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Opening the black box: using process evaluation measures to assess implementation and theory building.

The past decade has seen increasing recognition in prevention science of the need to move away from a black box approach to intervention evaluation and toward an approach that can elaborate on the mechanisms through which changes in the outcomes operate (Chen & Rossi, 1989; Durlak & Wells, 1997; Spoth et al., 1995). An approach that examines issues of program implementation is particularly critical in the design of efficacy studies of school-based preventive interventions. Numerous preventive intervention strategies are now delivered within the schools, often by regular classroom teachers. The extent to which teachers faithfully deliver a particular curriculum or incorporate instructional strategies emphasized by an intervention is a critical question for the overall project evaluation. This article illustrates the utilization of process measures from a multicomponent school-based prevention program to examine implementation of a teaching staff development intervention, and the program's underlying theoretical basis. Given the nested study design, the analyses utilize hierarchical linear models (Bryk & Raudenbush, 1992) to examine changes in teaching strategies by condition and investigate the hypothesized relationships between teaching practices and student behaviors based on the program's theoretical framework. Results suggest that teaching practices in two of the six intervention focus areas were positively impacted in the first 18 months of the project. Findings also support the relationships between teachers' instructional practices and students' behavior.

Child↗

Compact disc interactive: a multimedia solution for staff education.

The findings acquired from two focus groups (13 generalist RNs and 13 specialist RNs) which were held to evaluate compact disc interactive (CD-i) as a self-learning option for staff development were reviewed. The findings from these groups were that the CD-i platform offers educators the opportunity to design programs that meet nurses' learning needs without the need for multi-media, computers, and the associated platform training and education. This study reinforced the previously identified problem that nurses have difficulty balancing the responsibilities of providing direct patient care and the need for additional education and training and that self-study is an acceptable alternative to the traditional lecture format.

Adult↗

Inquiry-based learning: facilitators' perceptions of their effectiveness in the tutorial process.

This preliminary study evaluates the effectiveness of facilitators in the inquiry-based learning tutorial process and identifies areas for staff development. Self-report checklists measure the key dimensions and role of the facilitator in four tutorial process steps: Exploration, Review, Consolidation and Plenary. The population study comprised 43 potential respondent facilitators in the pre-registration nursing programme. The response rate was 55% (N=23). Descriptive and non-parametric measures were used to analyse the data. Findings indicated that the overall majority of facilitators perceive the effectiveness of their role to be satisfactory. Differences in the results were found when compared by length of experience.

Attitude of Health Personnel↗

Achieving clinical excellence through evidence-based practice: report of an educational initiative.

We live in a political and professional climate which requires us to define, maintain and seek to improve the quality of all aspects of health care practice, not least via underpinning decisions and actions with robust evidence. In order to meet this challenge, staff must be clinically competent, reflective about their practice, committed to delivering a 'First Class Service' and able to work in a truly multidisciplinary way (as opposed to the unidisciplinary model frequently seen in operation). In addition, they need to be research 'literate' and able to contribute positively to the management and sustainment of planned change. For managers, the role of staff development in order to meet these goals is not inconsiderable. This paper discusses the process and outcomes of a successful educational initiative which sought to meet the plethora of challenges that face managers and their staff in the course of trying to achieve these goals.

Clinical Competence↗

Fairy tales of storyboarding.

Once upon a time, there were two creative, intelligent, staff development educators who worked in a large hospital in Dayton, Ohio, and who wanted to tell a story about how to share performance improvement initiatives with others. To narrate their story, they used a problem-solving method, a coordinating theme, bright colors, graphics, clip art, photography, data collection, and a board to display their story for "The Fundamentals of Storyboarding." A properly designed poster/storyboard can successfully attract attention, stimulate interest, and impart information. Poster presentations are effective tools for educators to share their knowledge and expertise as well as demonstrate performance-improvement initiatives in their organization. Join these storytellers as they open their book and present the chapters to help create a powerful poster presentation.

Abstracting and Indexing↗

A patient care training program for volunteers.

Properly trained and interested volunteers can perform basic nursing skills in a clinical setting. Staff development educators should 1) assess the needs of the area; 2) assess the skills of the volunteers available to them; 3) construct goals and objectives for a thorough orientation program geared to people with nonmedical backgrounds; 4) select appropriate course content and methods of presentation based on the framework provided by the goals and objectives and on the regulations governing the institution in which the volunteer will work; 5) implement the course; and 6) evaluate the adequacy and thoroughness of the program and the competency of the volunteers trained. The potential service that qualified and adequately trained volunteers could offer in patient care areas that are understaffed in nursing personnel is great. Similar programs can be used to supply needed assistance in facilities with limited nursing personnel.

Ambulatory Care↗

Expanding staff pharmacists' responsibilities to maintain pharmacy services in a neonatal intensive-care unit.

The conversion of pharmacist responsibilities in a neonatal intensive-care unit (NICU) pharmacy satellite from drug distribution to both clinical services and drug distribution is described. When the pharmacy department could not recruit a specialty-trained clinical practitioner to fill an open NICU position, the position was converted to a fourth satellite pharmacist position, and each of the four NICU satellite pharmacists assumed clinical responsibilities for the NICU. Clinical and distributive functions had previously been separate. Staff development programs and a contract with the previous NICU clinical practitioner for consultative services helped to ease the transition. NICU pharmacists currently provide inservice education to medical residents and the nursing staff, provide drug information, monitor drug therapy, perform pharmacokinetic monitoring, are involved in research, and work to streamline satellite operations. For one of every four months, the NICU pharmacists primarily provide clinical services; the remainder of the time clinical activities are combined with drug distribution responsibilities. The staffing schedule has enabled the department to extend the hours that clinical services are available. The NICU pharmacists maintain secondary areas of staffing, and other pharmacists periodically staff the NICU satellite. Staff pharmacists in the NICU pharmacy satellite developed clinical skills that permitted integration of clinical and distributive pharmacy services.

Hospital Bed Capacity, 500 and over↗

Professional development: factors that motivate staff.

Although many studies identify theories on learning motivation, few analyze motivating factors and barriers from the staff nurse perspective. A study involving RNs from a pediatric and an intensive care nursing service reveals factors that influence or restrain nurses from participating in professional activities.

Education, Nursing, Continuing↗

Standing in their shoes: an experiential learning experience in promoting age sensitivity.

The anticipated rise in the elderly population has been well documented. Nurses working in staff development have an important role in enabling healthcare staff to gain insights into the challenges of the aging process and positively affect the quality of life of elderly clients. This experiential program incorporates a variety of learning strategies to immerse staff in the elderly clients' world. Evaluations of the session have identified the need for staff to exercise patience, be proactive in anticipating elderly clients' needs, and appreciate client individuality.

Aged↗

Training program focuses on developing managers' skills.

The movement toward skill development and behavior modification in the training and staff development field is just beginning to affe(t management training in hospitals. The training model described in this article is adaptable to a variety of tasks involving the management of people.

Administrative Personnel↗

Images of aging--over the last 100 years.

Discussions on care of the elderly today often lack definitions of various issues and concepts relating to the elderly in question and their needs. One problem is the tendency to categorise the elderly in general as one homogeneous group of frail individuals. Another is an increasing tendency to paint a posy picture of the third age, overlooking the problems of "the fourth age". The categorisation of "the elderly" dates back 100 years in history, when the first political initiatives on pension policy were taken. Denmark was the first country to introduce such legislation, with old age (over 60) as the basic criterion. However, the basis for drawing a vertical line at the age of 60 was a series of findings by German and French scholars of medicine and statistics on age-related decline in various functions. The development of geriatric medicine occurred rather late in Denmark, probably because of a relatively high level of quality and capacity of social institutions and other services for the elderly. Thus, longterm care for old people was not a major issue in the health care system until recent decades. Today, the new images of aging are not limited to visualisation of old people in "the third age". Nursing homes are changed to individual flats and provision of 24-hour home care services is available. This development requires coordinated education, training, and management of staff. A better knowledge of the changing images of aging in history is an important element of staff development.

Aged↗

Why and how to develop an internal selection committee for EMR.

Educating and informing the practice staff; developing your selection committee through careful consideration of participants; conducting the committee's work through structured processes; and engaging and visible leadership and support from management are the foundation for EMR selection. Following these guidelines will help to ensure the success of the committee and subsequent installation of a new EMR system.

Choice Behavior↗

Educate your way to PPS success: one agency makes the grade with its wound care program.

The Home Health VNA's staff development department worked closely with nursing administration to devise an educational plan to prepare for PPS implementation. Developing an innovative wound care inservice for clinicians was a priority because the agency services a large number of wound care patients who will use a significant amount of resources in terms of number of staff visits, time, and supplies. In addition, the agency believed that the outcome of its financial reimbursement system could vary widely and would ultimately depend on a clinician's accurate documentation of wounds and pressure ulcers.

Community Health Nursing↗

Cranial Nerve Wheel of Competencies.

BACKGROUND: The neuroscience intensive care unit (ICU) staff development committee explored ways to test cranial nerve competencies of staff. With the assistance of the nurse manager, clinical nurse specialist, and education specialist, a game called Cranial Nerve Wheel of Competencies was developed. METHOD: The game tested learners' competency knowledge of cranial nerves. Game participants had the opportunity to attend classes on cranial nerve function and to review written materials prior to the day of testing. RESULTS: Staff evaluated the testing methodology as excellent and preferable to a written test. They found the game challenged their knowledge, yet was not intimidating. CONCLUSION: Gaming as a method to test competency knowledge of cranial nerves was an exciting alternative to written testing or return demonstration.

Attitude of Health Personnel↗

Beyond the job description: managing for performance.

Translation of individual effort into performance that effectively meets organizational goals is challenging. This article demonstrates a systematic approach that addresses both baseline performance and staff development by using personnel management concepts and relating them to existing resources available from the American Occupational Therapy Association. The systems approach described uses performance standards as a basis for staff recruitment, orientation, development, and appraisal. Also discussed are the applications to student clinical education.

Employee Performance Appraisal↗