<p> In the current health care environment, caring for the increasing numbers of seriously ill patients require novice nurses to use advanced, intuitive clinical decision-making skills like those of more experienced nurses. Educators are charged with developing instructional strategies to enhance clinical decision-making skills. The purpose of this quantitative study was to investigate the relationship between simulation as an instructional strategy and the use of intuition in clinical decision making among associate degree nursing students. In addition, the influence of age on student performance during simulation and the use of intuition in clinical decision making was examined. An explanatory, correlational design was conducted to examine the relationship between simulation, as measured by the Creighton Simulation Evaluation Instrument (Todd et al., 2008) and the use of intuition in clinical decision making, as measured by Rew&rsquo;s (2000) Acknowledges Use of Intuition in Nursing Scale. Results from the study found a slight but statically significant relationship between simulation and the use of intuition and no relationship between age and the use of intuition. Indications for future research include further analysis of the concept of intuition and its role in clinical decision making.</p>

There is widespread concern over the high levels of reported work-related stress, job dissatisfaction and psychological distress associated with teaching and the effects of stress on teacher's sense of well-being and their willingness to stay in the profession (Borg, 1990; MSLAT, 1996; Troman, 1998; Schonfeld, 1990; Wilson, 2002). Much of the traditional research on teacher stress has been carried out by external 'experts' using quantitative survey type approaches to analyze occupational stress levels resulting in restrictive data analysis unrepresentative of the true picture of stress in the teaching profession. Researchers have advocated a more holistic approach incorporating mixed methods combining both qualitative and quantitative methods in order to gain subjective teacher reports of stress and coping mechanisms resulting in a fuller picture on teacher stress with future recommendations grounded in research. Recently, the reflective practice movement in healthcare (eg:-Boswell, 2007) has suggested using a more integrative approach to advance practitioner knowledge and empower them to improve practice through reflection to create an understanding ofthe issues within a local context. My research was particularly interested in the issues relating to teacher stress including the way teacher stress was being measured and the effectiveness of qualitative over quantitative methods, the inclusion and exclusion practices of disruptive students and the use of practitioner research to encourage teacher collaboration as a way of dealing with teacher stress. Practitioner-Research methodology has been successfully adopted in Nursing and Health-Care and has recently been used in Education with mixed findings some successfully advocating p-r while other research was hampered by bureaucracy and top-down managerial agendas. In relation to this a single UK Secondary school was researched as a case study by the investigator who taught Sixth formers A'level Psychology at the school. The research was conducted in phases using a qualitative multimethod approach incorporating triangulation to include staff, students and researcher reflections about practice in order to encourage staff collaboration, empowerment and meta-cognition. A reflexive stance was thus adopted to underpin the research methodology. Semi-structured qualitative interviews were conducted on 20 teachers (varying levels, ages and mixed gender) to assess the proposed research objectives. Classroom observations and student interviews were carried out for a year 10 class to complete the data collection. The findings revealed how students felt caught up in a selffulfilling prophecy with teachers seeing them negatively, leading to a spiral of failure and lack of motivation and the teacher interviews with both newly qualified and experienced teachers, uncovered how different coping strategies were used to deal with disruption, classroom and task management in general. The most important findings came from middle managers who claimed there was poor communication between senior tiers and lower teaching tiers with a strong sense of bureaucracy ruling their decisions. In order to bridge this gap, the practice development phase of the research tried to establish collaborative meetings in order to encourage teachers from all levels to self-reflect, deal with problematic issues and action research solutions of teaching practices. The Senior Management Team (SMT, including the Head) did not encourage staff or the researcher to proceed further with the final phase and the research was abruptly halted. Despite this, I believe that practitioner-research is a viable methodology in education research as it gives 'ownership of knowledge' to the practitioner using a self-reflexive stance to increasing their evidence-based practice resulting in a growth in meta-cognition to make improvements in practice. I feel, we need to increase insider research and use Action Research spirals and collegial collaboration as a wayforward.

Background: Breastfeeding is recognised as the optimal feeding method, conferring short and long term benefits to infants and their mothers. In the UK some women do not initiate breastfeeding. Many commence formula milk feeding at birth or after a brief period of breastfeeding. Often women have decided how to feed their infants before conception or even during adolescence, prior to when infant feeding education has traditionally been provided. Negative attitudes to breastfeeding amongst some social groups, and lack of familiarity with the practice appear to contributing factors. This research has explored infant feeding awareness of children in primary schools as a first step towards informing appropriate health education interventions. Methods: Fifty six children aged 5/6, 7/8 and 10/11 years were recruited to the study from 3 schools in rural and urban areas of Southern England. Children were shown a series of drawings, and read a story about a hungry baby. They were asked to finish the story, showing how they thought the baby was fed, using the ‘draw, write and tell’ method, developed as an adaptation of ‘draw and write’. The children produced one or more pictures, often with text, and were offered the opportunity to talk about their work; the data were united in a ‘commentary’. Codes emerged, which were combined into categories. Mapping and charting techniques were used to identify five key areas for discussion. Results: The development, and flexibility, in children’s ideas regarding infant feeding was noted. Whilst breastfeeding was identified by some children, breastfeeding terminology and imagery were problematic for many. The prevalence of feeding bottles and references to formula milk were striking, with children identifying these as equivalent to breastfeeding. Solid foods were frequently referred to by children, and seemed to be identified with formula milk feeding rather than breastfeeding. Conclusions: For the first time this study identified primary school children’s awareness of different feeding methods and the inter-relationships between these methods. It appeared difficult for children to view breastfeeding as normal, perhaps because it is rarely seen or discussed, and formula milk feeding is so prevalent. The children were interested in the subject and it is anticipated that infant feeding education with these age groups would be beneficial. Introducing children to breastfeeding needs to be achieved with care and sensitivity, using language and imagery with which they are confident. In addition, the efficacy of ‘draw, write and tell’ and the challenges of using this method are discussed.

<p> Research has clearly defined the issue of nursing student incivility, with evidence that uncivil encounters are on the rise and occurring on a routine basis. The rise in incivility among nursing students is causing great concern for nurse educators and administrators alike. For this reason, it is necessary to determine the reason why the issue persists, despite efforts to manage it. This mixed-methods convergent parallel design study examines the relationship between the coping responses and perceptions about nursing student incivility among nurse educators in the southern region of the United States. The Transactional Model of Stress and Coping (Lazarus &amp; Folkman, 1984) forms the foundation of the study, which seeks to determine whether there is a correlation between the appraisals of stressful situations, like incivility, and the activation of coping responses. The model posits that individuals conduct a primary appraisal of the threat associated with a stressful encounter. If the encounter is deemed to be threatening, a secondary appraisal takes place to determine which coping response would best alleviate the stress. When no coping response is activated, no action is taken. Nurses are known to use negative coping responses like conflict avoidance when faced with stressful encounters; therefore, the chosen coping responses of nurse educators could be propagating the issue of nursing student incivility.</p>

<p> Aim &amp; Objective: The aim of this project is to review the background literature and discuss the PICOt question as follows: In adult nursing students, age 30+, who are experiencing anxiety in the clinical setting, does peer dyad mentoring support in the clinical setting enable these students to decrease their anxiety level and pass their clinical effectively over a 90 day period of time?</p><p> Background: Clinical experience is an integral part of nursing education and prepares students nurses to integrate knowing with doing. Anxiety can cause a disruption in the learning and professional functioning of the student, and subsequently of the graduate nurse. Further to this, many non-traditional mature nursing students are adults entering the college or university setting with life experience unrelated to their new nursing career. They are attempting to balance work, home and school responsibilities. This anxiety has a variety of causes and also appears to have a variety of solutions.</p><p> Design: This project is a mixed method analysis, which contains both quantitative and qualitative aspects. Participants in the project were a convenience sample of Nursing students age 30+, in the BSN program at California State University Sacramento, willing to partake in this intervention, to assist in reducing their anxiety level during clinical. The project engages the use of true peer dyads (students at the same level of education) for the purpose of collaborative learning in the clinical setting. All subjects were given pre- and post-tests consisting of the State form of the State-Trait Anxiety Inventory (STAI). The State-Trait Anxiety Inventory for Adults&trade; (STAI-AD) is the definitive instrument for measuring anxiety in adults. The participants also completed a written qualitative interview guide at the end of the semester. </p><p> Results: The mean score of the STAI Anxiety Scale shows a definite decrease in anxiety after the peer dyad intervention in clinical. Of interest is the fact that the trait anxiety level also decreased in the final measurement. All sixteen mature students completed the peer dyad experience. The overall quantitative response to the peer dyad experience in clinical was a positive one according to the mature students involved.</p><p> Conclusions: Nursing students, are stressed and anxious in both the clinical setting (State anxiety) and appear to be more anxious in general (Trait anxiety). Formalized peer learning can decrease anxiety, help students learn effectively and is an important addition to the repertoire of learning activities that can enhance the quality of nursing education. Meeting the present and future challenges of educating nurses will require innovative models of clinical instruction, such as collaborative learning using student peer dyads.</p>

<p> To ensure optimal patient care an especially high level of accountability is required when entering the workforce. The purpose of this qualitative study was to explore, describe, and define perceptions of accountability as described by sophomore and senior nursing students in two baccalaureate nursing programs. The research questions aimed to (a) define what it means to be accountable as a student in general and a nursing student in particular (b) describe the importance of accountability to the profession of nursing (c) describe the circumstances and conditions that demand accountability, and (d) engage in actions that promote self-accountability. After obtaining IRB approval, the researcher explained the study to the sophomore and senior nursing students who agreed to participate in the research. Eighteen participants were interviewed. </p><p> Six questions were asked during interviews conducted to investigate perceptions of accountability. Content analysis was used to discern the essence of the narratives, from which nine themes emerged. The nine themes identified are: Difficulty defining accountability and the interchangeable use of the terms; accountability and responsibility; emerging knowledge; focus on work of nursing; student attention to tasks and outcomes; motivation/self-discipline; student stress and sources of stress; conditions for accountability and responsibility, and faculty actions; and promoting self-accountability and accountability to others. </p><p> Study findings suggested that this group of students understood the importance of accountability but were unable to verbalize a definition, often confusing accountability with responsibility. Students perceived that faculty played a role in their academic success; students also promoted accountability in faculty and in peers who were less successful academically.</p><p>

<p> This research study was designed to examine accelerated, second-degree prelicensure baccalaureate graduates&rsquo; perceptions of the andragogical practices employed by faculty that prepared students best to begin practice as entry level professional nurses. The study further sought to identify the ways in which andragogical practices used by faculty incorporated the students&rsquo; prior learning and life experiences as they accrued knowledge of the art and science of nursing. It was anticipated that through the processes of interviewing and listening to the voices of graduates, that an emic perspective of the perceptions of the graduates would emerge. Analysis and interpretation of the results of this study demonstrated six key themes related to the educational experience. Perhaps most significantly, findings revealed that elements external to teaching strategy such as faculty attributes and program design influenced learning significantly for the study participants. This research adds to the existing body of literature related to the education of accelerated, second-degree prelicensure baccalaureate students. Findings of this study can be used to inform faculty about best practices for teaching this particular cohort of students who seek nursing as an alternate career and assist with innovative curricular designs to meet the needs of this unique group. Keywords: accelerated nursing programs, nursing education, second-degree students, teaching practices </p>

<p> This quantitative correlational, descriptive study examined what relationships exist, if any, between clinical design and implementation of nursing clinical curriculum with National Council Licensure Examination for Registered Nurses (NCLEX-RN&reg;) pass rates in Associate Degree Nursing (ADN) programs in the northeastern United States (U.S.). The population for this quantitative correlational, descriptive design included all ADN programs (N =132) located in this geographic. The sample for this study was all ADN accredited programs who willingly completed this survey (N=24). Dr. Martha Tanicala&rsquo;s questionnaire was used with permission and was renamed Clinical Experiences in Associate Nursing Programs (CEANP). The Statistical Package for the Social Sciences (IBM SPSS Version 21.0) was utilized to complete the descriptive and correlational statistical procedures. A point-biserial correlation revealed significant relationships between NCLEX-RN&reg; success and the following independent variables: accreditation standards and recommendations on the design of the clinical curriculum (<i> r</i>pbi= .419, <i>n</i> = 24, <i>p</i> = .041, administration influence on the design of the clinical curriculum (rpbi = .415, n = 24, p = .044), and assessing clinical faculty competency (rpb= -.555, n = 24, p = .005). The findings of this study indicate that accreditation guidelines and nursing program administrators&rsquo; significantly correlate with curriculum design and NCLEX-RN&reg; pass rates. The findings also show a significant relationship between assessment of clinical faculty competency and NCLEX-RN&reg; success. The findings demonstrate that a more even distribution of the type of clinical hours across the curriculum may assist students with readiness for practice and first-time NCLEX-RN&reg; achievement.</p>

A conceptual framework was developed based on Fawcett’s conceptual framework and Stufflebeam’s Decision Making Model. The merging of the concepts of the framework and the model gave rise to the concepts of the research model, viz. environment, registered midwife, curriculum and outcome. These concepts were researched. Donabedian’s Quality Assurance Model and Parlett and Hamilton’s Illuminative Evaluation guided the research methodology. The methodology adopts a triangulated approach, making use of both quantitative and qualitative data collection procedures. In order to study the concept “environment” 250 women were interviewed post-natally in order to determine their perceptions and expectations of care during pregnancy, labour and the puerperium. The findings show that women are not empowered in terms of their expectations of care. Caring appears to be viewed at a very low level and to be taskfocused. Furthermore, caring around the birth process appears to be seen as best when it is hospital-based. Attention needs to be given to health information and health promotion. This concept was also studied through four focus groups held with women in the community. These data were analysed qualitatively. The findings revealed women’s dissatisfaction with the role and function of the nurse. Women’s lack of empowerment was evident in their encounters with health care professionals. Women related more negative than positive experiences of relationships with nurses. Perceptions of lack of trust and lack of concern, inter alia, in and from nurses were highlighted in the interviews. The concept “registered midwife” was studied by requesting registered midwives in a la. e academic hospital’s maternity unit to complete a questionnaire. The questionnaire aimed to obtam the midwives perceptions of the needs of women during pregnancy, labour and the puerperium. It also probed midwives perceptions of their roles and functions. The findings reveal that midwives recognise their teaching responsibility, but appear to have difficulty in meeting this responsibility. Her own education has prepared her for hospitalv based practice. Administration, research and policy-making are not priority roles for the majority of the respondents. “Curriculum” was studied through two questionnaires given to students in the B.Nursing programme. The findings revealed a need to increase curriculum content which relates to primary health care and a need to restructure practical learning opportunities as students do not feel compete,nt to practise in rural hospitals and community settings. The concept “outcome” was studied through two sets of focus groups. One with graduands who were currently in midwifery practice and the other with supervisors of these practitioners. The findings from the graduands’ groups highlighted the need for greater emphasis on culture, health information and promotion and holistic care in their learning experiences. The groups held with the nursing supervisors highlighted their perceptions of student needs and the inadequacy of the hospital as a learning environment. The findings from the four concepts have been used to develop a curriculum for Women’s Health. The curriculum model encapsulates Stufflebeam’s model and the concepts of the conceptual framework. The curriculum process utilizes problem-based learning and community-based education as the means to learning.

<p> Basic nursing education is no longer sufficient to meet the escalating demands of today&rsquo;s complex healthcare environment. Recognizing the need for the advanced cognitive skills incurred by these demands, increasing numbers of registered nurses (RNs) have been enrolling in online Bachelor of Science in Nursing (BSN) programs. The problem identified in the RN to BSN degree completion program at a large Midwestern university was the lack of information as to how online teaching and learning strategies were experienced by students. Research has demonstrated that the online community of inquiry (CoI) model facilitates higher order thinking through collaborative learning strategies and the interaction of teaching, social, and cognitive presence. The purpose of this sequential explanatory mixed methods study was to investigate the perceptions of RNs enrolled in the program about a recently completed course utilizing a 34-item CoI survey and semi-structured interviews. The data from 109 completed survey responses were analyzed via descriptive statistics and indicated that student perceptions of social and teaching presence were lower than perceptions of cognitive presence, meaning that the perceived establishment of online relationships and instructor engagement were not as high as were the perceived experiences of higher order thinking. Interviews with 15 purposefully selected students were analyzed for emergent themes and suggested limited online collaboration, which is considered to be fundamental to higher order learning. Based on these findings, a faculty development workshop was designed using the CoI model to encourage collaboration. A potential increase in RN proficiency in higher order thinking fostered by the CoI model will optimize the quality of patient-related decisions, minimize medical errors, and provide the impetus to challenge the status quo in health care.</p>