<p> The purpose of this descriptive study is to collect the experiences of cervical cancer survivors related to the information they received from their health care providers about how their diagnosis and treatment may impact their sexuality and sexual health. The perspectives of the cervical cancer survivors will be used to modify public domain educational materials used in oncology practices and cancer support organizations to reflect a more patient centered approach to sexual health information. Study outcomes will contribute to existing knowledge through submission to appropriate journals and conferences to improve cancer patient-provider sexual health communication.</p><p>

<p> Identifying the primary barriers that block initial employment of newly licensed nurses is essential to smooth transition to the workforce. Enrollment in nursing education has increased and schools have added programs, but newly licensed nurses struggle to gain initial employment. This qualitative e-Delphi study solicits feedback from nurse employers through a series of three surveys. The surveys were delivered and returned electronically. They were distributed to 33 volunteer nursing participants who are responsible for hiring and evaluating nurse performance in the workplace. The average response rate was 46%. The identified skill gaps in newly prepared nurses are communication, critical thinking, organization, and professionalism. These skill deficits result in delayed initial employability and prolonged orientation times.</p><p>

This study was an effort to evaluate the effectiveness of a two day institute on "Evaluation of Personnel" as an educational experience in the continuing education of nurses, to submit to critical analysis a method of evaluation, and to examine the relationship of educational and experiential backgrounds of the participants to the learning which took place subsequent to an observational analysis of the institute. An unstructured interview technique was used three months after its completion to elicit subjectively what respondents thought they had learned at the institute. The information was later arranged in a structured format for compilation, tabulation and analysis, both by punch card and computer. The socioeconomic background data was gathered through the use of a structured questionnaire at the time of the interview. A behavioral concept of learning was used throughout. The results revealed that 91% of the sample indicated that learning had occurred, as they perceived a change in their behavior because they had attended the institute. Further, 76% perceived a change in knowledge, 62% in attitude, and 76% in practice, while over half perceived a change in all three areas. The greatest change was perceived by those who were younger, married, had less education (academic and post basic nursing), less experience in nursing, and who were employed in the larger agencies. The perception of little or no change was indicated by those with more education (academic and post basic nursing), more experience in nursing, and who were employed in the smaller agencies. The comparisons of change to background factors revealed that, although none of the comparisons were consistently significant, there was a positive relationship of learning with age, basic academic education, post basic nursing education, years of nursing experience, and size of employing agency. Marital status, husband's occupation, parental status, income, social participation, years of head nurse experience, size and type of nursing unit and size of staff showed some interesting comparisons by observation, but the sample proved too small for accurate inferences to be drawn. The conclusions of the study were that the institute was effective as an educational experience for continuing education in the three aspects of behavioral learning examined, provided the credibility of the respondents was acceptable. The instrument used was adequate for the purpose of indicating change of behavior with the above proviso, but not adequate for revealing whether change was relevant to certain socioeconomic data. No claim can therefore be made concerning the relationship between this data and learning in a situation such as this institute. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Student's feelings, ideas and understandings of their experiences when learning to nurse have received very little attention as indicated by the nursing literature. The purpose of this study was to develop a tool which would gather data of the student's perceptions of her clinical learning experiences. The type of tool selected for development was a questionnaire. The questions were derived from three specific areas: past learning experiences, expectations of the teacher and the individual's ideas of her own learning needs in the clinical setting. A sample of sixty-four student nurses from three basic nursing education programs were selected. These students, midway through their programs, had all had clinical learning experiences. The data were collected by the researcher who administered the questionnaire. All students who were asked to volunteer did so, all questions were completed by each group of students. The data results were compiled noting individual responses as well as similarities and differences between schools. No significant differences were noted in the responses between the three different nursing programs. A similarity of responses was noted for the majority of questions across the three schools. The students' choice of responses supports many of the findings revealed in the literature review. A specific preference for a small class size and the lecture-discussion method of instruction was evident. Students expressed a positive feeling toward clinical evaluation, but indicated that receiving a clinical evaluation from a teacher caused them a high degree of stress. Fifty-four per cent of the students supported past findings which suggest that students believe they most often receive feedback from the teacher when they have performed unsatisfactorily. The majority of students believed that teachers did perceive themselves as counselors. One-third of the students indicated they thought teachers avoided giving direct negative criticism. Another one-third believed this might happen but had not personally experienced it. Individual responses to the questions indicated a wide variety of perceptions related to clinical learning experiences. Although the tool may give an indication of trends in student's ideas and feelings, it is primarily designed to be used with individual students. Knowledge of the individual's perceptions may give the teacher insight into the meaning of events to the learner. Students in all three schools gave positive support for the collection and use of these data in attempting to improve individual teaching/learning experiences in the clinical area. / Applied Science, Faculty of / Nursing, School of / Graduate

The performance objectives of professional education are often more explicit, and the relationship with the world of work more immediate and comprehensive, than those of other university majors that are frequently the subject of writing-across-the-curriculum scholarship. This cross-sectional study of samples of both students and professors in the basic undergraduate program leading to the Bachelor of Science in Nursing degree seeks (1) to determine how they view the roles of writing in the major; (2) to ascertain the assumptions that inform how both groups handle writing within the context of classroom and clinical settings; and (3) to discover what practices result from these views and assumptions. Information was gathered from students through questionnaires, interviews and writing samples, and from faculty through a course writing inventory, course materials and interviews. The data show how writing serves individual, course and program goals; describe some of the ways in which writing is related to the theoretical frameworks and evolution of the discipline; and provide insight into how students conceive of and approach the writing required in their coursework. The final chapter outlines the interconnected roles of writing in this academic program and discusses how writing is used in fashioning professional identity, in teaching, in curricular structure, in fostering individual development, and in advancing professional nursing, and possible links between feminist epistemological studies and the roles of writing in professional education are suggested.

Recently there has been a call for the enhancement of environmental health content in undergraduate curricula to help nurses become more familiar with environmental hazards which place their clients at risk. This survey was conducted among the 478 National League for Nursing (NLN) accredited undergraduate programs in the United States. This non-experimental, descriptive, and exploratory research was conducted to determine the following with respect to environmental health: (1) current and ideal emphasis, (2) faculty preparation, (3) competencies expected of graduates, (4) didactic and clinical contact hours allocated, (5) barriers and incentives to greater emphasis, and (6) differences among type of institution with respect to education in this topic. A mailed self-administered questionnaire was sent to the Deans of these programs. The response rate was 81.4%. Data analysis indicated that ideally 94% of respondents believed environmental health should be given moderate to substantial emphasis while only 73.4% actually provided this emphasis. As actual and ideal emphasis increased, the respondents' perception of faculty willingness to modify the curriculum to include environmental health content, faculty preparation to teach or provide clinical supervision in environmental health, and expected program graduates competencies also increased (p = 0.001). Most significant barriers to increased emphasis were an already overburdened curriculum, lack of qualified faculty to teach this topic, and lack of emphasis on the NCLEX. Factors likely to increase the emphasis were nursing faculty with expertise in environmental health, greater emphasis on environmental health on the NCLEX, and "other", most often the need for faculty development in this area. No evidence of any relationship between research questions and institutional type or size was found (p =.05). Findings contribute to nursing education by providing an assessment of the status of environmental health content in nursing education and clarify some of the complex reasons for the present neglect of environmental health in the education of professional nurses.

The study was designed to explore with selected nurses in the employment setting their perspective of the clinical competence of newly graduated nurses as they entered practice. The study had three elements. The initial focus of the study was to examine the readiness of graduates from all preparatory programs to enter hospital practice, addressing, in particular, the clinical competence of the nurse and, therefore, the ability of that nurse to meet the nursing needs of the patient. The second element was to explore the differences, if any, between graduates of Baccalaureate, Associate Degree and Diploma Programs as those differences relate to clinical competence. The third area dealt with the nurturing and socialization of the new graduate in the practice setting and examined the methods employed by the hospital to orient the nurse to the practice setting and provide support and additional education and experience to bring the nurse to the practice level expected. Major findings identified differences in graduates from the three types of nursing programs. Graduates of Baccalaureate programs were described as having a stronger theoretical knowledge base and better critical thinking skills. It was expected the Baccalaureate graduate would become the more competent nurse over time. Graduates of Diploma Programs were reported to have better clinical skills. Associate Degree Program graduates were said to be lacking in both clinical skills and theoretical knowledge. Two factors were mentioned as important in shaping clinical competence. Individual differences which the nurse brings with her are thought to be a significant factor, even more than the program from which the nurse was graduated. Programs, which prepare the same type of graduate, do not always graduate nurses of the same quality. Graduates of all programs were noted as needing extensive support as they began their new role. Concern was expressed by the majority of respondents about the readiness of new graduates to enter the practice setting. Most respondents would like to see the clinical practice component strengthened in the curriculum of all nursing programs. Recommendations for Nursing Education and Nursing Practice and for further study are included.

The main purpose of this study was to investigate, through interviews, the factors influencing the career choice, role perception, and job satisfaction of 15 college health service nurse managers working in New England state colleges. The secondary purpose was to categorize nurse managers according to their attitudes and to determine the relevancy of the American College Health Association job description. The conceptual framework of the study included socialization, role theory, and job satisfaction. The 15 nurse managers who agreed to participate in the study comprise 75% of the potential subjects of this study. Interviews were conducted through the use of an open-ended interview guide. Qualitative analysis identified general themes from interview data. Selected segments of each audio taped interview were chosen by the interviewer to provide examples of key concepts related to career choice, role perception, and job satisfaction. Discussion of these findings resulted in the following conclusions: (1) Nurses need to assume a leadership role in developing policies and determining the direction for the college health service nurse managers' role. (2) Channels of communication between nurse managers and administrators must be identified and maintained to clarify role expectations and perceptions and to eliminate discrepancies. (3) Advanced education at the master's level and certification as a nurse practitioner may provide the nurse manager with the knowledge and skills needed to fulfill her role. Based on these findings, recommendations were made for future research.

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 thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfillment of the requirements for the degree of Doctor of Philosophy Johannesburg, 2019 / The development of competence among student nurses is important to nurse educators, nursing regulatory bodies, employers and patients. Several teaching and learning strategies have been developed to support the development of competence among student nurses but the level of competence at the point of graduation remains below expected standards. This study explored students’ experiences of the learning processes that support the development of competence in nursing practice in Namibia. Gaining an understanding of learning from the student’s perspective can strengthen the current teaching and learning strategies, hence improve the development of competence. The qualitative phenomenographic study that investigated the learning processes that best support the development of competence was conducted in Namibia at a nursing college. Forty- nine (49) participants (lecturers, clinical instructors, nurses and student nurses) were purposively sampled to take part in the study. Data were collected through in-depth interviews and focus group discussions. The analysis of data was managed through ATLAS. ti 8.1 and followed the process of familiarisation, condensation, comparison, grouping, articulating labelling and contrasting of excerpts in order to generate the outcome space. Ethical principles were applied to ensure that the study complied with ethical requirements set by institutions and international guidelines. Five categories of description emerged and showed that the development of competence involves students increasing their understanding of what competence is, hence changing their learning strategies to meet the level of competence as they understood it. In order of hierarchy from the lowest, the categories of description were; competence is understood as task completion; competence is understood as passing assessments /satisfying facilitators; competence is understood as applying theory to practice; competence is understood as performance of nursing according to clinical standards/guidelines; competence is understood as performance that yields positive health outcomes. An analysis of the outcome space culminated in a proposed model for the development of competence, which shows that the development of competence among student nurses is influenced directly and indirectly by the students’ understanding of competence. Students with a shallow understanding of competence adopt superficial learning approaches. As students progress in their education and are exposed to real practice settings, their understanding of competence deepens and they shift their learning strategies to deep approaches. / MT 2020