bluuebunny/crossref_metadata_2025 huggingface dataset:
ANTERIOR STABILIZATION OF THORACOLUMBAR BURST FRACTURES USING THE KANEDA DEVICE: A PRELIMINARY REPORT
Authors: Kirkpatrick John S , Wilber R Geoffrey , Likavec Matthew , Emery Sanford E , Ghanayem Alexander
Published: April 2021

ABSTRACT

Anterior decompression and fusion is a valuable technique in the treatment of thoracolumbar burst fractures. Anterior instrumentation has evolved to correct deformity and stabilize the spinal segments during decompression and bone grafting as a single-stage procedure. One anterior device developed by Kaneda has been used in our institution since 1989. This study is an initial review of our experience with this instrumentation. Anterior decompression and fusion augmented with the Kaneda device was performed in 20 patients with thoracolumbar burst fractures. Timing of surgery was early (<15 days) in 13 patients, intermediate (16 to 120 days) in 2, and delayed (>121 days) in 5. Sixteen patients were neurologically intact (Eismont grade D), 3 with distal weakness (Eismont grade B or C) and 1 with complete paraplegia (Eismont grade A). All patients with deficits recovered one Eismont grade after anterior decompression and fusion. Complications included pulmonary problems in 2 patients, a thoracic duct laceration requiring ligation, and a sympathectomy effect of the lower extremity. One patient had a pulmonary embolus and developed a hematoma at the graft harvest site while on anticoagulants with resultant meralgia paresthetica. There have been three screw failures and one definite pseudarthrosis. Anterior decompression and fusion supplemented by the Kaneda device was performed on 20 patients with thoracolumbar burst fractures. The average correction of kyphosis was approximately 50% acutely, with loss of approximately 50% of correction at follow up. In some patients, coronal plane deformity was created by the device. No effect on neurologic recovery could be shown with this small series. Perioperative complication rate was 30%, and 1 patient developed pseudarthrosis.
Joint Arthroplasty: Who, What, Where, and When
Authors: Booth Robert E
Published: April 2021

Current Concepts in Joint Replacement
Porous-Coated Fixation: The Experience
Authors: Mallory Thomas H
Published: April 2021

Femoral Component Fixation Options in the 1990s
An Accurate Method for Measuring Leg Length and Hip Offset in Hip Arthroplasty
Authors: Huddleston Herbert D
Published: April 2021

ABSTRACT

A method of intraoperative leg length and hip offset measurement in total hip arthroplasty is described. A bent pin anchored in the pelvis is used in combination with a rigid, molded cradle for the operated leg.
Spiral Computed Tomography With Two- and Three-Dimensional Reconstruction in the Management of Tibial Plateau Fractures
Authors: Liow R Y L , Birdsall P D , Mucci B , Greiss M E
Published: April 2021

ABSTRACT

Spiral computed tomography (CT) with three-dimensional and multiplanar reconstructions was used in the evaluation of tibial fractures in nine patients. Computed tomography added important information to that obtained by plain radiographs. Five (55%) fractures were reclassified. The degree of articular depression was often underappreciated on plain radiographs. Furthermore, the fracture complexity and the spatial relation of fragments could be readily demonstrated with 3-D reconstruction. This technique is useful in planning operative reconstruction.
Combined Limited Internal Fixation With Circular Frame External Fixation of Intra-Articular Tibial Fractures
Authors: Raikin Steven , Froimson Mark I
Published: April 2021

ABSTRACT

High-energy intra-articular fractures of the tibial plateau and plafond cause ongoing management problems for the orthopedic surgeon. This study retrospectively evaluated 37 such fractures treated with limited internal fixation and circular frame external fixators. Seventeen plateau fractures (5 open) and 20 plafond fractures (9 open) were treated. Time to union, number of procedures, complications, and functional outcomes were evaluated. All tibial plateau fractures healed within an average of 3.8 months. Eighteen of 20 plafond fractures healed at an average of 4.8 months. There was a high complication rate as is common with these injuries, but most of the complications were minor and easily treated.
Behavior of the Femoral Stem in the Bihapro Hip Prosthesis
Authors: Hernández-Vaquero D , Murcia-Mazón A , Paz-Jimenez J , Alegre-Mateo R , Martínez-García J , Pena-Vazquez J
Published: April 2021

ABSTRACT

This study evaluated the hydroxy apatite-coated femoral stem of the Bihapro hip prosthesis (Biomet Ltd, Bridgend, United Kingdom) using radiography, TC-99 scintigraphy, and bone densitometry. Thirty stems with >2 years of follow-up (mean: 31 months) were evaluated. No loosening or changes in the position of the implant were seen, and the mean subsidence was 2.2 mm. Radiography revealed a densification in the metaphyseal zone with reconstruction of the trabecular lines in 21 cases, while in 22 patients, radiolucent lines in the distal area of the femoral component were observed. Scintigraphy showed a diaphyseal normo-captation in 19 cases and a hype rea ptation <1 .4 with a mean index of 1.1 in 1 0 patients. Metaphyseal hypercaptation >1.4 was seen in 24 patients. Bone densitometry revealed increased density in the metaphyseal zones in 29 patients with a peri prosthetic/normal bone quotient of 1.4.
A Level One Trauma Center's Experience With the Posterior Approach to the Pelvis
Authors: Moon Charles N , Merkle Paul F
Published: April 2021

Abstract

A retrospective review of the experience at Los Angeles County and University of Southern California Medical Center was conducted as part of a multicenter study to evaluate the true complication rate of the posterior approach to the sacroiliac joint. Between 1995 and 1997, 35 patients underwent 42 approaches, representing all patients who underwent the posterior approach by a single staff surgeon at these medical centers. All patients underwent follow-up 2*1 year postoperatively.

There were 11 (33%) preoperative nerve palsies. Three (11%) neurologic complications were found postoperatively, all of which resolved prior to discharge. There was 1 (2.4%) wound complication. There was Î gluteal flap for closure (open fracture) and 1 secondary wound closure. Five patients had prolonged wound drainage (>5 days). There were no skin sloughs in the series and only 1 patient developed a deep wound infection. Contrary to reports by advocates of anterior approaches and closed reductions, the posterior approach allows anatomic reduction of posterior lesions with an acceptable complication rate.
The Clinical History and Development of the Low Contact Stress Total Knee Arthroplasty
Authors: Sorrells R Barry
Published: April 2021

Abstract

Contemporary total knee arthroplasty (TKA) has evolved over the past 30 years as a result of early prosthetic design failure. Hinge-type implants demonstrated a high loosening rate because of overconstraint. Curved-on-flat prostheses, which were popular in the late 1970s, became associated with a high incidence of polyethylene failure. The Low Contact Stress (LCS) Total Knee System (DePuy Orthopaedics Ine, Warsaw, lnd), a mobile-bearing knee arthroplasty design, was introduced in 1977. The LCS Total Knee System, now in its 25th year without alterations in articular geometry, has demonstrated clinical success and has had an impact on evolving prosthetic designs. Introduced in 2001, the LCS Complete Total Knee System provides further refinements in patient fit without changing the fundamental design principles. Surgeons are cautioned to use a well-proven clinical design, as biomechanical variations critically impact clinical outcomes.
Factors Affecting Polyethylene Wear in Total Knee Arthroplasty
Authors: Kuster Markus S , Stachowiak Gwidon W
Published: April 2021

Abstract

A complication of total knee arthroplasty (TKA) is fatiguetype wear, which can destroy a tibial inlay in <10 years. This deleterious wear mechanism occurs during cyclic loading if the yield stress of polyethylene is exceeded. Because increased stress on and within the polyethylene inlay is associated with increased wear, it is important to reduce the inlay stress by either activity restrictions or conformity changes of design. All stress parameters are more sensitive to conformity changes (eg, design changes) than to load changes (eg, activity restrictions). However, the reduction of stress on and within the polyethylene through increased conformity will increase the stress at the tibial fixation interfaces. An attempt was made to solve this problem with the introduction of mobile-bearing designs. Many mobile-bearing designs exist with good long-term results. One important difference among the various designs is the amount of flexion range with full conformity between the femoral component and the tibial inlay. Although a single radius design reduces polyethylene stress throughout the flexion range, it may be disadvantageous for a revision design to intraoperatively adapt to different degrees of constraint. Aseptic loosening and osteolysis due to small abrasive and adhesive wear particles have also been reported as a cause of failure. The design and material parameters affecting polyethylene wear in TKAs, as well as the potential detrimental effects of wear particle size, are the key issues in defining the life of a TKA.
Atrophy of Semitendinosus and Gracilis and Flexor Mechanism Function After Hamstring Tendon Harvest for Anterior Cruciate Ligament Reconstruction
Authors: Irie Kazunori , Tomatsu Taisuke
Published: April 2021

Abstract

The cross-sectional areas of individual knee flexors and isokinetic flexion measurements were evaluated using computed tomography in 1 3 patients following semìtendinosus and gracilis tendon harvest for anterior cruciate ligament reconstruction. The atrophy of tendon-dissected muscles demonstrated variance with two peaks: >70% and <50%. In three patients whose semìtendinosus and gracilis muscles displayed areas <50% of the contralateral area, the cross-sectional area of the entire flexor group and work at >75° of knee flexion was 88.1% and 51.9%, respectively. Therefore, hamstring tendon harvest can induce atrophy of tendon-dissected muscles and decrease flexor function.
Comparison of Posteromedial and Subtalar Release in Surgical Treatment of Resistant Clubfoot
Authors: Tschopp Olivier , Rombouts Jean-Jacques , Rossillon Renaud
Published: April 2021

Abstract

This preliminary study evaluated two surgical techniques for the treatment of resistant clubfoot: the posteromedial and the subtalar release. Two groups of matched patients with idiopathic clubfoot who underwent surgery between 1983 and 1995 were compared. In group 1 (12 patients, 1 8 feet), posteromedial release was performed. In this group, the results were satisfactory with a tendency to hypocorrection: 4 (22%) feet needed a secondary procedure (average follow-up: 97.8 months). Group 2 (12 patients, 17 feet) underwent complete subtalar release. The results were clinically better for group 2 (average follow-up: 38.8 months). Only 1 (5.9%) patient needed a secondary procedure. These results suggest complete subtalar release yields better postoperative correction than posteromedial release.
The Role of the Osteoconductive Scaffold in Synthetic Bone Graft
Authors: Vaccaro Alexander R
Published: April 2021

Abstract

Autogenous bone is regarded as the gold standard for bone graft materials as it provides 3 elements necessary to generate and maintain bone: scaffolding for osteoconduction, growth factors for osteoinduction, and progenitor cells for osteogenesis. Allograft is more limited than autograft in these essential elements and yields more variable clinical results. Composite synthetic grafts offer an alternative that can potentially unite the 3 salient bone-forming properties in more controlled and effective combinations than can be obtained in many clinical situations, without the disadvantages found with autograft. This article examines the underemphasized but crucial role of the osteoconductive scaffold in the composite synthetic bone graft.
Use of a Novel β-Tricalcium Phosphate-Based Bone Void Filler as a Graft Extender in Spinal Fusion Surgeries
Authors: Gunzburg Robert , Szpalski Marek
Published: April 2021

Abstract

Synthetic bone void fillers are gaining acceptance as graft extenders in spinal surgery. One such product is an ultraporous formulation of nanometer-sized particles of β-tricalcium phosphate (β-TCP). An ongoing prospective open-label, randomized, observer-blinded, comparative study evaluated the efficacy and safety of a novel β-TCP bone void filler as an additive to autogenous bone graft material in patients undergoing spinal fusion. Posterolateral instrumented or noninstrumented spinal fusion was performed at a single level or multiple levels with or without additional interbody fusion. Patients received autogenous bone on 1 side and autogenous bone augmented with extender (in a 1 :1 ratio based on the weight of the materials) on the opposite side, each patient serving as his or her own control. The graft material was placed at the level of the facet joints and the intertransverse processes. Patients were randomized to receive the extender on either the right or the left side. This article is a preliminary report on patients who have undergone this procedure.
Applications of Calcium Phosphate-Based Cancellous Bone Void Fillers in Trauma Surgery
Authors: Szpalski Marek , Gunzburg Robert
Published: April 2021

Abstract

For more than a century, fracture repair has been augmented with autogenous cancellous bone grafting, which supplies 3 requisite properties: growth factors for osteoinduction, progenitor stem cells for osteogenesis, and scaffolding for osteoconduction. However, disadvantages to using autogenous bone include procurement morbidity, longer operative time, and limited availability. Allograft is more readily available but does not supply osteoinductive or osteogenic properties. Better alternatives for bone grafting currently include autologous bone marrow, ceramics, allograft demineralized bone matrix, and regulatory growth factors; however, none of these fulfills all 3 requisite properties. Replacement or augmentation of autograft with a calcium phosphate-based composite graft, which combines the best elements of each component into a single engineered graft, is discussed.
Elbow Heterotopic Ossification in Head-Trauma Patients: Diagnosis and Treatment
Authors: de Palma Luigi , Rapali Stefano , Paladini Paolo , Ventura Angelo
Published: April 2021

Abstract

Heterotopic ossification is a disorder characterized histologically and radiographically by normal bone formation in soft tissues that normally have no ossification properties. In severe head-trauma patients, a high incidence of heterotopic ossification occurs. The diagnosis of this pathology in these patients often is difficult for residual neurological damage. The etiology of heterotopic ossification following head trauma is unknown. Similarities have been found between heterotopic ossification and myositis ossificans, a hereditary autosomal dominant disease.
Reduction of an Angled Displacement Using the Ilizarov Apparatus
Authors: Zolotov Alexander S
Published: April 2021

The llizarov method offers many advantages in the treatment of bone fractures, nonunions, and malunions.
Ultrasonography of the Infant Hip: The Significance of Provokable Instability With Normal Morphology
Authors: Reikerås Olav , Kristiansen Leif P , Gunderson Ragnhild
Published: April 2021

Abstract

The hips of infants 2- to 4-weeks-old were investigated with ultrasonography. In alt cases, ultrasonography verified morphologically normal hips; however, either a bilateral or unilateral instability of the hip could be provoked as demonstrated by ultrasonography. The first series of 27 infants (41 hips) were treated with abduction splint (Frejkas pillow) for 16 weeks. The second series of 28 infants (44 hips) were left untreated. All infants had repeat ultrasonography at 2 and 16 weeks and radiographs at 1 6 weeks. At 2 weeks, provokable instability was still seen in 1 0 hips in the treated group and 1 2 hips in the untreated group. At 1 6 weeks, all hips were ultrasonographically stable. The morphology was evaluated by alpha and beta angles by ultrasonography and also acetabular index by radiographs at 1 6 weeks. In all cases, normal hip development was noted wim no differences between die two groups. Therefore, sonographically, instability in morphologically normal or immature hips has no clinical significance.
Repair of a Subscapular Tear in a 13-Year-Old Boy
Authors: Kaplan Lee D , Hechtman Keith S , Schurhoff Matthias R
Published: April 2021

Subscapular tendon tears in the skeletally immature patient are rare. Accurate diagnosis through clinical examination and imaging studies promotes early repair, allowing the young patient to return to activities.
Antibiotic Bone Cement Approval: Fuss-in at the Feds!
Authors: Bourne Robert B
Published: April 2021

The Optimization of Patient Care 2001
Enhanced Cross-Linked Polymers: The Promise-In Opposition
Authors: Ritter Merrill A
Published: April 2021

Alternative Bearing Surfaces
A Biologic Solution: Preserving the Posterior Cruciate Ligament
Authors: Thornhill Thomas S
Published: April 2021

Achieving Posterior Stability in Knee Design
Relationship Between Mortality and Proximal Femur Fractures in the Elderly
Authors: Bettelli Graziano , Bianchi Giuseppe , Marinelli Alessandro , Stagni Cesare , Giunti Armando
Published: April 2021

Abstract

Four hundred ninety-three patients aged >65 years with proximal femur fractures were examined to assess the mortality rate within 1 year postoperatively. The risk factors that are most often associated with death were identified. Within the inhomogeneous group of patients, mortality was significantly higher in patients with poor mental status, with ≥2 pre-existing diseases, a 3 or 4 American Society of Anesthetists class rating, and a lateral fracture. Regarding treatment and rehabilitation, special attention needs to be paid to these patients postoperatively.
Overuse Injuries of the Olecranon in Adolescents
Authors: Parr Thomas J , Burns Travis C
Published: April 2021

Overuse injuries are common in elite adolescent athletes due to intensive training demands. Overuse injuries of the olecranon have been divided into true stress fractures and osteochondroses. This article presents a third overuse injury, painful intraosseous edema, in elite adolescent athletes.
Writing to Learn: A Reconceptualization of Thinking and Writing in the Nursing Curriculum
Authors: Allen David G , Bowers Barbara , Diekelmann Nancy
Published: April 2021

ABSTRACT

The connection between writing and thinking has been radically reconceptualized in recent years. Whereas the previous view saw writing as recording thought, the new perspective sees writing as developing thinking. The change in views about writing is discussed and implications of the "Writing to Learn" paradigm for instructional and curricular issues in nursing are explored.
Relationship Between a Preceptorship Experience and Role Socialization of Graduate Nurses
Authors: Clayton Gloria M , Broome Marion E , Ellis Linda A
Published: April 2021

ABSTRACT

The purpose of this quasi-experimental study was to determine the effect of preceptorship on the socialization of the baccalaureate graduate nurse into roles of professional nurses. Two groups, one having a preceptorship experience in the final quarter of their baccalaureate program (n = 33) and one having the traditional course (n = 33), participated in the study. Both groups completed Schwerian's SixDimension Scale of Nursing Performance on three testing occasions: prior to the course, immediately following the course, and the six months after graduation. There was a significant interaction effect between group and time. The preceptor group at the 6-month follow-up scored significantly higher on four of the six subscales as well as on the overall socialization instrument.
Comparison of Expected and Evidenced Baccalaureate Degree Competencies
Authors: Joyce-Nagata Barbara , Reeb Rene , Burch Sharron
Published: April 2021

ABSTRACT

The defining of beginning competencies for the baccalaureate degree in nursing education has been an issue over the past decade. Many researchers have attempted to investigate the performance of graduates of the basic nursing preparation programs. At present, there is little that links education to practice.

The purposes of this study were to validate whether the competencies of graduates of baccalaureate degree nursing programs were as expected by nursing service administrators, and whether the expected competencies were evidenced in the work setting. A two-part questionnaire was administered to 142 directors of nursing in health-care settings in Mississippi. The research project requested an evaluation of the baccalaureate competency statement from two perspectives. On a five-point Likert scale, administrators were asked to evaluate if the competency should be expected of a baccalaureate graduate. The administrators then evaluated to what extent the competency statement was evidenced. Analysis of the data was done using descriptive statistics. A mean for each competency was calculated for expected and evidenced responses. A difference of 30% between the expected and evidenced responses was deemed to be significant. Conclusions were drawn and recommendations for further study made.
Faculty Practice as a Requirement for Promotion and Tenure: Receptivity, Risk, and Threats Perceived
Authors: Herr Keela A
Published: April 2021

ABSTRACT

The purpose of this study was to determine the receptivity of nurse faculty to the proposal of adding faculty practice as an additional requirement for promotion and tenure and to investigate the perceived risk and threats from introduction of this proposal. Factors that affect the risk faculty perceived are examined. Nurse educators from all faculty ranks in public nursing programs in 15 states in the southern region of the United States served as subjects for this study (N = 280). Findings indicate that nurse faculty are more receptive than resistant to the proposal requiring faculty practice as a requirement for promotion and tenure. A high negative correlation exists between receptivity to the proposal and the risk faculty perceived from implementation of the proposal. A measure of the threat to job perquisites correlated moderately with the risk faculty perceive from the proposal, with specific threats and benefits perceived by faculty identified. Implications for administrators and faculty are discussed.
Student Perceptions of the Links Between Nursing and the Liberal Arts
Authors: Peck Mary Lou , Jennings Sybillyn
Published: April 2021

ABSTRACT

This article examines the extent to which nursing students are aware of the importance of liberal arts in their professional education. Based on a survey of nursing students and alumnae from a small, New York state college, the project further explored the channels through which they became aware of the significant links between these two aspects of their education. One finding is that nursing students give a relatively high weight to the importance of the liberal arts in their total learning process.

The more important conclusion is that students, on the whole, believe that they have made the links between liberal arts and nursing themselves. To the extent that other agents help forge these links, the most important seem to be nursing labs and clinicals, other nursing students, and nursing texts and modules. Students perceive that nursing faculty help draw links more often than liberal arts faculty, but neither rank very high.
Gerontological Curriculum in Schools of Nursing
Authors: Verderber Dolores Nelson , Kick Ella
Published: April 2021

ABSTRACT

This article investigates the availability of gerontological nursing programs that exist nationally and are found listed in the NLN Master's Education in Nursing: Route to Opportunities in Contemporary Nursing (1987). A sample of 12 programs offering gerontological nursing was selected from 64 schools listed. Six of the twelve (50%) schools of nursing responded to a survey for review and comparison of their programs for similarities and differences. The surveyed programs were compared with recommendations found in a review of the literature in four main categories: knowledge/course content, faculty, environment/clinical experience, and learner/student. The review of the responding programs followed the 11 recommended standards in the ANA Standards and Scope of Gerontological Nursing Practice (1987). Findings from the survey indicated similarities among the six responding schools, and indicated congruence with results of two previous national studies (AGHE, 1988 and ANA, 1986a). Specific findings in the study are discussed along with implications for gerontological nursing education. Recommendations are made for better defined curricula in gerontological nursing at both the undergraduate and graduate levels, more faculty qualified in gerontology, and further investigation of the learners or students entering gerontological nursing to facilitate curriculum development and appropriate instructional strategies.
Learning Styles and Learning Preferences of First and Fourth Semester Baccalaureate Degree Nursing Students
Authors: Wells Deborah , Higgs Zana Rae
Published: April 2021

ABSTRACT

Learning styles and preferred learning approaches are believed to have an influence on student learning. This study compared the learning styles and learning preferences of first and fourth semester baccalaureate nursing students, as well as explored changes in learning styles and learning preferences from first to fourth semester. The two predominant learning styles of both groups of students were Abstract Random and Concrete Sequential. According to Gregore, (1982a), these learning styles are on the opposite poles in relation to perceiving and ordering information. No significant changes were found in learning style scores from first to fourth semester. Students indicated a range of preferences for 12 learning methods. Mean scores on three methods (slide/filmstrip, short lecture with question and answer, television/movies) dropped significantly from first to fourth semester. Implications for nursing education are discussed.
Burnout in Doctorally Prepared Nurse Faculty
Authors: Dick Margaret Jorgensen
Published: April 2021

ABSTRACT

This correlational study examined burnout in doctorally prepared nurse faculty and its relationships to management style, collegial support, and workload. The Matthews Burnout Scale and the Maslach Burnout Inventory were used to measure burnout of 400 doctorally prepared American Nurses Association (ANA) members employed as faculty in schools of nursing. Analysis of 236 (59%) returns revealed that 39% of the faculty experienced moderate to high levels of burnout. Significant negative relationships (p<.05) were found between burnout and participative management, presence of collégial support, and time spent in research and in clinical practice. Multiple regression indicated that management style was the strongest predictor of burnout, with collégial support the second predictor.
The Level and Focus of Geriatric Nursing Content in ADN and BSN Programs
Authors: Fullerton Judith T , Lantz John , Quayhagen Mary P
Published: April 2021

ABSTRACT

The didactic and clinical focus of geriatric curriculum content within both associate (ADN) and baccalaureate (BSN) schools of nursing in California was reviewed. Geriatric nursing content experts confirmed the detail of a geriatric nursing curriculum, then determined which of the content items were basic to both educational levels, and which might be appropriately deferred to programs of baccalaureate preparation. Nurse educators may use the results of this study to guide curriculum development in both depth and breadth of content.
The Odds for Success on NCLEX-RN by Nurse Candidates from a Four-Year Baccalaureate Nursing Program
Authors: Mills Andrew C , Sampel Mary E , Pohlman Vivian C , Becker Ann M
Published: April 2021

ABSTRACT

First-time nurse candidates from a four-year baccalaureate nursing program were examined to identify predictors of success on NCLEX-RN. Five logistic regression models were tested to see if specific variables increased nurse candidates' odds for success or failure. The use of admission criteria was the poorest model in predicting performance. Cumulative grade point averages (GPAs) suggested that the end of the sophomore year was the best time for predicting success and the end of the junior year was best for predicting failure. Age was inversely related to successful performance in three of the five models. Using cumulative nursing GPAs, the likelihood of predicting success on NCLEX-RN increased at the end of each academic year.
Development of an Instrument to Measure Effectiveness of Clinical Instructors
Authors: Reeve Mary M
Published: April 2021

ABSTRACT

Evaluation of clinical instructors by their students is an important issue in nursing education. This study describes the outcome of the development of a method by which nursing students can evaluate their clinical instructors with a reliable and valid instrument. The instrument was developed using characteristics from the literature, which were rated in importance by students, faculty, and new graduates. The ratings are then subjected to statistical analysis using frequency, means, alpha coefficient, and item-to-total correlation and expert assessment to provide reliability and validity for the instrument and to aid in reducing the original list of 50 characteristics to a more usable number of 27. The instrument is pilot tested once with students rating clinical faculty. Results from the pilot are provided.
Enhancing Specialist Preparation for the Next Century
Authors: Lipman Terri H , Deatrick Janet A
Published: April 2021

ABSTRACT

While the curricula of clinical nurse specialist (CNS) programs have proved to be successful in meeting past and current health care needs of specialty populations, the needs of children requiring care by the CNS have changed greatly over the past few years. Because of advanced technology, more children are surviving, although they may have serious physical, developmental, and psychosocial disabilities. At the same time, the educational, health, and social services for these children have become harder to access. A conceptual model, Family-Focused Pediatrie Transitional Care (FFPTC), was used to interpret a survey of graduates of a pediatrie clinical specialist program and their employers. Recommendations regarding possible changes in pediatrie clinical nurse specialist curricula are offered to guide future educational agendas. Advanced skills in clinical decision making and coordinating care across the continuum from the hospital to the community and to the home have become essential role competencies for the clinical nurse specialist.
Nursing Professorate in America: Projected Retirements and Replacements
Authors: Ryan Marilyn , Irvine Phyllis
Published: April 2021

ABSTRACT

New paradigms are emerging in higher education, and institutions are facing financial shortfalls. Faculty retirements and resignations may have an impact on the quality of education across disciplines. Will adequate numbers of doctorally prepared replacements be entering nursing education to meet projected retirements and resignations? A national study was conducted of National League for Nursing-accredited baccalaureate and higher degree nursing programs with 296 (58%) responding. The purpose was to determine faculty profiles, policies related to retirement, and projected replacements. Projected retirements and resignations over the years 1992 to 2006 are estimated to be approximately one third of the current faculty work force. Numbers of anticipated graduates at the master's level seem to be adequate. However, doctorally prepared candidates will most certainly not fill all the gaps that will exist in nursing education. Implications call for an examination of clinical teaching practices to ensure continued quality nursing education. An examination of faculty retirement policies and plans is warranted.
Nursing Student Perspective of Learning in a Clinical Setting
Authors: Wilson Margaret E
Published: April 2021

ABSTRACT

The purpose of this qualitative study was to explore and describe nursing students' experience of learning in a clinical practice setting where the students learned to provide care for acutely ill infants. Data were collected using the techniques of observation and ethnographic interviewing. The findings included a nursing student perspective of learning in a clinical setting and consisted of six goals: to do no harm to a patient, to help patients, to integrate theory-based knowledge into clinical practice, to learn clinical practice skills, to look good as a student, and to look good as a nurse. Within this perspective, the students also defined roles for themselves, their instructors, and the staff nurses in the clinical setting. The students defined the learning environment and then used that definition to shape their responses to the educational program.
Reforming Nursing Education for Future Practice
Authors: Oermann Marilyn
Published: April 2021

ABSTRACT

Health care reform, regardless of the specific proposal ultimately accepted, calls for changes in baccalaureate nursing education to prepare students for community-based practice. These changes include a shift toward the community as the primary setting for clinical practice; greater emphasis in the curriculum and more extensive clinical experiences in health promotion and prevention of illness; integration of primary health care within different levels of the curriculum; more interdisciplinary experiences in the delivery of care; expanded knowledge and skills for care of mothers, children, the aged, and critically ill patients in varied settings; and the reexamination of teaching strategies for preparing students with these expanded competencies. As nursing faculty consider the impact of health care reform, they are called upon to reexamine the curriculum and clinical experiences provided within their programs to prepare students for practice in community-based systems.
The Clinical Evaluation Tool: A Measure of the Quality of Clinical Performance of Baccalaureate Nursing Students
Authors: Krichbaum Kathleen , Rowan Mary , Duckett Laura , Ryden Muriel B , Savik Kay
Published: April 2021

ABSTRACT

This article describes an approach to the evaluation of students' clinical performance. Specifically, the paper describes: (a) the history of the evaluation of clinical performance in nursing education; (b) the development of the Clinical Evaluation Tool (CET), an instrument designed to measure the clinical performance of nursing students across settings; and (c) the relationships between basic baccalaureate nursing students' scores on the CET and the following variables: age, college credits earned prior to entry to the program, grade point average at entry, college aptitude, and moral reasoning.
Role Model Behaviors in the Clinical Setting
Authors: Wiseman Rebecca F
Published: April 2021

ABSTRACT

The purpose of this study was to identify the role modeling behaviors of clinical nursing faculty that junior and senior baccalaureate students consider important. Bandura's Social Learning Theory provided the theoretical framework for the three research questions. A questionnaire, composed of 28 role model behaviors, was constructed to correspond to the three research questions. The overall alpha coefficient for the questionnaire was .95. The findings of this study indicate that clinical faculty are considered role models by their students. Students perceived themselves as practicing the role model behaviors, but they also perceived that the clinical faculty were inconsistent in rewarding them for their attempts to emulate those behaviors considered important. Areas for future research are discussed.
Insights Learned from Teaching Pathophysiology on the World Wide Web
Authors: Yucha Carolyn , Princen Tonya
Published: April 2021

ABSTRACT

This article describes a one-credit, graduate level pathophysiology module taught using the World Wide Web. Student outcomes are compared to those of students who took the same module in a traditional classroom setting. Although the majority of the graduate students were not Web literate, they became more comfortable with this instructional medium over time. A comparison of the Webbased instruction with the traditional format, both directed by the same instructor, showed no significant differences in student performance on a multiple choice examination.
Graduate Education in Nursing Leadership Through Distance Technologies: The Canada-Norway Nursing Connection
Authors: Iwasiw Carroll , Andrusyszyn Mary-Anne , Moen Anne , Østbye Truls , Davie Lynn , Støvring Turid , Buckland-Foster Irene
Published: April 2021

ABSTRACT

The Canada-Norway Nursing Connection was a collaborative project designed to provide an international educational experience for graduate students in nursing via distance technology. Computer-conferencing and videoteleconferencing were used to address nursing leadership content through case studies. The same technologies were employed to develop the project. The processes of planning and implementing the international linkage are described. Agreement about goals, content, context for online discussion, delivery methods, academic expectations, language support, and logistics was essential. The media proved to be effective for students to gain understandings about nursing leadership, health care, and the forces influencing the nursing profession globally. Insights from the project provided a basis for the development of a model for interactive, international graduate education that will be of value to educators dedicated to helping students gain a global understanding of nursing and health care issues.
Student Voice in Curriculum Making
Authors: Thornton Robert , Chapman Helen
Published: April 2021

ABSTRACT

Undergraduate student nurses (n = 117) were asked to reflect critically on their psychiatric clinical learning experience and identify strengths and weaknesses not only in the actions and behaviors of others, but also in their own. A questionnaire was specifically constructed to encourage the voicing of issues, concerns, actions, and behaviors that centered around the concept of quality in relation to four predetermined categories: clinical practice, clinical nursing staff, clinical facilitators, and students. Themes, inductively derived from the collected information within each category, were organized into clusters and then into frequency distributions to facilitate interpretation. The study generated information that should be useful in planning and supervising effective and mutually satisfying clinical practicums in any psychiatric context. Moreover, the responses gave voice to matters that otherwise may have gone unrecognized in the curriculum. The study confirms that student voice must become an integral part of the alternatives from which curriculum-making choice is made.
Experiences and Comfort with Culturally Diverse Groups in Undergraduate Pre-Nursing Students
Authors: Eliason Michele J , Raheim Salome
Published: April 2021

ABSTRACT

A sample of approximately 200 undergraduate students beginning their nursing education responded to questionnaire items concerning experience and levels of comfort working with diverse client groups. Students reported little discomfort with racial/ethnic groups, but reported they would have considerable difficulty working with lesbian, gay, or bisexual clients, and patients with human immunodeficiency virus. Their reasons for discomfort were examined.
A Tool to Evaluate How to Learn from Experience in Clinical Settings
Authors: Dumas Louise , Villeneuve Jean , Chevrier Jacques
Published: April 2021

ABSTRACT

The purpose of this study was to develop and validate an evaluation tool for the process of learning from experience in a clinical practicum at the post-RN baccalaureate level. This complex process, consisting of integrated cognitive, affective, and behavioral components, is the basis of a person's "good functioning" in a learning environment. To assess the process of learning during a clinical experience provides adult students with a mirror of thenown way to learn from their particular experience; the results can then enhance their abilities of learning-how-to-learn from any experience. The tool was developed during doctoral research following the works of Kolb (1984) and Chevrier and Charbonneau (1990, 1991a, 1991b). The psychometric evidence of the tool supports its initial value as a component of an integrated formative evaluation strategy. This reflective type of process evaluation helps students link theory to practice, think critically, and intervene creatively and professionally in very complex situations.
The Development and Testing of a Community Health Nursing Clinical Evaluation Tool
Authors: Hawranik Pamela
Published: April 2021

ABSTRACT

This article describes the process of developing and testing a clinical evaluation tool for a community health nursing course in a baccalaureate program for registered nurses. The study was qualitative with a multimethod approach to data collection. The development of the tool included collaboration with community health nurses from urban and rural areas within the province of Manitoba, faculty, and students who were currently enrolled in the community health nursing course. Development of the tool consisted of a review of the literature and focus groups with community health nurses and faculty. A list of behaviors deemed important was derived. Construct validity of the behaviors was tested using a number of strategies with the students, clinical advisors, faculty, and agencies. Testing for item clarity and apparent internal consistency followed. The evaluation tool was pilot-tested and the outcomes of its use are discussed.
Learning to Care for Clients in Their World, Not Mine
Authors: Ryan Marilyn , Twibell Renee , Brigham Carole , Bennett Patricia
Published: April 2021

ABSTRACT

Current literature and trends support the need to incorporate concepts for culturally focused nursing care and experiences with diverse cultures into nursing curricula. The purposes of this qualitative research were to describe the phenomena of being immersed in a different culture and to generate a conceptual map depicting process and outcomes of the immersion experience. From analysis of stories told by practicing nurses (n=9) who had an immersion experience during a baccalaureate program, a dimensional matrix emerged. The core dimension was learning to care. Situational predetermining factors included educational setting, personal characteristics, and demographic factors. Characteristics of the immersion context were site conditions. Transitional factors included strategies for "learning to care" such as social support, coping responses, and openness to adapt communication patterns. Outcomes included personal and professional growth in values, communication, and nursing practice. The matrix can guide nurse educators in incorporating immersion experiences into nursing curricula.
Clinical Nursing Competence of RN-to-BSN Students in a Nursing Concept-Based Curriculum in Taiwan
Authors: Lee-Hsieh Jane , Kao Chihui , Kuo Chienlin , Tseng Hung-Fu
Published: April 2021

ABSTRACT

This 3-year longitudinal study used a questionnaire to evaluate the clinical nursing competence of RN-to-BSN students in a nursing concept-based curriculum in Taiwan. The research sample consisted of 52 full-time and 69 part-time RN-to-BSN students. A four-dimensional Clinical Nursing Competence Questionnaire was developed to measure student caring, communication/coordination, management/teaching, and professional self-growth competence. Results indicated full-time students' scores on self-evaluations of overall clinical nursing competence significantly increased with each successive evaluation (p < .05). The scores of part-time students fell significantly with successive evaluations, with the exception of professional self-growth competence (p < .01). Instructor evaluations generally showed no significant difference between the two groups. Student self-evaluations were significantly higher than instructor evaluations (p < .05). The results of this study may serve as a reference for nurse educators developing curricula for RN-to-BSN education.
Lights! Camera! Action!: Video Projects in the Classroom
Authors: Epstein Carol Diane , Hovancsek Marcella T , Dolan Pamela L , Durner Erin , La Rocco Nicole , Preiszig Patricia , Winnen Caitlin
Published: April 2021

ABSTRACT

We report on two classroom video projects intended to promote active student involvement in their classroom experience during a year-long medical-surgical nursing course. We implemented two types of projects, Nursing Grand Rounds and FPBTV. The projects are templates that can be applied to any nursing specialty and can be implemented without the use of video technology. During the course of several years, both projects have proven effective in encouraging students to promote pattern recognition of characteristic features of common illnesses, to develop teamwork strategies, and to practice their presentation skills in a safe environment among their peers. The projects appealed to students because they increased retention of information and immersed students in the experience of becoming experts about an illness or a family of medications. These projects have enabled students to become engaged and invested in their own learning in the classroom.
Persistence of the Primary Vitreous in Association with the Morning Glory Disc Anomaly
Authors: Brown Gary C , Gonder John , Levin Andrew
Published: April 2021

ABSTRACT

Two patients with the morning glory disc anomaly are reported. In one, fibrovascular stalk passed forward into the vitreous cavity, while in the second a persistent hyaloid artery extended anteriorly from a tuft of fibrous tissue to the posterior lens capsule. These cases suggest that in some eyes the morning glory disc anomaly occurs as a variant of persistent hyperplastic primary vitreous (PHPV).
The Role of Retinal Cryopexy in the Management of Experimental Perforation of the Eye During Strabismus Surgery
Authors: Mittelman David , Bakos Irene M
Published: April 2021

SUMMARY

In order to investigate the role of retinal cryopexy in the management of accidental perforation of the globe during strabismus surgery, the retinas of 30 rabbit eyes were perforated with a needle simulating the clinical incident. Ten of these eyes received no further treatment, ten eyes were treated with moderate transscleral cryopexy of the surrounding retina, and the remaining ten eyes were treated with excessively heavy cryocoagulation. The incidence of secondary retinal detachment was identical in the first two groups of rabbits, while it was markedly increased in those rabbits treated with excessively heavy transscleral cryopexy (P < .01). Based on these findings and a review of the literature, recommendations are made for the management of accidental perforation of the globe during strabismus surgery.
Role of the Neural Crest in Anterior Segment Development and Disease
Authors: Beauchamp George R , Knepper Paul A
Published: April 2021

ABSTRACT

Certain eye and associated systemic developmental anomalies are apparently related by virture of a common neural crest origin. The development of the anterior segment is extremely complex and is dependent upon the presence or absence of certain local factors (including extracellular matrices and glycoproteins), inductors, receptors, and specific time sequencing. Understanding anterior segment anomalies and their systemic associations requires an understanding of neural crest proliferation and migration patterns; and they may be unified under the designation of neurocristopathies. Goldenhars syndrome, not previously considered a neurocristopathy, may be considered one on the basis of the relationship between clinical findings and neural crest embryology.