e-Learning Object Portals: a new resource that offers new opportunities for librarians

e-Learning Object Portals are emerging as a new form of electronic information. Four portals most effective in providing health care information are identified: The Medical Library Association's Center of Research and Education (CORE), the Health Education Assets Library (HEAL), the American Academy of Medical College's MedEDPortal, and the Multimedia Education Resource for Learning and Online Teaching (MERLOT). Various user groups such as librarians, educators, and students are discussed, as well as their reasons for using e-learning object portals. New roles for librarians in promoting and developing these portals are also reviewed.

State of the science: intuition in nursing, a generation of studying the phenomenon

A systematic review of nursing literature was conducted to determine the state of the science with respect to the use of intuition in nursing practice and nursing education. The Cumulative Index for Nursing and Allied Health database was used to identify the priority population. From this database, 45 research articles that were written in English, published in nursing journals, and that contained the word intuition in the title and/or abstract and in which intuition was a major term were analyzed. Findings show that, to date, most studies are descriptive, exploratory in design. Nurses affirm that intuition is salient to expertise in clinical practice and should be carefully taught to students and novice nurses.

[Fragments of history: the nurse becoming a subject of herself]

The purpose of this survey is to analyze how the Nursing Graduation teaching has contributed for legitimizing and crystallizing the knowledge, as a subaltern profession and the keeper of such status quo, and for providing visibility to the constitution of another discourse based on the practices. The survey has involved nurses and teachers over 60 years of age. The discourse analysis has been utilized for the documentary analysis. The data indicate the little progress in some truth regimes, among which we could mention: the perpetuation of a teaching still centered in a biology, healing and hospital-centered model, and the little or almost no autonomy for exercising the competencies of the professional exercise in certain health scenarios.

Reusable learning units: an innovative teaching strategy for online nursing education

Constructivist and adult learning theory provided the theoretical framework for reusable learning units (RLUs) developed for a Southeastern University's family nurse-practitioner and nurse-midwifery distance educational programs. Reusable learning units are an organized series of learning events that satisfy one or more interrelated learning objectives that cannot be broken down to component parts without losing semantic and pragmatic meaning. This paper describes the conceptual framework, background and history of RLUs, and collaborative efforts for development and implementation.

An Evidence-based Model for Enriching Academic Nursing Leadership

The challenge of developing contemporary nurse leaders for today and tomorrow is compounded not only by the faculty shortage but also by limited faculty expertise in healthcare administration. The authors describe an effective academic-service partnership designed to ground future nursing leaders in the knowledge, skills, and abilities essential for success.

Incubadora de aprendizagem: uma nova forma de ensino na Enfermagem/Saúde

Este artigo tem como objetivo apresentar, uma idéia inovadora de aprendizagem na enfermagem: incubadora de aprendizagem, uma nova maneira de ensinar e aprender. Esta estratégia avançada de aprendizagem procura integrar a educação à inovação tecnológica. Ela pode ser o ponto de partida para uma nova maneira de "aprender a aprender" na enfermagem. Essa modalidade, utilizada em outras áreas do conhecimento, permite: compreender a realidade no qual o profissional está inserido, desenvolver competências, habilidades, adquirir novos conhecimentos, ampliar a criatividade e conseqüentemente aguçar o espírito empreendedor, incentivando a criação de oportunidades profissionais. A incubadora de aprendizagem capacita multiplicadores de idéias e atividades/serviços, alia aprendizagem às tecnologias capazes de fazer a diferença na trajetória profissional, enquanto exercita o empreendedorismo da enfermagem.

[The application of student-centered teaching to nursing education]

Nursing education in Taiwan is currently facing an extensive reform toward student-centeredness. However, few articles were found in the Taiwanese nursing literature focusing on student-centered teaching and nurse educators in Taiwan may have different interpretations of it. Misinterpretation of the term 'student-centeredness' may lead educational reform into inconsistency or ineffectiveness. This study aims to expand student-centered teaching's application to nursing education, stressing that not only the teaching techniques but also a consistent thinking approach is essential for educational reform. The content of this article addresses the meaning of student-centeredness and the differences between teacher-centeredness and student-centeredness. The article also advocates Weimers' five key changes toward student-centered teaching: the balance of power, the function of content, the role of the teacher, the responsibility for learning, and the purpose and process of evaluation, and further expounds their application to nursing education. Hopefully this article can provide Taiwanese nursing educators and students with an explicit view of student-centeredness and facilitate a more effective application of it to educational reform in nursing.

O ensino de enfermagem e as diretrizes curriculares nacionais: utopia x realidade

Este artigo busca provocar reflexões acerca do ensino de enfermagem à luz das Diretrizes Curriculares do Curso de Graduação de Enfermagem e sua relação com as políticas de saúde e o mercado de trabalho atual. Os fatos relatados mostram que as mudanças curriculares, no ensino de enfermagem no Brasil, tiveram historicamente a preocupação com a adequação da formação do enfermeiro aos interesses do mercado de trabalho. Entretanto, o desafio na formação precisa transpor o foco desses interesses e inserir efetivamente o futuro enfermeiro no sistema de saúde, comprometido com as transformações exigidas pelo exercício da cidadania.

A construção de um software educativo sobre ausculta dos sons respiratórios

O estudo objetivou relatar a experiência da construção de um software educativo sobre a ausculta dos sons respiratórios. Nesse processo, aplicou-se o referencial pedagógico de Lev Semenovic Vygotsky, e delimitou-se o conteúdo de modo a abarcar o método da ausculta passo a passo, as finalidades, a classificação dos sons normais e adventícios e as respectivas características estetoacústicas. Para o desenvolvimento do sistema, foi utilizada a tecnologia 3D, incluindo avatares (personificações virtuais do paciente, do enfermeiro e dos objetos) e ambiente virtual para a ausculta, usando procedimentos de simulação. Ao final do processo, concluiu-se que iniciativas dessa natureza, embora sejam permeadas de dificuldades, trazem contribuições importantes ao ensino-aprendizagem de conteúdos relativos à área da Enfermagem.

Critical incidents in the teaching-learning process of a nursing course through the perception of students and faculty

The teaching-learning process is complex and leaves many question marks, mainly when one thinks about quality. Therefore, this study aims at identifying factors that interfere positively or negatively in the teaching-learning process, through the perspective of students and faculty of the Nursing course at the Universidade Norte do Paraná- UNOPAR. This descriptive study with a qualitative approach was carried out through the critical incidents technique. Thirty-six faculty and 140 students participated. Data analysis revealed that the students mentioned 435 critical incidents related to the category faculty behavior, being 317 negative references and 118 positive. According to the faculty members' reports, the category interaction with the group produced 58 references, being 10 positive and 48 negative. An adequate teaching-learning process requires good faculty-student and student-student relationships, favoring good interaction and efficient learning.

Is the humanistic view of the nurse role still alive--in spite of an academic education?

AIM

This paper is a report of a study exploring what 'being a good nurse' means by following nursing students during their pre-registration education and for some years after graduation.

BACKGROUND

There have been few studies focusing on the nurse role in the transition from student to experienced nurse. Studies with a qualitative design, in particular, are limited in number.

METHODS

A longitudinal survey design was adopted, using an open-ended questionnaire at the beginning of education (n = 164), just before graduation (n = 123), and 3-5 years after graduation (n = 77). The participants were students in the nursing programme at a Swedish university. The data were collected during the period 1993-2002. Latent and manifest content analyses were used.

FINDINGS

Four categories were identified in the data. 'To do good for others', with the sub-category 'to care for others', was most frequent over time and quite stable. The category 'to be competent and skilled' was frequent and increased over time. 'To have professional courage and pride' and 'to seek professional development' were mentioned to lesser extent and showed a slight increase over time. The meaning of being a good nurse grew in complexity over time and informants' professional awareness seemed to increase, especially concerning 'to be competent and skilled'.

CONCLUSION

Attention needs to be paid both to nursing education and practice. Clinical supervision given by nurses with Master's degrees is suggested in order to convey positive attitudes towards nursing development and research into practice. Further studies are needed to compare what 'a good nurse' means to graduate nurses and how they actually behave when performing good nursing care.

Learning in practice--practice educator role

Learning in practice is increasingly becoming the focus of attention for higher education institutions, commissioners of health care education and the National Health Service in the United Kingdom. This article describes an evaluation of an initiative to provide specific support for pre qualifying nursing students in the practice environment. The initiative was the establishment of a new role, titled practice educator. The aim of the study was to evaluate the effectiveness of the practice educator role from the perspective of the three main constituent groups, practice educators themselves, mentors and students. Both qualitative and quantitative methods were used. The views of all three groups were that the role of practice educator was an important link between the University and practice providers. The issue of high credibility, accessibility and approachability was highlighted by post holders and reinforced by both students and mentors. The study indicates that practice educators are seen as supportive to both mentors and students and are perceived as a vital link between the University and practice environment.

Clinical learning environments for student nurses: key indices from two studies compared over a 25 year period

In 1978, a longitudinal study commenced in England to illuminate criteria for the evaluation of hospital wards as clinical learning environments for student nurses. It derived measures to quantify the clinical learning experienced by 71 students in three cohorts in three training hospitals over their entire programme. In 2003, a second study, based in one English School of Health Studies, using clinical placements in three NHS trusts, employed a retrospective, cross-sectional, analytic survey design with anonymised, self-completion questionnaires, to map the clinical learning of 272 students as part of a quality assurance and enhancement initiative. This paper explores changes over time by comparing data based on five key indices, devised in the first study and revisited in the second. Concepts of clinical learning and supervision are reviewed as part of this changing context and background together with limitations implicit in the comparison. The findings suggest an average 20% improvement in the quality of hospital based clinical learning environments over a 25 year period, based mainly on trained staff personally supervising students more extensively, testing their theoretical knowledge more frequently and spending more time performing practical procedures with them. However, unacceptable variations in clinical learning opportunities persist for some students.

Education needs for integrated care: a literature review

AIM

This paper reports a systematic review to identify the education needs of the workforce within primary care to promote the effective delivery of integrated health and social care services.

BACKGROUND

The need for different professionals to work more closely dominates global health policy. The drive to develop a workforce prepared for the future is crucial to the success of integrated services. However, some have argued that nurses are ill-equipped to meet the challenges of integrated service provision. The ability to work interprofessionally is an important skill which needs to be developed to support integrated working.

METHODS

Structured searches were undertaken on organizational websites and the Caredata, CINAHL, Cochrane Library, MEDLINE, Sociofile databases between December 2002 and April 2004 to identify policy documents and primary research studies. The robustness of identified research studies were appraised using recognized appraisal tools.

FINDINGS

Six themes were identified which indicate essential elements needed for integrated care. The need for effective communication between professional groups within teams and an emphasis on role awareness are central to the success of integrated services. In addition, education about the importance of partnership working and the need for professionals to develop skills in relation to practice development and leadership through professional and personal development is needed to support integrated working.

CONCLUSION

Education which embeds essential attributes to integrated working is needed to advance nursing practice for interprofessional working. Further research exploring this and its impact on integrated provision is essential to ensure that evidence-based services are provided. The reinforcement of partnerships between higher education institutions and health and social care organizations should ensure that the workforce is educated to manage continuous change in service delivery. Innovative ways of teaching and learning which promote inter-professional working need to be explored.

Teaching critical reflection skills for advanced mental health nursing practice: a deconstructive?reconstructive approach

AIM

This paper presents a literature review conducted to establish what was already known about critical reflection in the nursing literature and what work had been done on using a critical social theory framework as the basis for critical reflection.

BACKGROUND

Critical thinking emerged as a significant aspect of nursing education and practice in the late 1980s. It has been promoted as a means by which issues in clinical practice can be examined through a systematic process of exploration and reasoning. Traditionally, critical thinking has commonly involved an attempt to link practice with theory using a scenario or exemplar from practice to illustrate a practice dilemma. This process is often constructed as a retrospective narrative of events. This paper provides a deconstructive-reconstructive approach that differs from some traditional approaches by taking a critical social theory perspective with an emphasis on improving practice.

METHODS

The nursing literature reviewed was accessed through Cumulative Index of Nursing and Allied Health Literature (CINAHL). The search was restricted to English language and published between 1995 and 2005. Based on these findings, we developed a postgraduate advanced mental health nursing programme.

FINDINGS

There were 490 articles related to 'nursing' and 'critical thinking'; 34 articles related to 'nursing' and 'critical reflection'; 23 articles related to 'nursing' and 'critical social theory'; 15 articles related to 'mental health nursing' and 'critical thinking'; and two articles related to 'mental health nursing' and 'critical reflection'. In the programme we developed based on these findings, students were facilitated to deconstruct concepts and knowledge integral to their own practice. In the reconstructive phase, students implement a change project in clinical practice, supported by a mentor.

CONCLUSION

The deconstructive-reconstructive approach to the development of critical thinking skills provides advanced practitioner with the opportunity to integrate practice, theory and research.

[Change the teaching paradigm]

Based on a change in paradigms, an innovative teaching method, problem-based learning, has been employed since the 2002-03 academic year at the Vall d'Hebron University School of Nursing. This method centers on the responsibility of a student in his/her self-learning process and on the learning/unlearning by teachers in order to perform their new role as tutors.

E-learning for healthcare students: developing the communities of practice framework

AIM

This paper presents research considering whether healthcare students were able to develop characteristics of communities of practice when engaged in an online module.

BACKGROUND

Little is known about whether the communities of practice framework can be applied to online learning, with no previous consideration of its potential use within healthcare education.

METHODS

Using a case study approach the research, completed in 2004, had two phases. A questionnaire was administered to a group of 109 healthcare students to gain information on which to base sampling for the subsequent phase. Phase 2 employed three strands of data collection: five students completed an online diary, the online interactions of seven students were captured on a discussion board and three students were interviewed. Data were analysed using a form of pattern matching.

FINDINGS

Students were able to develop essential elements of communities of practice: mutual engagement, joint enterprise and shared repertoire, though this was not uniformly seen. Particular issues emerged for the online community, including enabling access to the online environment to support mutual engagement. The development of trust was also threatened by difficulties of presenting identities online. Joint enterprise was hampered by the online situation, although the virtual classroom proved essential for supporting endeavour. Not all students were committed to their groups. There was some evidence of group members developing shared repertoire, as routines of group working emerged. Professional understanding and computer skills were also enhanced.

CONCLUSION

The framework can be applied to supporting online learning internationally amongst students and has applicability to professional groups. Those intending to employ the framework should ensure that students can gain access to the community and have the computer skills to engage. Course design should be considered to ensure support for developing the essential components of communities of practice.

Effectiveness of intermediate-fidelity simulation training technology in undergraduate nursing education

AIM

The aim of this paper is to present the results of a study designed to determine the effect of scenario-based simulation training on nursing students' clinical skills and competence.

BACKGROUND

Using full-scale, realistic, medical simulation for training healthcare professionals is becoming more and more common. Access to this technology is easier than ever before with the opening of several simulation centres throughout the world and the availability on the market of more sophisticated and affordable patient simulators. However, there is little scientific evidence proving that such technology is better than more traditional techniques in the education of, for example, undergraduate nursing students.

METHODS

A pretest/post-test design was employed with volunteer undergraduate students (n = 99) from second year Diploma of Higher Education in Nursing programme in United Kingdom using a 15-station Objective Structured Clinical Examination. Students were randomly allocated to either a control or an experimental group. The experimental group, as well as following their normal curriculum, were exposed to simulation training. Subsequently, all students were re-tested and completed a questionnaire. The data were collected between 2001 and 2003.

RESULTS

The control and experimental groups improved their performance on the second Objective Structured Clinical Examination. Mean test scores, respectively, increased by 7.18 and 14.18 percentage points. The difference between the means was statistically significant (P < 0.001). However, students' perceptions of stress and confidence, measured on a 5-point Likert scale, was very similar between groups at 2.9 (1, not stressful; 5, very stressful) and 3.5 (1, very confident; 5, not confident) for the control group, and 3.0 and 3.4 for the experimental group.

CONCLUSIONS

Intermediate-fidelity simulation is a useful training technique. It enables small groups of students to practise in a safe and controlled environment how to react adequately in a critical patient care situation. This type of training is very valuable to equip students with a minimum of technical and non-technical skills before they use them in practice settings.

Nursing and midwifery students' approaches to study and learning

AIM

This paper reports an investigation of the approaches to study and learning of nursing and midwifery students at a school of nursing and midwifery in Iran.

BACKGROUND

Current knowledge suggests that students approach their studies in surface, deep or strategic manners. Students' approaches to study have an important impact on their academic success. Awareness of their approaches to study and factors that affect their choices is important for curriculum planners as well as nurse and midwife educators.

METHODS

A cross-sectional design was used with a convenience sample of nursing and midwifery students in all 3 years of study at one university in Iran. The validated Persian translation of Entwistle and Ramsden's Approaches and Study Skills Inventory was administered in a classroom context in 2003.

RESULTS

Sixty-four per cent (95% CI; 57-72%) of nursing and 63% (95%; CI 50-75%) of midwifery students adopted a deep approach. The use of a surface approach was negatively correlated to the stage of study for midwifery but not nursing students. There was also a statistically significant positive correlation between level of interest in the field of study and use of strategic approach for both nursing and midwifery students. Grade point average for the nursing students adopting the strategic approach was statistically significantly higher than for those adopting deep or surface approach. The grade point average for midwifery students adopting strategic approach was statistically significantly higher than that for those adopting deep approach, but not different from the grade point average of those adopting surface approach.

CONCLUSION

Our findings suggest that adoption of strategic or deep approaches to learning was associated with better educational outcome, as indicated by higher grade point averages. Moreover, the findings emphasize the impact of students' interest in their field on their academic success. Therefore, the adoption of factors which foster deep or strategic approaches and activities which increase students' interest should lead to improved academic outcomes.

Teaching the Abyss: Living the Art-Science of Nursing

This column addresses how nurse educators can provide the teaching-learning experiences for novice nurses to develop the leadership competence to effectively practice nursing in an extremely demanding healthcare environment. The authors delve into Mitchell and Bunkers’ use of the metaphor of an abyss to explore the lived experience of risking being with others in extremely intense interpersonal situations. Using reflection, students’ journal narratives affirm connections made among past experiences and the new knowledge gleaned from exploring and naming the phenomenon of the abyss. Several teaching-learning strategies are offered as ways for addressing the leadership issues related to dealing with intense relational experiences in nursing practice, including exploring nurse theorist Rosemarie Rizzo Parse’s essentials of leadership.