Medical education leaders have been concerned about the decline in professionalism among medical students. While many studies have documented the professional socialization of medical students most have simply noted the process or examined the adaptation on the part of the students to the environment of the academic health center. Few have examined the socialization of professionalism, although many articles in the literature have discussed the lack of professionalism seen among medical students and they progress through their medical education. This is seen in students' distancing from patients, adopting the use of dehumanizing terminology when referring to patients and their families, and the decline in psycho-social functioning. There appear to be many factors that have facilitated this decline in professional values. Some include the increasing involvement of managed care in the teaching hospital, requirements for faculty to increase their clinical revenue thus reducing their time spent with students, and relegation of the teaching of medical students to residents. This study examines an alternate environment, the rural site, as one that may favor the adoption of the traditional or core professional values of physicians. This research qualitatively examines student's comments related to their involvement in a rural medical education program. This program, which selects 15 students each year from the entering class of medical students, seeks to nurture interest in rural practice. These medical students appear to have increased exposure to professional values due to their increased time spent in the rural environment. These teaching sites provide an alternative with which to compare the values held and reinforced in the academic health center. The values in the rural environments appear to be different than those in the academic health center, and seem to reflect professionalism in ways that are more consistent with the traditional values of physicians. These values include ones such as service to the community, altruism, honesty, respect and collegiality. The professional socialization of medical students requires the socialization of professional values. The rural medical education sites examined here through the students' comments reflect a different type of experience, one in which professional values are modeled, expected and upheld.

The purpose of this secondary analysis of data from the pilot study of Self-Help Intervention Project (SHIP) was to describe the relationship among subject background and nursing interventions (self-help class, independent study, and nurse case manager) in 29 women with breast cancer at time one, prior to participation in one of three nurse interventions. Twenty six women provided data upon completion of the nurse interventions. A low statistical relationship was found between demographic variables of age (r =.29, p =.10) and income (r =.32, p =.09) with the nurse case manager intervention. Having had a partial mastectomy (r =.34, p =.07) was positively related to the independent study. Having received chemotherapy (r =.33, p =.08) was positively related to the self-help class intervention. The information seeking style blunter subscale was found to have a negatively statistically significant relationship with the self-help class intervention (r = -.31, p =.10) and a positive relationship with the nurse case manager intervention (r =.33, p =.08). The nurse case manager intervention was found to be positively related to adult self-care (r =.29, p =.10). Results indicate that nurses should continually assess their patients' individual variables in order to provide appropriate interventions.

The qualitative research methodology of phenomenology was used to explore the experience of surviving breast cancer following a bone marrow transplant. Three women who had undergone a bone marrow transplant for breast cancer were interviewed using an open-ended question. The interviews were audiotape recorded. The interviews were analyzed using an adaptation of Colaizzi's eight step procedure. Eight theme categories were identified: Coming to Know You Have Breast Cancer, Going to War, The Core of Survival, Knowing Myself, Control of Survival, Family Survival, Time Orientation, and Possibility of Death. An essential structure was derived from the data indicating that survival of breast cancer following bone marrow transplant is three dimensional. The dimensions include a perspective of the survival experienced in the past intertwined with daily survival and a future perspective.

<p> National calls for a better-educated nursing workforce are proliferating. The Institute of Medicine (IOM) challenged the nursing profession by setting the goal of having 80% of the nation's nurses prepared at the baccalaureate level (BSN) or higher by 2020. This is an ambitious goal given that, nationally, only 50% of nurses have a BSN. In fact, only 40% of nurses in Michigan have a BSN, and in the rural North-Central Region of this state, only 29% (the lowest in the state) of the nurses have a BSN. The purpose of this hermeneutic phenomenological study was to understand and interpret the meaning of being an associate degree (AD) nurse, the meaning attaining a BSN has for rural registered nurses who currently have an AD, and the barriers they experience that inform their decisions to return to school (or not). The investigator interviewed 11 AD nurses from rural North-Central Michigan and analyzed interview transcripts to identify common experiences and shared meanings using methods identified by Diekelmann, Allen, and Tanner (1989). Two themes were explicated in this study: "Getting in and Getting out" and "What Difference Does it Make?" The findings in this study challenge many of the common assumptions about academic progression in nursing and provide educators, administrators, and legislators with insight about the strategies that may be most helpful for achieving the IOM goal in rural Michigan.</p>

<p>The purpose of this study was to examine the effects of utilizing high-fidelity simulation on the team performance, perceived level of learning, and satisfaction of resident physicians in a simulated cardiac resuscitation scenario. This study was significant because it filled a gap in the literature about how methods of education impact healthcare practitioners. While a body of research exists in education on adult learning principles, there are few studies on how applying adult learning principles to professional development is an effective method of instruction in healthcare. </p><p> A convenience sample of resident physicians from two hospitals that are part of a large health system was utilized for this study. Resident physicians participated in a simulated mock cardiac resuscitation scenario monthly. The Simulated Cardiac Resuscitation Team Performance Evaluation instrument was utilized to assess the team performance of the residents in the scenarios. A program evaluation form was administered to measure perceived level of learning and satisfaction with the simulation experience. </p><p> One-way multivariate analyses of variance were conducted to evaluate the relationships between year of residency and gender and the team performance score on the Simulated Cardiac Resuscitation Team Performance Evaluation. Significant differences were not found among the years of residency on the dependent measures. Significant differences were not found between the genders on the dependent measures. A one-way multivariate analysis of variance was conducted to evaluate the relationship between year of residency and the level of satisfaction and perceived level of learning of the resident physicians. Significant differences were not found among the three years of residency on the dependent measures. A one-way multivariate analysis of variance was conducted to evaluate the relationship between gender and the level of satisfaction and perceived level of learning of the resident physicians. Significant differences were not found between genders on the dependent measures. A one-way multivariate analysis of variance was conducted to evaluate the relationship between prior use of simulation and the level of satisfaction and perceived level of learning of the resident physicians. Significant differences were not found between prior use of simulation on the dependent measures. </p>

<p> Child Life Specialists are integral members of the medical team and work directly with medical staff to provide support and end-of-life care and interventions to critically ill patients and their families; however there is no research regarding how Child Life Specialist copes with the death of a patient. The purpose of this study was to investigate how Child Life Specialists cope with the death of a patient in the hospital setting, and which factors influence how they cope with the death of a patient. The current study surveyed 106 Certified Child Life Specialists [CCLSs] and how they coped with the death of a patient. Results revealed factors such as length of time working with patient, relationship with patient and family, bereavement training and end-of-life interventions such as memory making and legacy building, were all factors that influenced how the CCLS coped with the death of a patient. Results conclude that future research would allow for a more in-depth understanding and analysis of how CCLS cope with the death of a patient in the hospital setting.</p><p> <i>Keywords:</i> Medical professionals, coping, death, bereavement </p>

<p> Preparing nursing students to address spiritual needs of clients is a challenge for nursing education programs. There is minimal evidence in the literature exploring the spiritual needs of clients from the perspectives of nursing students and faculty. While licensed nurses can confirm the importance of meeting the physiological and psychosocial needs of the client, nursing professional practice standards demand nurses include acknowledging the client&rsquo;s spirituality. As required by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), American Association of Credentialing Nursing (AACN), and the National Council State Boards of Nursing (NCSBN), spiritual care is a requirement, not an option. By determining how nursing students are prepared to address the spiritual needs of the client in a large Midwestern baccalaureate nursing program, nursing faculty can identify effective methods of including spirituality in the nursing education curriculum. This research study used qualitative inquiry and focused on understanding experiences from nursing students and nurse educators. A grounded theory approach was utilized to assess faculty and student perceptions of preparation of senior baccalaureate nursing (BSN) students to address the spiritual needs of the clients. Two themes emerged from the faculty interviews: students need a clear definition of spirituality, and students are not prepared to address the spiritual needs of clients with a spiritual assessment tool. Three themes emerged from the student interviews: students cannot clearly define spirituality versus culture versus religion, they are not equipped to do a spiritual assessment, and there is a lack of role models by both nursing faculty and staff in the clinical setting demonstrating how to address the spiritual needs of clients. There are two sub-categories that support how to define spirituality and how to better equip students to address the spiritual needs of clients. Using a grounded theory approach, the outcomes of this study support a new theory to facilitate nurse inclusion of spirituality in the nursing curriculum. </p><p> This study provides support for integration in the nursing curriculum and inclusion of teaching strategies focusing on spirituality in the nursing curriculum. Findings from this study help minimize gaps in the literature by contributing new knowledge about spirituality in the nursing curriculum that previously had not been empirically identified.</p>

<p> The purpose of the qualitative grounded-theory study was to generate a theory to explain workplace readiness and needs of new graduates entering the intensive care unit (ICU) from the viewpoint of managers, clinical educators, preceptors, and new registered nurses (RN) graduates. The study involved 24 nurses including five managers, four educators, eight preceptors, and seven new graduates working in Florida with 1,550 beds, which includes 115 specialized ICU beds. A qualitative grounded theory developed from analyzing the responses from face-to-face interviews and identifying competencies and skills required for new graduates to enter the ICU. The following four themes emerged: (a) embracing the new ICU role, (b) overwhelming experience of performance ambiguity or anxiety, (c) adapting to the ICU, and (d) embodying the new ICU RN role. </p><p> The results of this study indicate that new ICU RN&rsquo;s have limited exposure in nursing school to the ICU and the inclusion of the novice nurse embracing the ICU theory (NNEIT) could enhance the new nurses&rsquo; transition into the ICU. Through the reduction of overwhelming experience of performance ambiguity or anxiety, the new graduate will adapt to the fast-paced ICU environment and embody the new ICU RN role. Novice nurses embodying the new role require time, preparation, and support. This study adds to a growing body of knowledge on facilitating the workplace readiness of new ICU nurses from the perspectives of the manager, educator, preceptor, and new graduate. The novice nurse embracing the ICU theory (NNEIT) will provide guidance in resolving the discourse of the competencies and skills for new nurses entering the ICU.</p>

<p> <b>Background:</b> Individuals with developmental disabilities (DD) experience poorer dental health than the general population. They have limited access to health care services and face barriers to maintaining good oral health. Dental schools provide minimal didactic and clinical training to prepare their students to manage individuals with disabilities. As a result, future dentists may not feel well prepared to provide dental care to these individuals.</p><p> <b>Objective:</b> This study was conducted to compare the attitudes of senior dental students at the Faculty of Dentistry at King Abdulaziz University (KAU), in Jeddah, in Saudi Arabia, and students at Tufts University School of Dental Medicine (TUSDM) in Boston, in the United States. The authors also aimed to determine if there was an association between pre-doctoral training in treating individuals with special needs, and having positive attitudes toward providing dental care to individuals with DD.</p><p> <b>Methods:</b> The authors surveyed 617 senior dental students at both schools using a 40-item online survey questionnaire. The questionnaire asked students about their experiences with individuals with DD, their pre-doctoral education in managing these individuals, and their attitudes toward these individuals. Data was analyzed using Chi-square tests, Independent Sample t-tests, Mann-Whitney U tests, and Spearman's rank correlation coefficient tests.</p><p> <b>Results:</b> Only 214 students responded to the online survey, with a response rate of 34.6%. Seventy six respondents (36.7%) were TUSDM students with a response rate of 21.2%, and 131 respondents (63.3%) were KAU students with a response rate of 50.8%. Only 15 (11.6%) of KAU students, compared to 64 (86.5%) of TUSDM students (p&lt;0.001), reported treating an individual with a DD. Seventy one (58.2%) of KAU students, compared to only 10 (13.5%) of TUSDM (p&lt;0.001), reported not receiving any training in treating individuals with DD. Fifty six (57.1%) of KAU students, compared to only 15 (20.3%) of TUSDM students (p&lt;0.001), reported that their education had not prepared them effectively to treat individuals with DD. There was a significant difference in the attitudes between students at KAU and students at TUSDM. Students at TUSDM had more positive attitudes, compared to students at KAU. Fifty six (45.9%) of the KAU students, compared to 47 (67.2%) of the TUSDM students (p=0.047), "strongly disagreed" or "disagreed" that they would not desire individuals with DD in their practice. Forty two (34.4%) of the KAU students, compared to 60 (85.7%) of the TUSDM students (p&lt;0.001), "strongly disagreed" or "disagreed" that dental services for individuals with DD should only be provided in a hospital.</p><p> <b>Discussion:</b> Students at TUSDM had more positive attitudes toward individuals with DD, compared to KAU students. These differences in the attitudes may be attributed to the significant differences in students' experiences, education, and training in treating individuals with DD at both schools.</p><p> <b>Conclusions:</b> There is a significant difference in the attitudes between students at TUSDM and students at KAU. There is an association between pre-doctoral training in treating individuals with special needs, and having positive attitudes toward providing dental care to individuals with DD.</p>

Chronic health conditions such as obesity, cardiovascular disease, and diabetes are on the rise in Canada, and particularly in Nova Scotia. Lifestyle-related factors including stress level, exercise, and a healthy diet are crucial to preventing such illnesses. Research shows that access to greenspace can greatly effect physical and mental health in terms of stress-reduction, social cohesion and exercise promotion. Importantly, food-producing greenspace provides further mental and physical benefits; highlighting the importance of a healthy diet and a connection to the earth. Despite these findings, productive greenspace in our cities as a viable source of wellness is not optimized. This project, located in Halifax, Nova Scotia, examines how productive greenspace can be integrated with interactive learning spaces to encourage a preventative approach to lifestyle-based illnesses.