Thesis (M.S.P.H.)--University of Michigan, 1947.

Thesis (M.S.P.H.)--University of Michigan, 1947.

<p> High-stakes testing in undergraduate nursing education are those assessments used to make critical decisions for student progression and graduation. The purpose of this study was to explore the different ways students experience multiple high-stakes tests for progression in one undergraduate BSN program. Research participants were prelicensure senior baccalaureate nursing students enrolled in their final semester of the nursing program. A descriptive qualitative design, using the framework of phenomenography, captured the various ways a group of prelicensure BSN students described their experiences with multiple high-stakes to progress throughout the nursing program towards graduation. Phenomenography is designed to examine the various ways in which a group individuals experience or perceive the same phenomenon. Analysis revealed five major categories of descriptions, including values, stress, inconsistency, high demand/expectations, and transfer of learning. Each category included various sub-categories. The findings provided a rich understanding of the student's point of view of high-stakes tests that is lacking in the nursing education literature. In addition, the results were used to develop a structure of learning model as a useful tool to guide nursing faculty in developing program-specific strategies that promote student success with high-stakes testing throughout nursing curricula. </p>

<p> Nurses at a suburban northeastern U.S. community hospital reported that they felt unprepared to effectively respond to a pediatric emergency. Empirical data were not available to identify if this local problem was due to a lack of the nurses&rsquo; self-confidence or if other factors were involved. The purpose of this study was to determine if there were relationships between nurses&rsquo; self-efficacy in pediatric emergencies and their knowledge of pediatric emergency care, as well as their years of clinical experience, nursing education, pediatric life support certification, specialty certification, and caring for pediatric patients. In addition, the research questions guided the investigation to determine if any of the variables could predict nurses&rsquo; self-efficacy in pediatric emergencies. The theoretical framework was based on Bandura&rsquo;s social learning theory, which incorporates the concept of self-efficacy, as well as Zimmerman&rsquo;s self-regulated learning theory. A quantitative correlational design was used with a convenience sample of 37 nurses. Self-efficacy was measured with the General Self-Efficacy Scale and knowledge was quantified using a 32-item researcher-developed instrument. The data were analyzed using multiple regression analysis and correlations. Results showed that none of the variables predicted self-efficacy; however, years of nursing education, pediatric life support certification, and clinical experience were all significantly related to knowledge. Based on the results, a 3-day educational program was developed to address pediatric emergency practice. The results of this study can direct positive social change by informing future nursing education and training efforts in order to improve the medical outcomes of pediatric patients.</p>

<p> Current trends in healthcare have impacted every level of nursing education. Challenges to nurse educators to increase the level of education for all nurses have resulted in an increase in the number of students applying to baccalaureate nursing programs. With this increase in the number of applicants, schools of nursing continue to search for admission criteria that allow admission of the students who are most likely to successfully complete the program. The purpose of this study was to determine if the TEAS V, given as part of the admission process to the school of nursing, is predictive of completion of the BSN nursing program. The sample consisted of 93 nursing students (19 &ndash; 59 years old) at a private university in the southeastern United States. A correlational, retrospective review of the records was used to collect data for the study. Program completion was investigated to determine if there was a relationship to age, gender, TEAS V composite score, TEAS V subject content scores or pre-nursing GPA. The results of data analysis revealed a statistically significant relationship between age and program completion. The older the student, the more likely the student is to complete the BSN program. The TEAS V composite score, TEAS V reading score and the TEAS V science score were also identified to have statistically significant relationships with program completion. The results of the study are limited to the student population at the study school. </p><p> Recommendations include replication of the study with a different student population and a study of the relationship between the TEAS V composite score, reading score and science score with a larger sample size. As nurse educators continue to search for appropriate admission criteria for the BSN program, the TEAS V composite score may be a valid tool to identify students who are most likely to successfully complete the BSN program.</p>

<p> One way to mitigate health disparities in the provision of nursing care and impact social justice with vulnerable populations is the development of cultural competence. Although addressed in nursing curricula, gaps in how to best address cultural competence remain. A study was undertaken to determine whether participation in a researcher-designed intervention, entitled Transcultural Humility Simulation development, based on components of Campinha-Bacote&rsquo;s model with an emphasis on &ldquo;becoming&rdquo; culturally competent, improved cultural competence in graduating baccalaureate nursing students. A longitudinal, descriptive, quasi-experimental, pretest-posttest comparison group design using embedded mixed methods was used. A total of 57 student participants from one baccalaureate nursing school in the western US were randomly assigned to the intervention group (<i>n</i> = 22) or the comparison group (<i>n</i> = 35). All participants completed the Inventory for Assessing the Process of Cultural Competence-Student Version before and after the intervention. Intervention participants also completed three written reflection exercises the day of the workshop. A subgroup of participants in the intervention group (<i>n</i> = 12) and the comparison group (<i>n</i> = 8) were interviewed two to three months after graduation. No statistically significant differences were obtained between groups while treating the pretest as a covariate. Participants who identified as more than one race on the demographic survey perceived they were more culturally competent than those who identified as one race, <i>F</i> ratio of <i> F</i>(10, 3) = 15.13, <i>p</i> = .02. Analysis of participant reflections during the intervention indicated they anticipated incorporating cultural competence into their practice by <b>shattering preconceived perceptions, constructing innovative insights, improving effective communication,</b> and <b>emerging personal development.</b> Once in practice, they incorporated cultural competence through <b>cultivating nursing-person relationships, providing quality nursing care, serving the patient and family, establishing extraordinary communication</b> and <b>approaching care with humility. </b> This study suggests that bringing attention to cultural competence through participation in Transcultural Humility Simulation Development could raise awareness and foster developmental growth among student participants through transformative learning, epistemic belief change, and double-loop learning.</p>

<p> The purpose of this basic qualitative study was to explore the experiences of nursing faculty members who taught in associate degree nursing programs and how they implemented the hidden curriculum. The hidden curriculum is referred to as the subtle messages relayed to students either verbally or nonverbally. In higher education, it is understood that the hidden curriculum is used to socialize students into professional roles, but, the process of how to socialize individuals varies. The sample consisted of 12 nursing faculty members who taught in associate degree programs in the Pacific region of the United States. Research on the hidden curriculum in nursing education has focused on the student&rsquo;s perspective. Upon reviewing the literature, a gap existed in regards to the experiences of nursing faculty with the hidden curriculum. Information was gathered through semistructured interviews to learn how these faculty members implemented the hidden curriculum. Data analysis revealed four reoccurring themes on how nursing educators implement the hidden curriculum in their practice. The first two themes uncovered how nursing faculty members described themselves as mentors and role models to their students to help students become successful in school and later in the workforce. Another theme revealed how nursing faculty members saw themselves as experts who could demonstrate skills and explain procedures. Lastly, nursing faculty members saw themselves as implementing the hidden curriculum by being advocates who could help students troubleshoot problems, as well as assisting them to navigate the nursing program. After interviewing the nursing faculty members, it became apparent that they used the hidden curriculum to provide a pathway for success for their students. The findings also highlight the need for the hidden curriculum to be included in faculty professional development workshops and seminars, and perhaps, the need to bring the hidden curriculum out from hiding.</p><p>

<p> Lifelong learning in professional communities is changing to adapt to professions in the anesthesia field with input from the public and various stakeholders. An extensive review on learning styles identified a gap in literature, specifically evidence on sensory learning styles among adult professionals. Changes in Certified Registered Nurse Anesthetist (CRNA) recertification requirements, most importantly the incorporation of an assessment component, prompted the research to address CRNA enhancement methods in learning. The main purpose of the current study was to contribute to the body of literature if a CRNA&rsquo;s knowledge of sensory learning styles mix influences test score achievement. The posttest-only control-group design was utilized, wherein a Sensory Learning Styles Self-Assessment (SLS-SA) instrument was piloted to establish content validity and internal reliability prior to its application with the treatment group. The American Association of Nurse Anesthetists (AANA) Learn&rsquo;s Health and Wellness Module 1 provided the 10-hour posttest, which measured the test score achievement among participants. An analysis of variance (ANOVA) was conducted and yielded a nonsignificant effect of the current study&rsquo;s treatment on test score results among CRNAs. Interaction effects of the CRNAs&rsquo; gender and years of practice were also examined, which produced the same results (e.g., not significant). No effect was established in the current research, however, several research limitations were identified and specific outcomes on an individual participant level were acknowledged, which were recommended to substantiate further research. </p>

<p> High fidelity human simulation (HFHS) has become a common feature in nursing education in recent years. This case study explored the practices and perceptions of nursing directors, faculty, and students regarding the integration of HFHS in associate degree RN and LPN programs. The course of study in these particular programs is two years or less in length, presenting added challenges for faculty to introduce new pedagogies into an abundantly full curriculum. Multiple data sources were used and included 41 participants through interviews with nursing directors and instructors, observation of instructors and students during HFHS scenarios and debriefing sessions, and student focus group interviews at four nursing schools in two Midwestern states. Data analysis resulted in the emergence of four major themes: time limitation, limited resources, instructional disconnect, and student perspectives. These findings were consistent with much of the current literature. Findings also demonstrate the negative effects of limited time, resources, and faculty practices on the ability of nursing students to suspend disbelief and fully engage in the learning scenarios. Given the financial investments in HFHS, achieving best use through supporting student participation in active learning and facilitating the development of clinical judgment are goals which should be considered.</p>

<p> The problem addressed in this study was the need for evidence-based teaching strategies that prepare nursing students to enter practice at graduation with the competencies to provide safe patient care. The purpose of the study was to investigate whether the addition of a patient safety focused human patient simulation (PS-HPS) learning activity during the final senior semester of a nursing program in southeast Michigan changes students&rsquo; perceptions of patient safety competence learning. For the pre-test post-test quasi-experimental study, a convenience sample of 48 undergraduate senior nursing students who engaged in the simulation was compared to 50 senior nursing students from the previous semester that did not receive the intervention. The Health Professional Education in Patient Safety Survey (H-PEPSS) was administered to both groups of nursing students during the second week of the final semester of a baccalaureate nursing program and again at the end of the semester. For the first research question, the ANCOVA test determined that there was no significant difference in post-test classroom learning scores between the comparison and treatment groups, controlling for pre-test classroom learning H-PEPSS scores, F (1, 95) = .000, p = .983, partial eta squared = .000. For the second research question, the ANCOVA test determined that there was no significant difference in post-test clinical learning H-PEPSS scores between the comparison and treatment groups, controlling for pre-test clinical learning scores, F (1, 95) = .496, p = .483, partial eta squared = .005. Implications for nursing education practice include: (a) simulation learning may not be more effective than traditional classroom learning strategies and (b) educators should continue to explore both classroom and clinical teaching strategies to advance students&rsquo; patient safety competence learning. One recommendation is to replicate the study with other nursing students from different locations. Secondly, the simulation scenario presented in this study could be modified by other instructors to effectively facilitate students&rsquo; patient safety learning. Additionally, a mixed methods research design may yield student responses that better reflects student learning within simulation. The proposed study adds to the nursing educational research about the effectiveness of simulation for students&rsquo; patient safety competence learning.</p>