The University of Wisconsin-Milwaukee Flexible Option for Bachelor of Science in Nursing Degree Completion

The 2010 "Future of Nursing: Leading Change, Advancing Health" report from the Institute of Medicine recommended that 80% of registered nurses (RNs) obtain a bachelor of science in nursing (BSN) degree by 2020. Hospitals with BSN nurses have reduced morbidity and mortality. In 2014, the University of Wisconsin-Milwaukee and the University of Wisconsin-Extension launched the University of Wisconsin Flexible Option BSN (UW Flex BSN) as an additional model for BSN degree completion, adding to the in-person and online delivery models already being offered.In this article, the authors examine the decision to launch the UW Flex BSN program as a competency-based, time-variable approach to RN-to-BSN degree completion. They discuss the factors contributing to its success (including proactive, wraparound support for students through the use of academic success coaches and regular and substantive interaction with faculty), design and program elements and decisions, and continuing challenges that have yet to be resolved.UW Flex BSN is one version of direct-assessment, competency-based education, and it represents the first of its kind in a public institution for postlicensure BSN degree completion. The program meets all Higher Learning Commission standards and requirements and is grounded in the American Association of Colleges of Nursing Baccalaureate Essentials and program quality standards. The UW Flex BSN for degree completion is a successful example of a competency-based, time-variable education model that has been applied in a practice discipline.

[The nurse training reference framework in Ile-de-France]

In 2009, the changes introduced by the nurse training reference framework revolutionised the nursing curriculum. Partnerships were set up from the beginning of its implementation. The first three-year cycle has ended and the experience acquired opens up a new phase of further reflection and evolution.

An initial investigation of the applicability of the Dreyfus skill acquisition model to the professional development of nurse educators

AIM

This investigation represents an attempt to design and validate a skill acquisition model for the nurse educator role.

BACKGROUND

The preparation and role development of nurse educators has become a significant focus for the profession.The NLN Nurse Educator Competencies and skill acquisition theory provide a basis for studying skill acquisition among nurse educators.

METHOD

A total of 339 nurse educators from North Carolina and West Virginia were surveyed using an instrument designed to assess skill among nurse educators.

RESULTS

The survey discriminated among five levels of skill (novice, advanced beginner, competent, proficient, and expert). Participants reported a proficient level of total skill acquisition and a proficient level for each of the eight NLN Nurse Educator Competencies. Internal consistency for the survey tool was high at .977.

CONCLUSION

Results of this study add to the body of knowledge of skill acquisition, role development, and transition.The study provides a unique method to study skill acquisition.

The impact of a simulation lab experiencefor nursing students

A simulation clinical learning experience was initiated by a diploma school of nursing at a multidisciplinary training and research facility for simulation-based education. The simulation focused on pediatric and obstetrical scenarios. The purpose of this study was to investigate the impact simulation laboratory experiences have on critical thinking, student satisfaction, self-confidence, and cognitive learning. With 63 students participating over four semesters, a positive response was found for satisfaction and self-confidence in learning; there was also a significant increase in cognitive knowledge. No definitive conclusion regarding critical thinking was established, but a discovery was made regarding the importance of process during the simulation.

HeartCode BLS with voice assisted manikin for teaching nursing students: preliminary results

The purpose of this study was to evaluate the effectiveness of HeartCode BLS, a self-directed, computer-based course for obtaining basic life support (BLS) certification. For part 2 of the course, students learned and practiced their cardiopulmonary resuscitation (CPR) psychomotor skills on a voice assisted manikin (VAM). Students from 10 schools of nursing were randomly assigned to two types of CPR training: HeartCode BLS with VAM or the standard, instructor-led (IL) course with manikins that were not voice assisted; 264 students trained using HeartCode BLS and 339 had an IL course. When students passed their respective courses and were certified in BLS, their CPR skills were tested using the Laerdal PC SkillReporting System. Students who trained using HeartCode BLS and practiced their CPR skills on VAMs were significantly more accurate in their ventilations, compressions, and single-rescuer CPR than students who had the standard, IL course with regular manikins.

Association between academic and non-academic variables and academic success of diploma nursing students in Pakistan

This paper reports findings of an exploratory study conducted to determine an association between academic and non-academic factors and academic success of nursing diploma students in a province of Pakistan. Data were collected from the academic records of a cohort of 628 students. Multiple linear regression was used to identify the predictive association between certain academic and non-academic factors and academic success of the students. Regression models for each of three years were developed. Results indicated academic factors including preadmission qualifications, previous academic performance, academic performance in year one, academic performance in year two and type of school are significantly associated with the academic success of the students. Among non-academic factors, gender and place of domicile were found to be significantly associated with the academic success of the students.

The impact of assessment methods on the learning of nursing students

Assessment methods can influence the learning approaches of nursing students. Assessments designed to assess understanding rather than rote learning can contribute to a deep learning approach. Multiple-choice questions can be formulated at high cognitive levels for nursing assessments. This study aimed to examine the effect of high quality multiple-choice tests on the learning approaches of students enrolled in a mental health nursing course as measured by the revised two-factor study process questionnaire (R-SPQ-2F). Data were collected from 136 students in a higher diploma (HD) in nursing programme and 142 baccalaureate (BSN) nursing students. Two-step cluster analysis yielded three clusters represented by students who were predominantly deep, predominantly surface or intermediate in their orientation to learning. There was a general decrease in the deep learning score and an increase in the surface learning score of the students on the course, possibly related to the excessive workload in nursing studies. However, there was no direct association with multiple-choice assessment. The academic achievement of students correlated negatively with their surface learning approach. Students (n=31) in four focus group interviews believed that assessments constructed using scenario-based questions, simulated role-play situations and case studies could direct desired learning in order to facilitate their understanding of knowledge, their use of critical thinking, and their application of knowledge.

Conducting clinical post-conference in clinical teaching: a qualitative study

AIM AND OBJECTIVE

The aim of this study was to explore nurse educators' perceptions regarding clinical postconferences. Additional aims included the exploration of interaction characteristics between students and faculty in clinical postconferences.

BACKGROUND

Nursing students are challenged to think and learn in ways that will prepare them for practice in a complex health care environment. Clinical postconferences give students the opportunity to share knowledge gained through transformative learning and provide a forum for discussion and critical thinking. Faculty members must guide students as the latter participate in discussions, develop problem-solving skills and express feedings and attitudes in clinical conferences.

METHODS

The study used qualitative research methods, including participant observation and an open-ended questionnaire. Participant observers watched interaction activities between teachers and students in clinical postconferences. A total of 20 clinical postconferences, two conferences per teacher, were observed. The Non-Numerical Unstructured Data Indexing Searching and Theory-building qualitative software program was used in data analysis.

CONCLUSIONS

Research findings indicated that, of the six taxonomy questions, lower-level questions (knowledge and comprehensive questions) were mostly asked by faculty members' postclinical conferences. The most frequently used guideline was task orientation, which is related to practice goals and was found in discussions of assignments, reading reports, discussions of clinical experiences, role plays, psychomotor skill practice, quizzes and student evaluations.

RELEVANCE TO CLINICAL PRACTICE

It is an essential responsibility of nurse educators to employ postconferences to assist students in applying their knowledge in practical situations, in developing professional values and in enhancing their problem solving abilities.

Establishing library 'key skill' confidence levels amongst a cohort of nursing students at an English university

This article presents the findings of a small-scale preliminary survey of one cohort of students studying towards a Diploma/BSc in Nursing. The survey sought to establish student characteristics and indicate their confidence levels using identified key library facilities. From questionnaires (N=64), the data confirmed the 'typicality' of the student group illuminating a breadth of prior experiences in terms of students' prior learning and perceived confidence in using library resources. Whilst a number of respondents indicated confidence using identified library resources, a significant number of students (typically over one third n=14+) indicated that they lacked confidence in and did not utilise library facilities. This suggests that they may not be using the resources to full advantage. Over half of the respondents (53% n=23) had not attended library skills training within the last two years and 9% (n=4) had not used the library although they were completing assignments. This survey points to gaps in student confidence, and by implication, use of key library skills, particularly those involving electronic resources. At a time of widening participation and the explosion of information technology, this survey is a timely reminder of the need to revisit key skill development for nursing students studying in higher education.

Opening up pre-registration education for nurses (the OPEN Project): A partnership approach

METHODS

Using a combination of focus groups and questionnaires, data were obtained from 20 health care assistants/pre-registration nursing students taking part in the OPEN Project, their 20 respective clinical mentors, three National Health Service Trust-based facilitators and three University Tutors. The aim was to evaluate development and delivery of the project by: Data were analysed using a combination of Framework Technique and descriptive statistics.

RESULTS

The three main emergent themes were: Personal, Professional and Organisational learning. Through a combination of predominantly work based learning, teaching and assessment methods, students were able to demonstrate how they transformed existing knowledge into a usable tool on which to build further learning, while challenging previous assumptions about practice arising from their health care assistant role. Familiarity with the workplace while in the dual role of student/health care assistant allowed them to explore practice issues and implement changes while also gaining the credit to step onto year two of the Diploma in Nursing Science/Registered Nurse Programme. The main recommendations related to the issues of role identity for the students and infrastructure development in the Trusts and informed further similar projects.

Learning style preferences of undergraduate nursing students

AIM

To determine the predominant learning style preferences of undergraduate nursing students.

METHOD

A demographic questionnaire and Honey and Mumford's (2000a) learning styles questionnaire were administered to a purposive sample of 136 students.

RESULTS

A response rate of 81% (110) was obtained. The results are congruent with U.K. studies, which show that the reflector is the preferred learning style of undergraduate nursing students. A 'dual' learning style category was also identified.

CONCLUSION

A mismatch between teaching style and the learning styles of students has been found to have serious consequences. A variety of modes of teaching and learning should be used to meet the learning needs of students.

Learning style preferences of undergraduate nursing students

AIM

To determine the predominant learning style preferences of undergraduate nursing students.

METHOD

A demographic questionnaire and Honey and Mumford's (2000a) learning styles questionnaire were administered to a purposive sample of 136 students.

RESULTS

A response rate of 81% (110) was obtained. The results are congruent with U.K. studies, which show that the reflector is the preferred learning style of undergraduate nursing students. A 'dual' learning style category was also identified.

CONCLUSION

A mismatch between teaching style and the learning styles of students has been found to have serious consequences. A variety of modes of teaching and learning should be used to meet the learning needs of students.

Nursing students' mathematic calculation skills

This mixed method study used a pre-test/post-test design to evaluate the efficacy of a teaching strategy in improving beginning nursing student learning outcomes. During a 4-week student teaching period, a convenience sample of 54 sophomore level nursing students were required to complete calculation assignments, taught one calculation method, and mandated to attend medication calculation classes. These students completed pre- and post-math tests and a major medication mathematic exam. Scores from the intervention student group were compared to those achieved by the previous sophomore class. Results demonstrated a statistically significant improvement from pre- to post-test and the students who received the intervention had statistically significantly higher scores on the major medication calculation exam than did the students in the control group. The evaluation completed by the intervention group showed that the students were satisfied with the method and outcome.

Personal tutor encounters: understanding the experience

AIM

To investigate the lived experience of the 'support' relationship between students and their personal tutors.

METHOD

The purposive sample comprised 36 personal tutors and 44 pre-registration undergraduate nursing students on diploma and degree-level courses (adult, mental health and child branch) from a London university school of nursing and a northern university school of nursing. Private audiotaped interviews were conducted with the participants. Data analysis was undertaken to identify important themes.

FINDINGS

The tutees varied in their readiness to learn, define, discuss and negotiate support. Positive encounters were when the tutees felt supported. Tutors had an overwhelming feeling of frustration when tutees lacked study skills and came unprepared to tutorials. However, some tutors indicated a high level of empathic understanding for tutees and spent much of their personal time supporting them.

CONCLUSION

The study illuminated the complexity and skill required to be a tutee and a tutor. Tutors' individual support style reflected tutees' expectations and perceptions to varying degrees. A positive experience by tutees and tutors was perceived when each had a shared understanding of the support concept. Mutual trust, engagement, respect and accepting responsibilities were important elements of the personal tutor and tutee relationship.

Computer-aided vs. tutor-delivered teaching of exposure therapy for phobia/panic: randomized controlled trial with pre-registration nursing students

BACKGROUND

Exposure therapy is effective for phobic anxiety disorders (specific phobias, agoraphobia, social phobia) and panic disorder. Despite their high prevalence in the community, sufferers often get no treatment or if they do, it is usually after a long delay. This is largely due to the scarcity of healthcare professionals trained in exposure therapy, which is due, in part, to the high cost of training. Traditional teaching methods employed are labour intensive, being based mainly on role-play in small groups with feedback and coaching from experienced trainers. In an attempt to increase knowledge and skills in exposure therapy, there is now some interest in providing relevant teaching as part of pre-registration nurse education. Computers have been developed to teach terminology and simulate clinical scenarios for health professionals, and offer a potentially cost effective alternative to traditional teaching methods.

OBJECTIVE

To test whether student nurses would learn about exposure therapy for phobia/panic as well by computer-aided self-instruction as by face-to-face teaching, and to compare the individual and combined effects of two educational methods, traditional face-to-face teaching comprising a presentation with discussion and questions/answers by a specialist cognitive behaviour nurse therapist, and a computer-aided self-instructional programme based on a self-help programme for patients with phobia/panic called FearFighter, on students' knowledge, skills and satisfaction.

DESIGN

Randomised controlled trial, with a crossover, completed in 2 consecutive days over a period of 4h per day.

PARTICIPANTS

Ninety-two mental health pre-registration nursing students, of mixed gender, age and ethnic origin, with no previous training in cognitive behaviour therapy studying at one UK university.

RESULTS

The two teaching methods led to similar improvements in knowledge and skills, and to similar satisfaction, when used alone. Using them in tandem conferred no added benefit. Computer-aided self-instruction was more efficient as it saved teacher preparation and delivery time, and needed no specialist tutor.

CONCLUSION

Computer-aided self-instruction saved almost all preparation time and delivery effort for the expert teacher. When added to past results in medical students, the present results in nurses justify the use of computer-aided self-instruction for learning about exposure therapy and phobia/panic and of research into its value for other areas of health education.

The Triangle Technique: a new evidence-based educational tool for pediatric medication calculations

Many nursing student verbalize an aversion to mathematical concepts and experience math anxiety whenever a mathematical problem is confronted. Since nurses confront mathematical problems on a daily basis, they must learn to feel comfortable with their ability to perform these calculations correctly. The Triangle Technique, a new educational tool available to nurse educators, incorporates evidence-based concepts within a graphic model using visual, auditory, and kinesthetic learning styles to demonstrate pediatric medication calculations of normal therapeutic ranges. The theoretical framework for the technique is presented, as is a pilot study examining the efficacy of the educational tool. Statistically significant results obtained by Pearson's product-moment correlation indicate that students are better able to calculate accurate pediatric therapeutic dosage ranges after participation in the educational intervention of learning the Triangle Technique.

EN to RN: the transition experience pre- and post-graduation

INTRODUCTION

The context for this study is a conversion program for enrolled nurses (ENs) or division 2 level nurses who want to further their career as a registered nurse (RN) or division 1 nurse. While the conversion program is available to both metropolitan and rural nurses, it is designed specifically for experienced rural ENs. The conversion program is able to offer an educational alternative that does not disrupt family life or adversely impact the rural nursing workforce. This alternative is necessary for both the rural EN's career opportunities and for the health outcomes of rural communities in particular. This article reports on the experiences of the first cohort to graduate from the EN to RN conversion program. The conversion program offers three semesters of advanced standing within a seven-semester Bachelor of Science (Nursing) degree. The advanced standing or recognition of prior learning is awarded to applicants with more than one year's clinical experience, regardless of the type of enrolled nurse course completed. Enrolled nurses with a technical college qualification or higher meet university entry criterion but students from a hospital-based program are required to complete a mature-age university entry test. The degree to which the three semesters of advanced standing within an external conversion course for ENs would adversely affect participants' transition to student status and course completion is not known. The conversion program: The two-year, fully external EN conversion program relies on learning centre partnerships with country hospitals and agencies. Teaching strategies consist of a mix of external-mode strategies, including fully web-based units, and a compulsory eight-day on-campus foundation study block at the beginning. The compulsory study block provides the opportunity for students to familiarize themselves with the various areas of the university they need to contact as an external student, prepare for expectations of their first unit, including assessment expectations, and to practise selected nursing skills that are not common to the EN role. With the program being delivered from the metropolitan area of a vast state that occupies one-third of the Australian landmass, a key feature is the establishment of rural learning centres to support students. Apart from two of the seven clinical units in their course, the designated rural academic mentors arrange clinical placements in school-approved health care agencies situated locally or in nearby towns. This later strategy avoids the necessity for students to relocate to the metropolitan area or larger towns to complete the clinical component of the course. The conversion program has enrolled a limited number each year since 2000 and continues to be in high demand. Rural ENs are given preference and metropolitan enrolled nurses are included when quota allows.

PURPOSE

The purpose of this article is to describe the two aspects of the transition experiences of graduates from an external conversion degree. First, their transition experience from experienced enrolled nurse to undergraduate student and, second, from graduate to novice RN.

PARTICIPANTS

Participants were volunteer graduates from the Bachelor of Science (Nursing) two-year conversion degree. The 10 study participants were mature-age females, aged between 33 and 53 years (mean = 42 years). Five were from rural areas. Their educational background included hospital-based diploma or technical college certificate.

METHOD

Data were collected using open-ended questions in semi-structured interviews. The interviews were transcribed and thematic analyses of the data were undertaken. Major categories were identified and relationships among them detailed.

RESULTS

The four categories identified included adjusting to higher education, achieving academically, becoming critical thinkers and adjusting to the RN role: accepting responsibility. Participant responses in this study have highlighted the necessity for timely responses to email, feedback on assignments and more mentor support for rural students during the course. Participants report changing the way they approached their nursing practice.

CONCLUSIONS

The transition experiences for participants in the external conversion program are generally positive although, as with other studies, the transition to student status is stressful. However, the course is able to facilitate the career aspirations of the study participants and to contribute to the retention of nursing staff in rural areas. Strategies to provide career opportunities for health-care professionals in rural areas are always a challenge. As one such strategy, the external mode EN to RN conversion program has proven to be effective for experienced ENs.

An exploration into the most effective way to teach drug calculation skills to nursing students

Drug calculations are an essential skill for nurses. Nurses need to be able to perform them accurately to calculate correct dosages of drugs to administer to patients. Incorrect calculations can cause drug errors and potential harm to patients (; ). For student nurses therefore learning how to calculate drug dosages is an important skill that they need to be taught during their nurse training. This paper describes an action research project undertaken to explore the most effective way of teaching drug calculations to a group if 2nd year diploma and degree pre registration nurses. The evaluation of this project has demonstrated that a three stage approach to drug calculation appears to be an effective teaching strategy. These stages involve addressing mathematical concepts, teaching drug calculation formulae and then practising these skills in a clinical setting.

Novices in clinical practice settings: student nurses stories of learning the practice of nursing

Drawing on 24 stories of clinical practice in an apprenticeship context of training in Israel, this qualitative study examined student nurses' perspectives towards learning to become a nurse, as revealed through the language and content of their written stories of clinical practice. As our findings suggest, student nurses' stories of learning to become a nurse in practice settings, are characterized by procedural language, by medical rather than nursing terminology, and by a focus on actions rather than on interactions. We have learned that, despite the rich content that characterizes clinical practice settings, the apprenticeship orientation of the training program, combined with student nurses' state of being a novice, yielded representations of the experience of learning to nurse which were characterized by an instrumental perspective towards the practice. We interpret these findings through four interrelated insights that emerge from the study: (1) an 'instrumental practice' orientation in the setting of caring, (2) knowledge of clinical facts-not knowledge of clinical principles, (3) the fragmented character of novices' learning to nurse in practice, and (4) rich content of practice alone does not yield rich content of learning.

Assigning readings: faculty perceptions and strategies

Nursing faculty routinely assign readings to undergraduate, prelicensure students. When asked what types of readings they required, almost all said they required readings from textbooks. Most expect students to either read or skim all the assignments before class. However, experience has taught faculty that often students do not read. Strategies are provided to enhance reading experiences or provide meaningful alternatives.

NVQs and practice assessment in a pre-registration course

In response to the government's strategic intentions for nursing outlined in Making a Difference (DoH 1999), the University of Brighton has used national vocational qualification (NVQ) standards to facilitate assessment of practice during the common foundation year of the pre-registration diploma in nursing. The aim of this initiative is to provide 'step on' and 'step off' points using a nationally recognised qualification to meet government requirements for a more flexible approach to nurse education.

Assignment writing skills

This article offers students on diploma and degree courses a constructive step-by-step guide to planning, writing and critically reviewing their module assignment papers. Guidance is accompanied by a selection of practical activities designed to enhance students' information gathering and assignment writing skills.

An Exploration of Content on Legal Aspects of Practice in Nursing Programs

The paucity of literature on legal content in nursing curricula was used to frame the research question that guided this study. In what ways and to what extent are nursing educators addressing the subject of legal aspects of nursing practice? This study was designed to explore the area of legal aspects of nursing practice in nursing programs curricula. The researchers gathered information on numerous areas, including course content, methods of delivery, topics covered, and time devoted to legal content. The results revealed that content on legal aspects of nursing practice is commonly a component of nursing programs curricula and provided information on many areas; however, the results also revealed other areas that need to be researched.

The use of questioning strategies by clinical teachers

By using questioning and other appropriate teaching strategies, clinical teachers can facilitate the development of critical thinking, decision making and problem solving in students. This study examined clinical teachers' use of questioning and the variations in their use of questioning as a teaching strategy. Although there was a variation in the number of questions asked, predominantly low level questions were asked by 26 clinical teachers at two post-clinical conferences. Based on the findings of this study, it is recommended that clinical teachers are taught how to ask questions, particularly high level questions.

Using individual and group reflection in and on assessment as a tool for effective learning

This paper outlines the background to the current United Kingdom educational scene for post-registration nurse education, highlighting the influence of the English National Board (ENB) framework and higher award. The study reported was undertaken with the help of two student cohorts who were registered consecutively on a 6 month ENB course at diploma level. Formal reflection using both individual written and group discussion was introduced focusing on the two summative course assessments. This kind of formal reflection was seen as a learning strategy to influence positively students' educational outcomes and professional practice via six key factors: (a) academic self-concept; (b) task awareness; (c) views of knowledge; (d) the influence of knowledge on behaviour; (e) writing as a learning activity; and (f) generating knowledge by reflecting in and on assessment with discussion. The findings, reported under the six factor-headings, fully support the use of reflection in this way for these purposes.

Learning styles of nursing students: a 3-year cohort longitudinal study

The theoretical framework of this study was based on Kolb's model of experiential learning which proposes four phases: concrete experience, reflective observation, abstract conceptualization, and active experimentation. Kolb's Learning Style Inventory was used to assess preferences for these four learning modes. A freshman questionnaire developed by Peter Dietsche was used to determine basic demographic and background information, education goals, goal of obtaining a diploma, and goals in attending college. This study was conducted over a 3-year period (1990-1992). One hundred seventy-six female nursing students were tested in year 1. In the second year 138 of the original cohort were tested and in the third year 144 were tested. First year nursing students on the average selected as their cycle of learning: active experimentation "doing," reflective observation "watching," abstract conceptualization "thinking," and concrete experience "feeling." Little difference was noted in the learning style selected in year 2 and 3. In years 1, 2, and 3 nursing students' dominant learning style was that of Assimilator which combines the learning steps of abstract conceptualization (thinking) and reflective observation (watching).

An exploratory study of students' perceptions of the benefits of regular small group tutorials in a 2-year day release course

This study was undertaken with the intention of improving the effectiveness of small group tutorials in a diploma in nursing course. There was concern to avoid some of the less valuable aspects of tutorials highlighted in the literature. An investigation was conducted to elicit students' perceptions of the benefits of group tutorials at a comparatively early stage in their 2-year course, at the end of the second term. A qualitative approach was taken to explore the views of four students through individual semi-structured interviews. Additional data were gathered through personal field notes to add the tutor's perspective of the group process. Data were analysed inductively using a phenomenological approach in an attempt to elucidate the essence of each participant's experience of the tutorials. While the findings suggested that students valued their involvement in small group tutorials, some questions were raised which point to the need for further investigation. Themes were revealed which drew attention to the value students place on the experience of small group tutorials, thus endorsing the strategies employed. Benefits to students include the opportunity to get to know a small group of people when part of a larger learning group, support when coping with the pressures of course work and being able to share ideas about issues relevant to nursing. The report concludes that there is scope for further investigation and reflection in order to develop educational practice.

Education. Nursing by degrees

It is quite clear in PREP that community nurses will still be able to practice, whether their current qualification was at certificate or diploma level. However, future community nurse courses will be at degree level and many nurses who are currently practising are concerned that they too should have a degree. Sarah Forester provides brief guidance for community nurses who are considering further academic study.

The view from within: perspectives of clinical teaching

This article presents the findings of a year-long exploratory and descriptive research study designed to explore and describe the perspectives of six Canadian nurse educators regarding clinical teaching. A perspective consists of a teacher's theoretical, knowledge and value claims in regard to teaching. The participants' perspectives revealed how they intended to teach in the clinical area, as well as how they perceived and responded to situations which arose in clinical learning experiences. The research highlights the need to explore the possible consequences of teachers' value and knowledge claims with all clinical teachers, particularly novices.

Teaching behaviours of clinical instructors: an audit instrument

This article describes the development and initial psychometric testing of an instrument that permits the observation and recording of teaching behaviours exhibited by clinical instructors while supervising nursing students. Observations of Nursing Teachers in Clinical Settings (ONTICS) consists of 44 items grouped into nine categories of desirable and undesirable teaching behaviours: questioning method; responding style; method of giving feedback; teaching skill; method of demonstration; interaction with patient/family; interactions with health team; undesirable teaching behaviours; undesirable questioning/responding method. The instrument was refined on several occasions based on input from expert judges. Construction validity, internal consistency reliability and test-retest reliability were found to be acceptable. ONTICS appears to capture an aspect of clinical teaching not readily identified by other, more subjective, instruments.

Assessment of learning in the cross-cultural domain: reflection leads to learning for the teacher

The imposition of one set of cultural values on students from another culture is an ethical and practical concern for nurse educators. Theories of developmental psychology have been worked out mainly in the Western culture. Other cultures are studied, but measured against the Western framework, which is often uncritically accepted as 'usual'. This paper explores the ways in which the use of reflective practice allowed a group of nurse educators to perceive a cultural bias to their evaluation and to develop a strategy which they believe is more just and culturally fair for the student. Their experience is presented as a paradigm case to illustrate both reflection-in-action and the reframing of a cultural perspective which had limited educational development for both the student and the teachers.

Can we insulate trainee nurses from exposure to bad practice? A study of role play in communicating bad news to patients

This paper investigates the effects of three different role models in teaching trainee nurses to cope with the sensitive task of communicating a traumatic event to patients or their relatives. This is a long-standing problem with a high level of dissatisfaction within the field of nurse training. This study, in contrast to other studies of telling bad news (TBN), has focused on the person who gave rather than received bad news. This study also reinforces the view that role play and role modelling are not only effective learning methods in nurse training but are natural methods of learning in the profession. Student nurses are constantly exposed to other people's attempts at caring. Eighteen student nurses were randomly selected from a total student intake of 66 students for study in depth. Nine main skills were identified in a TBN task. Six student nurses were exposed to negative examples of a novice telling bad news, six to an expert model doing it and six to both models. The results showed that nurses learned quickly from role models, whether it was the negative instance of a poor model or the positive instance of an expert model or a combination of both. No significant difference in effectiveness between the three models was observed. The findings are discussed with reference to implications for nursing education in general.

The Roper nursing model as an educational and research tool

Models are thought to be of value as guides to professional practice; however, nursing models are often criticized. This article examines the concept of a model as a 'tool' and describes how the Roper model was used in a research project and proved to be both flexible and educationally sound as a teaching model.

Undergraduate preparation of the oncology nurse

Determining appropriate cancer-related content for undergraduate nursing curricula requires careful consideration of content that is needed versus content that is desired for the nurse generalist. Studies have indicated a wide variety of topics and time allotment for this content among schools of nursing. Innovative strategies using games, computers, preceptors, and elective courses have allowed schools of nursing to include more comprehensive coverage of oncology-related topics. Issues concerning clinical oncology nursing opportunities for undergraduate studies still need to be clarified. Undergraduate students must be afforded the legitimacy of their status as novices in nursing and in the specialty of oncology. Didactic and clinical experiences should result in the knowledge and skills needed to develop professionally from novice to expert.

Nurse socialization: issues and problems

A comparative study was conducted of the professional socialization process of student nurses in three nurse education centres in South Wales. Patterns and problem areas can be identified of relevance to issues in role theory and with practical implications for the more effective implementation of Project 2000. Three cohorts of students were interviewed using a semi-structured interview schedule whilst in the introductory block and at the end of the first year. The teaching and ward staff directly involved in the socialization process were also interviewed so that their views could be compared with those of the students. There were differences between the types of ward in the opportunities they offered for role modelling. It was doubtful whether the three categories of students, teaching staff and ward staff were all employing a single conception of 'the good nurse'. The student has to find her own pathway through the divergent and often conflicting values and philosophies of the teaching staff and those in authority on the wards. It is recommended that a more unified approach be adopted to reduce the conflict which learners experience. In accordance with Project 2000, the teaching staff should act as practitioners and thereby be perceived as a professional role model with clinical credibility.

The Effect of Preceptorship Upon Diploma Program Nursing Students' Transition to the Professional Nursing Role

This quasi-experimental study determined the effect of a 17-week pregraduate preceptorship program upon diploma nursing students' (N = 22) performance of the professional nursing role. Nine students participated in the preceptorship program; 13 received the standard pregraduate clinical experience. Nursing performance was measured using Schwirian's Six Dimension Scale of Nursing Performance prior to, during, and upon completion of the pregraduate clinical experience. Based on the faculty adviser's appraisals, the preceptorship program was associated with significantly greater improvements in nursing performance within the teaching/collaboration and planning/evaluation dimensions.