Thesis--Ed. D. Columbia University Teachers College, Health Sciences, nursing, 1975. / Includes bibliographical references.

Thesis (Ph.D.)--Indiana University, 2010. / Title from screen (viewed on March 3, 2010). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Judith Halstead, Anna McDaniel, Mary L. Fisher, Lillian Stokes. Includes vitae. Includes bibliographical references (leaves 98-107).

<p> A severe and worsening nursing shortage exists in the United States. Increasing numbers of new graduate nurses are necessary to meet this demand. To address the concerns of increased nursing demand, leaders of nursing schools must ensure larger numbers of nursing students graduate. Prior to practicing as registered nurses in the United States, graduates of nursing schools must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Various companies, such as the Assessment Technologies Institute (ATI) and Kaplan have created NCLEX-RN predictor tests that report candidates&rsquo; chances of passing the NCLEX-RN. ATI created a test called the RN Comprehensive Predictor and Kaplan created an NCLEX-RN predictor examination called the Kaplan Readiness Test. Students with less than optimal scores on the predictor can remediate to improve their knowledge of nursing, critical thinking, and test-taking skills. The intent for the ATI RN Comprehensive Predictor and the Kaplan Readiness Test is to predict the probability of success on the NCLEX-RN. The focus of the quantitative study was the ability of the aforementioned examinations to predict both success and failure on the NCLEX-RN. The overall TEAS score did not have a significant relationship with NCLEX-RN results. However, the ATI TEAS Math score was significantly higher (<i>p</i> = .005) for students who passed the NCLEX-RN. Data analysis showed no significant relationship between the Kaplan NCLEX-RN Readiness Test and NCLEX-RN results (<i>p</i> > .05). A significant relationship between the ATI RN Comprehensive Predictor and the NCLEX-RN scores existed in both the total sample (<i>p</i> = .001) and the BSN subsample (<i> p</i> = .001). In the MSN student subsample, all 37 students passed the NCLEX on the first attempt.</p>

<p> Attitudes toward patient safety are the foundation of patient safety culture. Nursing students begin to formulate their attitudes toward patient safety while in educational programs. Nursing faculty have been challenged in their efforts to enhance the patient safety culture of students because there is a lack of empirical evidence as to which teaching strategies positively affect student attitudes toward patient safety. The purpose of this study was to examine the relationship between a 50-minute teaching module based upon the concept of medical error recovery and 9 dimensions of patient safety culture as measured by the Attitudes to Patient Safety Questionnaire. The guiding framework for the study was the reciprocal interactive theory of patient safety culture in nursing. The conceptual model used to illuminate the role of nurses in recovering medical errors in the educational intervention was the modified Eindhoven model of near-miss events. The sample comprised 4 student cohorts (N = 142) enrolled in an accelerated bachelor of science in nursing (ABSN) program at one university, with 4 participants lost to follow-up (n = 138). A quasi-experimental, nonequivalent control group, pretest/posttest design was used to compare mean attitude scores between the control (n = 75) group and the intervention group (n = 63) after statistically controlling for the pretest. ANCOVA revealed statistically higher mean attitude scores for the intervention group in 5 of 9 dimensions of patient safety culture with a small-medium effect size associated with the intervention: patient safety training, error inevitability, professional incompetence as error cause, patient's role in error, and importance of patient safety culture in curriculum. The results supported the use of a short-duration educational session on medical error recovery to enhance a subset of patient safety culture dimensions among ABSN students.</p>

At the outset, I dis-claim any knowledge or understanding what-so-ever, which is a peculiar stance to take for a nurse educator immersed in the language of “expertise,” “best practices,” and “champion” healthcare offerings. I do not dis-claim knowledge to absolve my professional accountability, nor do I absolve myself of being responsible for my text, rather I apprehend this journey of sentience and incarnation as an infant experiencing and learning the world in which it finds itself. It is only through a naïve, furtive play that I am able to proceed, through the difficulties and paradoxical tensions of constructed identities, without complete paralysis. As I play and ponder my way through multiple methodologies, a representational form emerges between repetitious moments of contemplation, remembering lived experiences, and reflecting on philosophical discourses. The difficulty or tension lies in the provocation of identities, as nurse, educator, and mother, among many other stances and formulations. Each identified discourse compels me to challenge the gaps in my knowledge in new ways. As I explore, I unravel the forms of text that are various incarnations of narrative reflection. The choices I make are about inquiring through concept, form and identification, which I both uniquely challenge as an individual and hold in common by being socially and historically situated. Each transition, contemplation and provocation is hopeful and volatile. I am always attuned to how it is that I live the spaces between each, unknowing my “self” as my otherness, letting go the ideal/real and becoming the (/) through a relational pedagogy.

<p> Registered nurses practice in an environment that involves complex healthcare issues requiring continuous learning and evaluation of cognitive and technical skills to ensure safe and quality patient care. The purpose of this basic qualitative study was to gain a better understanding of the continuing educational needs of the expert nurse. This study focused on the use of simulation as a learning platform in the continuation of competency. The study was based on the theories of adult learning and novice to expert. A sample of 10 expert nurses was interviewed regarding their experiences in the use of simulation during continuing education endeavors. The finding indicated that the use of simulation in this study population was effective in the maintenance of competency or in the delivery of new information. The study finding also offered developmental ideas for nurse educators in the planning and delivery of simulation to this study population.</p>

<p> Male nurses are but a small percentage of the total nurse population in the United States, and most certainly have potential to increase in numbers if the profession appeared more attractive as a career option for men. The purpose of this research was to discover the decision factors used by males that led them to enroll in Associate Degree nursing programs in Illinois community colleges. To set the background and context, the study explored the history of community colleges and that of nursing. Included was nursing as a profession, nursing in the United States, the country&rsquo;s impending nursing shortage and the role of men in nursing. </p><p> Using a qualitative case study method of design, the study adapted a multi-theoretical framework encompassing gender theory (GT) and career developmental theory (CDT). These theories were further broken down by discussing, in particular, Holland&rsquo;s Theory (HT) of Personality and Vocational Choice and Krumboltz&rsquo;s Social Learning Theory (KSLT) under CDT. Nine first year male ADN students from three separate Illinois community colleges were individually interviewed. Findings discovered that the first year male students experienced a distinctive decision making process with eight emerging themes revealing the males&rsquo; decision making about their ADN enrollment process. </p><p> As a result of the study&rsquo;s findings, MURSE: Resurreccion&rsquo;s Male Nursing Student Decision Making Pyramid model was developed to elaborate the steps of how males make decisions about their ADN enrollment. An understanding of these factors can provide opportunities for community colleges, and perhaps universities, to improve recruitment and retention of males in nursing programs. A result would be increased numbers of males enrolling in Associate as well as Baccalaureate nursing programs. Such knowledge held by colleges may help to address a manpower solution to the impending worldwide nursing shortage. </p>

<p>Critical reflection as a learning tool for nursing supervisors is a complex and multifaceted process not completely understood by healthcare leadership, specifically nurse supervisors. Despite a multitude of research studies on critical reflection, there remains a gap in the literature regarding the perceptions of the individual, the support required in the environment, and stimulus needed to integrate critical reflection into the nurse supervisor role. The purpose of this qualitative hermeneutic phenomenological study was to explore the meaning critical reflection has for nurse supervisors and the role of critical reflection within clinical practice settings. The data obtained through a modified vanKaam analysis employing <i>NVivo 9</i> software revealed five themes concerning critical reflection. These five themes include (a) personal experience, (b) sources of valuing critical reflection, (c) self-awareness as primary competency, (d) time is a function of prioritization and (e) framework tools for workplace integration. Critical reflection meaning developed through nurse supervisors&rsquo; past experiences with critical incidents and a willingness to develop their own self-awareness. The role critical reflection plays in the environment can be enhanced through making it a priority in the workplace and providing training necessary to increase understanding of the process. Workplace integration requires developing nurse supervisors&rsquo; facilitation skills. The study findings support the underlying value critical reflection holds as a significant part of supporting organizational transformation toward a learning organization culture. </p>

<p> <b>Background.</b> Nurse educators are challenged with a new generation of students referred to as the Millennial generation. These millennial students, who have different learning style preferences, are testing the traditional pedagogical methods of nurse educators such as lecture. The social nature of millennial students coincides with the social constructivism theory that students learn in groups. </p><p> <b>Purpose.</b> The purpose of this quasi-experimental study was to examine if there was an improved retention of knowledge in millennial students who were taught by collaborative learning strategies rather than the traditional lecture method in an associate degree nursing program. Additionally, the study examined if learning by the students' preferred learning style resulted in a higher level of achievement on a comprehensive standardized examination versus learning by a nonpreferred style. </p><p> <b>Theoretical Framework.</b> The theoretical framework for this study was founded on the social constructivism theory suggesting students build knowledge through social group interactions. </p><p> <b>Methods.</b> The quasi-experimental study was conducted at an associate degree program in the Midwest. The nonprobability purposive sampling was utilized to examine the means of a comprehensive standardized examination and a learning styles preference assessment. </p><p> <b>Results.</b> The statistical analysis utilizing the analysis of covariance did not produce statistically significant findings in the differences in the comprehensive standardized examination score means between the students taught by the lecture method and students taught by the collaborative method when controlled for the cumulative grade point average. Additionally, the study did not find statistically significant differences in mean comprehensive standardized examination scores when taught by the students' preferred learning style versus being taught by their nonpreferred style. </p><p> <b>Conclusions.</b> Although not significant, the study did find students who were taught by the collaborative method had higher scores than those who were taught by the lecture method. In addition, learning styles preferences were not significant in determining academic success. The implications of the study are significant to nursing education by highlighting the importance of using collaborative activities and multiple teaching modalities.</p>

<p> <b>Background:</b> Implementation of evidence-based knowledge in healthcare is challenging with success rates less than optimal at times. This is particularly true in the area of pressure ulcer prevention. Attention to use of the affective domain in educational interventions to implement best practices may be part of the solution. </p><p> <b>Purpose:</b> The ultimate purpose of this study was to compare the use of two different educational interventions on medical-surgical nurses' behavioral intent to use evidence-based practice in preventing pressure ulcers. </p><p> <b>Theoretical Framework:</b> The theoretical framework for this study was the theory of planned behavior. </p><p> <b>Methods:</b> This study proceeded in three phases and collected both qualitative and quantitative data for instrument development and instrument testing. The resultant instrument was used to collect data for hypothesis testing in a cluster randomized experiment. </p><p> <b>Results:</b> The theory of planned behavior was not fully supported in this study. Attitudes toward pressure ulcers were predictive of behavioral intent. Nurses who experienced the affective domain educational intervention showed significant improvements over the control group on attitude and perceived behavioral control. Behavioral intent and subjective norm were not impacted. </p><p> <b>Conclusions:</b> A reliable and valid theory of planned behavior derived instrument was created. The theory of planned behavior was partially supported. An affective domain intervention has the potential to favorably impact nurses in valuing pressure ulcer prevention, despite any barriers.</p>