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This article describes the establishment of a coordinated education program for patients having a cardiac catheterization. The article focuses on developing the program content, instructional aids, and the education of the staff doing the actual patient education for this group of patients and their families.
This validation study investigated the effectiveness of an instructional unit on the topic of donor phlebotomy. The unit consisting of 3 modules based on a videotape and 3 booklets covered (1) donor selection, (2) donor arm preparation, (3) donor phlebotomy. A separate-sample pretest-post-test design was used. All 3 modules were found to be instructionally effective as measured by objective referenced tests. Student appraisal data also was collected for the purpose of revising and improving these materials.
This study focuses on the instructional technique of correspondence instruction--the learner, the setting, and the problem of course non-completion. The purpose of this study was to develop a model of completion of correspondence courses which identifies factors related to progress towards course completion. The objectives were to estimate the model and identify factors associated with course completion. The causal model for this study was adapted from Bean's synthetic model of student attrition from institutions of higher education. Data to test the model were obtained from a questionnaire, transcripts, and progress records of students enrolled in independent study programme courses and declaring a nursing major. Eleven variables in the model estimated in this study accounted for 44% of variance in course progress. Students making progress intended completing the course in 3 months, submitted the first lesson within 40 days, had high SAT scores and GPAs, completed (and did not drop) other correspondence courses, perceived family support but not employer support, had high goals for completing the programme and obtaining the BSN, lived closer to the instructor, and entered the nursing programme with college preparation (as a registered nurse). The model can be used for understanding and explaining progress toward course completion as well as the distance education setting of correspondence instruction. The intent variable explains most variance and can be measured while students are enrolled in the course. The lesson submission variable is theoretically justified.
The study was prompted by a long-standing concern about how best to educate nurse administrators for work in complex health service organizations. In the last decade, there has been increasingly widespread agreement in nursing that advanced education for clinical specialization alone may be insufficient. To improve understanding of education for nursing administration (NA), the suggestions in 37 publications printed between 1976 and 1985 were analyzed. Inferences were made from these publications about curriculum content, program structure, instructional placement, and practicum experiences. Content suggested most often pertained to health systems, nursing practice, research, and policy. Reference was least often made to perspectives in organization theory, ethics, and future studies. Suggestions for international NA were made in only one publication. Administration majors with a clinical nursing emphasis in multidisciplinary programs controlled by schools of nursing were widely recommended, as were administrative practicums of variable length. Few suggestions were made about the epistemological considerations needed to guide the development of interdisciplinary nursing administration. In the future, consideration of the overlap--from nursing and management science--of concepts, research problems, and modes of inquiry, will be important for the education of nurse administrators. In the 1960s and early 1970s, clinical specialization was the central focus of graduate nursing education. During this period of time, emphasis on nursing administration (NA) declined, as did the number of NA programs, resulting in a critical shortage of nurse administrators academically prepared to manage health services (Blair, 1976a-b).(ABSTRACT TRUNCATED AT 250 WORDS)
Tailoring instruction to the individual needs of students is one approach to ensuring that students with lower scholastic aptitudes obtain the skills and knowledge necessary to function successfully as professionals. This study determined the effects of the personalized system of instruction (PSI) on end-of-course achievement, aptitude-achievement relationships, long-term retention, and course attitudes. The PSI method of instruction was compared to a conventional lecture/laboratory approach for teaching a dental materials course to dental hygiene students. Although there was no significant difference between conventionally taught and PSI students on the end-of-term final examination, lower aptitude students in the PSI class scored significantly higher on the final examination than lower aptitude students in the conventional class. Of students completing a one-year retention examination, those in the PSI class scored significantly higher than students in the conventionally taught class. Student course ratings favored PSI instruction both at the end of the course and at the one-year follow-up interval.
Three preschool children repeatedly did four kinds of sorts with a deck of stimulus cards: a difficult, untaught target sort and three other sorts considered analytic of self-instructing the target performance. The untaught target sort was to find in a deck of cards those matching what two sample cards had in common. Most preschool children must be taught to mediate this problem. The three other kinds of sorts taught skills involved in the target performance or its mediation. As correct self-instructive talk emerged in the target sorts, it was confirmed. The untaught target sorts were interspersed infrequently among the three alternating directly taught skill sorts, to see if accurate target sorts, and accurate self-instructive talk about the target sorts, would emerge as the three skill sorts were mastered. As all the sorts progressed, increasing accuracy was seen first in the skill sorts and then in the untaught target sorts. All three subjects showed subsequent generalization to new target sorts involving other stimulus sets. Correct spontaneous self-instructions about the target sorts increased from near zero at the beginning of the experiment to consistency at its end. Thus the three skill sorts appeared sufficient for the emergence of a self-instructed solution to the previously insoluble target performance.
Does the method of instruction affect retention of Basic Cardiac Life Support (BCLS) knowledge and skill? This was the primary question addressed in a study conducted in a university school of nursing. The teaching methods studied were a lecture-demonstration-return demonstration method and a self-paced method. The sample consisted of 63 baccalaureate nursing students who were assigned to one of the two teaching methods. American Heart Association instructional materials and cognitive and performance tests were used with both treatment groups. Initial mastery and retention were tested during week two and eight respectively. Cognitive knowledge was retained at a mastery level by both groups at eight weeks. In addition, there was no difference in retention of performance skills based on teaching methods. However, neither group was able to demonstrate retention of performance skills at a mastery level. Additional data indicate the self-paced subjects spent less time in BCLS learning activities. While the self-paced instructional package was more costly on a one-time basis, repeated applications would decrease the cost/student.
The sophomore pathology course at the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, was substantially modified with the intention of promoting guided, independent learning. The emphasis has been shifted from lectures to other modalities of instruction. This article delineates the curricular changes made, describes the instructional modalities used, and reports student performance after two year's experience with the new curriculum.
The Levels of Cognitive Functioning Assessment Scale (LOCFAS) is a behavioral checklist used by nurses in the acute care setting to assess the level of cognitive functioning in severely brain-injured patients in the early post-trauma period. Previous research studies have supported the reliability and validity of LOCFAS. For LOCFAS to become a more firmly established method of cognitive assessment, nurses must become familiar with and proficient in the use of this instrument. The purpose of this study was to find the most effective method of instruction by comparing three methods: a self-directed manual, a teaching video, and a classroom presentation. Videotaped vignettes of actual brain-injured patients were presented at the end of each training session, and participants were required to categorize these videotaped patients by using LOCFAS. High levels of reliability were observed for both the self-directed manual group and the teaching video group, but an overall lower level of reliability was observed for the classroom presentation group. Examination of the accuracy of overall LOCFAS ratings revealed a significant difference for instructional groups; the accuracy of the classroom presentation group was significantly lower than that of either the self-directed manual group or the teaching video group. The three instructional groups also differed on the average accuracy of ratings of the individual behaviors; the accuracy of the classroom presentation group was significantly lower than that of the teaching video group, whereas the self-directed manual group fell in between. Nurses also rated the instructional methods across a number of evaluative dimensions on a 5-point Likert-type scale. Evaluative statements ranged from average to good, with no significant differences among instructional methods.
OBJECTIVE: Unintentional firearm injuries threaten the safety of children in the United States. Despite the occurrence of these injuries, few studies have evaluated the effectiveness of child-based programs designed to teach children gun-safety skills. This study compared 2 programs that were designed to reduce gun play in preschool children. METHODS: A between-groups no-treatment control design was used. Children were randomly assigned to either 1 of 2 firearm-injury prevention programs or a no-treatment control condition. Participant recruitment, training, and data collection occurred in preschools and children's homes located in a midwestern city with a population of approximately 80,000. Thirty-one 4- and 5-year-old children participated in the study. The effectiveness of the National Rifle Association's Eddie Eagle GunSafe Program and a behavioral skills training program using instruction, modeling, rehearsal, and feedback was evaluated. Children were issued 0 to 3 ratings on the basis of their ability to say correctly the safety message and similar ratings on the basis of observations of their ability to perform correctly the skills in the classroom and when placed in a realistic simulation. RESULTS: Both programs were effective for teaching children to reproduce verbally the gun-safety message. The behavioral skills training program but not the Eddie Eagle GunSafe Program was effective for teaching children to perform gun-safety skills during a supervised role play, but the skills were not used when the children were assessed via real-life (in situ) assessments. CONCLUSIONS: Existing programs are insufficient for teaching gun-safety skills to children. Programs that use active learning strategies (modeling, rehearsal, and feedback) are more effective for teaching gun-safety skills as assessed by supervised role plays but still failed to teach the children to use the skills outside the context of the training session. More research is needed to determine the most effective way to promote the use of the skills outside the training session.
This publication describes MACGEN, an interactive development tool to assist teachers to create, modify and extend case simulations, tutorial exercises and multiple-choice question tests designed for computer-aided instruction. The menu-driven software provides full authoring facilities for text files in MACAID format by means of interactive editing. Authors are prompted for items which they might want to change whereas all user-independent items are provided automatically. Optional default values and explanatory messages are available with every prompt. Errors are corrected automatically or commented upon. Thus the program eliminates the need to familiarize with a new language or details of the text file structure. The options for modification of existing text files include display, renumbering of frames and a line-oriented editor. The resulting text files can be interpreted by the MACAID driver without further changes. The text file is held as ASCII records and as such is also accessible with many standard word-processing systems if desired.
We introduced medical education for general thoracic surgery to medical students and a new surgical residency program to instruct residents who aspire to become general thoracic surgeons. It is important to understand the etiology of thoracic diseases, methods of diagnosis for tumorous lesions, anatomy of the interior thorax, surgical therapies and indications for thoracic diseases, and management of perioperative periods in the medical education of general thoracic surgery. According to the new residency program, a surgical resident must complete a super rotating system that consists of the subjects of internal medicine, general surgery, emergency and critical care medicine, anesthesiology, pediatrics, gynecology, and local healthcare for several months each in the first two years. On the other hand, a surgical residency program includes core surgical residencies to train clinical patient-care oriented surgeons and advanced residencies in such areas as thoracic surgery, cardiovascular surgery, pediatric surgery, and digestive organ surgery. Residents who want to become general thoracic surgeons must complete 350 cases of general surgery including at least 120 cases for an operator in the first 4 or more years in core programs. After passing the board for general surgery, they can advance to a subspecialty program for thoracic surgery in the final 3 or more years to pass the board for general thoracic surgery. It is essential to train the general thoracic surgeons who empathize with patients with thoracic diseases and can contribute to overcoming thoracic diseases by practicing evidence- or science-based medicine.
STUDY OBJECTIVE: To survey American anesthesiology residency program directors to determine the availability and extent of training in peripheral nerve block techniques. DESIGN: Survey questionnaire was mailed and faxed to 132 American anesthesiology residency program directors and followed up 4 weeks later with another mailing to nonresponders. SETTING: University medical center. MEASUREMENTS AND MAIN RESULTS: Of the 132 American anesthesiology residency program directors surveyed, 69 (52%) responded. Of the responders, 40 (58%) offered a specific peripheral nerve block rotation. The rotation was of 1 month's duration in 61% of these programs. Formal instruction was administered during the rotation in 69%. The regional instruction approach consisted of a nerve stimulator (98%), paresthesia (75%), and transarterial (85%). Multimedia, mannequins, and cadaver dissection were used infrequently (13-25%). During the rotation, residents performed a variety of blocks, but the number of each block varied from 2 (supraclavicular) to 10 (axillary). These blocks were performed in the operating room in 48% of programs. Finally, in the programs with a specific peripheral nerve block rotation, residents were evaluated. CONCLUSIONS: Specific peripheral nerve block rotations are not always included in anesthesiology residents' curriculum. In addition, residents in programs with a specific nerve block rotation are exposed to a greater number of peripheral nerve block techniques than those who do not have such a rotation included in their curriculum.
The authors, as members of the Ohio Regional Medical Audiovisual Consortium (ORMAC), recognized that many high-quality audiovisual materials for medical education are under-utilized because small segments do not exactly fit the curricular needs or scientific positions of faculty outside the institution where they were produced. It was postulated that redesign or reconfiguration of such materials by a broadly representative faculty group into flexible, modular learning packages would enhance their applicability for varied curricular and instructional settings. Experience with the three case studies described is that the reconfigured materials are highly acceptable to faculty, teach well and are enjoyed by students.
Smokers requesting self-help materials for smoking cessation (N = 2,021) were randomized to receive (a) an experimental self-quitting guide emphasizing nicotine fading and other nonaversive behavioral strategies, (b) the same self-quitting guide with a support guide for the quitter's family and friends, (c) self-quitting and support guides along with four brief counselor calls, or (d) a control guide providing motivational and quit tips and referral to locally available guides and programs. Subjects were predominantly moderate to heavy smokers with a history of multiple previous quit attempts and treatments. Control subjects achieved quit rates similar to those of smokers using the experimental quitting guide, with fewer behavioral prequitting strategies and more outside treatments. Social support guides had no effect on perceived support for quitting or on 8- and 16-month quit rates. Telephone counseling increased adherence to the quitting protocol and quit rates.
The purpose of the project reported here was to develop and evaluate an educational intervention to improve the interviewing skills learned in medical school. Sixty fourth-year medical students in a required ambulatory care rotation were randomly selected and randomly assigned to one of four conditions. All students interviewed a simulated patient who presented with one of five main complaints, and the interview was videotaped. Students were assigned to a control group or to one of three intervention groups: viewing a self-instruction videotape, viewing and critiquing a videotape of their interview, or both of these activities. The students assigned to the control group did not participate in any educational interventions. At the end of the intervention period, the students again interviewed a simulated patient and were videotaped. The 120 videotaped interviews were reliably rated by a scoring system developed by the project team. The postintervention interviews conducted by students in the two groups that used the self-instruction videotape received significantly higher ratings than those in the control group. These results suggest that this self-instruction intervention can improve the interviewing skills of senior medical students.
The Internet's World Wide Web (WWW) offers educators a unique opportunity to introduce computer-assisted instructional (CAI) programs into the medical school curriculum. With the WWW, CAI programs developed at one medical school could be successfully used at other institutions without concern about hardware or software compatibility; further, programs could be maintained and regularly updated at a single central location, could be distributed rapidly, would be technology-independent, and would be presented in the same format on all computers. However, while the WWW holds promise for CAI, the author discusses ten reasons that educators' efforts to fulfill the Web's promise may fail, including the following: CAI is generally not fully integrated into the medical school curriculum; students are not tested on material taught using CAI; and CAI programs tend to be poorly designed. The author argues that medical educators must overcome these obstacles if they are to make truly effective use of the WWW in the classroom.
Twelve mentally retarded children were taught anticipation and paraphrase strategies imbedded in either a self-instructional format that provided strategy initiation and modification routines or a traditional didactic training format: six children in a control condition received no explicit strategy instructions. Maintenance tests were administered 1 and 3 weeks following three training sessions; generalization tests were given in the afternoon of each training and maintenance session. Although no differences were found for self-instructional vs. traditional training formats, both conditions were superior to the control condition on the maintenance tests. Strategy generalization did not occur during training or short-term maintenance. On the final generalization test, however, significant improvements in recall accuracy were noted for both format conditions. In the self-instructional condition, several children successfully generalized the strategies during the early phases of training to facilitate gist recall.