bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Comorbidity in Severity and Outcome
Authors: Fawcett Jan
Published: March 2009

This November issue of Psychiatric Annals, guest edited by Barbara Mason, MD, PhD, focuses on comorbidity. Psychiatric diagnoses face many challenges generated by the natural heterogeneity that is intrinsic to humanity. But the inevitable presence of “comorbidity,” with a large portion of psychiatric disorders, complicates our understanding and treatment even further. I’ve always said that psychiatry is the right discipline for people who like to deal with messy issues. What are the most common comorbidities? The one’s dealt with in this series — anxiety, alcohol, and drug dependence — are most common.
Psychiatric Risk Factors for Suicide in the Alcohol-dependent Patient
Authors: Conner Kenneth R. , McCloskey Michael S. , Duberstein Paul R.
Published: March 2009

Suicide is a serious public health concern. In 2004, more than 32,000 individuals died by suicide in the United States, exceeding the number of deaths by homicide that year. This number represents only a small portion (about 5%) of suicide attempts, many of which result in hospitalization and/or disability. Overall, suicide is the 11th leading cause of death in the United States and is the second leading cause of death among young adults. Thus, the need for improved efforts at suicide prevention is clear. Effective suicide prevention requires risk-identification and intervention strategies specifically tailored to high-risk populations. A wealth of data indicates that individuals with alcohol dependence are such a population. A meta-analysis concluded that individuals with alcohol dependence identified through treatment venues are at 9.8 (9.0-10.7) times greater risk for suicide compared to the general population. Furthermore, U.S. national survey data shows that alcohol dependence confers 6.5 (3.6-11.5) times greater risk for attempted suicide compared to individuals without alcohol dependence. Unequivocally, suicide prevention efforts must focus on alcoholism.

ABOUT THE AUTHORS

Kenneth R. Conner, PsyD, MPH; and Paul R. Duberstein, PhD, are with the Center for the Study and Prevention of Suicide and Laboratory of Personality and Development, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York. Michael S. McCloskey, PhD is with the Department of Psychiatry, University of Chicago.

Address correspondence to: Michael McCloskey, Department of Psychiatry, University of Chicago, 5841 S. Maryland Ave MC #3077, Chicago, IL 60637. mmcclosk@yoda.bsd.uchicago.edu.

Dr. Conner, Dr. Duberstein, and Dr. McCloskey have disclosed no relevant financial relationships.
Treatment of Co-occurring Depression and Substance Dependence: Using Meta-analysis to Guide Clinical Recommendations
Authors: Nunes Edward V. , Levin Frances R.
Published: March 2009

Depression is a common phenomenon among patients with alcohol or drug dependence, as is evident to any practitioner working with these patients. Numerous studies have documented high rates of depressive disorders among patients seeking treatment for substance use disorders. Community surveys have consistently found elevated rates of major depression and dysthymia among patients with alcohol or drug dependence. Further, current major depression has been associated with worse clinical outcome among substance-dependent patients. The data are less clean on the prognostic implications of a past depression or elevated depressive symptoms without identification of a depressive disorder. These epidemiological data suggest that a co-occurring depressive disorder is important and warrants clinical attention.

ABOUT THE AUTHORS

Edward V. Nunes, MD; and Frances R. Levin, MD, are with the Columbia University College of Physicians and Surgeons, and N.Y. State Psychiatric Institute, New York.

Address correspondence to: Edward V. Nunes, MD, 1051 Riverside Drive (Unit 51), New York, NY 10032; or e-mail nunesed@pi.cpmc.columbia.edu.

Dr. Nunes and Dr. Levin have disclosed no relevant financial relationships.

Research in this article has been supported by Grants P50 DA09236 and K24 DA022412 (Dr. Nunes) and K02 000465 (Dr Levin).

EDUCATIONAL OBJECTIVES

To understand how meta-analysis can be used to evaluate antidepressant treatment efficacy for depression in substance abusers seeking treatment.

To gain knowledge of what methodologic features of pharmacologic treatment trials targeting depressed substance abusers predict better treatment response.

To understand recommendations derived from findings of placebo-controlled antidepressant medication trials for clinical management and treatment of depressed, substance-dependent patients.
Design and Analysis of Longitudinal Studies
Authors: Gibbons Robert D.
Published: March 2009

In this issue of Psychiatric Annals, we focus on topics that have arisen in
the analysis of longitudinal data over the past 15 years that we as statisticians
believe are important for the progress of medical research in general, and psychiatric
research in particular.
Missing Data in Longitudinal Clinical Trials Part A: Design and Conceptual Issues
Authors: Lavori Philip W. , Brown C. Hendricks , Duan Naihua , Gibbons Robert D. , Greenhouse Joel
Published: March 2009

There are numerous types of missing data that can occur in clinical trials. Some types of missing data cannot be prevented and are beyond the research team’s control. For example, a patient may relocate and be unavailable for an assessment. Other types occur because the research team actually designs the study to generate incomplete data. For example, it may not be cost-effective to obtain a full diagnostic assessment on each subject. Instead, an inexpensive screening tool is used to assess everyone. All screen positives, plus a random sample of screen negatives, are then given the full diagnostic. The incomplete diagnostic data on the majority of those screened negative are taken into account in assessing treatment effects.1-3 These types of data are missing by design, and there are statistical procedures to handle such planned missing data if designed appropriately. The third type occurs because of a faulty design plan by the research team. In this case, data are lost because a less than adequate protocol is followed. For example, if no screen negatives are given the full diagnostic, it will not be possible to ascertain the false negatives.

ABOUT THE AUTHORS

Philip W. Lavori, PhD, is Professor of Biostatistics, and Chair, Department of Health Research and Policy, Stanford University School of Medicine. C. Hendricks Brown, PhD, is with the Prevention Science and Methodology Group, Departments of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa. Naihua Duan, PhD, is Professor of Biostatistics in Psychiatry, Departments of Biostatistics and Psychiatry, Columbia University, New York; and Director, Division of Biostatistics, N.Y. Psychiatric Institute. Robert D. Gibbons, PhD, is Professor of Biostatistics and Psychiatry, and Director of the Center for Health Statistics, University of Illinois at Chicago. Joel Greenhouse, PhD, is with the Department of Statistics, Carnegie Mellon University, Pittsburgh.

Address correspondence to: Philip Lavori, HRP/Redwood Building, 259 Campus Drive, Stanford, CA 94305-5405; fax 650-725-6951; or e-mail lavori@stanford.edu.

Dr. Lavori, Dr. Brown, Dr. Duan, Dr. Gibbons, and Dr. Greenhouse have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

Describe problems associated with missing data in psychiatric research.

Define how missing data can be minimized by improved experimental designs.

Identify methods that should be avoided when analyzing studies with missing data.
Balancing Treatment Comparisons in Longitudinal Studies
Authors: Marcus Sue M. , Siddique Juned , Ten Have Thomas R. , Gibbons Robert D. , Stuart Elizabeth , Normand Sharon-Lise T.
Published: March 2009

Evaluation of treatment efficacy in psychiatric trials involves a comparison of outcomes for those who receive a treatment versus those who receive a control or comparison treatment. However, if the treatment and comparison groups are not comparable or “balanced,” observed differences in outcomes between treated and comparison groups may be due, in part, to these imbalances. In such settings, estimates of treatment efficacy may be biased unless some adjustments are made to make the groups more comparable.

ABOUT THE AUTHORS

Sue M. Marcus, PhD, is with the Department of Psychiatry, Mount Sinai School of Medicine, New York. Juned Siddique, DrPH, is with the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago. Thomas R. Ten Have, PhD, is with the Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia. Robert D. Gibbons, PhD, is Professor of Biostatistics and Psychiatry, and is Director of the Center for Health Statistics, University of Illinois at Chicago. Elizabeth Stuart, PhD, is with the Johns Hopkins Bloomberg School of Public Health, Baltimore. Sharon-Lise T. Normand, PhD, is with the Department of Health Care Policy, Harvard Medical School, and the Department of Biostatistics, Harvard School of Public Health, Boston.

Address correspondence to Sue Marcus, PhD, Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029; fax 212-860-4630; or e-mail sue.marcus@mssm.edu.

Dr. Marcus, Dr. Siddique, Dr. Ten Have, Dr. Gibbons, Dr. Stuart, and Dr. Normand, have disclosed no relevant financial relationships.
Developmental Disabilities: Improving Competence in Care Using Virtual Patients
Authors: Sanders Carla L. , Kleinert Harold L. , Free Teresa , King Pam , Slusher Ida , Boyd Sara
Published: March 2009

Nurse practitioners (NPs) have an increasingly important role in health care provision in the United States. However, most nurses report that they receive little or no clinical training in the area of developmental disabilities. A core development team consisting of NP faculty members from three universities, one physician assistant faculty member, the parents of children with developmental disabilities, and educational specialists developed two multimedia interactive pediatric instructional modules in CD-ROM format: one involving a child with Down syndrome and the other, an infant born at 26 weeks gestation. Participants were required to make decisions about proper clinical interaction throughout the cases. The modules on CD were piloted with NP students at three universities. Effectiveness study results demonstrated significant gains in both knowledge and comfort level regarding the care of patients with developmental disabilities.
Videoconferencing and Web-Based Conferencing to Enhance Learning Communities
Authors: Daley Linda K. , Spalla Tara L. , Arndt Mary Jo , Warnes Anne-Marie
Published: March 2009

Preparing nursing students to develop the leadership and management skills necessary to adapt to ever-changing practice environments is a challenge for educators. Videoconferencing and Web-based conferencing allow for expansion of traditional classroom walls to develop partnerships among peers, exchange perspectives, and gain a more global understanding of nursing care delivery systems. A collaborative leadership seminar using videoconferencing was used to connect two large colleges of nursing in the midwestern United States, and through Web-based conferencing, one of the midwestern colleges was connected to a university in the United Kingdom. Objectives for students were exposure to different schools of thought, management of care via technology, network and cultivation of global perspectives on health care delivery, and experience of novel educational approaches.
The Omaha System and Quality Measurement in Academic Nurse-Managed Centers: Ten Steps for Implementation
Authors: Canham Daryl , Mao Chia-Ling , Yoder Marian , Connolly Phyllis , Dietz Elizabeth
Published: March 2009

Measuring and describing client problems, nursing interventions, and outcomes is a challenge in nursing care. This study reviews the literature about the use of the Omaha System and describes the steps used to introduce and implement the Omaha System as a documentation and outcome measurement system in academic nurse-managed centers. The goal of the article is to provide a guide for nurse educators to develop and implement a quality measurement system that can be used in clinical settings by undergraduate students. The Omaha System is a strategy to introduce and incorporate evidence-based practice in the undergraduate nursing clinical experience.
Team-Based Learning in an Undergraduate Nursing Course
Authors: Clark Michele C. , Nguyen Hoang Thanh , Bray Chris , Levine Ruth E.
Published: March 2009

To increase student participation in the learning process, active learning methods, including small group learning, have become increasingly popular in modern curricula. One kind of small group learning, team-based learning, is a relatively new instructional strategy in health care education. Team-based learning uses theoretically based and empirically grounded strategies for ensuring the effectiveness of small groups working independently in classes with high student-to-faculty ratios (e.g., up to 200:1), without losing the benefits of faculty-led small groups with lower ratios (e.g., 7:1). To explore the effectiveness of this learning pedagogy, we evaluated students' level of engagement and attitudes toward the value of teams. Findings demonstrated that team-based learning is an effective teaching strategy for large groups of students.
Integrating the Curriculum to Advance Baccalaureate Nursing Education
Authors: Kemsley Martha J. , Riegle Elizabeth
Published: March 2009

In 2004, the School of Nursing at the University at Buffalo began a program in which individuals with a degree in another field could complete an intensive 12-month program leading to a baccalaureate degree in nursing. Curriculum design using courses from the basic baccalaureate and RN-to-BS program, as well as graduate courses, not only provided the opportunity to integrate accelerated bachelor of science (ABS) students with the other student populations but eliminated the need for the development of courses specific to the ABS program. A unique feature of the program is the incorporation of graduate courses, allowing students to earn 9 to 12 graduate credits. The potential for future nursing leaders has also increased, given the characteristics of these mature, highly motivated, career-minded students who have chosen nursing as a second career.
A Tobacco-Free Service-Learning Pilot Project
Authors: Bassi Sherry , Cray Janet , Caldrello Lois
Published: March 2009

This pilot project was a collaboration between a public university school of nursing in New England and an elementary school in southeastern Connecticut, with 450 student participants. The school was selected because of the presence of poverty, health disparities, and single-parent homes in the population. Eighteen nursing students participated as part of a service-learning project. The nursing students provided tobacco-use education. Fourth and fifth grade students were taught components of the pro-health tobacco education program, the Tar Wars curriculum. Other age-appropriate strategies targeted grades pre-kindergarten through 3. One hundred percent of fourth and fifth grade students achieved the learning objectives; in addition, 415 of the students participated in a school-wide poster contest reproducing the learned content. Ninety-five percent of the nursing students earned a grade of A and viewed the project positively. Ten parents enrolled in a smoking cessation program offered on site—20% completed the program and 10% remain tobacco-free.
KATTS: A Framework for Maximizing NCLEX-RN Performance
Authors: McDowell Betsy M.
Published: March 2009

A key indicator of the quality of a nursing education program is the performance of its graduates as first-time takers of the NCLEX-RN
®
. As a result, nursing schools are open to strategies that strengthen the performance of their graduates on the examination. The Knowledge base, Anxiety control, Test-Taking Skills (KATTS) framework focuses on the three components of achieving a maximum score on an examination. In KATTS, all three components must be present and in proper balance to maximize a test taker's score. By strengthening not just one but all of these components, graduates can improve their overall test scores significantly. Suggested strategies for strengthening each component of KATTS are provided. This framework has been used successfully in designing remedial tutoring programs and in assisting first-time NCLEX test takers in preparing for the licensing examination.
Building an Integrated Model of Tobacco Control Education in the Nursing Curriculum: Findings of a Students' Survey
Authors: Chan Sophia S.C. , So Winnie K.W. , Wong David C.N. , Lam Tai-Hing
Published: March 2009

This study examined the outcome of a 2-hour introductory lecture on tobacco and health in improving the knowledge and attitudes of nursing students toward smoking and tobacco control. A group of 78 first-year undergraduate nursing students of a major university in Hong Kong were invited to complete a self-administered questionnaire before and after the lecture. The findings indicated a significant improvement in knowledge of and attitudes about tobacco control. The study suggests that education about smoking and tobacco control should be introduced into the nursing curriculum at an early stage so appropriate knowledge, attitudes, and skills can be subsequently strengthened to prepare students to lead an effective role in delivering tobacco control nursing interventions. Finally, a model of integrating tobacco control content in the under graduate nursing curriculum was recommended.
Student Perceptions of Team Learning in Nursing Education
Authors: Feingold Carol E. , Cobb Martha D. , Givens Raquel Hernandez , Arnold Joanna , Joslin Sarah , Keller Jill Leslie
Published: March 2009

Nurse educators are challenged to find instructional methods that actively engage learners and help students understand concepts for application in practice situations. During the 2003–2004 academic year, faculty implemented team learning in a first-semester clinical nursing course in a baccalaureate nursing program at a Research I state university in the southwestern United States. Team learning engages small groups in learning tasks that require problem solving and decision making. Student perceptions about team learning were evaluated using classroom observations and interviews. The results verified that team learning predominantly promotes learner-to-learner engagement and indicated that students struggled with application problems that had several plausible answers yet recognized the relevance to clinical practice. Students appreciated the need for increased individual accountability for learning and identified value in learning through discussion, both characteristics inherent to team learning. Students were concerned about their team learning grade and its dependence on group performance.
Integrating Forensic Nursing into the Undergraduate Nursing Curriculum: A Solution for a Disconnect
Authors: Freedberg Pauline
Published: March 2009

Violence occurring in the home and community, and its resultant negative effects on public health, is of critical concern to health care professionals. The aim of this article is to underscore the importance of the role of nurse educators in preventing and reducing the consequences of domestic violence and abuse. A viable solution for the disconnect that exists between violence reduction strategies and their effective implementation is proposed, including an integration of forensic nursing concepts and skills into the undergraduate nursing curriculum. Doing so will enable nurse educators to prepare practitioners who can help break the cycle of violence and close the gap that exists in health care delivery for individuals affected by violence. Related issues and challenges are presented, including the need to prepare culturally competent health care professionals, to examine and revise overloaded curricula on the basis of empirical research and societal trends, and to address faculty competence.
Teaching Epidemiology: The Role of the Public Health Nurse
Authors: Sistrom Maria Gilson
Published: March 2009

With the baccalaureate as the desired entry level to practice for community health nurses, schools of nursing must ensure their content and methods are robust and current to the fields of both nursing and public health. A foundation in such diverse areas as population biology and population genetics is now desirable for practice. Combining principles of adult learning and case study methodology, this article describes the development of a central case study with extensive related components. Students explored the principles of population biology, epidemiology, community health nursing, and public health sciences and policy in multiple media using several learning strategies.
Bringing Pediatric Nursing to Life in a Baccalaureate Curriculum
Authors: Smith Cheryl M. , Hamner Jenny B.
Published: March 2009

Nurse educators are challenged to prepare nursing students to practice in a changing environment. Pediatrics is a particularly challenging and important area to prepare nursing students for future nursing practice. Several factors emerged that suggested the current approach to teaching pediatrics was not adequate. This article describes the revision of the baccalaureate curriculum to address concerns related to pediatric nursing concepts. These revisions include the integration of pediatric concepts into three major theory and clinical courses and the implementation of an elective designed for those students with a special interest in pediatrics. A popular preceptorship program for nursing students who want to complete their cumulative final clinical experience in pediatrics was also developed.
A Review of Narrative Pedagogy Strategies to Transform Traditional Nursing Education
Authors: Brown Sylvia T. , Kirkpatrick Mary K. , Mangum Dana , Avery Jeanette
Published: March 2009

Traditional nursing pedagogies using teacher-centered learning approaches have produced efficient, knowledgeable nursing graduates for many years. However, 21st century learners will require and demand new educational approaches. The information age of computers has challenged all facets of education to keep pace. Nursing education must evolve with ever-changing forms of communication and technology and recognize generational differences in learning. The creation of partnerships in learning, rather than the traditional hierarchy of education, is projected to meet the needs of today's learners more effectively. The National League for Nursing, in its position statements, has challenged nurse educators to develop new research-based pedagogies responsive to the changing health care environment and reflective of new partnerships between and among students, teachers, and clinicians. This article will explore examples of one approach, narrative pedagogy, and its usefulness in nursing education as a way to expand the pedagogical literacy of nurse educators.
Enhancing Cancer Nursing Education Through School of Nursing Partnerships: The Cancer Nursing Faculty Fellows Program
Authors: Hermann Carla P. , Conner April L. , Mundt Mary H.
Published: March 2009

This article describes the Cancer Nursing Faculty Fellows Program, an innovative program designed to provide nurse educators with state-of-the-art cancer knowledge to enhance their ability to teach cancer content. The Faculty Fellows Program was developed at the University of Louisville School of Nursing and was part of a multifaceted educational intervention to improve cancer nursing education. This intervention included comprehensive curriculum reviews, conferences with national consultants, cancer-specific faculty seminars, and funded instructional projects. The Faculty Fellows Program consisted of a mentored experience attending the Oncology Nursing Society Congress and a month-long intensive program to provide faculty with exposure to cancer experts, researchers, and clinical and community resources. By providing a forum for nurse educators to obtain this knowledge and provide the resources they need to change the way they educate nursing students, the program can significantly affect cancer-related nursing education and, ultimately, the care of patients with cancer and survivors.
Nursing Students' Perceptions of Barriers to Addressing Patient Sexuality Concerns
Authors: Magnan Morris A. , Norris Diane M.
Published: March 2009

Little is known about nursing students' perceptions of barriers to addressing patient sexuality concerns. The twofold purpose of this study was to identify and describe attitudes and beliefs that might act as barriers to addressing patient sexuality concerns and to determine the extent to which these attitudes and beliefs are influenced by personal factors such as age, gender, and education. The Sexuality Attitudes and Beliefs Survey was used to assess students (
N
= 341) enrolled in either a traditional or accelerated second-degree baccalaureate program. Important barriers to addressing patient sexuality concerns reported by the majority of the students included not making time to address the concerns (67.9%) and believing that patients do not expect nurses to address the concerns (66.4%). Findings also revealed that accelerated second-degree students were more restrictive in their attitudes toward addressing patient sexuality concerns, compared with traditional students. Results of this study have implications for BSN program development and evaluation.
Relationship Skills Building with Older Adults
Authors: McNeill Cheryl , Shattell Mona , Rossen Eileen , Bartlett Robin
Published: March 2009

Relationship skills building is the focus of an innovative clinical experience with older adults for junior level nursing students in a psychiatric mental health course. The clinical experience is designed to help students apply, integrate, and validate previously learned therapeutic communication skills and experience discovery of self and others. This article describes a clinical experience that introduces students to older adults, who will make up the majority of health care recipients in the students' future careers, and helps students explore the nurse's role in mental health care for older adults.

Not only did students engaged in the clinical experience learn to develop a relationship with the older adults, but they learned much more—they learned to appreciate the value of life, the importance of listening, and the rich and varied life stories of older adults.
Beyond Transculturalism: Critiques of Cultural Education in Nursing
Authors: Campesino Maureen
Published: March 2009

New and innovative educational approaches are needed to prepare a workforce that responds to diverse needs of people from a wide variety of cultural backgrounds, languages, and worldviews. Despite some movement toward standardization of cultural curricular content, there remains a lack of consensus regarding pedagogical approaches to cultural education in nursing. An increasing number of nurse scholars have identified significant limitations in the process of cultural education in nursing and transcultural nursing theory. These critiques reflect a schism in the discipline regarding foundational theoretical perspectives and conceptualizations of culturally competent health care. This article offers a synthesis of transcultural nursing critiques that have appeared in the nursing literature over the past decade and explicates the philosophical tensions that underlie the varying pedagogical approaches to cultural education in nursing.
Today's Challenge, Tomorrow's Excellence: The Practice of Evidence-Based Education
Authors: Emerson Roberta J. , Records Kathie
Published: March 2009

Nurse educators are being challenged to maintain quality in light of increasing numbers of students, declining numbers of experienced faculty, societal mandates, and rapid changes in health care. The scholarship underlying the practice of nursing education, or evidence-based education, must continue to be explored through the design, testing, and refinement of education strategies from nursing and other disciplines. The involvement of every educator in this process will help create institutional valuing that serves to retain inquisitive and reflective educators in academic settings, while expanding evidence-based education in nursing. This article describes a literature review of the scholarship of nursing education practice and suggests approaches to generate a dynamic explosion of growth in nursing education to inform our students, promote optimal client health outcomes, and challenge each of us to reach higher levels of excellence in the practice of nursing education.
Teaching Undergraduate Nursing Research from an Evidence-Based Practice Perspective
Authors: Meeker Mary Ann , Jones Janice M. , Flanagan Nancy A.
Published: March 2009

We revised the undergraduate nursing research course using levels of evidence as the template with which to organize the course content and learning activities. A primary purpose in restructuring the course using an evidence-based practice framework was to increase student interest and engagement, and to promote the development of practitioners who will continue to learn about and use research. Learning to systematically locate, evaluate, and use the best available research is the hallmark of evidence-based practice and quality improvement initiatives. Students developed these skills as they sought the answer to a specific clinical problem. One of the most significant outcomes of this approach was students' ability to integrate previously fragmented components of research knowledge and to see the relevance of research evidence for providing excellent patient care.
Strategies for Learning Evidence-Based Practice: Critically Appraising Clinical Practice Guidelines
Authors: Singleton Joanne , Levin Rona
Published: March 2009

Nurse educators have a mandate to educate our students about using an evidence-based practice approach to clinical decision making. At the Lienhard School of Nursing, Pace University, faculty have successfully integrated evidence-based practice into the family nurse practitioner curriculum. This article describes one teaching-learning strategy to help students learn how to critically appraise clinical practice guidelines using the AGREE instrument. There are several steps to the learning exercise: completing preparatory reading, obtaining the guideline that forms the focus of the assignment, working as teams, using the AGREE tool to assess the guideline's validity, and reporting team findings to the entire class. Students have found this learning activity helpful in preparing them for clinical practice.
Evaluation of Evidence-Based Methods Used to Teach Nursing Students to Critically Appraise Evidence
Authors: Smith-Strøm Hilde , Nortvedt Monica W.
Published: March 2009

This study evaluated whether students can learn to critically appraise a scientific article through evidence-based teaching methods. The course trains students in three steps of evidence-based practice—formulating a question, searching the evidence, and critically appraising the evidence. We gave the students two scientific articles. The articles were divided into sections, and 1 to 2 days were spent on each section. Every day had the same structure: a brief lecture on the relevant part of the article, group work, and interactive plenary discussions. At the end of the course, the students had a group examination in which they critically appraised a new scientific article. Most students reported that having learned steps one, two, and three involved in evidence-based practice was useful in critically appraising a scientific article. The results from the examination supported this. Knowledge about evidence-based practice can increase students' critical attitudes toward the evidence and their own practice.
Faculty-Student Boundaries in Associate Degree Nursing Programs
Authors: Henshaw Christine M.
Published: March 2009

Professionals are called to high standards of behavior. The purpose of this study was to investigate nursing faculty beliefs about appropriate behaviors for nurse educators. Nursing faculty are generally conservative in their beliefs and even more conservative in their actions. Three behaviors of educators are universally viewed as inappropriate: telling a student of the educator's sexual attraction; sexual involvement with a current student; and making deliberate or repeated sexual comments, gestures, or physical contact that are unwanted by the student. Insulting or ridiculing an absent student and insulting or ridiculing a present student were considered appropriate by few respondents (5% and 2.1%, respectively). Little guidance exists for nursing faculty in determining the appropriateness of various behaviors. This exploratory research gives an introductory view of faculty perceptions of appropriate teacher behaviors.
Back to the Future with Hands-On Science: Students' Perceptions of Learning Anatomy and Physiology
Authors: Johnston Amy Nicole Burne , McAllister Margaret
Published: March 2009

This article examines student perceptions of learning related to anatomy and physiology in a bachelor of nursing program. One strategy to teach the sciences is simulated learning, a technology that offers exciting potential. Virtual environments for laboratory learning may offer numerous benefits: teachers can convey information to a larger group of students, reducing the need for small laboratory classes; less equipment is required, thus containing ongoing costs; and students can learn in their own time and place. However, simulated learning may also diminish access to the teacher-student relationship and the opportunity for guided practice and guided linking of theory with practice. Without this hands-on experience, there is a risk that students will not engage as effectively, and thus conceptual learning and the development of critical thinking skills are diminished. However, student perceptions of these learning experiences are largely unknown. Thus, this study examined students' perceptions of anatomy and physiology laboratory experiences and the importance they placed on hands-on experience in laboratory settings.
Clinical Faculty Development: Using Simulation to Demonstrate and Practice Clinical Teaching
Authors: Krautscheid Lorretta , Kaakinen Joanna , Warner Joanne Rains
Published: March 2009

Students spend more time in clinical settings with smaller student-to-faculty learning ratios than in the didactic setting, yet many clinical faculty have had little exposure to evidence-based teaching strategies and learning theories. Orientation for newly employed clinical faculty, whether novices or experienced teachers, typically focuses on the details of running the clinical experience and not on teaching and learning. Multiple barriers for clinical faculty limit the ability to provide consistent and comprehensive education. The purpose of this article is to share the use of simulation as a strategy to prepare and support clinical faculty in their teaching role.
Looking Below the Surface: Developing Critical Literacy Skills to Reduce the Stigma of Mental Disorders
Authors: McAllister Margaret
Published: March 2009

Although clinicians and the public are more informed about the factors that give rise to mental disorders, stigmatization does not seem to be abating. This article argues for one solution: altering the way students are taught, moving beyond content toward a focus on enticing attitudinal shifts, such as empathy and personal commitment to social change. This article describes a strategy for learners to develop critical literacy skills and to acknowledge and develop their role in encouraging students to become critical agents who possess the knowledge and courage to struggle against despair and to embrace hope.
Learning Nursing Procedures: The Influence of Simulator Fidelity and Student Gender on Teaching Effectiveness
Authors: Grady Janet L. , Kehrer Rosemary G. , Trusty Carole E. , Entin Eileen B. , Entin Elliot E. , Brunye Tad T.
Published: March 2009

Simulation technologies are gaining widespread acceptance across a variety of educational domains and applications. The current research examines whether basic nursing procedure training with high-fidelity versus low-fidelity mannequins results in differential skill acquisition and perceptions of simulator utility. Fifty-two first-year students were taught nasogastric tube and indwelling urinary catheter insertion in one of two ways. The first group learned nasogastric tube and urinary catheter insertion using high-fidelity and low-fidelity mannequins, respectively, and the second group learned nasogastric tube and urinary catheter insertion using low-fidelity and high-fidelity mannequins, respectively. The dependent measures included student performance on nasogastric tube and urinary catheter insertion testing, as measured by observer-based instruments, and self-report questionnaires probing student attitudes about the use of simulation in nursing education. Results demonstrated higher performance with high-fidelity than with low-fidelity mannequin training. In response to a self-report posttraining questionnaire, participants expressed a more positive attitude toward the high-fidelity mannequin, especially regarding its responsiveness and realism.
The Doctor of Nursing Practice Degree: Lessons from the History of the Professional Doctorate in Other Health Disciplines
Authors: Brown-Benedict Deonne J.
Published: March 2009

Despite the American Association of Colleges of Nursing's adoption of the Doctor of Nursing Practice (DNP) degree as the appropriate level of education for advanced practice, a number of controversies have persisted, including questions of timing, academic support, grandfathering, diffusion of nursing research, and economics. This article discusses the path to the professional doctorate in optometry, osteopathy, public health, pharmacy, physical therapy, audiology, chiropractic, and naturopathy. It reveals similar struggles to professionalism and the consensus drawn from doctoral development in these fields. It concludes with lessons for a path forward for the DNP.
A Unique Simulation Teaching Method
Authors: Hawkins Kim , Todd Martha , Manz Julie
Published: March 2009

Simulation is an excellent venue for students to learn experientially and provides opportunities for students to practice problem solving and psychomotor skills in a safe, controlled environment. Through the use of a specifically designed format, faculty at Creighton University School of Nursing have developed a unique method of implementing high-fidelity simulation that allows a more comprehensive learning experience. This innovative teaching strategy incorporates not just skill acquisition, but also care management concepts into the scenario, while requiring only one faculty member. Students simultaneously take one of two paths through the components of this method to achieve the same learning outcomes.
Critical Thinking Among RN-to-BSN Distance Students Participating in Human Patient Simulation
Authors: Rush Kathy L. , Dyches Cathy E. , Waldrop Susannah , Davis Angie
Published: March 2009

Simulation is a strategy increasingly being used to promote critical thinking skills among baccalaureate nursing (BSN) students. It has been used to a limited extent with RN-to-BSN students, many of whom take their educational program through distance delivery. The purpose of this qualitative study was to understand the critical thinking of distance RN-to-BSN students who participated in a simulation designed with interactive questions. Students taking the program, either by live televised broadcast (educational television [ETV]) or by online instruction, participated in the simulation. The ETV student simulation was facilitated from a broadcast studio by faculty, whereas Internet students completed the simulation by DVD. Postsimulation students participated in debriefing sessions, which were audiotaped by ETV students and completed by Internet students using a Blackboard
®
discussion board. Data were analyzed using Scheffer and Rubenfeld's conceptualization of critical thinking. Findings revealed that simulation used by distance delivery cultivated critical thinking in RN-to-BSN students.
The Importance of Awareness of Nursing Students' Denotative Images of Nursing
Authors: Lyckhage Elisabeth Dahlborg , Pilhammar Ewa
Published: March 2009

The aim of this article is to describe the images that recent nursing students in Eurocentric culture have of nursing and discuss how these images can be used to highlight nurses' authority and autonomy in comparison with the medical profession. The empirical material consists of short narratives from 168 nursing students. Three themes emerged from the categories of answers: The Nurse as an Idealistic Helper, The Nurse as a Realistic Developer, and The Nurse as a Young Seeker.

The essence of nursing could be traced in these themes even if a solid ground of nursing shows itself in changing forms. According to this study and previous research, nursing can be considered as a mummified occupation in its essence, given that the old values and stereotypes largely remain. The main motives for becoming a nurse are altruism, a desire for autonomy, and flexibility. To strengthen the profession, both teachers and clinical supervisors should use the students' images of nursing as a starting point in nursing education and develop them in different contexts.
The Schumacher Model: Fostering Scholarship and Excellence in Nursing and for Recruiting and Grooming New Faculty
Authors: Schumacher Gretchen , Risco Kerry , Conway Alice
Published: March 2009

In 2004, U.S. nursing schools turned away 32,797 qualified nursing applicants. One contributing factor was an insufficient number of nursing faculty. Projected retirements will require nursing faculty units to work in smaller numbers and actively recruit new faculty. The Schumacher model provides a framework for fostering scholarship and excellence in nursing and for recruiting and grooming new faculty. It articulates methods for nurse educators to capitalize on each other's strengths to work together to address the current shortage. This article describes the Schumacher model, its application to mentorship among nursing faculty, and the current nursing faculty climate.
Development of a New Prototype for an Educational Partnership in Nursing
Authors: Yeh Ming-Lee , Rong Jiin-Ru , Chen Mei-Li , Chang Shu-Fang , Chung Ue-Lin
Published: March 2009

The purpose of this 2-year study was to evaluate a new educational partnership for a nurse-managed community center in Taiwan. This project provided care to senior residents in an apartment complex and was integrated into a nursing educational program in Taiwan. In collaboration with these organizations, an educational partnership model was developed and evaluated. Three goals were accomplished: to provide health care to elderly residents, practical learning experience for nursing students, and practical experience for nursing faculty. The findings indicated that teachers, students, and residents in the apartment complex presented a high level of satisfaction with this model. The model created a vivid, practical, community-based resource and applied the principles of service-learning into practical nursing education in Taiwan. The model not only facilitated the empowerment of involved organizations, but also served as a reference for developing other community center-based nursing educational partnerships.
“Once Upon a Time”: A Discussion of Children's Picture Books as a Narrative Educational Tool for Nursing Students
Authors: Crawley Josephine Mary
Published: March 2009

Narrative pedagogy influences many areas of nursing education, with emphasis on the co-constructing of narrative between students, educators, and clinicians. Little has been written about published children's literature as a basis for narrative discussion in nursing education. This article describes how narrative pedagogy already works within nursing education and explores features of children's picture books that give them value as a narrative educational tool for nursing students, providing stories that encourage self-understanding and deconstruct the multiple realities of narratives about the human condition.
Building a Virtual Community for Nursing Education: The Town of Mirror Lake
Authors: Curran Christine R. , Elfrink Victoria , Mays Barbara
Published: March 2009

RNs take pride in delivering high-quality individualized care to their patients. However, how do nursing students learn the principles of professional nursing or develop the competencies necessary to individualize patient care? At the Ohio State University College of Nursing, we embarked on deploying a virtual community of patients to enhance our students' learning experience. Our community, the town of Mirror Lake, contains 165 people and 62 households, with an apartment complex, a medical center, and a retirement center with assisted and skilled nursing care. This community serves as the main source of patients for Mirror Lake Medical Center, our virtual hospital. We think we can teach many key principles of sound nursing care using this virtual community of patients. This article presents the rationale behind the decision to take on this endeavor, as well as the processes used for development of our community.
Interventional Strategies to Decrease Nursing Student Anxiety in the Clinical Learning Environment
Authors: Moscaritolo Linda M.
Published: March 2009

The clinical setting is a significant learning environment for undergraduate nursing students. However, the learning that occurs in this environment presents challenges that may cause students to experience stress and anxiety. High levels of anxiety can affect students' clinical performance, presenting a clear threat to success in a clinical rotation. It is crucial for clinical nursing faculty to foster a supportive learning environment conducive to undergraduate nursing student learning. The purpose of this article is to provide clinical nursing faculty with the current literature related to humor, peer instructors and mentors, and mindfulness training as strategies to decrease undergraduate student nurse anxiety in the clinical setting. The Neuman Systems Model is used as a theoretical framework, and the application of this model to humor, peer instructors and mentors, and mindfulness training is examined.
Factors Related to Successful Teaching by Outstanding Professors: An Interpretive Study
Authors: Rossetti Jeanette , Fox Patricia G.
Published: March 2009

The purpose of this study was to identify and describe factors associated with successful university teaching within the cultural norms of a public university in the midwestern United States. An interpretive analysis was conducted using the educational philosophy and goal statements of 35 university professors who received Presidential Teaching Awards from the university. The professors' diverse disciplines included nursing, curriculum and instruction, accountancy, music, and political science. The authors offer nursing educators the opportunity to increase their confidence and effectiveness by “learning” from faculty members who have been recognized as exceptionally successful in teaching. Four main relevant themes associated with successful university teaching were identified: Presence, Promotion of Learning, Teachers as Learners, and Enthusiasm. The narratives of the professors helped define the meaning of successful teaching across disciplines and offer nursing faculty additional perspectives and experiences.