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The clinical achievement portfolio: an outcomes-based assessment project in nursing education.

Dynamic healthcare market forces impel educators to search for innovative methods of academic assessment to measure learning outcomes. The clinical achievement portfolio is a creative and systematic tool for documenting continuous improvement of student clinical learning. The authors describe the use of the portfolio as a pilot project aimed at introducing reflective thinking and measuring clinical learning in undergraduate nursing education. Potential benefits of the clinical portfolio and implications for future research are proposed.

Attitude of Health Personnel↗

Increasing self-efficacy through empowerment: preoperative education for orthopaedic patients.

PURPOSE: To examine whether patients who received an empowerment model of education for preoperative orthopaedic teaching had improved outcomes compared to patients who received the traditional education. DESIGN: An experimental (empowerment teaching method) group vs. comparison (traditional teaching method) group posttest design. SAMPLE: Seventy-four patients undergoing elective orthopaedic surgery. METHODS: Following the preoperative teaching session, patients in both groups completed a questionnaire designed to measure their perceptions of the teaching (empowerment) and self-efficacy (belief in their ability to carry out perioperative tasks). A chart audit and phone interview was done after discharge to assess length of stay, pain management, complications, and patient perceptions of the ability to complete perioperative tasks. FINDINGS: Patients in the empowerment group felt the educational approach was more empowering and had significantly higher self-efficacy scores than those in the traditional teaching group. There was much less variation in empowerment and self-efficacy scores in the empowerment group. The empowerment group reported feeling greater confidence in performing perioperative tasks. There were no differences in length of stay, complications or pain control. CONCLUSION: Use of an empowerment teaching approach enabled patients to become more confident in their ability to carry out perioperative tasks and become a more integral part of the preoperative teaching process. IMPLICATIONS FOR NURSING RESEARCH: The theoretical model will be used to structure other educational programs and guide research. More sensitive measures of complications and pain control should be considered for future studies.

Adolescent↗

Smoking education and prevention: a developmental model.

A developmental approach to smoking education and prevention for children and adolescents is proposed. Literature is reviewed concerning the most appropriate agent, content, and presentation, of anti-smoking education for each of three age groups: children to age ten, pre/early adolescents eleven to fifteen, and adolescents fifteen to eighteen. For children to age ten, it is suggested that parents are the best agents of education, with teachers, peers, and the mass media, also playing some role. For pre/early adolescents, peers are suggested as the best agents of education, building onto the earlier and ongoing work of the agents mentioned above. For adolescents, the role of the media hero-figure is discussed. It is emphasized that sources of influence may function additively in affecting the child or adolescent's decisions about smoking, and that education in each stage must build on the stage before.

Adolescent↗

Self-regulated learning during a clinical preceptorship: the reflections of senior baccalaureate nursing students.

This research was conducted to test the efficacy of audiotapes as a method of recording reflections of senior baccalaureate nursing students in a clinical preceptorship. The over-all aim of the research was to promote cognitive and metacognitive thinking processes with self-regulated learning strategies for problem solving in clinical situations. Verbal protocol technique revealed a consistent use of self-regulated learning strategies with a focus on environmental structuring for metacognitive activities. Common themes of thought were found in both clinical experiences and the use of critical thinking skills.

Adult↗

Creating the practice-learning environment: using information technology to support a new model of continuing medical education.

Many of the traditional approaches to providing continuing medical education (CME) have failed to improve physician performance and health care outcomes. In the current health care environment, physicians are being held to unprecedented levels of accountability to patients, payers, and society at large. A greater emphasis is being placed on measuring and improving the clinical and fiscal outcomes of medical care. If they are to help physicians practice more effectively and efficiently, CME developers must reformulate the missions and goals of their programs. CME must become a means for improving patient outcomes through enhanced physician performance. The author describes how a new practice-learning model for CME might be implemented using currently available information technology. She also discusses how CME programs, with the help of information technology, can help physicians identify learning opportunities, find the best resources for learning, and apply learning to practice. She then briefly discusses three programs that have begun to utilize information technology to expand the scope of CME: the Maintenance of Competence Program in Canada, the Stanford Health Information Network for Education, and a computer-simulation program at the Indiana University School of Medicine.

Competency-Based Education↗

Change and professional development: an adult education approach.

The purpose of this article is to explain the staff development approach as a means of enhancing the nurse manager's professional growth as well as the growth of employees. Staff development is growth-oriented, provides opportunity for self-direction, and integrates the needs of the learner and the facility while focusing on long-term goals. The author discusses integrating the goals of the adult learner and those of the health care organization as a means of meeting the needs of the institution and the individual employee.

Adult↗

Measuring learning, student engagement, and program effectiveness: a strategic process.

What if there was an effective way to address the age-old question from students, "Why do we have to do this assignment?" And from faculty, "How do we know our students are really learning?" And from administrators, "How will we demonstrate to our peers, our accrediting agencies, and other program stakeholders that our programs are educationally effective?" As it undertook a curriculum redesign, faculty in a baccalaureate school of nursing developed a 9-step process for curriculum implementation. The authors discuss how they applied the 9 steps strategically, positioning the program for 2 successful accreditation self-studies and concurrently addressing, with greater confidence, some of these age-old questions.

Attitude of Health Personnel↗

Blending education, research, and service missions: the Arkansas model.

Creating school and community partnerships with academic health centers (AHC) offers one strategy for initiating and sustaining broad-based change in health systems. This article describes the development, initial evaluation, and current iteration of the Arkansas Partners in Behavioral Health Sciences Model, a collaboration between personnel from an AHC and K-12 schools to address behavioral health issues in children. The model's focus on education, research, and service provides an opportunity for AHC faculty and school personnel to collaborate to promote mental health in school-aged youth. Quantitative and qualitative methods have been used to inform development and confirm effectiveness of the program. From 2001 through 2005, more than 2,700 school personnel from 72 of the 75 counties in Arkansas participated in more than 30,000 hours of continuing education. The programs have also targeted students using interactive televideo presentations, supplemental classroom curricula, and an exhibit in a state science museum, resulting in an outreach to more than 2,500 youths. Results of longitudinal and randomized studies also show changes in knowledge, attitudes, and behaviors. In an era of extraordinary need and finite resources for school systems, AHCs are poised to provide the critical link to improve the scientific knowledge and understanding of behavioral health conditions. The current program targets behavioral health, but AHCs also can incorporate other health conditions, scientific topics, and medical interventions to provide a important service for the public and to accomplish an important mission toward health leadership in the community.

Academic Medical Centers↗

Integrating mental illness prevention into community-based undergraduate education.

Including preventive models of health care in undergraduate education is essential as the nursing profession moves increasingly to community-based care. Traditionally, mental health curricula have focused primarily on psychopathology. This article presents current research in the attachment and temperament literature, which provides sound evidence for the need to synthesize prevention of mental illness concepts into undergraduate education. A curriculum model that integrates concepts from psychiatry and public health to prepare nursing students to promote mental health is described.

Community Health Nursing↗

Martha Rogers' model in associate degree education.

This article describes the first associate degree nursing program in the country to adopt Martha Rogers' science of unitary humans as the conceptual model for the program. The authors discuss the rationale for choosing the model, the curriculum design, the special challenges to implementation, and student and faculty reactions to the model.

Attitude↗

Särimner: a computer model of diabetes physiology for education of physicians and patients.

Often diabetic patients have developed their skills by some trial-and-error-like training over a long period of time. To minimize this inconvenience we have made a mathematical model to facilitate diabetes education. The model consists of a number of blocks involved in diabetes physiology: digestion, blood (transport), pancreas, injected insulin absorption, liver, muscles, kidneys, metabolism and insulin sensitivity. The model serves as a demonstration object and the user can change meals, exercise and injections and see the resulting blood glucose level. A more experienced user can search for further explanations of different phenomena deeper in the physiology of the model. The model does not solve any problem for the user, but creates a learning situation in which the user, led by his own curiosity, successively increases his experience of diabetes physiology. Särimner is implemented as an easy-to-use menu driven computer program for IBM PC-clones with Hercules, EGA or VGA graphics.

Adolescent↗

Freedom to enjoy learning in the 21st century: developing an active learning culture in nursing.

In 1994, the Wolfson School of Health Sciences was created in Thames Valley University, UK. This paper discusses an active learning approach being implemented throughout the university, and gives an outline of its application within nursing education. Practising as a confident, competent, reflective practitioner in the profession of nursing cannot automatically commence on the day of registration. Rather, the philosophical underpinnings necessary should be fostered throughout the initial nursing education curricula. In a political climate where there is a strong emphasis on efficiency, nurse teachers need to reconsider how the acquisition of nursing knowledge is facilitated. A description of how an active learning approach is being further developed in the nursing skills laboratory and the physiology laboratory is given. An outline identifies how these facilities may help students of nursing to gain knowledge and skills in relation to respiration. The authors recognize that while laboratories have been used widely in general education, their use has been limited in nursing education, particularly in the UK. Informal feedback from students implies that not only do they enjoy learning in these facilities, but also motivation towards learning is raised, an important element in the learning process. It is suggested that this will result ultimately in increased nursing competence. The authors acknowledge that these are preliminary informal findings and that formal investigation is required.

Education, Nursing, Baccalaureate↗