registered dietitians for Professional Development 2001

In the year 2001, the Commission on Dietetic Registration (CDR) will begin a new process of recertifying Registered Dietitians (RD) using a self-directed lifelong learning portfolio model. The model, entitled Professional Development 2001 (PD 2001), is designed to increase competency through targeted learning. This portfolio consists of five steps: reflection, learning needs assessment, formulation of a learning plan, maintenance of a learning log, and evaluation of the learning plan. By targeting learning, PD 2001 is predicted to foster more up-to-date practitioners than the current method that requires only a quantity of continuing education hours. This is the first major change in the credentialing system since 1975. The success or failure of the new system will impact the future of approximately 60,000 practitioners. The purpose of this study was to determine the readiness of RDs to change to the new system. Since the model is dependent on setting goals and developing learning plans, this study examined the methods dietitians use to determine their five-year goals and direction in practice. It also determined RD's attitudes towards PD 2001 and identified some of the factors that influenced their beliefs. A dual methodological design using focus groups and questionnaires was utilized. Sixteen focus groups were held during state dietetic association meetings. Demographic data was collected on the 132 registered dietitians who participated in the focus groups using a self-administered questionnaire. The audiotaped sessions were transcribed into 643 pages of text and analyzed using Non-numerical Unstructured Data - Indexing Searching and Theorizing (NUD*IST version 4). Thirty-four of the 132 participants (26%) had formal five-year goals. Fifty-four participants (41%) performed annual self-assessments. In general, dietitians did not currently have professional goals nor conduct self-assessments and they claimed they did not have the skills or confidence to perform these tasks. Major barriers to successful implementation of PD 2001 are uncertainty, misinterpretation, and misinformation about the process and purpose, which in turn contribute to negative impressions. Renewed vigor to provide a positive, accurate message along with presenting goal-setting strategies will be necessary for better acceptance of this professional development process. ^

Profile of Florida: Services in transitional housing programs for homeless women with children

Family homelessness is a disturbing social problem in the United States. This study was conducted to determine the scope of components that included services and programs available for homeless women with children in transitional housing programs in Florida and the effectiveness of these components in helping these women move towards independence. Primary data for this study were obtained through questionnaires sent to directors of homeless centers in Florida. Supportive services offered by these centers were evaluated to determine if they enabled homeless women with children to become self-sufficient. The findings of this research indicated that regardless of the size, length of participation, and scope of services provided by the centers, these women showed gains in their ability to move toward self-sufficiency. The results support the hypothesis that transitional housing programs have a positive effect on homeless women with children. ^

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. ^

A study of dual cultures in dyadic relations

Elderly caregiving, a fact of life for millions of Americans, has gained significance with the increase in the elderly population. Over 25 million family caregivers in the US, most of whom are women rearing their own children, care for severely ill or disabled family members. The increased flow of women into the labor force has caused this traditional role to be entrusted to hired caregivers, mainly home health aides. ^ This case study describes and explains the dyadic experiences of elderly Jewish clients and their Jamaican home health aides in a mixed-culture environment. The inquiry was conducted with a purposive sample of four dyads, their case manager, and the placement officer, all of whom were selected through a home care agency in Fort Lauderdale, Florida. Strategies of data collection including non-participant observation, interviews, document analysis, and researcher's journals. Data from verbatim transcription of interviews and field notes were coded, sorted into emic categories, and reduced as linkages were identified via cross-case comparison. Three major themes—mixed-culture experiences, relationship building and maintenance, and agency role perceptions—emerged from the interpretative analysis of the data. ^ Assertions from these findings include that dyads have established a range of relationships to meet their personal needs, expectations, and desires in these goal-driven relationships. Relationally, they have reached interactional synchrony with some achieving the ideal family-type bond. Cultural difference is but one of the many contextual variables in the home care environment, which has its own cultural norms and expectations. Conflicts transcend cultural difference and seemed more a factor of individual relational disposition. ^

Selected psychosocial and demographic factors affecting levels of pre-retirement planning

In September 2002, the State of Florida implemented a new retirement structure for those employed in the Florida Public School System. Teachers were given the option to maintain their existing defined benefit plan or choose the newly offered defined contribution plan. The variables that affect planning for retirement are innumerable. Identifying the most significant variables is essential to understanding how one plans for retirement. ^ This study examined the relationship between hypothesized psychosocial and demographic factors and an individual's level of pre-retirement planning. The criterion variable, the level of pre-retirement planning, comprised two concepts. First, the time spent thinking about retirement was determined by the score an individual received on a pre-retirement planning scale. This scale included the concepts of information gathering, goals, anticipated resources, and long-range planning. Second, implementation of retirement plan procedures was determined by the percentage an individual annually deferred to retirement. ^ The survey used for data collection contained 50 close-ended items. It was distributed to all full-time teachers in nine randomly selected elementary, middle, and senior high schools throughout Miami-Dade County Public Schools. Multiple regression and crosstabulation indicated that math anxiety, general risk, years of service, and total family income were significant predictors of the level of pre-retirement planning, as measured by the pre-retirement planning scale. In addition, the statistical analysis indicated that math anxiety, internal locus of control, years of service, and total family income were significant predictors of the level pre-retirement planning, as measured by the amount deferred to retirement. An individual's level of math anxiety and family income were the two factors that were the most significant predictors for both concepts on the level of pre-retirement planning. ^ Based on the findings of the study, recommendations focused on assessing an individual's level of math anxiety and educating teachers, particularly pre-service candidates, about the factors that affect pre-retirement planning. Further research should investigate the benefit of such educational programs. ^

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. ^

Effects of cooperative and individual integrated learning system on attitudes and achievement in mathematics

This study compares the effects of cooperative delivery (CD) and individual delivery (ID) of integrated learning system (ILS) instruction in mathematics on achievement, attitudes and behaviors in adult (16-21 yrs.) high school students (grades 9-13). The study was conducted in an urban adult high school in Miami-Dade County Public Schools using a pre-test/post-test design. Achievement was measured using the Test of Adult Basic Education (TABE) by CTB MC-Graw-Hill and Compass Learning. An attitudinal survey measured attitudes towards mathematics, the computer-related lessons, and attitudes toward group activities. Behavior was assessed using computer lab observations. ^ Two-way analyses of variance (ANOVA) were conducted on achievement (TABE and Compass) by group and time (pre and post). A one-way ANOVA was conducted on the overall attitude by group on the five components (i.e., content mathematics, delivery/computers, cooperative, partners, and self efficacy) and a one-way ANOVA was conducted on the on-task behavior by group. ^ The results of the study revealed that CD and ID students working on mathematics activities delivered by the ILS performed similarly on achievement tests of the TABE. The CD-ILS students had significantly better overall mathematics attitudes than the ID-ILS students and the ID-ILS group was on-task significantly more than the CD-ILS group. This study concludes that regularity and period of time over which the ILS is used may prove to be important variables although there were insufficient data to fully investigate the impact of models of use. Additionally, a minimum amount of time-on-system is necessary before gains can become apparent in innumeracy and increasing exposure to the system may have beneficial effects on learning. ^

Theological reflection at work: A phenomenological study of learning processes

Using the learning descriptions of graduates of a graduate ministry program, the mechanisms of interactions between the knowledge facets in learning processes were explored and described. The intent of the study was to explore how explicit, implicit, and emancipatory knowledge facets interacted in the learning processes at or about work. The study provided empirical research on Yang's (2003) holistic learning theory. ^ A phenomenological research design was used to explore the essence of knowledge facet interactions. I achieved epoche through the disclosure of assumptions and a written self-experience to bracket biases. A criterion based, stratified sampling strategy was used to identify participants. The sample was stratified by graduation date. The sample consisted of 11 participants and was composed primarily of married (n = 9), white, non-Hispanic (n = 10), females (n = 9), who were Roman Catholic (n = 9). Professionally, the majority of the group were teachers or professors (n = 5). ^ A semi-structured interview guide with scheduled and unscheduled probes was used. Each approximately 1-hour long interview was digitally recorded and transcribed. The transcripts were coded using a priori codes from holistic learning theory and one emergent code. The coded data were analyzed by identifying patterns, similarities, and differences under each code and then between codes. Steps to increase the trustworthiness of the study included member checks, coding checks, and thick descriptions of the data. ^ Five themes were discovered including (a) the difficulty in describing interactions between knowledge facets; (b) actual mechanisms of interactions between knowledge facets; (c) knowledge facets initiating learning and dominating learning processes; (d) the dangers of one-dimensional learning or using only one knowledge facet to learn; and (e) the role of community in learning. The interpretation confirmed, extended, and challenged holistic learning theory. Mechanisms of interaction included knowledge facets expressing, informing, changing, and guiding one another. Implications included the need for a more complex model of learning and the value of seeing spirituality in the learning process. The study raised questions for future research including exploring learning processes with people from non-Christian faith traditions or other academic disciplines and the role of spiritual identity in learning. ^

An analysis of student and instructor perceptions of students' writing skills at the university level

This study examined university students' writing skills as perceived by university students and their English instructors. The goal of the study was to provide English instructors with objective, quantified information about writing perceptions from both the students' and instructors' viewpoints. ^ A survey instrument was developed based on a survey instrument created by Newkirk, Cameron, and Selfe (1977) to identify instructors' perceived knowledge of student writing skills. The present study used a descriptive statistical design. It examined five writing skill areas: attitude, content, grammar and mechanics, literary considerations, and the writing process through a questionnaire completed by a convenience sample of summer and fall admitted freshmen who were enrolled in Essay Writing and Freshman Composition courses and English Department instructors at a large South Florida public university. ^ The study consisted of five phases. The first phase was modifying of the Newkirk, Cameron, and Selfe (1977) questionnaire. Two versions of the revised survey were developed - one for instructors and one for students. The second phase was pilot testing the questionnaire for evaluation of administration and scoring. The third phase was administering the questionnaire to 1,280 students and 48 instructors. The fourth phase was analyzing the data. The study found a significant difference in the perceptions of students and instructors in all areas of writing skills examined by the survey. Responses to 29 of 30 questions showed that students felt they had better attitudes toward writing and better writing skills than instructors thought. ^ The final phase was developing recommendations for practice. Based on findings and theory and empirical evidence drawn from the fields of adult education and composition research, learner-centered, self-directed curriculum guidelines are offered. ^ By objectively quantifying student and instructor perceptions of students' writing skills, this study contributes to a growing body of literature that: (a) encourages instructors to acknowledge the perception disparities between instructors and students; (b) gives instructors a better understanding of how to communicate with students; and (c) recommends the development of new curriculum, placement tests, and courses that meet the needs of students and enables English instructors to provide meaningful instruction. ^

Best practices in exemplary service delivery: A multiple case study of service quality

The purpose of this study was to explain how exemplary service providers in luxury hotels provide consistently excellent service. Using a case study framework, the study investigated the service provider's strategies and concepts of service delivery, the importance and implementation of organizational and individual controls, and the role of training and learning. The study identified barriers to service provision and characteristics of the exemplary individuals that affect their ability to deliver luxury service. This study sought to better understand how exemplary service providers learn, think about, and do their work. The sample population of three Five-Diamond-Award winning resorts was selected for their potential for learning about the phenomenon of interest. The results demonstrate that exemplary service providers possess individual characteristics that are enhanced by the organizations for which they work. Exemplary service providers are often exemplary communicators who are emotionally generous and genuinely enjoy helping and serving others. Exemplary service organizations treat their employees as they treat their customers, as suggested by the Service-Profit Chain (Heskett, Sasser & Schlesinger, 1997). Further, they have systems and standards to guarantee satisfactory service experiences for every guest. They also encourage their service providers to personalize their service delivery and to seek opportunities to delight their guests, using a combination of controls, traditions and cultural values. Several customer service theories are discussed in relationship to whether they were or were not supported by the data. The study concluded that the delivery of exemplary service is a complex phenomenon that requires successful interactions between guests, service providers and the organization. A Model of Exemplary Service Delivery is presented and discussed that demonstrates the components of service quality as shown in the data. The model can be used by practitioners seeking to create, enhance, or evaluate their service quality, and by researchers seeking insights into the complex concepts in service quality research. Implications for future research are discussed.

Team Primacy Concept-based employee evaluation and job performance

This qualitative case study explored how employees learn from Team Primacy Concept (TPC)-based employee evaluation and how they apply the knowledge in their job performance. Kolb's experiential learning model (1974) served as a conceptual framework for the study to reveal the process of how employees learn from TPC evaluation, namely, how they experience, reflect, conceptualize and act on performance feedback. TPC based evaluation is a form of multirater evaluation that consists of three components: self-feedback, supervisor's feedback, and peer feedback. The distinctive characteristic of TPC based evaluation is the team evaluation component during which the employee's professional performance is discussed by one's peers in a face-to-face team setting, while other forms of multirater evaluation are usually conducted in a confidential and anonymous manner.^ Case study formed the methodological framework. The case was the Southeastern Virginia (SEVA) region of the Institute for Family Centered Services, and the participants were eight employees of the SEVA region. Findings showed that the evaluation process was anxiety producing for employees, especially the process of peer evaluation in a team setting. Preparation was found to be an important phase of TPC evaluation. Overall, the positive feedback delivered in a team setting made team members feel acknowledged. The study participants felt that honesty in providing feedback and openness to hearing challenges were significant prerequisites to the TPC evaluation process. Further, in the planning phase, employees strove to develop goals for themselves that were meaningful. Also, the catalyst for feedback implementation appeared to stem from one's accountability to self and to the client or community. Generally, the participants identified a number of performance improvement goals that they attained during their employment with IFCS, which were supported by their developmental plans.^ In conclusion, the study identified the process by which employees learned from TPC-based employee evaluation and the ways in which they used the knowledge to improve their job performance. Specifically, the study examined how participants felt and what they thought about TPC-based feedback, in what ways they reflected and made meaning of the feedback, and how they used the feedback to improve their job performance.^