Purpose: Identify specific legislative barriers to full practice authority (FPA) legislation and describe how they were overcome during the 2013 legislative session in Nevada. Background: Legislative restrictions in 31 states prevent nurse practitioners from practicing to the full extent of their education and training. FPA legislation is introduced, but not often signed into law. A comprehensive literature review revealed multiple barriers to autonomous practice: conflict between medical and nursing roles, lack of nurse practitioner role recognition, financial challenges, and a lack of business knowledge. Barriers caused by policy limitations were most frequently mentioned: limited scope of practice, limited prescriptive authority, limited clinical privileges, credentialing limitations and reduced reimbursement rates. Methods: This study employed a qualitative, multiple case study design. Semi-structured interviews were conducted with four actively-involved contributors to the 2013 FPA initiative in Nevada. Homogeneous questions were used, guided by the use of a predetermined set of questions based on Kotter’s (1995) Change Management Model. Each interview began with the question, "What prompted this movement and why was it introduced at this time?" Participants were asked to identify perceived barriers to FPA legislation, and how they were overcome. Recorded interviews were transcribed into text, which led to thematic analysis. Results: Repetition of shared perceptions revealed eleven barriers separated into six main themes. 1) Vision includes the barrier of lacking a clear and shared vision. 2) Physician Support includes the barrier of lacking the support of physicians and Organized Medicine. 3) Addressing Stakeholders includes the barriers of the inability to address stakeholders, lack of role recognition and community support, and social media. 4) Community Organization Support includes the barriers of having a Board of Nursing with a poor reputation, and a lack of support from the Board of Pharmacy. 5) Leading Coalition includes the barriers of lacking a strong, leading coalition lacking history of leadership and legislative experiences, and choosing a legislator without experience, authority, and respect in the legislature and the community. 6) Resources include the barrier of lacking necessary resources including time and preparation. Implications: The findings of this study may be useful for those living in one of the 31 states without FPA legislation. This is one of the first published studies to identify the importance of literature identifying legislative barriers to FPA, and starts to fill the current gap in the literature surrounding this topic. This information may be invaluable in the preparation and introduction of FPA legislation in other states. The findings may also act as a stepping-stone to addressing the provider shortage in the U.S., and may be instrumental in improving access to care. Further research is needed to identify whether similar barriers found in this study are prevalent in other states with FPA legislation for nurse practitioners.

Magister Curationis - MCur / Self-directed learning (SDL) has become a focus in the past years due to the increase in the complexity and changes in the nursing profession development. Employing SDL methodologies has been advantageous to the learner nurses, since these methodologies are associated with moderate improvement in the knowledge and effective improvement in the affective and psychomotor domains. Despite the efforts to expose students to SDL, the challenge remains the lack of students‘ commitment to SDL during clinical activities in the skills laboratory. This lack of commitment may result from students‘ perceptions of SDL. Therefore, this study seeks to explore and describe the perceptions of first year learner nurses about self-directed learning activities in a skills laboratory at a school of nursing in the Western Cape. An exploratory descriptive quantitative design was used to answer the research question. All the first year learner nurses (N=336) pursuing a 4-year Bachelor Nursing Degree served as the target population and a sample of 168 respondents was selected by simple random sampling. A self-administered 5-point Likert scale questionnaire with an additional four open-ended questions was used to collect data for the study. Data was analysed by using the Statistical Package for the Social Sciences (SPSS) Version 21 software. Descriptive statistics were used to present frequencies, mean values, standard deviations, and the results were illustrated by means of tables. The Spearman correlation coefficient indicated the correlations between the 4 The findings revealed that most of the respondents positively perceived self-directed learning in the skills laboratory. However, it was also found that learners had challenges in relation to time management during the implementation of self-directed learning.

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This qualitative study examines high school students´ views on independent practice in drums, as well as the drum students' experiences of strategies for practice. The study also intends to investigate which cultural tools the drum students use in their practice and whether any form of practice culture emerges. Previous research shows that independent practice in music is influenced by cultural context, knowledge of practice strategies, the quality of the exercise, teaching content, motivation and goals. In the present study, four semi-structured interviews were conducted with drum students in high school. The collected data underwent a thematic analysis from a sociocultural perspective. The result show that independent practice in drums in high school depends on physical and intellectual tools in the form of drumsticks, practice-pads, hands, feet, knees, thighs, drums, digital playback devices and headphones, motivation, social meetings with other musicians, role models, personal goals and practice strategies. The cultural tools are appropriated according to the aspect of the drumming that the informants intend to practice. The independent exercise also proves to be a cultural tool in itself that is used to handle ensemble practice as a social context. The rehearsal culture can thus be considered an important aspect of playing music with other musicians.