The post-9/11 security environment is one that confronts the United States, and specifically the U.S. Army, with complex problems that require development of leaders with improved knowledge, skills, and attributes to meet the challenges of defending the nation. The problem confronting the U.S. Army is that Army leaders lack a learning environment or methodology that enables effective self-development throughout their career. Research suggests that PLNs (PLNs) and a connectivist approach may address that problem, but these have been limited to civilian educational environments. This qualitative case study explored the use of PLNs with a connectivist approach for leader self-development in Army organizations. The case in this study was that of a cohort of 22 officers in a U.S. Army unit. Each officer developed a PLN and then employed a connectivist approach to connect, curate, create, and share knowledge. Data were collected using semistructured interviews and analyzed with a focus on themes that could inform future decisions by Army senior leadership on the self-development of leaders, and that could enable decisions that will reduce loss of life and destruction in wartime. The major themes developed in this study account for the approach and challenges to Army self-development, the motivation for and execution of connected learning, and the structuring and desired characteristics of self-development that employs PLNs and connectivism. Recommendations included integrating a semistructured approach to self-development into emerging educational approaches to Army leader development. More prepared Army leaders can respond to crises more effectively, reducing adverse effects, damage, and loss of life

The nurse practitioner (NP) role transition is difficult and ill-supported before and after graduation. Although preceptorships are essential in supporting a NP's role transition, there is a paucity of data on student and novice NPs' experiences with their role transition and how it is supported through preceptorships. The purpose of this hermeneutic phenomenological study was to understand and describe the meaning of NPs' role transition experiences while in a preceptorship before and after graduation. Schlossberg's transition theory and the cognitive apprenticeship models were used to guide the exploration of concepts of role transition and preceptorship. One face-to-face, 3 Skype, and 12 phone interviews were conducted with NPs who were currently practicing in the NP role (>3 months but <5 years) in those states that require collaborative practice agreement. Transcribed interviews were coded using Van Manen's analysis strategies. Findings suggested that NPs' difficult transition to practice was related to their preceptorship support in NP school and in NP work settings. The data showed ill-supported preceptorships when in NP programs. Lack of preceptorships after the graduation was accompanied by employers' expecting novice NPs to function at an expert level, frequently with minimal guidance. Understanding how NPs transition to practice and how their role transition is supported through preceptorships can be used to inform NP educators and organizations that hire NPs of the changes needed to strengthen NPs' role transition. These findings may promote positive social change by guiding stakeholders to improve the NP role transition, which could, in turn, increase NPs' autonomy, retention, and job satisfaction.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) disproportionately affect African Americans in the South; given that population's high rate of church attendance, churches have been one potential avenue for HIV/AIDS education. Research has shown the importance of HIV/AIDS education in reducing risk behavior and infection, although church-based HIV/AIDS prevention programs for adults have received little scholarly attention, including the impact of such programs on attitudes, behavioral control, and intention to engage in safe sexual practices. Using Ajzens' theory of planned behavior as a foundation, the purpose of this quantitative study was to explore whether there is a statistically significant difference in attitudes, behavior control, and intention to engage in safe practices as a result of participation in a church program. Survey data were collected from a convenience sample of 132 adult participants, 68 of whom participated in a church-based HIV/AIDS prevention program, and a control group of 64 participants from a congregation without a program. Wilcoxon Ranks Tests were used to analyze the data. The results indicated a statistically significant difference between the experimental and control groups in regards to social norms and perceived behavioral control. There was no significant difference in the attitudes between the 2 groups. Implications for positive social change include informing policy makers and practitioners of the importance of church-based HIV/AIDS prevention programs as an innovative tool for adults to establish more effective HIV/AIDS prevention programs that will positively impact other ethnic groups at higher risk of acquiring the infection and disease.

Educators at a public high school in Southeastern United States depend on mentor teachers to minimize the attrition rate among beginning teachers, yet the strategies implemented by mentors lack definition and clarity. The purpose of this study was to explore mentor teachers' perceptions of effective mentoring strategies and their needs when mentoring new teachers. Maslow's humanistic learning theory guided this bounded basic qualitative study. The research questions focused on the mentoring strategies mentor teachers perceived as effective and the needs of the mentors. Ten high school mentor teachers, who currently mentor new teachers, were purposefully selected to participate in individual and focus group interviews. Precoding, open and axial coding were used to inductively analyze the data. The results showed mentors promote school culture, are a source of information, build relationships, use data to drive discussion, provide opportunity for reflection, conduct observations, connect theory with practice, and model professional behavior as effective strategies. Mentor teachers indicated that effective communication is crucial when mentoring new teachers. Additionally, they need specific skills to help beginning teachers better understand the reality of teaching and address their unrealistic expectations of the profession. Based on the findings a 3-day professional development for mentor teachers was developed to address mentors' needs. This endeavor may contribute to positive social change when district administration provides mentor teachers with professional development to enrich their mentoring strategies which in turn may address the challenges new teachers experience and reduce the attrition rate.

The death of a neonate is a life-changing and tragic experience for the individuals involved in the final moments of the infant's life. As the frontline provider in this clinical scenario, the bedside nurse supports the patient and family through their individual journey of loss. If the nurse does not possess the palliative care educational background and communication skills to support this unique care delivery process, the journey of death can evolve into a particularly negative experience for the parents and the nurse. This specific delivery of care concern was identified and gleaned from a parental bereavement exit interview after the loss of an infant in the neonatal intensive care unit (NICU) at Arkansas Children's Hospital (ACH). Due to the lack of educational preparation, the NICU nursing staff members had demonstrated inexperience, awkwardness, and insecurity in their provision of the end-of-life care activities and family support interventions. The purpose of this doctor of nursing practice project was to develop an evidence-based neonatal palliative care educational program to support the NICU nursing staff and families at ACH. The educational program is multimodal in approach to address the cognitive, affective, and psychomotor domains of adult learning through the use of palliative care informational modules, videos, and simulation training. The clinical outcome of this new palliative care educational program will promote a positive change in the NICU nursing staff's clinical practice during the provision of nursing care when faced with neonatal end-of-life situations at ACH. This capstone project on adult education should be read by professional frontline nursing staff who care for these fragile patients in the specialized intensive care world of neonatology.

The Premier Technical College of Qatar (PTC-Q) has seen high failure rates among students taking a college statistics course. The students are English as a foreign language (EFL) learners in business studies and health sciences. Course delivery has involved conventional content/curriculum-centered instruction with minimal to no interactive components. The purpose of this quasi-experimental study was to assess the effectiveness of an interactive approach to teaching and learning statistics used in North America and the United Kingdom when used with EFL students in the Middle East. Guided by von Glasersfeld's constructivist framework, this study compared conceptual understanding between a convenience sample of 42 students whose learning experience included a hands-on, interactive component and 38 students whose learning experience did not. ANCOVA was used to analyze posttest scores on the Comprehensive Assessment of Outcomes in Statistics (CAOS) as the dependent variable, the course placement (hands-on versus no hands-on component) as the independent variable, and the pretest score on CAOS as the covariate. Students who were exposed to the hands-on learning demonstrated greater conceptual understanding than students who were not. Based on these results, a 3-day workshop was designed to create a learning community to enable statistics instructors to address the problem of high failure, to introduce delivery methods that involve place-based examples, and to devise hands-on activities designed to reflect authentic research. This study has implications for positive social change in Qatar, in that application of the findings may result in producing trained graduates capable of filling the shortage of qualified researchers, thereby supporting the nation's goal of being a leader in research as stated in the Qatar National Vision 2030.

Previous studies and official organizations have indicated that African Americans are underrepresented in the healthcare workforce and that patients belonging to minority groups feel they are treated slightly differently in healthcare settings. Limited research examines perceptions of the nursing profession among a variety of demographic groups, and exploratory investigations into the perceptions of nursing as a career by African Americans are limited. The purpose of this quantitative descriptive study was to explore perceptions of nursing as a career by African American students who attend an undergraduate program at a historically black college or university (HBCU) in an attempt to further explain the shortage of African American healthcare professionals. Gottfredson's theory was used as a framework for this study. Gottfredson's theory explains career choices and gives an explanation based on three social determinants, namely gender, interest, and prestige. Two hundred ninety-five African American college students were asked to complete a Career Values scale survey from the tool Measuring Attributes of Success in College Students to collect data from African American college students to assess their attitudes toward the nursing profession. Findings revealed that nursing was perceived favorably regarding job prospects and prestige, but negatively regarding working conditions and status. Independent samples t tests indicated a statistically significant mean difference in perceived nursing prestige and status between men and women, M = -.32, 95% CI [-.52, -.12], t (246) = -3.13, p = .002, d = -0.40. This study may contribute to positive social change through raising awareness regarding the need for additional African American nurses in the healthcare system.

Healthcare agencies and stakeholders expect registered nurses to be competent at all times. When nurses are not confident in competencies, negative patient outcomes can occur. The purpose of this quantitative quasiexperimental with posttest only study was to investigate Quality and Safety Education for Nurses (QSEN) competency confidence levels of 2 groups of new nurses who had 5-6 months of clinical experience. Framed by the Duchscher theory and the QSEN framework, the research question was developed to examine the differences between QSEN competency confidence levels of new nurses who participated in a prelicensure program plus a residency program and nurses who only attended the residency program. Sixty-eight new nurses from 1 health facility answered the Nursing Quality and Safety Self-Inventory (NQSSI). An independent t test was used to compare each knowledge, skills, and attitudes (KSA) QSEN competency confidence levels for two groups. The results of this study demonstrated a difference between QSEN competency confidence levels between the 2 groups, but not all 18 NQSSI items reached a statistically significant difference. The 7 items that reached a statistically significant difference included the QSEN competency confidence level in knowledge and skills in evidence-based practice, quality improvement, and informatics. A statistically significant difference was also noted in the QSEN competency confidence level for patient-centered care skills. A 3-day professional development (PD) workshop was developed based on the results. Participating in the PD workshop could further increase the new nurses' QSEN competency confidence levels which can enhance patient outcomes resulting in positive social change.

A training program was established in the Midwestern United States to help employers understand compliance requirements of the health insurance industry. The purpose of this study was to conduct a modified program evaluation of the effectiveness of Pay or Play, a portion of a larger Benefit Compliance Program. The reason for the evaluation was the high percentage of remediation needed for administrators of employee health insurance following Pay or Play seminar sessions, which posed the question of program effectiveness in education of participants. This study is important because administrators of employee health insurance are responsible for understanding compliance regulations and face penalties for noncompliance. The theoretical frameworks of constructivism, andragogy, and critical thinking and the conceptual framework of responsive program evaluation were used to guide the study. Document analysis of seminar materials and interviews were conducted with a sample of 12 volunteer seminar participants needing remediation from the school administration and business. Interviews and documents were manually coded and analyzed to identify themes. Findings included lack of variety of teaching methods and training materials appropriate for adult learners, a lack of engagement in critical thinking, and a lack of active construction within their own learning. Recommendations were made for changes in the facilitation methods and presentation of materials to support more effective training for adult participants. The implications of this study for positive social change include more effective training of employers on compliance regulations, which could result in greater understanding of government regulations of the health insurance industry, fewer cancellations of insurance coverage, and more effective implementation of benefits policy.

Today's college students are diverse and include students who differ in chronological age and developmental learning levels. This recent shift in student demographics, including millennials and adult learners, has created a need for instructors to understand and address their students' learning preferences. Traditionally, student feedback has been collected from course evaluation forms after each term ended, thus preventing instructors from incorporating student feedback into their teaching. Accordingly, this narrative qualitative case study was conducted to explore what instructional methods students in a community college developmental reading course preferred to meet their learning preferences and classroom needs. Willingham's interpretation of informational processing theory that reinforced instructional reading comprehension strategies framed this study. Sampling was purposeful, and criterion-based logic was used to determine the participants. Participants ranged in age from 18-43 and were enrolled in 1 section of a developmental reading course. Data were collected through 8 student interviews, 3 classroom observations, and the participating instructor's lesson plans as an alternative to using course evaluation forms. Data were analyzed using open and axial coding. Findings indicated that students preferred when their instructor used active approaches to learning. Findings also indicated that students preferred receiving instruction that met the needs of their different learning styles. Findings contributed to social change as understanding students' learning preferences may assist instructors with incorporating teaching methods to promote improved support to students in developmental reading courses.