Thesis (M. Nurs.)--University of Hong Kong, 2005.

Thesis (Ph. D.)--School of Nursing. University of Missouri--Kansas City, 2006. / "A dissertation in nursing." Advisor: Thad Wilson. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed Jan. 29, 2007. Includes bibliographical references (leaves 213-230). Online version of the print edition.

M.Tech. / Palpation is a skill taught to manual practitioners on a daily basis. This skill is used by health care professionals, including chiropractors, to examine patients complaining of spinal pain. It is the chiropractor’s responsibility to have the ability and experience to locate and identify individual spinal levels, as well as any changes in tissues affected, to accurately diagnose and treat their patients (Downey, Taylor and Niere, 1999). The inability of the therapist to have this skill, can lead to incorrect diagnosis, and in turn, incorrect treatment being provided (Downey et al, 1999). Numerous research studies have been conducted to determine how significant clinical experience is in terms of reliable palpation being achieved. Researchers such as Koran (1975) and McConnell (1980), Simmonds and Kumar (1993), McKenzie and Taylor (1997), Burton and Edwards (1990) have all been unable to support the hypothesis that experience plays a significant role in improving inter-examiner or intra-examiner reliability in their research studies. This study aims to determine the inter-examiner reliability of locating the spinous process of the seventh cervical vertebra by palpation, and to explore the role that clinical experience plays upon efficacy. Thirty participants were recruited to become part of this study. The 6 examiners chosen consisted of two 5th year and two 6th year chiropractic students as well as two qualified chiropractors. A random allocation was used which ensured that every participant was examined by 3 examiners, each from the different clinical experiences. Examiners were provided with instructions before proceeding with the study. Each participant was palpated to locate the C7 spinous processes and once located, the level was marked with a UV pen. The UV marks were located by illuminating with a UV light and these were replaced with metal markers. Each participant was then positioned to have both the AP and lateral x-ray views done. vii Once all participants were x-rayed, horizontal lines were drawn through the C7 spinous processes and metal markers on both the AP and lateral x-ray films. Distances from the lines through the spinous processes to each metal marker, were measured. The provided statistical tests were used to analyse the data. According to the Pearson Chi-square test used, there was no statistically significant difference amongst all examiners on the ability to correctly palpate, locate and mark the C7 spinous processes. Results further showed that the 6th year students correctly identified more levels on the AP x-ray films, whilst both 6th year students and the qualified chiropractors correctly located more and equal levels on the lateral x-ray films. This study showed that there were difficulties amongst all examiners across all levels of clinical experience and this important role of experience is therefore not fully understood.

M.Tech. (Chiropractic) / The most accepted method of identifying the second sacral spinous process is by using an accepted landmark known as the Posterior Superior Iliac Spines (PSIS). The PSIS lies about 4cm lateral to the second spinous tubercle of the sacrum (Williams and Warwick, 1980). However, in a search of published work, no evidence could be found of any study which established these generally accepted statements (Stonelake, 1983). This was an inter-examiner reliability study aimed to determine whether palpation of the PSIS was a reliable and accurate method of determining the location of the second sacral spinous process (S2) in participants experiencing lumbosacral joint dysfunction. Thirty participants were marked by three examiners in the prone position using the PSIS to locate S2. An x-ray was taken of each participant in the prone position, after being marked by all three examiners. Measurements were then made on the x-rays to assess the location of the markers on the sacral anatomy. The reliability. of palpation of anatomical landmarks needs to be validated further in future studies, as motion palpation and the palpatory assessment of effectiveness of treatment, applied to correct motion restrictions, are predicted- upon accurate localisation of anatomical landmarks (O'Haire and Gibbons, 2000).

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand for the Degree of Doctor of Philosophy Johannesburg, 2017. / Simulation laboratories help students build a strong foundation of clinical competence in an environment that is stress free prior to clinical placements. A number of Investigations regarding simulation impact in college-based training institutions in developed countries have taken place. However, there is paucity of such research from nursing education institutions in developing countries. With this in mind, an evaluation study was conducted to assess how clinical teaching, learning and the OSCE method of evaluation are experienced from the nurse educators’ and students’ perspectives in the skills laboratory. Additionally, the study sought to determine the effect of the Formative Assessment Framework for learning in the skills laboratories. The specific objectives were to explore the students and educators’ perspectives of teaching and learning and describe how the current mode of assessment, namely, the OSCE is experienced. From these perspectives, the researcher extrapolated the factors and issues that affect students’ clinical learning and the OSCE. Finally, the objective was to develop, validate, implement and evaluate the impact of a Formative Assessment Framework (FAF) by determining and comparing students’ competence in selected general nursing and midwifery skills between and within the experimental and control groups. A sequential, mixed methods design was chosen, starting with a qualitative approach in phase 1 followed by a quantitative approach using a quasi-experimental design in phase 2. In phase 1, in-depth and focus group interviews were used to collect data from nurse educators (n=6) and students (n=45). Data were organized and managed with the MAXQDA software version 11 and were analysed thematically. The synthesis of the teaching, learning and evaluation gaps with input from the literature reviewed on concepts of formative assessment and deliberate practice supported the development of a Formative Assessment Framework (FAF). The FAF involved a minimum of 2 demonstrations on each procedure before and after practise sessions, a minimum of two supervised return demonstrations, feedback and supervised practise. Nursing education experts validated the FAF using the Delphi technique. Quantitative data from the senior students (n= 101) and junior students (n= 160) was collected using the FAF. Data was collected using structured checklists from the eighteen selected nursing and midwifery procedures. Pre and post-testing of the students’ performance and competence was tested. Quantitative data were analysed using the STATA software version 13. Qualitative findings showed that demonstrations and return demonstrations contribute effectively to students teaching and learning in the skills laboratories. The practise sessions, presence of the nurse educators and availability of resources make the learning environment more conducive than teaching and learning in the practice sites. However, students have limited practise sessions, which seriously affect teaching and learning in the skills laboratories negatively. In terms of the OSCE, the method is good because the environment resembles the clinical setting; it is appropriate for large student numbers and ensures standardization of the examinations. However, the preparation for the OSCE is inadequate. Quantitatively, the paired t-tests, Wilcoxon sum rank and Wilcoxon, sign rank tests, were used to test the results. Usage of a formative assessment framework had a significant effect on senior students’ clinical performance in physical examination of a pregnant woman, the triage process in under five clinic, contraceptive implant insertion, contraceptive implant removal, breast examination, episiotomy repair, management of the third stage of labour, subsequent examination of the newborn and speculum examination procedure among the junior students. There were also significant effects on the junior students’ performance in the procedures of blood transfusion, female catheterisation, health education, and insulin intravenous injection, naso-gastric tube insertion, airway suctioning and wound dressing except on colostomy care. The mean differences between the control and experimental groups for most of the tested procedures were significantly different. The results were statistically significant with a p-value of <0, 05, set at 95 % confidence intervals. In conclusion, the integration of the FAF in students’ learning in the skills laboratories has the capacity to improve the student’s clinical performance and competence. The use of the FAF has the capacity to prepare a student adequately for the summative OSCE in the skills laboratory and ultimately, his/her clinical competence for better patient and client care. / MT2017

A Standardized Patient (SP) is a trained actor who portrays a particular illness to provide training to medical students and professionals. SPs primarily use written scripts and additional paper-based training for preparation of practical and board exams. Many institutions use various methods for training such as hiring preceptors for reenactment of scenarios, viewing archived videos, and computer based training. Currently, the training that is available can be enhanced to improve the level of quality of standardized patients. The following research is examining current processes in standardized patient training and investigating new methods for clinical skills education in SPs. The modality that is selected for training can possibly affect the performance of the actual SP case. This paper explains the results of a study that investigates if there is a difference in the results of an SP performance assessment. This difference can be seen when comparing a virtual human modality to that of a pre-recorded human modality for standardized patient training. The sample population navigates through an interactive computer based training module which provides informational content on what the roles of an SP are, training objectives, a practice session, and an interactive performance assessment with a simulated Virtual Human medical student. Half of the subjects interact with an animated virtual human medical student while the other half interacts with a pre-recorded human. The interactions from this assessment are audio-recorded, transcribed, and then graded to see how the two modalities compare. If the performance when using virtual humans for standardized patients is equal to or superior to pre-recorded humans, this can be utilized as a part task trainer that brings standardized patients to a higher level of effectiveness and standardization. In addition, if executed properly, this tool could potentially be used as a part task trainer which could provide savings in training time, resources, budget, and staff to military and civilian healthcare facilities.

Background: The definition of mental illness is characterized by a lack of management regarding mood, thoughts or behavior. It is difficult for the person to cope with everyday duties as well as relationships with other people. The study revealed that the society should take action to prevent social isolation for those with mental illness. The central concepts of care theory is love, learning and well-being, where nurses' conditions and actions create results in the patient. Aim: Describe skills and prerequisites nurses need at the meeting of patients with mental illness. A further aim was to examine the ethical considerations included studies made use of. Method: A descriptive literature study Main result: Nurses feel they do not have skills regarding mental illness. When nurses care for patients with mental illness are often formed stigmatizations regarding these patient groups and care will suffer. That creates difficulties in dealing with situations where patients' mental health problems are preventing optimal care efforts. The nurses felt that the general nursing care was better if the right knowledge and training in mental health raised further. Conclusion: Nurses need increased knowledge and training regarding mental illness in order to have skills and opportunities.

Thesis (Ph.D.) -- Australian Catholic University, 2006. / Submitted in partial fulfillment of the requirements of the degree of Doctor of Education, School of Educational Leadership, Faculty of Education. Bibliography: p. 229-248. Also available in an electronic format via the internet.

Thesis (Ph. D.)--Open University. BLDSC no. DX199046.

Thesis (M.S.)--University of Wisconsin--Madison, 1986. / Typescript. Thesis approval page has authors' names reversed. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 195-201).