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Rural nurses as self-directed learners: overcoming obstacles to continuing education.

Evaluation of a fieldtest of a self-directed learning (SDL) program included assessing rural nurses' self-perceived competencies in this method and loci of control for motivation. A significant negative relationship occurred between high scores for learner skills and internal motivation ratings. Sixty-two percent rated themselves above the mean as self-directed learners regardless of perceived loci of control in the stressful rural practice environment. SDL can offer an alternative way to meet continuing education needs of rural nurses in their efforts to overcome the many obstacles to professional growth in rural practice.

Clinical Competence↗

Evaluating clinical educators: an employer's perspective.

An Australian school of nursing's attempt to introduce an evaluation process required by management for clinical educators involved in undergraduate preregistration education is discussed. Reliance on student feedback and clinical agencies' perceptions of the quality of teaching were seen as inadequate mechanisms for evaluation. The evaluation process adopted incorporated observation of the educators together with self-reflection on their performance. We conclude that post-briefings were poorly used and generally not reflective. Educators relied heavily on their clinical skills and used a limited range of teaching strategies. Whilst evaluation of clinical educators was time consuming and therefore costly, it is argued that it is essential to the integrity of the course. The evaluation process has provided direction for support and development of clinical educators within the context of the curriculum.

Education, Nursing, Diploma Programs↗

New directions in the evaluation and education of handicapped children.

The Education for All Handicapped Children Act of 1975, which went into effect last October, ensures the right of handicapped children to free appropriate public education. State and local education agencies are required to identify, evaluate and provide services for all disabled children. This multibilliondollar program will guarantee special education resources for up to 12 per cent of American children. A role for physicians in the program is implied rather than defined in the law. Their involvement will vary somewhat from state to state, but will at a minimum involve counseling parents whose children are under evaluation. The law assumes a sophistication of diagnostic ability and curriculum design that does not yet exist, and therefore places a special burden upon physicians to deal effectively with patients now, while developing better training programs and assessment tools, and makes essential the enhancement of the communication between doctors and educators.

Adolescent↗

Evaluating patient education: a case study of a diabetes program.

This paper presents an evaluation of a diabetic education program for patients at Stephens County Hospital in Toccoa, Georgia. An analysis of covariance is employed along with multiple classification analysis to determine the effect of the program in reducing hospital readmissions. The major finding is that the teaching program is an important variable in the reduction of readmissions. A second outcome is that the occurrence of diabetic ketoacidosis (DKA) on initial admission is a second factor in determining readmissions. Patients having the benefit of instruction are less likely to experience readmission than those not being educated; those having DKA are more likely to be readmitted within six months from release than those not having this degree of loss of control. Implications of this study suggest that in designing a diabetic education program, greater attention must be focused upon the needs of the ketosis-prone patients.

Analysis of Variance↗

Evaluating your educational plan: Are you meeting the needs of nurses?

The authors discuss a descriptive educational needs assessment survey based on Benner's Skill Acquisition Model to determine staff nurses' perception of quantity and relevance of educational programs offered to nurses. The evaluations of the feedback received, such as lack of knowledge of available educational offerings and the need to expand the current curriculum, are presented. The main assumption that course offerings have changed or validated practice was supported. Changes based on the information obtained by the survey participants involve expansion of the curriculum using a case study approach.

Clinical Competence↗

Participation of the school community in AIDS education: an evaluation of a high school programme in South Africa.

An AIDS education programme was developed and evaluated in a high school in a socio-economically disadvantaged, urban, African area in South Africa. The programme, which addressed the whole school community, aimed to raise awareness about AIDS using a variety of educational methods and operating through a number of channels. Students and teachers were actively involved in its design and implementation. Students' knowledge of and attitudes towards AIDS prevention were investigated before and after the AIDS programme, and compared to a neighbouring school, in which no AIDS education was conducted. The programme greatly improved student knowledge of HIV transmission and prevention. It increased levels of acceptance of people with AIDS and had a small impact on behavioural intentions. The process of involving the school community in the design of the AIDS education programme is discussed.

Acquired Immunodeficiency Syndrome↗

The effect of a teaching award on the quality of continuing medical education participant evaluations.

OBJECTIVE: To improve compliance with the completion of speakers' evaluation forms in a pediatric hospital continuing medical education program. DESIGN: Preintervention and postintervention analysis. SETTING: Pediatric hospital in Cincinnati, Ohio. PARTICIPANTS: Attendees at pediatric grand rounds programs. MAIN OUTCOME MEASURE: Analysis of speaker evaluation forms for each of 20 pediatric grand rounds programs were used as the basis for speakers' awards. RESULTS: Spontaneous written comments were found on a mean of 7.3 evaluations per preintervention program and 13.5 evaluations per postintervention program (P<.01). The distribution of objective scores in 3 items examined was wider postintervention than preintervention (P<.01). CONCLUSION: When participants in continuing medical education programs know that their evaluations of an activity are used as the basis for an educational award, they may be more reflective in completing such evaluations.

Awards and Prizes↗

A simple guide for design, use, and evaluation of educational materials.

Few health workers in Latin America are trained in how to produce effective and appropriate health education materials. In order to provide an instrument and a strategy to help overcome this problem, the Pan American Health Organization developed an effective methodology to orient the design, use, and evaluation of health education materials. This article describes the development of this methodology and summarizes the basic operating principles and criteria for evaluation. These operating principles include developing educational materials from the community perspective, ensuring that they are an integral part of a health education program, relating them to health services delivery, pretesting the materials, and distributing instructions for use along with these materials. An evaluation scale helps health personnel assess materials that have been designed elsewhere and decide if they would be appropriate for their own target audiences. The scale also promotes self-evaluation by the community in the development of its own materials. This simple and straightforward methodology has been successfully applied in courses and seminars as well as in the design, use, and evaluation of health education materials throughout Latin America.

Evaluation Studies as Topic↗

The American College of Nurse-Midwives' Domestic Violence Education Project: evaluation and results.

From October 1994 through September 1998, the American College of Nurse Midwives conducted a nationwide Domestic Violence Education Project. The project aimed to encourage universal screening for domestic violence among all women being seen for care. A four-pronged set of objectives was used, including policy, basic education, continuing education, and advocacy/activism. A description of the project and the results of the project evaluation, including replicable features, are presented. Process and outcome evaluations were performed using both quantitative and qualitative data. Surveys, interviews, and site visits formed the basis for the evaluation of the policy reform, education program, and advocacy components. Pretests and posttests of training participants formed the basis of the evaluation of the continuing education component. All project objectives were met. Policy reform occurred as expected. Changes were noted in education programs in both didactic content and clinical exposure. Changes in clinical behavior as assessed by the pretests and posttests look promising, although numbers of respondents at 12 and 24 months after training are small. Participants reported an increase in advocacy and activism. The Domestic Violence Education Project seems to be a successful and somewhat replicable model for changing attitudes about a health topic (among providers) with possible implications for clinical practice.

Curriculum↗

Evaluating an education programme in general palliative care for community nurses.

AIMS: To evaluate the effects of a palliative care education programme on the self-reported knowledge and confidence of 72 community nurses. DESIGN: a prospective longitudinal postal questionnaire survey was conducted. FINDINGS: seventy-one (99%) completed a pre-course questionnaire, 52 (72%) a questionnaire at completion of the course, and 37 (51%) a questionnaire one year later. Following the programme, more nurses felt that their professional needs were being met well or very well. Confidence in practice showed an increasing trend over time. Desire for education was lower on course completion than at its start. Palliative Care Nursing Quiz scores rose from a pre-course median of 12.5 to 15 at course completion (P=0.001) which was maintained 1 year later. CONCLUSION: the education programme was successful in raising standards of knowledge, professional development and confidence. Improvement was maintained one year later.

Community Health Nursing↗

Ethnic differences in achievement of cholesterol treatment goals. Results from the National Cholesterol Education Program Evaluation Project Utilizing Novel E-Technology II.

BACKGROUND: African Americans (AA) have the highest coronary heart disease mortality rate of any ethnic group in the United States. Data from the National Cholesterol Education Program Evaluation ProjecT Utilizing Novel E-Technology (NEPTUNE) II survey were used to assess ethnic differences in low-density lipoprotein cholesterol (LDL-C) goal achievement. METHODS: NEPTUNE II surveyed patients with treated dyslipidemia to assess achievement of treatment goals established by the Adult Treatment Panel III of the National Cholesterol Education Program. United States physicians working in primary care or relevant subspecialties enrolled 10 to 20 consecutive patients (May to September 2003), and patient data were recorded in Personal Digital Assistants and uploaded to a central database via the internet. RESULTS: Among 4,885 patients receiving treatment for dyslipidemia, 79.7% were non-Hispanic white (NHW) and 8.4% were AA. Non-Hispanic white and AA patients had significantly different frequencies of treatment success, with 69.0% and 53.7%, respectively, having achieved their LDL-C goal (P<.001). African-American patients were more likely to be in the highest risk category, and less likely to be using lipid drug therapy, taking high-efficacy statins, and receiving care from a subspecialist, but the difference in goal achievement remained significant (P<.001) after adjustment for these and other predictors of treatment success. CONCLUSIONS: The frequency of treatment success in dyslipidemia management was significantly lower in AA than NHW patients. Additional research is needed to elucidate reasons for this disparity and to evaluate strategies for improving goal achievement among AA patients receiving therapy for dyslipidemia.

Black or African American↗

Evaluating an educational intervention to improve the treatment of asthma in four European countries. Drug Education Project Group.

In the international Drug Education Project, a new educational program for peer groups of doctors was developed and tested to improve the treatment of asthma patients in The Netherlands, Norway, Sweden, and Slovakia. Individualized feedback on prescribing and the underlying decision strategy was presented and discussed within the group of doctors, in relation to existing guidelines. In a parallel, randomized controlled design the effect on competence and actual prescribing was tested. Results were related to national guidelines. In general, the program improved the doctors' attitudes as well as some of their prescribing behavior. The proportion of patients treated with inhaled corticosteroids significantly improved in The Netherlands (effect size 1.27), and the proportion of oral corticosteroid use for exacerbation treatment increased both in The Netherlands and in Norway (effect sizes 1.99 and 0.87, respectively). Overall attitudes of Dutch and Norwegian doctors also improved significantly (effect sizes 1.06 and 0.87, respectively), as did both knowledge (effect size 1.06) and attitudes (effect size 1.49) concerning exacerbation treatment in Slovakia. In Sweden no significant improvements could be measured. Conclusively, improvements in asthma treatment are possible with an educational program based on self-learning in small peer groups, although effects in one health care setting may not occur in another health care setting. Possible explaining factors may be different attitudes to and experiences with guidelines as well as with continuing medical education programs, and differences in the opportunities for change, including prevailing trends in prescribing behavior.

Adult↗