Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest – intervention – posttest study

BACKGROUND: Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. METHODS: A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. RESULTS: As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. CONCLUSION: The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses

Prior knowledge in student and experienced nurses' clinical problem solving

This study reports an investigation of student and experienced nurses' use of prior knowledge in clinical problem solving. 30 experienced and 30 student nurses were asked to verbalise their thoughts while undertaking a simulated clinical problem solving task. All verbal protocols were coded for use of prior knowledge based on a coding scheme developed for the study. The theoretical basis of the coding scheme was derived from the knowledge-driven models indicating that the development of expertise is strongly linked with the evolution of sophisticated knowledge structures. Repeated measures MANOVA were used to examine group differences across the coding categories. Results indicated that the experienced nurses were more likely to have available a more readily accessible and highly structured knowledge base, allowing for rapid recognition of highly significant clinical data and the transformation of that data into highly relevant clinical schemes. The student nurses relied on a less accessible and less structured knowledge base, and was only able to identify and interpret less significant clinical data at a surface level. The results suggest an important role for prior knowledge in explaining clinical problem solving performance. Implications for nurse education is discussed

Developing a framework for the assessment of musical learning: resolving the dilemma of the 'parts' and the 'whole'

Recent debate within the domain of music education has focussed on issues of discriminating between higher and lower quality learning outcomes. Much of this debate has centred on the language of music education, particularly in giving both substantive and psychometric meaning to terms as diverse as ‘the craft of music’, ‘musical skills’, ‘originality’, ‘musically convincing’, and ‘convincing development of ideas’. Moreover, in the search for standardisation in music assessment, much of what is conventionally described in assessment criteria reduces musical assessment to quantifiable competencies often not indicative of the higher-order musical thinking underlying the production of these competencies. That is, assessment often fails to resolve the dilemma of the ‘parts’ and the ‘whole’. In this paper we propose an assessment framework based upon a synthesis of current text processing theory with Biggs and Collis’ (1982) SOLO Taxonomy. We propose that musical assessment should primarily be sensitive to the quality and structure of music thinking. We argue that musical learning, like other domains of learning, can be analysed for evidence of structural quality and coherence, and that such evaluations may provide viable diagnostic as well as summative information about musical outcomes