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Requiring attendance at staff development activities does not insure that staff members will be motivated to learn or to use the skills and information being taught. Such motivation can be increased by asking a representative sample of prospective learners to help determine program content. This article will discuss the process used to capture learner input in educational program planning.
CONCEPTS AND ASSUMPTIONS of self-in-relation theory of women's development, as proposed by feminist scholars at the Stone Center in Wellesley, Massachusetts, are applied in this article. This theory was used as a framework to guide staff development and mentorship roles of advanced practice nurses. How the theory served to direct these roles and assisted in development of a professional practice model is discussed. Exemplars from the authors' practices and professional practice outcomes after 2 years of theory implementation are presented.
In today's cost-conscious marketplace, it is critical to identify the true costs of professional staff development within a healthcare organization. Many hidden costs can be difficult to quantify. This article will help administrators identify these costs, and decide whether their professional staff education would be done better internally or using outside resources.
Mentoring in the career development of hospital staff nurses was explored using a qualitative, grounded-theory method in a descriptive study design. Verbatim audiotaped interviews of hospital staff nurses and their nurse managers from four hospitals in the northeast were used. Document analysis of key hospital and nursing organizational policy statements was included. Two models were identified from the study regarding the mentoring of hospital staff nurses, ie, a structural and a process model. Within the structural model, mentoring influentials were noted to be people, events, and environments. Peers and nurse managers proved to be the primary people influential in providing key mentoring strategies. Within the process model, four phases were identified leading to three separate career development outcomes toward which hospital staff nurses strive: the development of career-building relationships, facilitation of career transition points, and positive interaction within the organizational climate.
One concern of healthcare professionals today is the high turnover rate of hospital nursing staff. This article discusses role efficacy and its relation to job satisfaction of hospital nurses. It describes a role-efficacy model and analyzes nurses' perceptions of feedback from the job itself, nursing supervisors, physicians, and hospital administrators. The impact of role efficacy and job satisfaction on improved recruitment and retention of nurses and the role of staff development in the improvement process is explained.
The concept of "Least Restrictive Environment" has become the cornerstone on which placement decisions for hearing-impaired children are made. Living outside the family unit is considered restrictive. Schools with a residential component must, therefore, demonstrate that the level and quality of programming provided in the residence halls counteract the restrictiveness of the placement. Since formal educational opportunities for residential staff are limited, administrators must provide effective, on-site training. This study looks at the prioritization of in-service topics by residential staff at ten schools for deaf children in the western United States. It also explores the relationship between certain demographic variables and selection of training topics. The results of the study provide practical information, ideas and considerations for administrators, curriculum coordinators, superintendents and other responsible for residential staff development.
Budgetary constraints have compelled hospital administrators to take a more discerning look at the role of the pharmacist within the healthcare team. In 1991, financial difficulties and hospital-wide cutbacks at Northern Michigan Hospital resulted in the loss of pharmacy personnel. Consequently, the department has increasingly found it necessary to document the clinical activities of the pharmacists and their potential effect on patient care. To document therapeutic interventions, two forms specific to this activity were developed. These forms allowed evaluation of both the quantity and quality of interventions. The authors realize it is essential for pharmacists to not only maintain, but to continually update their knowledge base to be prepared for the future. A staff development program was developed to help meet the educational needs of the pharmacists. This article describes how therapeutic interventions were integrated into the quality improvement and performance plans to help motivate staff to continually improve their pharmacy practice skills at this institution.
Staff development units (SDUs) across New South Wales Health are in a state of flux. Traditional models of training may no longer be meeting the continuing professional education needs of staff. This paper outlines how one SDU, the Rural Health Education and Research Centre at Tamworth, with few resources, has successfully negotiated the transformation from delivering ad hoc, face-to-face teaching, to a model encompassing competency-based training, recognition of prior learning, workplace assessment and distance education.
The scope of services provided by the Staff Development Department or clinical educators in healthcare settings includes, but is not limited to, employee orientation, continuing education, and competency assessment. The critical issue of ascertaining competency of nursing staff in medication dosage calculation encompasses each of these functions. The authors describe the process of pilot testing a dosage calculation test in an ambulatory care setting, adapting it based on feedback, using it with orientees and current staff, and using the educational process with nurses needing assistance in dosage calculation.
What is the philosophical basis of knowledge development for nursing? How can knowledge be developed and enhanced in clinical practice? The purpose of this article is to explicate more clearly knowledge acquisition and decision-making of the practicing nurse. The relationship of knowledge with decision-making is explored and implications for ongoing staff development in a service setting are delineated.
BACKGROUND: Members of the CHRISTUS Santa Rosa Children's Hospital staff development committee identified a need for a mock code program which would address a range of learning needs for nurses and other caregivers with varying levels of knowledge, skills, and experience. METHOD: We implemented a mock code program using experienced caregivers, usually emergency room and pediatric intensive care RNs and respiratory therapists to serve as facilitators to code participants during the mock code drills. Facilitators have dual roles of teaching and guiding the code participant as well as evaluating performance. RESULTS: Code participants and facilitators benefit from the design of this program. Debriefing session input and written program evaluations show that code participants value the opportunity to practice their skills in a nonthreatening situation in which they receive immediate feedback as needed. Facilitators learn to teach and coach and strengthen their own code knowledge and skills at the same time. CONCLUSION: This mock code program serves as a unique way to include novice and experienced nurses in mock codes together. The knowledge, skills, and confidence of the code participants and the facilitators have matured. The design of the program allows for immediate teaching/learning where needed, as well as appropriate evaluation. This program develops stronger, calmer, more efficient, and more confident nurses during codes. Practice and equipment changes can be based on findings from the mock codes. The program is invaluable to patients, staff, and hospital.
This paper summarises the key results and recommendations from a major study of the management problems and professional development needs of Australian health executives. Key issues of major concern to a nationally representative sample of senior nursing, medical and general administrators, included the following: change, information, financial constraints, evaluation, corporate planning, human resources, conflict and staff development. Over 80% of respondents considered that they were not sufficiently involved in executive development activities and the paper addresses their preferences as to learning styles, settings, timing and location. Specific recommendations are made regarding desirable responses to the key issues of information and corporate planning.
The purpose of this article is to describe a training program for managing agitation of long-term care residents and to report results of a pilot study. The program emphasizes the development of behavioral skills for the assessment, prevention, and reduction of both aggressive and non-aggressive agitated behavior. It includes 8 hours of class instruction followed by 8 hours of weekly supervision by the trainers. The nursing staff of all working shifts of a unit located in a large nursing home and the residents of this unit participated in the pilot study. Residents and staff were assessed prior to and after the 2-month training program. Staff members reported using behavioral techniques to a greater extent and feeling more effective in managing agitation after training. More than 90% of staff members were satisfied with the training program. During the supervision period, the staff developed and implemented individualized interventions for two residents. The interventions involved providing more attention to these residents and, in one case, modifying some aspects of the direct environment which seemed to trigger agitation. Both residents were less agitated after the interventions were implemented. Moreover, there was a reduction in the number and frequency of agitated behaviors for the other residents of the trainees' unit following staff training.
The CIPP model of evaluation was used through its Context, Input, Process and Product elements, to evaluate the process of introducing a quality development program established in a nursing department within a teaching referral hospital in Amman, Jordan. The evaluation was intended to test whether the development program had achieved its overall goals: Management within a static state of nursing manpower; improvement in the general patterns of communication; management of some operational and organizational level problems and enhancement of measures to facilitate staff development. Several sets of action were suggested and implemented within the period of the quality development program. The results indicated partial achievement of the overall goals with certain difficulties remaining. The hospital's overall strict budget remained the major operational problem to be resolved. Other research was recommended to be carried out to specifically test the effectiveness of each set of actions (measures) included in the study.
The use of Nursing Grand Rounds as a teaching tool helps students gain clinical competence and become more proficient in nursing processes. Adaptation of this learning tool for staff development could be an important strategy for personal and professional growth of nurses in gerontological settings.
BACKGROUND: Preparing healthcare professionals for teaching is regarded as essential to enhancing teaching effectiveness. Although many reports describe various faculty development interventions, there is a paucity of research demonstrating their effectiveness. OBJECTIVE: To synthesize the existing evidence that addresses the question: "What are the effects of faculty development interventions on the knowledge, attitudes and skills of teachers in medical education, and on the institutions in which they work?" METHODS: The search, covering the period 1980-2002, included three databases (Medline, ERIC and EMBASE) and used the keywords: staff development; in-service training; medical faculty; faculty training/development; continuing medical education. Manual searches were also conducted. Articles with a focus on faculty development to improve teaching effectiveness, targeting basic and clinical scientists, were reviewed. All study designs that included outcome data beyond participant satisfaction were accepted. From an initial 2777 abstracts, 53 papers met the review criteria. Data were extracted by six coders, using the standardized BEME coding sheet, adapted for our use. Two reviewers coded each study and coding differences were resolved through discussion. Data were synthesized using Kirkpatrick's four levels of educational outcomes. Findings were grouped by type of intervention and described according to levels of outcome. In addition, 8 high-quality studies were analysed in a 'focused picture'. RESULTS: The majority of the interventions targeted practicing clinicians. All of the reports focused on teaching improvement and the interventions included workshops, seminar series, short courses, longitudinal programs and 'other interventions'. The study designs included 6 randomized controlled trials and 47 quasi-experimental studies, of which 31 used a pre-test-post-test design. KEY POINTS: Despite methodological limitations, the faculty development literature tends to support the following outcomes: Overall satisfaction with faculty development programs was high. Participants consistently found programs acceptable, useful and relevant to their objectives. Participants reported positive changes in attitudes toward faculty development and teaching. Participants reported increased knowledge of educational principles and gains in teaching skills. Where formal tests of knowledge were used, significant gains were shown. Changes in teaching behavior were consistently reported by participants and were also detected by students. Changes in organizational practice and student learning were not frequently investigated. However, reported changes included greater educational involvement and establishment of collegiate networks. Key features of effective faculty development contributing to effectiveness included the use of experiential learning, provision of feedback, effective peer and colleague relationships, well-designed interventions following principles of teaching and learning, and the use of a diversity of educational methods within single interventions. Methodological issues: More rigorous designs and a greater use of qualitative and mixed methods are needed to capture the complexity of the interventions. Newer methods of performance-based assessment, utilizing diverse data sources, should be explored, and reliable and valid outcome measures should be developed. The maintenance of change over time should also be considered, as should process-oriented studies comparing different faculty development strategies. CONCLUSIONS: Faculty development activities appear highly valued by participants, who also report changes in learning and behavior. Notwithstanding the methodological limitations in the literature, certain program characteristics appear to be consistently associated with effectiveness. Further research to explore these associations and document outcomes, at the individual and organizational level, is required.
Although the need for cultural competence in healthcare is well established, the integration of cultural competence approaches in most healthcare settings is not yet a reality. A review of the literature reveals several factors in clinical settings that pose barriers for health providers. The purpose of this article is to explore the barriers to cultural competence faced by nurses and to examine the role of staff development in addressing these barriers.
This paper describes the structure and function of the department of Information Services at Sacred Heart Health System in Eugene, Oregon. This department has gone through a process of reorganization. The new department design features self-directed work teams with a strong customer service orientation; a mentor role stressing staff development; and a skill-based compensation system.