Student Perceptions of the Clinical Education Environment

This Masters Project surveyed nursing clinical students at a University School of Nursing in the Pacific Northwest using a recently developed tool, the Student Evaluation of Clinical Education Environment (SECEE, version 3). Use of the SECEE (version 3) helped identify differences in student perceptions of various clinical learning environments. Results of nonparametric statistics were non-significant due to the small sample size; however there appeared to be consistent preference by students for clinicals at Magnet designated facilities. Additionally, higher instructor facilitation scores were also noted among students assigned to the university main campus (n = 31, M = 45.19, SD = 9.39) compared to students assigned to the distance campus (n = 9, M = 36.89, SD = 20.63). The findings have implications for nursing education, specifically the potential benefit of student learning at Magnet designated facilities and the importance of adequate support and engagement between university faculty and students in distance learning environments

The Telehealth Skills, Training, and Implementation Project: An evaluation protocol

External stabilization is reported to improve reliability of hand held dynamometry, yet this has not been tested in burns. We aimed to assess the reliability of dynamometry using an external system of stabilization in people with moderate burn injury and explore construct validity of strength assessment using dynamometry. Participants were assessed on muscle and grip strength three times on each side. Assessment occurred three times per week for up to four weeks. Within session reliability was assessed using intraclass correlations calculated for within session data grouped prior to surgery, immediately after surgery and in the sub-acute phase of injury. Minimum detectable differences were also calculated. In the same timeframe categories, construct validity was explored using regression analysis incorporating burn severity and demographic characteristics. Thirty-eight participants with total burn surface area 5 – 40% were recruited. Reliability was determined to be clinically applicable for the assessment method (intraclass correlation coefficient \u3e0.75) at all phases after injury. Muscle strength was associated with sex and burn location during injury and wound healing. Burn size in the immediate period after surgery and age in the sub-acute phase of injury were also associated with muscle strength assessment results. Hand held dynamometry is a reliable assessment tool for evaluating within session muscle strength in the acute and sub-acute phase of injury in burns up to 40% total burn surface area. External stabilization may assist to eliminate reliability issues related to patient and assessor strength

Effect of Sequence of Simulated and Clinical Practicum Learning Experiences on Clinical Competency of Nursing Students

Two different sequences of blocks of simulated and clinical practicum learning experiences compared the clinical competency development of nursing students using a randomized crossover design. Competency was measured 3 times: after each block of simulated and clinical experiences and after a final simulated experience. No significant differences in competency scores between the 2 groups across the 3 time points were found. Using alternative models of clinical and simulation learning may help address barriers to the delivery of clinical education faced by schools of nursin

Service Learning Enhances Conceptual Learning in a RN to BSN Program

A qualitative study using transcript analysis was conducted to examine the effectiveness of service learning in enhancing conceptual learning in RN to BSN students. As part of their capstone course in an online program, students engaged in 64 hours of service learning in their local community. The transcripts of asynchronous discussions and journal entries formed the data for analysis. The findings illustrated that the student’s conceptual understanding was enhanced from the service learning experience. Further, the students demonstrated higher-level thinking by linking concepts that could be applied to nursing practice. Service learning reinforced the community-based philosophy of the School of Nursing, and strengthened their abilities in leadership, teamwork, and collaboration with a greater orientation to community, vulnerable populations, and health promotion. Service learning was found to be an effective way to use the skills of the registered nurse for health related service in the community while also meeting their academic and individual learning needs

Are Rural and Urban Newly Licensed Nurses Different? A Longitudinal Study of a Nurse Residency Programme

Aim This study aimed to compare rural and urban nurse residency programme participants’ personal and job characteristics and perceptions of decision-making, job satisfaction, job stress, nursing performance and organisational commitment over time. Background Nurse residency programmes are an evolving strategy to foster transition to practice for new nurses. However, there are limited data available for programme outcomes particularly for rural nurses. Method A longitudinal design sampled 382 urban and 86 rural newly licensed hospital nurses during a 12-month nurse residency programme. Data were collected at the start of the programme, at 6 months and the end of the programme. Results At the end of the programme, rural nurses had significantly higher job satisfaction and lower job stress compared with urban nurses. Across all time-periods rural nurses had significantly lower levels of stress caused by the physical work environment and at the end of the programme had less stress related to staffing compared with urban nurses. Perceptions of their organisational commitment and competency to make decisions and perform role elements were similar. Conclusions Differences in these outcomes may be result from unique characteristics of rural vs. urban nursing practice that need further exploration. Implications for nursing management Providing a nurse residency programme in rural and urban hospitals can be a useful recruitment and retention strategy

Work-role transition : from staff nurse to clinical nurse educator : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing at Massey University

There is an imperative for health professionals today to maintain competence in clinical practice, which for registered nurses in New Zealand requires current experience of practice, continued professional development and education. In many organizations in New Zealand today, practice based clinical education for nurses is delivered by clinical nurse educators (CNEs). The purpose of this study was to explore the opinions and perceptions of CNEs as they transitioned from a staff nurse position to the CNE role, a designated senior position within the District Health Board (DHB) involved in this study. The aim of the study was to describe the experiences of CNEs in their first year in the role to gain a clearer understanding of the knowledge and skills required to be successful in the role. This understanding will enable a smoother and more satisfactory transition into the role and provide targets for career development for nurses aspiring to become CNEs. Qualitative description, using a general inductive approach was the methodology chosen to underpin this study. A sample group of eight CNEs from a New Zealand DHB were interviewed about their experiences using a semi structured interviewing technique. The results of the data analysis have been presented using Bridges (2003, 2004) transition theory as the theoretical framework. The data chapters are titled endings, neutral zone and beginnings. The main themes were; entering transition, getting started, chaos and turmoil, overwhelmed and opening doors. The themes present the feelings and perceptions of the CNEs using their own words. The CNEs experienced the journey through transition and discovered the role they had undertaken was much larger than expected. In addition information and shared understandings of the role were limited and orientation to the role, minimal. The CNEs experienced a variety of emotions and challenges while moving through this transition period. By sharing their stories and insights they have given the opportunity for learning to occur, which will enable improved succession planning, orientation and transition periods for future CNEs

Birthing pains: How cyborgs refigure medical bodies, technologies, and objectives

Cyborgs are polymorphic and not yet visibly different from humans in part because cyborgic technologies have just been developed, in part because we are not trained to see how the post human arises. The birth of cyborgs alters the core of medicine from disease-containment and death-assessment to enhancement of function and image, to transgression of previous natural bounds as established by the possibility of space and oceanic travel. Cyborgs, as postmodern/ posthuman products of medicine, make visible the current shift in the construction of medical bodies, technologies, and objectives. Medical bodies have been determined by a conception of patienthood or diseased body. The connection of body and disease as distinct species happened in the medical enclosure: the hospital-clinic, during mid-late 19th century. In the hospital-clinic, the medical body has been clearly mapped in terms of disease identity or malfunction, and it has encountered medical technologies used to aid in diagnosis. The patient-doctor relationship has shifted because of the revolution in instrumentation at the turn of the century. Another shift can be discerned, as it is again mirrored in the relations of doctor-patient, as it has been re-structured through cyberspace and expert systems. Clearly, the revolution or scientification of medicine has been fueled by the tuberculosis crisis as it challenged medical and political institutions. A similar crisis has occurred with AIDS: is cyborg-technology the fulfillment of the modem dream of immortality and total control in the face of the epidemic? An easy answer to such question cannot be produced. Cyborgs are a product of the meeting of natural and human sciences through cybernetics. Their existence and proliferation destabilize assumptions at the philosophical foundations of knowledge and medicine as well as our conceptions of identity and rights, through an unsettling of the connection between community-individuality, of the distinction between private and public domains