bluuebunny/crossref_metadata_2025 huggingface dataset:
What We have Learned from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Study
Authors: Fawcett Jan
Published: March 2009

The first publications from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) began to appear in 2003. STEP-BD was conceived in response to an initiative by the National Institutes for Mental Health (NIMB) seeking a public health intervention model that could generate externally valid answers to questions related to bipolar disorder. The study uses a hybrid design to collect longitudinal data for a patient’s transition between naturalistic studies and randomized clinical trials. About 4,360 patients were admitted to the STEP-BD program, receiving a systematic assessment battery at entry and treated by a range of psychiatrists trained to deliver care and measure outcomes in bipolar patients. A registry of all bipolar patients of every subtype = / > 15 was maintained. A report of the first 1,000 patients enrolled in this study found that the sample was 92.6% white and 58.6% female, less racially diverse than the national population, with higher than average education but also higher than average unemployment and lower than average income.
 ABOUT THE AUTHOR
Jan Fawcett, MD, is Editor of Psychiatric Annals, and is Professor, Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque.

Address correspondence to: Jan Fawcett, MD, jan.fawcett@comcast.net.

Dr. Fawcett has disclosed the following relevant financial relationships: Eli Lilly & Co.: Member of Speakers’ Bureau; and Abbott Laboratories: Member of Medical Advisory Board.
 EDUCATIONAL OBJECTIVES
 Describe the findings of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study.

Discuss how the course and treatment of bipolar disorder and the difficulties in treating and preventing recurrences of bipolar depression.

Demonstrate the difficulties of successfully treating bipolar disorder and its comorbidities.
Early Intervention for Psychotic Disorders
Authors: Compton Michael T.
Published: March 2009

The articles in this issue of Psychiatric Annals reveal that although future prospects for early intervention in schizophrenia are good, there are still many challenges. The articles discuss interventions and services in the early stages of psychosis; treatment delay in the early course of schizophrenia and the duration of untreated psychosis; the Early Treatment and Intervention in Psychosis (TIPS) study; and how to intervene during the prodrome.
Sleep Disturbances in Cancer
Authors: Liu Lianqi , Ancoli-Israel Sonia
Published: March 2009

One of the major complaints of cancer patients is disturbed sleep. Patients with cancer complain of difficulty falling asleep, difficulty staying asleep, and non-restorative sleep, before, during, and for years after treatment. Although some studies have explored the prevalence of sleep disordered breathing (SDB) in head and neck cancer patients, and some studies examined limb movements in sleep among breast cancer patients, the majority of sleep studies conducted in cancer patients have almost exclusively examined insomnia.

ABOUT THE AUTHORS

Lianqi Liu, MD; and Sonia Ancoli-Israel, PhD, are with the Department of Psychiatry, University of California San Diego, and the Department of Veterans Affairs, San Diego Healthcare System.

Address correspondence to: Sonia Ancoli-Israel, PhD, Department of Psychiatry, University of California San Diego, La Jolla, CA 92093-0603; fax 858 552 7536; e-mail sancoliisrael@ucsd.edu.

Dr. Liu has disclosed no relevant financial relationships. Dr. Ancoli-Israel has disclosed the following relevant financial relationships: Arena, Acadia, Cephalon, Sanofi-Aventis, Sepraco, Somaxon, and Takeda: Consultant; and Sepracor and Takeda: Research grant recipient.

This study was supported by National Cancer Institute (NCI) CA112035, National Institutes of Health (NIH) M01 RR00827, the Rebecca and John Moores UCSD Cancer Center, and the Research Service of the Veterans Affairs San Diego Healthcare System.
The Evolution of Insomnia in Relation to Comorbidity
Authors: Drake Christopher L. , Schwartz Jonathan R.L. , Roth Thomas
Published: March 2009

Insomnia is a chronic disorder characterized by impaired, initiation, maintenance, or restorative properties of sleep combined with impaired waking function. Although the pathophysiology of primary insomnia has been studied extensively, it is well recognized that insomnia typically occurs in the context of other chronic medical and psychiatric conditions. This raises the question of whether the pathophysiology of primary and comorbid insomnia is similar. Despite recent advances in treatment, relatively little is known about the development of insomnia or how it changes over time.

ABOUT THE AUTHORS

Christopher L. Drake, PhD; and Thomas Roth, PhD, are with Henry Ford Hospital Sleep Disorders and Research Center, Detroit, Michigan. Jonathan R.L. Schwartz, MD, is Medical Director, Integris Sleep Disorder Center, and with University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Address correspondence to: Christopher L. Drake, PhD, Sleep Disorders and Research Center, Henry Ford Hospital, 2799 West Grand Blvd, CFP3, Detroit, MI 48202; fax 313-916-5167; e-mail: cdrake1@hfhs.org.

Dr. Drake, Dr. Roth, and Dr. Schwartz have disclosed no relevant financial relationships.

This study was supported by National Institute of Mental Health (NIMH) Grant 068372.
Cognitive Behavioral Treatment for Insomnia
Authors: Ong Jason C. , Cvengros Jamie A. , Wyatt James K.
Published: March 2009

Many patients presenting with a complaint of chronic insomnia have strong preferences in terms of treatment modality. Application of cognitive-behavioral treatment for insomnia is ideal for patients wishing to avoid or who have had limited success with pharmacologic treatments, for patients who may not be good candidates for pharmacologic treatments (eg, with history of either alcohol abuse or unauthorized dose increase of sedating medications), or in the case of clinicians espousing the belief that pharmacologic treatments are not the ideal long-term treatment for chronic insomnia. As follows, we describe routine elements of the assessment of insomnia, two commonly-used diagnostic systems for insomnia subtypes, and the elements that make up a cognitive-behavioral treatment package for patients with insomnia.
 ABOUT THE AUTHORS

Dr. Ong, Dr. Cvengros, and Dr. Wyatt are with the Sleep Disorders Service and Research Center, Department of Behavioral Sciences, Rush University Medical Center, Chicago.

Address correspondence to: Jason C. Ong, PhD; Sleep Disorders Service and Research Center; Rush University Medical Center; 1653 West Congress Parkway; Chicago, IL 60612-3833; fax: 312.942.8961; or e-mail Jason_C_Ong@rush.edu.

Dr. Ong, Dr. Cvengros, and Dr. Wyatt have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES
List the various tools needed to make an insomnia diagnosis.

Review the various components of cognitive behavioral therapy (CBT).

Describe behavioral therapies that are not routinely included in CBT.
 
From Demoralization to Bereavement to Major Depression
Authors: Fawcett Jan
Published: March 2009

This month’s edition of Psychiatric Annals features an excellent and informative series of articles on bereavement, ranging from its diagnosis and concomitant conditions to its treatment, guest edited by Paula J. Clayton, MD, and M. Katherine Shear, MD. Because bereavement is a condition that touches everyone, this series, which is exemplary of the latest thinking in the area, is a valuable contribution.
Bereavement: Signs, Symptoms, and Course
Authors: Hensley Paula L. , Clayton Paula J.
Published: March 2009

In his paper “Mourning and Melancholia,” Freud described five features of melancholia, “ … a profoundly painful dejection, cessation of interest in the outside world, loss of the capacity to love, inhibition of all activity, and a lowering of the self-regarding feelings to a degree that finds utterance in self-reproaches and self-revilings, and culminates in a delusional expectation of punishment. He felt that mourning includes these same symptoms, except for the last. Freud believed that mourning is not a pathological condition and that it subsides with time; interfering with it was useless and potentially harmful. Indeed, the loss of a loved one is a universal experience that may be one of the most significant and traumatic life events that people face. Nevertheless, most people cope with loss with minimal morbidity. For a minority, the death of a loved one may lead to increased use of substances (alcohol, benzodiazepines, and other hypnotics), the development of a psychiatric illness like chronic depression, or even greater mortality.
 ABOUT THE AUTHORS
Paula L. Hensley, MD, is with the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM. Paula J. Clayton, MD, is with the American Foundation for Suicide Prevention, New York, NY.

Address correspondence to: Paula L. Hensley, MD, 2118 Central Ave. SE Suite 37, Albuquerque, NM 87106; or e-mail: phensley@salud.unm.edu.

Dr. Hensley and Dr. Clayton have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES
Describe the symptoms of bereavement in adults and children.

Recognize the signs that an individual is experiencing difficulty with the course of bereavement.

Discuss the morbidity and mortality of bereavement in adults.
 
Challenges in Comorbidity
Authors: Mason Barbara J.
Published: March 2009

Approximately 10% of U.S. adults meet the Diagnostic and Statistical Manual for Mental Disorders, fourth edition (DSM-IV), criteria for a current alcohol or illicit drug use disorder. The presence of an alcohol or illicit drug use disorder doubles the risk of a concurrent independent anxiety disorder, is associated with 2.5 times greater risk of a concurrent independent major depression, and quadruples the risk of mania. Similarly, the presence of mood and anxiety disorders confer increased risk for substance use disorders.

ABOUT THE GUEST EDITORS

Barbara J. Mason, PhD, is The Pearson Family Professor and Director of the Laboratory of Clinical Psychopharmacology in the Committee on the Neurobiology of Addictive Disorders at The Scripps Research Institute, La Jolla, California. Dr. Mason began her career as a member of the faculty of Cornell University Medical College where she initiated a program of clinical research funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), with a focus on investigating treatment of comorbid depression and alcohol dependence. Moving to the University of Miami School of Medicine, Dr. Mason investigated nalmefene as a novel treatment of alcohol dependence and served as overall principal investigator for the first U.S. study of acamprosate, which was conducted in support of Food and Drug Administration approval of acamprosate (Campral) as a novel treatment of alcohol dependence.

Dr. Mason is currently pursuing a program of National Institutes of Health (NIH)-funded research that includes human laboratory studies to screen potential relapse prevention medications and early phase clinical trials to evaluate the safety and efficacy of novel medications to prevent relapse in outpatients with alcohol or cannabis dependence. She initiated a Translational Center on the Clinical Neurobiology of Cannabis Addiction funded by the National Institute on Drug Abuse (NIDA), which is dedicated to studying the neurobiology of cannabis dependence in teenagers and young adults. Dr. Mason’s work has been recognized with a Merit Award from NIH, the Dean’s Senior Clinical Research Award from the University of Miami School of Medicine, and the Andrew W. Mellon Foundation Teacher-Scientist Award from Cornell University Medical College.
Dr. Mason has served on the NIAAA Scientific Advisory Council and as a guest expert for the FDA, and is an elected fellow of the American College of Neuropsychopharmacology.
Diagnostic and Treatment Considerations: Bipolar Patients with Comorbid Substance Use Disorders
Authors: Salloum Ihsan , Douaihy Antoine , Williams Lauren
Published: March 2009

Diagnostic and Treatment Considerations: Bipolar Patients with Comorbid Substance Use Disorders

Comorbidity of bipolar disorder (BD) and alcoholism and substance use disorders (SUDs) represents a serious public health problem and a major challenge to treatment systems. Bipolar disorder is among the top causes of disabilities worldwide, and reportedly the fourth leading mental illness as a source of disease burden in established market economies. Large epidemiologic surveys in the United States have consistently confirmed a high association between bipolar disorder and SUDs. The Epidemiological Catchments Area Study reported bipolar I and bipolar II disorders as having the highest association with SUDs when compared with any other major psychiatric disorder. The prevalence of lifetime alcohol abuse or dependence in persons with bipolar I disorder and bipolar II disorders were found to be 46%, and 39.2% respectively. Similarly, the National Comorbidity Survey reported respondents with mania to be 8 to 9 times more likely to have an additional lifetime disorder of drug or alcohol dependence compared with the general population. The most recent and largest epidemiologic survey of more than 42,000 respondents in the United States, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), reported that mania and hypomania were associated with very high rates of SUDs. Those with mania were 6 times more likely to have alcohol dependence and 14 times more likely to have drug dependence over the past 12 months.

ABOUT THE AUTHORS

Ihsan Salloum, MD, MPH; and Lauren Williams, MD, are with the Department of Psychiatry and Behavioral Science, University of Miami Miller School of Medicine. Antoine Douaihy, MD, is with the Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine.

Address correspondence to: Ihsan M. Salloum, MD, MPH, 1120 NW 14th Street, Miami, FL 33136; fax 305-243-1682; or e-mail isalloum@med.miami.edu.

Dr. Salloum and Dr. Williams have disclosed no relevant financial relationships. Dr. Douaihy has disclosed the following relevant financial relationship: AstraZeneca: Research grant recipient.

EDUCATIONAL OBJECTIVES

Develop knowledge about the frequency and clinical significance of bipolar disorder and substance use disorders comorbidity.

Demonstrate the diagnostic considerations in patients with co-occurring bipolar disorder and substance use disorder

Identify the latest research-based psychotherapy and pharmacotherapy treatments for this comorbidity.
Clinical Implications of Epidemiologic Data for Diagnosis and Treatment of Psychiatric Comorbidity
Authors: Samet Sharon , Hasin Deborah
Published: March 2009

The term “psychiatric comorbidity” describes the co-occurrence of two or more distinct psychiatric disorders within a specified time period. Since the early 1980s, psychiatric epidemiologic research has demonstrated that psychiatric disorders are commonly comorbid with alcohol and drug use disorders. Data from these studies provide clinicians with important information about the correlates and co-occurrence of disorders. However, the relationship of co-occurring disorders is complicated by the fact that many symptoms of psychiatric disorders also arise as the direct physiological effects of the substances. This commonality presents diagnostic challenges for clinicians and also raises questions about the documented high rates of comorbidity because this could, in part, be spurious due to misdiagnosed intoxication and withdrawal effects. Epidemiologic data have also provided some answers to these more complicated questions about comorbidity diagnosis, a central concern for clinicians who rely on accurate diagnosis to identifying the most effective treatments when patients abuse alcohol or drugs.

ABOUT THE AUTHORS

Sharon Samet, PhD, is with the NY State Psychiatric Institute, New York, New York, and Columbia University School of Social Work. Deborah Hasin, PhD, is with the NY State Psychiatric Institute, the Mailman School of Public Health, Columbia University, and Columbia University College of Physicians and Surgeons.

Address correspondence to: Sharon Samet, PhD, N.Y. State Psychiatric Institute, Unit 123, New York, NY 10032; or e-mail ss1456@columbia.edu.

Dr. Samet and Dr. Hasin have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

Summarize the epidemiologic comorbidity data from U.S. general population and treatment studies.

Describe Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) classification of comorbidity and resulting diagnostic challenges.

Discuss the clinical implications of the epidemiologic data.
Missing Data in Longitudinal Trials – Part B, Analytic Issues
Authors: Siddique Juned , Brown C. Hendricks , Hedeker Donald , Duan Naihua , Gibbons Robert D. , Miranda Jeanne , Lavori Philip W.
Published: March 2009

Longitudinal designs in psychiatric research have many benefits, including the ability to measure the course of a disease over time. However, measuring participants repeatedly over time also leads to repeated opportunities for missing data, either through failure to answer certain items, missed assessments, or permanent withdrawal from the study. To avoid bias and loss of information, one should take missing values into account in the analysis. Several popular ways that are now being used to handle missing data, such as the last observation carried forward (LOCF), often lead to incorrect analyses. We discuss a number of these popular but unprincipled methods and describe modern approaches to classifying and analyzing data with missing values. We illustrate these approaches using data from the WECare study, a longitudinal randomized treatment study of low income women with depression.

ABOUT THE AUTHORS

Juned Siddique, DrPH, is with the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago. C. Hendricks Brown, PhD, is with Prevention Science and Methodology Group, Department of Epidemiology and Biostatistics, College of Public Health, University of Illinois at Chicago. Donald Hedeker, PhD, is with Division of Biostatistics, University of Illinois at Chicago. Naihua Duan, PhD, is Professor of Biostatistics in Psychiatry, Departments of Biostatistics and Psychiatry, Columbia University; and Director, Division of Biostatistics, N.Y. State Psychiatric Institute, New York, N.Y. Robert D. Gibbons, PhD, is with Professor of Biostatistics and Psychiatry, and Director of the Center for Health Statistics, University of Illinois at Chicago. Jeanne Miranda, PhD, is with UCLA Health Services Research Center. Philip W. Lavori, PhD, is Professor of Biostatistics, and Chair, Department of Health Research and Policy, Stanford University School of Medicine.

Address correspondence: Juned Siddique, DrPH, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N. Lake Shore Drive, Suite 1102, Chicago, IL 60611; fax: 312-908-9588; e-mail: siddique@northwestern.edu.

Dr. Siddique, Dr. Brown, Dr. Hedeker, Dr. Duan, Dr. Gibbons, Dr. Miranda, and Dr. Lavori have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

Describe design and analytic methods for dealing with missing data in longitudinal studies.

Discuss which methods should be used and which methods should not be used for analysis of longitudinal studies with missing data.

Describe the various types of missing data and how they can be dealt with analytically.
Impact of Depression and Cardiovascular Disease
Authors: Ibishi Nazmie F. , Musliu Nebi R. , Kamberi Ahmet , Qirko Spiro , Brokaj Sabit , Lezha Mimoza , Haxhiu Bekim , Masala John
Published: March 2009

CME Educational Objectives

1.

Assess the impact of depression in cardiovascular disease (CVD) patients.

2.

Determine the relationship of depression and CVD, including biological and behavioral factors.

3.

Explain the significance of early recognition of depression in CVD patients and the role of indirect self-destructive behavior as an independent risk factor for morbidity and mortality in these patients.
Psychosis of Alzheimer's Disease
Authors: Klimstra Sibel , Mahgoub Nahla
Published: March 2009

CME Educational Objectives

1.

Discuss the etiology and risk factors of psychosis in Alzheimer's disease.

2.

Review the clinical manifestations of psychosis in Alzheimer's disease.

3.

Summarize the treatment recommendations for psychosis in Alzheimer's disease.
An 80-year-old Woman with Alcohol Problems
Authors: Mahgoub Nahla
Published: March 2009

CME Educational Objectives

1.

Discuss the risk factors of alcohol use disorders in the elderly.

2.

Review the clinical manifestations and complications of alcohol use disorders in the elderly.

3.

Summarize the treatment recommendations for alcohol use disorders in the elderly.
Depression in Parkinson's Disease and Treatment Challenges
Authors: Mahgoub Nahla
Published: March 2009

CME Educational Objectives

1.

Discuss the risk factors of depression in Parkinson's disease (PD).

2.

Review the clinical manifestations of depression in Parkinson's disease.

3.

Summarize the treatment recommendations for depression in Parkinson's disease.
Handheld Computers in Nursing Education: A PDA Pilot Project
Authors: Koeniger-Donohue Rebecca
Published: March 2009

Interest in the use and application of handheld technology at undergraduate and graduate nursing programs across the country is growing rapidly. Personal digital assistants (PDAs) are often referred to as a “peripheral brain” because they can save time, decrease errors, and simplify information retrieval at the point of care. In addition, research results support the notion that PDAs enhance nursing clinical education and are an effective student learning resource. However, most nursing programs lack the full range of technological resources to implement and provide ongoing support for handheld technology use by faculty and students. This article describes a 9-month pilot project for the initial use of PDAs by novice faculty and students at Simmons College.
Should I Take this Course Online?
Authors: O'Neil Carol , Fisher Cheryl
Published: March 2009

As the number of online nursing courses increases, students are faced with the daunting question, “Should I take this course online?” Although online courses are convenient, convenience should not be the sole factor for making this decision. Students and their advisors should discuss the characteristics of successful online students before deciding to take a course online. A study was conducted in which the same face-to-face and online version of a course were compared using Ragan's framework. The results of the study describe characteristics that can serve as useful criteria for predicting student success in an online course.
Using Interactive Video Technology in Nursing Education: A Pilot Study
Authors: Zerr Daria M. , Pulcher Karen L.
Published: March 2009

A pilot study was conducted to analyze the benefits of using interactive technology with external assessors and graduating senior nursing students during Senior Nurse Leadership Assessment Day at the University of Central Missouri. The primary aim was to determine whether videoconferencing technology would promote recruitment and retention of professional nurse external assessors without compromising student learning. Among the issues discussed are the advantages and disadvantages of using interactive videoconferencing technology in education and the influence of external assessors in nursing education. The study results indicate that interactive videoconferencing is an effective, accepted format for educational opportunities such as Senior Nurse Leadership Assessment Day, based on the lived experiences of the study participants. In addition, the results demonstrate that interactive videoconferencing does not compromise student learning or assessment by external assessors.
Creating a Home Care Simulation Laboratory
Authors: Simones Joyce
Published: March 2009

Simulation laboratories are being created to prepare students and new staff for clinical experiences. With puppets and garage sale objects, a life-in-home laboratory was developed to meet the needs of those first encountering a home care situation.
Student Evaluations: Advice for Novice Faculty
Authors: Hessler Karen , Humphreys Jeanette
Published: March 2009

Student evaluations can be a valuable method to transform teaching strategies and course design in nursing education. Negative student comments are difficult to view as constructive criticism and have the potential to lead to negative changes, rather than positive, productive changes for improved instruction and course design. This article provides a glimpse of recent empirical evidence regarding student evaluations of instructors as well as providing novice faculty with suggestions for promoting positive change in teaching strategies.
Spirituality and Spiritual Care in Nursing Fundamentals Textbooks
Authors: Pesut Barbara
Published: March 2009

Educators are increasingly being called on to teach nursing students the fundamentals of spiritual care. The purpose of this study was to investigate and analyze what was being taught to nursing students about spirituality and spiritual care through nursing fundamentals textbooks. Findings of this study suggest that although this body of literature provides comprehensive content about spirituality and spiritual care, there are some underlying conceptual problems. The clear demarcation between spirituality and religion creates problematic dichotomies between patients' individual and cultural selves and their cognitive and experiential selves. Defining spirituality primarily by positive emotional descriptors and cognitive capacity tends to pathologize the basic human experience of suffering and marginalize those most vulnerable in society. Spiritual care is problematic in that it is difficult to identify what constitutes a uniquely spiritual intervention, the outcomes being proposed for care are questionable, and there is an assumption that nurses' spiritual worldviews are biases in the context of care.
The Relationship Between Nurse Education Level and Patient Safety: An Integrative Review
Authors: Ridley Renee T.
Published: March 2009

The relationship between patient safety and nurse education level has implications for current and prospective nurses, hospital administrators, policy makers, and nurse educators. This integrative literature review assesses the current state of science on the topic during a 20-year period, using the Agency for Healthcare Research & Quality's Patient Safety Indicators to measure outcomes. Twenty-four studies of variable quality were included. Although studies suggest that increasing RN dose (i.e., number of care hours) and skill mix (versus LPN) are associated with improved patient safety, evidence linking RN education level (i.e., BSN, ADN, diploma) is sorely lacking.
Responding to Increasing RN Demand: Diversity and Retention Trends Through an Accelerated LVN-to-BSN Curriculum
Authors: Porter-Wenzlaff Linda Jean , Froman Robin D.
Published: March 2009

By providing accelerated licensed vocational nurses (LVN)-to-BSN academic mobility, our university addresses the nationwide nursing shortage, as well as concerns for retention, diversity, and career advancement. LVNs are committed to health care, are likely to remain working as nurses, and represent ethnic and racial minorities. However, LVNs differ from generic students and benefit from tailored curricula and educational strategies. Disadvantaged personal and academic backgrounds, lower grade point averages, cultural diversity, language challenges, age, life responsibilities, and learned LVN behaviors are considered in the development and implementation of this baccalaureate nursing (BSN) degree program. Strategies to build professional identity, reading comprehension, verbal and written articulation, critical thinking, and leadership skills are addressed. A combination of teaching strategies are used to address adult learner needs, including online and face-to-face projects and case studies. Mixing LVN-to-BSN and RN-to-BSN students benefits both and increases efficiency.
Deliberative Discussion as an Innovative Teaching Strategy
Authors: Goodin Heather Janiszewski , Stein David
Published: March 2009

The discussion method is a teaching strategy commonly used by nurse educators in a variety of educational settings. However, relatively unknown to nursing education is a unique discussion teaching strategy: the deliberative discussion method. The deliberative discussion method was developed by the National Issues Forums Institute for the sole purpose of creating a means to engage people and communities to dialogue with one another. In essence, a deliberative discussion is a shared inquiry that asks participants to talk through and weigh the costs and consequences of a variety of options of solutions to a public problem. At the heart of deliberation is the group's willingness to work through the conflicts, to accept the consequences of their choices, and to establish grounds for action. Deliberative discussion offers an innovative approach to health care or other nursing issues in the classroom.
The Cognitive Style of Nursing Students: Educational Implications for Teaching and Learning
Authors: Noble Kim A. , Miller Susan M. , Heckman James
Published: March 2009

As cognitive and kinesthetic demands on nursing students increase, so does the need for optimal learning environments. Witkin's empirically supported measure of field dependent/independent cognitive style assesses the manner in which students perceive and process information and classifies them along a continuum of field dependence to field independence.

Witkin's Groups Embedded Figures Test (GEFT) was administered to 876 students enrolled in 10 health care programs. Statistically significant differences in the GEFT mean scores of students enrolled in the different programs were discovered. The effect size was moderate. Undergraduate nursing students scored higher on the GEFT than did graduate or RN-to-BSN nursing students. However, nursing students were classified as more field dependent than students in other health-related disciplines. Due to their cognitive processing requirements, field-dependent nursing students may be at risk for academic failure. Therefore, instructional strategies tailored to students' needs should be incorporated into the nursing curriculum.
Partnering with Schools: A Win-Win Experience
Authors: Schwartz Misty , Laughlin Ann
Published: March 2009

In many states, budget cuts have influenced school systems to question whether school nurses are necessary. Consequently, many schools no longer have a nurse to coordinate school health services. Creighton University School of Nursing saw this situation as an opportunity. Using schools as clinical sites for nursing students has resulted in positive outcomes for all involved.

Competencies successfully demonstrated by nursing students have included understanding concepts of health and illness, identification of strategies to promote and protect the school-age population, and the ability to provide population-focused prevention within the community. Faculty think the school population is healthier and school personnel have increased knowledge of health promotion and protection strategies for school-age children as a result of the school health project. The education provided serves to promote the well-being of students, families, and the community and prepares them to make health-related choices. The project has also resulted in health benefits for the community.
The Importance of Educational and Social Backgrounds of Diverse Students to Nursing Program Success
Authors: Evans Bronwynne C.
Published: March 2009

This article compares the educational and social backgrounds of Anglo students with those of Hispanic/Latino and American Indian students receiving stipends and other services from a Nursing Workforce Diversity Grant to determine the possible effects of such backgrounds on success in a baccalaureate nursing program. Stipend recipients provided baseline background data by interview on admission, and the results were compared with corresponding data from a volunteer sample of Anglo students to enhance understanding of the educational and social circumstances of the stipend recipients and to identify a need for individualized, tailored grant approaches. The Hispanic/Latino and American Indian students demonstrated less adequate educational backgrounds and lower social class as gauged by parental occupation, than did the Anglo students. Although overall comprehensive grant strategies maximized the potential for success of stipend recipients, strategies need to be tailored to fit each individual's unique educational and social background.
Faculty Notions Regarding Caring in Male Nursing Students
Authors: Grady Carole A. , Stewardson Gary A. , Hall Janice L.
Published: March 2009

Men are entering the field of nursing in increasing numbers. As men enter nursing programs, they may encounter role stereotyping and gender bias through the faculty's assumption of stereotypical notions of caring. The purpose of this interpretive phenomenological study was to describe the ways faculty perceive and respond to caring in male nursing students to better understand how to facilitate it. The central question for this study was: What are the essences and meaning of nursing faculty notions regarding caring in male nursing students? Six faculty members in a nursing program with a large percentage of male student enrollment were interviewed. Applying a phenomenological data analysis method, the researchers identified six themes: altruism, antecedents, attainment, ambiguity, agency, and anecdotes. Implications for nursing education and practice are made, including the need to recognize, allow, and support male nursing student ways of caring.
Recruitment and Retention of Alaska Natives into Nursing (RRANN)
Authors: DeLapp Tina , Hautman Mary Ann , Anderson Mary Sue
Published: March 2009

In recognition of the severe underrepresentation of Alaska Natives in the Alaska RN workforce, the University of Alaska Anchorage School of Nursing implemented Project RRANN (Recruitment and Retention of Alaska Natives into Nursing) to recruit Alaska Natives into a nursing career and to facilitate their success in the nursing programs. Activities that created connections and facilitated student success were implemented. Connection-creating activities included establishing community partnerships, sponsoring a dormitory wing, hosting social and professionally related events, and offering stipends. Success facilitation activities included intensive academic advising, tutoring, and mentoring. The effectiveness of Project RRANN is evident in the 66 Alaska Native/American Indian students admitted to the clinical major since 1998, when Project RRANN was initiated; of those, 70% have completed the major and become licensed, and 23% continue to pursue program completion.
Linguistic and Cultural Adaptation Needs of Mexican American Nursing Students Related to Multiple-Choice Tests
Authors: Lujan Josefina
Published: March 2009

Hispanic nurses represent less than 2% of the current U.S. nursing workforce, despite that approximately 14% of the nation's population is Hispanic. There is an urgent need to correct the gross underrepresentation of Mexican Americans, the largest subgroup among Hispanics, in the U.S. nursing workforce to provide culturally concordant care. One solution is to increase the academic success of Mexican American nursing students with English as a second language through improved linguistic and cultural adaptation to multiple-choice tests. This article will discuss these students' linguistic and cultural adaptation needs related to multiple-choice tests and will also present several intervention strategies and a case study.
Evaluation of the Outcome-Present State Test Model as a Way to Teach Clinical Reasoning
Authors: Bartlett Robin , Bland Ann , Rossen Eileen , Kautz Donald , Benfield Susan , Carnevale Teresa
Published: March 2009

The Outcome-Present State Test (OPT) Model of Clinical Reasoning is a nursing process model designed to help students develop clinical reasoning skills. Although many nurse educators are using the OPT model as a teaching strategy, few are formally evaluating its use as a method. We used the OPT model as a teaching tool in an undergraduate psychiatric and mental health clinical nursing course and evaluated how quickly students became adept at using it. Most students mastered the use of the model; 29 of 43 students achieved the criterion score (a score greater than 65 on 3 or more models completed over 4 weeks). Not only did the students gain clinical reasoning skills, but they also used and learned more about the North American Nursing Diagnosis Association, Nursing Interventions Classification, and Nursing Outcomes Classification languages. Recommendations for future use of the model include adding client strengths and increasing focus on the quality of students' responses.
Decision Making by Baccalaureate Nursing Students in the Clinical Setting
Authors: Baxter Pamela E. , Boblin Sheryl
Published: March 2009

Many researchers who have explored nurse decision making have concluded that decision making is a learned skill that must be taught by nurse educators. Yet little research has been conducted to explore nursing students' decision making. If nurse educators are to teach this skill, it is necessary to have a better understanding of the kinds of decisions students are making in the clinical setting and the factors that influence this process. Once we have a greater knowledge in this area, curricular materials can be developed to ensure this skill is taught throughout an undergraduate education, resulting in graduates who possess strong, independent, and interdependent decision making skills. This article will describe one component (the kinds of decisions) of a larger qualitative case study that explored the kinds of decisions and the factors that influenced nursing students' decision making throughout a baccalaureate degree program.
Reshaping Students' Attitudes Toward Individuals with Mental Illness Through a Clinical Nursing Clerkship
Authors: Romem Pnina , Anson Ofra , Kanat-Maymon Yaniv , Moisa Regina
Published: March 2009

The purpose of this study was to evaluate the degree to which a psychiatric clinical clerkship alters nursing students' attitudes toward individuals with mental illness. The goal of the 4-week clerkship is to provide students with the knowledge, skills, and professional attitudes that will enable them to care for individuals with mental illness in different health care settings. A pencil-and-paper questionnaire was administered to 126 third-year students before and after the clerkship. Students were presented with four hypothetical patients with schizophrenia and were asked to what extent the patient was responsible for his condition, the emotions students felt, and whether students were willing to care for the patient or to segregate him in the hospital. After the clinical clerkship, students became more compassionate and less frightened by psychiatric patients, were more willing to care for individuals with mental illness, and expressed less need to segregate them from the community. In addition, in accord with professional attitudes, students became aware of their own attitudes (the responsibility attributed to patients) and their emotional responses, but these were no longer associated with reluctance to provide care.
Factors Affecting Practical Nursing Student Attrition
Authors: Stickney Margaret Christine
Published: March 2009

This study investigated factors that affect student attrition for 151 students in a practical nursing program. The academic variables studied were scores on preadmission tests and grades in required prerequisite courses. The demographic variables included age, gender, and race. The analysis of the data obtained from student records revealed a statistically significant difference between the retention and attrition student groups for the variables of race, preadmission test scores, and prerequisite course grades. Recommendations for a retention program to reduce attrition were made based on the findings of this study.
Nursing Students' Expectations of the College Experience
Authors: Zysberg Leehu , Zisberg Anna
Published: March 2009

Nursing students' expectations of college have not received much attention in the empirical literature. These expectations may be important in better understanding nurses' motivations, role acquisition, and academic and professional success. The first study discussed in this article examined the reliability and construct validity of an instrument designed to assess students' (
N
= 95) expectations of their college experience. The results indicate good reliability and validity. The second study discussed in this article examined differences in expectations, comparing nursing and non-nursing students (
N
= 160) in an urban college setting. The results suggest expectations emphasizing practical and professional aspects (i.e., acquiring a profession, earning more money), followed by self-betterment and social life expectations. Nursing students differed from non-nursing students by reporting higher self-betterment and professional expectations but lower academic expectations. Implications for application and further research are discussed.
Using a Wiki to Meet Graduate Nursing Education Competencies in Collaboration and Community Health
Authors: Ciesielka Debbie
Published: March 2009

The wiki is an innovative means of creating, editing, and disseminating information in an online environment. Students and faculty may be most familiar with Wikipedia—the free online encyclopedia that anyone can author—but less familiar with the possibilities of the wiki as a learning tool. This article describes the use of a wiki as a means to foster collaboration and meet core competencies related to community study. The graduate nursing students completing the project created a wiki that not only showcased the community of study, but also gave them a better appreciation of group work.
Analyzing Graduate Student Trends in Written Paper Evaluation
Authors: Giddens Jean Foret , Lobo Marie
Published: March 2009

Writing is valued as an essential skill in nursing education. However, the evaluation of written scholarly work is challenging. Limited nursing literature addressing issues or strategies associated with evaluation exists. The purpose of this study was to describe and evaluate differences that exist in the evaluation of a standardized written paper. The study included a sample of 47 graduate nursing students enrolled in a nursing education course. Participants were asked to grade a mock paper as part of a course assignment; their work was retained for data analysis. Wide variability in scoring and comments on the paper were noted; significantly lower scores were assigned by participants who had experience teaching in academic settings. The majority of written comments made by participants were related to grammar and American Psychological Association formatting or citation problems. Further research is needed to better understand paper evaluation practices of nursing faculty.
A Problem-Based Learning Hybrid in a Women's Health Course
Authors: Rash Elizabeth M.
Published: March 2009

To facilitate nurse practitioner students' critical thinking and information retention, a problem-based learning hybrid was introduced in an advanced women's health course. This article discusses the design and implementation, as well as the student and instructor perceptions, of this innovation.
Role Transition During RN-to-FNP Education
Authors: Steiner Susan H. , McLaughlin Diana G. , Hyde Roberta S. , Brown Rosemary H. , Burman Mary E.
Published: March 2009

This study examines the role transition that occurs during RN-to-family nurse practitioner (FNP) education, described in an earlier qualitative study that identified a role transition framework of influential positive forces and obstacles. The purposes of the study were to validate the educational phase of the original framework and explore other role transition issues. The study used a descriptive correlational design by asking all FNPs in two rural western states to participate by answering a questionnaire. Findings evidenced a stronger level of agreement with the positive forces than with the obstacles. In addition, two significant relationships were found between the positive forces and obstacles and personal life circumstances. These included personal support systems, which were significant for those who had to travel to class, and personal sacrifices, which were significant for those who had children at home. Further research will focus on testing across nurse practitioner specialties nationally.
The Doctor of Nursing Practice Degree and Research: Are We Making an Epistemological Mistake?
Authors: Webber Pamela B.
Published: March 2009

There has been much discussion in the literature about whether Doctor of Nursing Practice (DNP) curricula should prepare students to be principle investigators of research or whether this skill should be left to other doctorally prepared nurses. Currently, nurse practitioners have to rely on medical research to support their practice due to a lack of research and researchers. Consequently, these practitioners run the risk of adopting practice values of medicine rather than those unique to this specialty. Despite this risk, several national organizations have recommended that DNP programs not prepare graduates to be principle investigators. Epistemologically, this decision poses several levels of concern, including failure to analyze the adequacy of our current approach to research, the mixed messages presented in the position statements of these national organizations, and the effects of the looming doctoral faculty shortage. These issues, among others, are explored in this article.
Simulating Health Promotion in an Online Environment
Authors: Rash Elizabeth M.
Published: March 2009

Although Web-based courses have distinct advantages, one of the challenges of the medium is to assess students' abilities to apply knowledge, especially regarding interpersonal communication skills. The purpose of this article is to describe a motivational interviewing application exercise developed for a graduate-level online health promotion course. Small groups of students met online for synchronous role-play chatroom experiences in which students guided each other toward healthy lifestyle behavioral changes using motivational interviewing skills. Chatroom transcripts and students' reflections demonstrated a deeper understanding and appreciation for motivational interviewing and appeared to alter their perceptions of health promotion beyond the task of providing patient education.
Creating a Nursing Simulation Laboratory: A Literature Review
Authors: Rothgeb Marcia K.
Published: March 2009

Currently in nursing education, active student participation, discussion, observation, and reflection are paramount for successful learning. Simulation is one of the up-and-coming tools that can be used across the nursing curriculum to replicate experiences in nursing practice. This interactive experience immerses students in patient health care scenarios in a safe environment. Simulation experience reinforces the development of skills in assessment, psychomotor activity, critical thinking, problem solving, decision making, and collaboration with others. Experiential learning through simulation affects patient care, health, and safety. These interactive experiences engage students through participation, observation, and debriefing. As preparation for establishing a simulation laboratory, a review of the purpose of simulation, learning theories, advantages and challenges, regulatory viewpoints, budgetary needs, and educator training will be discussed.