Indiana University-Purdue University Indianapolis (IUPUI) / Clinical simulation is an innovative teaching/learning strategy that supports the efforts of educators to prepare students for practice. Despite the positive implications of clinical simulations in nursing education, no empirical evidence exists to inform effective teaching in simulated learning environments. The purpose of this research is to create an instrument to measure effective teaching strategies in clinical simulation contexts. The conceptual framework for this study is the Nursing Education Simulation Framework. The Student Perception of Effective Teaching in Clinical Simulation (SPETCS) is a survey instrument scored on a 5-point Likert scale with two response scales: Extent and Importance. The Extent response scale measures participants’ perception of the extent to which the instructor used a particular teaching strategy during the simulation, and the Importance response scale measures perception of the degree of importance of the teaching strategy toward meeting simulation learning outcomes. A descriptive, quantitative, cross-sectional design was used. Evidence to support content validity was obtained via a panel of simulation experts (n = 7) which yielded a content validity index of .91. A convenience sample of undergraduate nursing students (n = 121) was used for psychometric analysis. Internal consistency reliability met hypothesized expectations for the Extent (α = .95) and Importance (α = .96) response scales. Temporal stability reliability results were mixed; correlations between administration times met expectations on the Importance scale (ICC = .67), but were lower than expected on the Extent scale (ICC = .52). Both response scales correlated within hypothesized parameters with two criterion instruments (p < .01). The Importance scale was selected for exploratory factor analysis (EFA). EFA revealed 2 factors: Learner Support and Real-World Application. The result of careful item and factor analysis was an easy to administer 33 item scale with 2 response scales. The SPETCS has evidence of reliability and validity and can serve as a tool for the assessment, evaluation, and feedback in the ongoing professional development of nurse educators who use clinical simulations in the teaching/learning process. In addition, results of this study can support the identification of best practices and teaching competencies in the clinical simulation environment.

The purpose of this study was to develop and refine an instrument to assess knowledge levels of the discipline provisions of the Individuals with Disabilities Education Act Amendments of 1997 (IDEA '97). Such an instrument will assist in determining whether or not and to what extent additional training opportunities may be needed for school personnel who are responsible for disciplining students served in special education under IDEA '97. School officials who do not have proper knowledge and understanding of these provisions may violate students' rights by denying them the free appropriate public education to which they are entitled. The initial researcher designed instrument was a fixed-response test, consisting of 102 questions. Questions were based upon five identified areas of knowledge found in the discipline provisions: manifestation determination; functional behavior assessments; behavior intervention plans; interim alternative educational settings; and general procedural safeguards. Instrument items were written to assess knowledge for basic recall, commprehension, and application. A panel of experts reviewed this instrument to ensure content validity. Based upon the panel's recommendations, the instrument was revised and several questions were removed. A pilot study was then conducted with the resulting 68-question instrument. Fifty-eight graduate school students at East Tennessee State University participated in a test-retest study of the instrument. Pearson Product Moment Correlations and paired samples t-tests were used to determine test-retest reliability on the total test, as well as each subscale. Additionally, KR-20 estimates of internal consistency were obtained to determine the power of the instrument. The corrected item total correlations were utilized for each subscale to eliminate items that did not contribute to the consistency of the instrument. Finally, an item analysis was used to determine the final make up of the instrument. The final instrument contained 35 items, with seven items for each subscale.

The nursing profession perpetuates an outdated model that fails to address the health concerns of racialized gender-diverse people. Evidence supports that this population experiences poorer health outcomes, care-avoiding habits, and incompetent healthcare providers. A literature review illuminated gaps in the nursing lens when considering gender-diverse identities outside of Whiteness. An intersectionality framework and cultural humility were used to explore the contexts in which nurses provide care. To fill this knowledge gap, the proposed research question was: How prepared are nurses to provide care to racialized gender-diverse people? A questionnaire was developed by modifying three pre-existing instruments. The online questionnaire served as a pilot feasibility study to collect preliminary baseline descriptive cross-sectional data about Ontario nurses' training, education, knowledge, attitudes, and beliefs about racialized gender-diverse people. Findings indicated potential gaps in training and education that may affect racialized gender-diverse peoples' healthcare. Recommendations are provided for future research and interventions.

Intuition is an important aspect of counseling, several revered counselors have either attested to the powers of their intuition or have had such powers attributed to them by their contemporaries. Moreover, many counselors believe that their intuition is more influential in their work with clients than are evidence-based practices (EBPs). However, the academy criticizes intuition for its susceptibility to cognitive errors and its poor performance when compared to statistical methods. In addition, the exact nature of intuition’s role in counseling is largely unknown. Therefore, its contribution to client outcomes is equally a mystery, making it difficult for counselors to justify their reliance on its powers. Until this study, counselor intuition has been regarded as a, more or less, phantom construct in need of evidence to even suggest that it does in fact exist. Therefore, the purpose of this study was to develop the Counselor Intuition Scale (CIS). The construction of the CIS began by adapting the methodology of instruments already in existence and whose purpose was to measure interpersonal and emotional sensitivity. The construction of the CIS began by creating a series of 39 video segments (lasting approximately two minutes each) depicting a client discussing a presenting problem. The video segments were then reviewed by two rounds of counseling experts (N = 45) whose intuitive responses to the clients featured in the CIS were used to create the criterion responses of the instrument. The expert responses were analyzed using Q-Methodology, the results of which suggested that the counseling experts approached the clients from a unidimensional perspective, which the researcher named "counselor intuition." The expert ratings were also analyzed using generalizability theory to assess the consistency of expert responses, the results of which iv suggested that interrater reliability was excellent, ranging from .88 to .85. Lastly, the experts identified 263 criterion responses that can be used for the future development of the instrument. The implications of the study’s findings, as well as the recommendations for future research are discussed

The need to address spiritual and religious issues is well established in the counseling literature and in accreditation standards, however, many graduates counseling students do not feel prepared to address these issues. In the United States, the vast majority of clients consider themselves to be spiritual or religious, so counselors who lack competence in addressing spiritual and religious issues in counseling are likely to offer ineffective or perhaps unethical care to clients. Counselor educators must improve education and assessment in this critical specialty area of counseling. Of primary concern is a student’s ability to demonstrate spiritual competence in counseling. The 2009 ASERVIC Spiritual Competencies offer the most comprehensive standard of spiritual competence in counseling in any mental health profession, however there is no reliable and standardized assessment that measures demonstrated spiritual competency. Competency can best be measured when the examinee makes choices in a context that is similar or the same as that in which he or she will practice, therefore an effective competency measurement must include client cases. The purpose of this study was to investigate whether a case based assessment for measuring clinical judgment in situations of uncertainty, called a Script Concordance Test, could be constructed by experts using the Delphi Method. This instrument was based on the 2009 ASERVIC Spiritual Competencies as the standard for demonstrated competence. iv The results of this study indicated that expert practitioners and educators could come to consensus on appropriate cases, appropriate competencies to measure in each case, items to assess competency in each case, and an instrument that included items assessing all 14 of the 2009 Spiritual Competencies. Additionally, the constructed instrument demonstrated excellent test retest reliability and adequate internal reliability. There are several implications for counselor education, First, this study provides evidence that expert practitioners and educators can come to consensus to construct a highly contextual instrument to measures clinical decision making about spiritual competence in counseling. Second, a promising new type of instrument with excellent reliability and strong content validity has been introduced to the field of counselor education. Third, with appropriate assessment, counselor education programs can begin to measure student competence, in terms of clinical judgment, on addressing spiritual and religions issues in counseling over time because this instrument is appropriate for use at different intervals throughout professional development. Fourth, the format of this instrument is also useful for educational purposes and reflective practice. Finally, the theoretical foundations of the Delphi Method and script concordance tests are compatible with one another and with instrument development. The researcher recommends that future studies to construct script concordance tests for other specialty areas of competence employ and refine this method.

It is estimated that there are approximately 42,000 beverage establishments in the U.S. whose annual revenue surpasses $20 billion (First Research, 2014). To facilitate discussion of beverage establishments, it is essential to recognize beverage establishments as businesses whose majority of sales come from alcoholic drinks (Moss, 2010a). In this research, beverage establishments are divided into beverage-only bars, bar/entertainment combinations, and food and beverage combinations. Even though they are a well-established industry, beverage establishments have received little academic attention (Moss, 2010b). For example, previous studies have given little attention to the development of the model that examines the relationships between quality attributes, convenience, perceived price fairness, customer experience, and customer loyalty in beverage establishments. However, current research in other service sectors has showed that quality, pricing and convenience have a strong effect on customer experience and behavioral intentions (Baker & Crompton, 2000; Cronin et al., 2000; Taylor & Baker, 1994; Tian-Cole, Crompton, & Willson, 2002; Woodside et al., 1989). Quality is tightly related to customer experience since it positively affects customer satisfaction and therefore company's profitability (Hallowell, 1996). This study has the following objectives: (1) to develop an instrument to measure the antecedents of customer experience in beverage establishments; (2) to examine the relative importance of different antecedents of customer experience in different types of beverage establishments; and (3) to build a model of various antecedents of customer experience in beverage establishments. This study was conducted in six phases. The first phase was the analysis of previous literature regarding quality attributes, convenience, perceived price fairness, customer experience, customer loyalty, and beverage establishments. The second phase was a development of mixed methodology research design. The third phase was the data collection based on interviews with management of beverage establishments, customer focus groups, and a survey of customers of beverage establishments. The fourth phase was a pilot study that involved a refinement of the study instrument. The fifth phase was a main quantitative study based on the survey design. The results from each qualitative and quantitative phase of the study were integrated and analyzed. The results from the instrument development part of the study identified the following eleven antecedents of customer experience in beverage establishments: (1) service quality, (2) product quality, (3) physical environment design, (4) physical environment layout, (5) music quality, (6) social environment, (7) information convenience, (8) location convenience, (9) parking convenience, (10) entrance fee fairness, and (11) perceived price fairness. Additionally, the second instrument development study was used to recognize different customer experiential state dimensions. The factor structure included two customer experiential states: (1) the affective experiential state and (2) the cognitive experiential state. A comprehensive theoretical model that integrates different dimensions of antecedents of customer experience, customer experiential states, customer loyalty and the moderating affect of the type of the beverage establishment was developed. One of the most important findings of the study is the relationship between the social environment and the affective experiential state. The results of the study indicate that the majority of other antecedents of customer experience did not have a significant effect on two experiential states or that effect was relatively weak. However, social environment was the strongest predictor of customers' positive emotions and therefore customer loyalty and behavioral intentions. Finally, the study results confirmed Oliver's (1997) theory of customer loyalty by providing support for the sequential relationship between cognitive, affective, and conative loyalty. This study has several important theoretical contributions. Different antecedents of customer experience in beverage establishments were recognized and an instrument that measures these dimensions was developed. To the best of our knowledge, this is the first scale specifically developed to measure experience in beverage establishments. Additionally, the importance of each of the antecedent of customer experience was examined in regards to their effect on customer experience. Additionally, an instrument that measures cognitive and affective experiential states was developed and was a foundation for the study model. Finally, this study integrates different customer experience and customer loyalty dimensions into a comprehensive theoretical model that could be applied and retested in other service settings.

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