This study purposed to determine Registered Nurses' levels of knowledge and support of the Professional Nursing Practice Act considered by the Sixty-fifth Texas Legislature. According to the findings previously described, it may be concluded that many Registered Nurses participate infrequently in continuing nursing education programs. If the proposed Act had been passed during this session of the Texas Legislature, most Registered Nurses licensed in Texas would have been required to change their levels of participation when regulations regarding continuing education were implemented, no later than January 1, 1982. It may be further concluded that Registered Nurses lacked sufficient knowledge about the Act that was proposed in 1977. Both comments made by respondents and answers to specific questions in the questionnaire pointed to this conclusion.

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All professions have practitioners who are considered to be experts. Less is known, however, about how these people achieve this level of excellence and about the factors that influence the attainment of expert practice in any profession. Using acknowledged expert nurses as a focus, this dissertation explored and evaluated the following factors that the literature suggested affect the progression from novice to expert: information-processing, problem-solving, and intuition abilities: mentors and mentoring: motivation and education: experience: and institutional incentives. An additional factor -- intrinsic motivation, which was not identified a priori, emerged in the course of the research. The conceptual framework used for this study was the novice-to-expert progression developed by Dreyfus & Dreyfus and applied to nursing by Benner. Benner's framework comprises novice, advanced beginner, competent, proficient, and expert. A qualitative case study method was used employing in interviews of ten clinical nurse specialists (CNSs). Data analysis was conducted following standard procedures for qualitative descriptive analysis. The study demonstrated that all of the CNSs progressed through each of Benner's stages during their careers. The following factors were identified as influential in their achieving expertise: information-processing and problem solving; mentors and mentoring; motivation and education; experience; intrinsic motivation. Institutional incentives and intuition played very weak roles and were not considered influential in achieving expertise, although the CNSs stated that the latter was an important element of their practice. This study has several implications for practice and research. With respect to practice, there is a clear need for mentoring programs, graduate education, internship programs, a stronger emphasis on experience, and policies to assure patient assignments are correlated with the level of the practitioner. Further research is suggested on all factors identified, especially the clinical ladder. The study contributes to adult education theory by clarifying the factors which foster the attainment of expertness, and to practice by suggesting areas in which interventions and innovation might be effective. / Ph. D.

This study was undertaken to identify continuing education program design and promotion preferences of nurses in the Washington metropolitan area and to determine relationships between these preferences and selected demographic characteristics of study participants. Data were collected using a 73-item survey instrument. The instrument developed by the investigator, collected information from 279 respondents in fourteen categories. Analysis of collected data indicated nurses preferred continuing education programs that are four to six hours in length, held in the middle of the week, held anywhere space is adequate and available but within one hour's driving distance. Program titles featuring lengthy descriptions and new information were preferred as were programs listing several speakers on one topic. Academic degrees of faculty do not seem to influence nurses decisions to participate, but experience related to topic does. Subjects generally wanted detailed information about programs to make decisions and tended to learn about programs through brochures mailed to their home. Program approval by recognized bodies would positively influence nurses choices but the awarding of contact hours for participation would not influence decisions. Cost and distance were sited as attendance deterrents and the majority of respondents would not personally pay more than $25 for a CE program. Employed nurses are receiving registration fee support and paid leave time for CE. The data also indicated that nurses are making their own CE program decisions. Study findings suggest that, for these nurses, some modifications in program design and use of promotional materials may be warranted by continuing education providers. / Master of Science

The problems of declining enrollments and shrinking resources seem particularly acute for baccalaureate schools of nursing. In a study of responses to these and other problems, deans of five types of baccalaureate nursing schools described how they collected and channeled information as they developed strategies to ensure the future of their programs. A questionnaire was sent to the deans of 344 baccalaureate schools of nursing. Forty-two percent of the deans returned the questionnaire. A follow-up study of 30% of the nonrespondents produced an inadequate return and did not permit comparison of respondents and nonrespondents. The data were summarized using frequencies, percentages, means, and standard deviations. Relationships were examined with one-way analyses of variance and Pearson correlation coefficients. The most commonly perceived factors impacting each type of school, the types of information sought for each factor, the ways information was channeled, the actions taken regarding each factor, and potential future actions were reported. Two one-way analyses of variance found no differences ∝= .05) among the types of schools in (a) the total amount of impact on the school of all the factors and (b) the total amount of influence over these factors felt by the dean of the school. Pearson correlation coefficients for total impact and the number of years the dean had been in office and total influence and the number of years the dean had been in office were not large enough to be statistically significant ∝= .05). Suggestions for research included studies of the information-processing and decision-making strategies of deans and comparative studies of information-processing and decision-making in schools of nursing and schools in other academic areas. / Ed. D. / incomplete_metadata

A review of the literature reveals that data about Second Step baccalaureate nursing programs for registered nurses remain elusive due to a lack of comprehensive research although such programs represent a significant trend in nursing education. The purpose of the study was to describe post-licensure professional nursing education according to selected institutional, program, faculty, and student characteristics; analyze the importance of educational decisions made about and for registered nurses in Second Step programs; and compare post-licensure professional nursing education, Upper Two and Two-Plus-Two programs, with NLN generic baccalaureate nursing education. The population included 100 Second Step programs consisting of two curriculum patterns: 82 Upper Two and 18 Two-Plus-Two programs, and a random sample of 30 NLN. generic baccalaureate nursing programs who responded to the survey questionnaire. The major findings reveal a great deal of similarity between the characteristics of Second Step programs and NLN generic baccalaureate programs in faculty preparation; faculty/student classroom and clinical size; proportion of nurse administrators with doctorates; required hours for the baccalaureate nursing degree including nursing-cognate, humanities, foundations, and electives; types of institutions which contain programs; and the awarded degrees. TwoPlus-Two graduates appeared similar to NLN generic baccalaureate graduates by being predominantly full-time, single, white, and female. More Upper Two graduates were married, divorced, widowed, older, and attended school on a part time basis. Nurse educators had a high degree of consensus on the importance of educational decisions made about and for registered nurses in selecting applicants, awarding credit, nursing curriculum content required at the upper division level, nursing learning experiences, evaluation of students' learning experiences, and program objectives. Post-licensure professional nursing offers a mechanism for nursing career mobility and higher education articulation for non-degree registered nurses. The proliferation of programs and graduates demonstrates Second Step programs are part of the mainstream of professional nursing education. / Ed. D.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room, for example, is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite the numerous studies that have been undertaken in this field, few studies that have investigated the operating room as a clinical learning environment in the South African healthcare system have been published. The aim of this study was to determine students’ perceptions of the operating room as a clinical learning environment in a private hospital context. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Data was collected from nursing students undertaking their training at a private nursing education institution. Ten nursing students participated in an open-ended questionnaire (N=10), and twelve students participated in the focus group discussion (N=12). From the results, four themes emerged, namely, ‘interpersonal factors’, ‘educational factors’, ‘private operating room context’, and ‘recommendations’. This study has highlighted some of the challenges experienced by students in the private sector operating room context. Despite the potential learning opportunities, the key findings reveal negative perceptions of students regarding learning experiences. However, the opinion that the operating room offers an opportunity to gain skills unique to this context, as well as facilitates the integration of theory and practice, was also expressed. Some students reported that the emphasis on profitability and cost to patient, and the lack of a mentoring process in this context posed a constraint to learning. Exploration into the specific preparatory needs of students specific to learning outcomes before operating room placement should be considered. It would also be necessary to improve collaboration between lecturers, mentors and theatre managers so that a structured teaching programme may be developed for students entering the perioperative environment. / AFRIKAANSE OPSOMMING: Studente onderneem hul kliniese plasing in verskeie kliniese omgewings vir die blootstelling aan en aanleer van vaardighede wat verband hou met daardie spesifieke konteks. Die operasiesaal, byvoorbeeld, is ’n kliniese omgewing wat die geleentheid bied om kritiese vaardighede te ontwikkel wat verband hou met die perioperatiewe versorging van die pasiënt. Ten spyte van die talle studies wat in die operasiesaal onderneem was, het slegs ’n paar studies uit ’n Suid-Afrikaanse gesondheidsorg oogpunt, die operasiesaal as ’n kliniese opleidings omgewing ondersoek. Die doel van hierdie studie was om studente se persepsies van die operasiesaal as ’n kliniese omgewing in ’n privaat hospitaal konteks te bepaal. ’n Ondersoekende, verklarende en beskrywende ontwerp wat kwalitatiewe data genereer, is gebruik. Data is ingesamel van verpleegstudente wat hul opleiding by ’n privaat verpleegonderrig instelling ontvang. Tien verpleegstudente (N=10) was genooi om ’n onbepaalde vraelys te voltooi en twaalf student (N=12) het aan die fokusgroep bespreking deelgeneem. Vier temas het na vore gekom, naamlik ‘interpersoonlike faktore’, ‘opvoedkundige faktore’, ‘privaat-operasiesaal konteks’, en ‘aanbevelings’. Hierdie studie het ’n paar van die uitdagings uitgelig wat die studente in ’n privaat sektor operasiesaal ondervind. Ten spyte van die potensiële leergeleenthede teenwoordig in die privaat sektor operasiesaal, toon die belangrikste bevindings egter die negatiewe persepsies van studente jeens hierdie kliniese omgewing. Die opinie is egter ook uitgespreek dat hierdie omgewing ook ’n geleentheid aanbied om unieke vaardighede aan te leer. Dit bied ook ’n geleentheid om teorie en praktiese kundigheid te integreer. Sommige studente rapporteer dat die klem op winsgewendheid en koste vir die pasiënt, asoók die gebrek aan mentorskap in hierdie kliniese omgewing ’n beperking plaas op die leerproses. Die spesifieke voorbereidings behoeftes van studente insake leeruitkomste voordat plasing in die operasiesaal omgewing geskied, moet eers deeglik ondersoek word. Dit is ook nodig om die nodige samewerking tussen dosente, mentors en operasiesaal bestuurders te verbeter sodat ’n gestruktureerde onderrig program ontwikkel kan word vir studente wat die perioperatiewe omgewing betree.

背景: 高擬真情境模擬（HFS）已成為一種流行的護理教育教學法，能讓學生安全及有效地利用高擬真情境模擬人練習護理。許多西方的研究報告指出，HFS對護理學生的自信心培育、解決問題的能力和批判性思維均有正面影響。然而，對本地護理學生所做的研究有限。基於文化差異，以及不同的學習風格，西方國家的證據未必能套用在香港的護理學生身上。 / 目的: 本研究志在探討高級護理文憑課程的學生對研究員研發的高擬真情境模擬訓練課程(HFSTP)的滿意度，及HFSTP對學生的學習自信及批判性思維發展的影響。 / 研究方法: 這項研究採用了混合方法研究設計，分為兩個階段。第一階段為準實驗性研究，利用前測後測設計，以探討HFSTP對護理學生的自信心、滿意度以及批判性思維發展的影響。共90位護理學高級文憑課程二年級學生，按他們就讀課程的要求，參加了第一階段的研究。而HFSTP是参照科爾布的經驗學習週期所研發，當中包括兩個1小時的小組研討和兩個1小時HFS實驗室培訓。第一階段的研究採用了四份問卷，包括學生滿意度和學習中自信量表（SCL），批判性思維調查（CTS），仿真設計量表（SDS）和人口表。而在SCL得分最高及最低各12位學生會被邀請參加第二階段的焦點團體訪談。這階段研究以半結構化面試指南來探索學生們對HFSTP的看法。所得數據以內容分析法作分析。 / 結果: 配對t檢驗結果表明，SCL和CTS的後測平均分均顯著高於前測（P = 0.001）。而對HFSTP的設計評價，學生評定保真度和匯報會為HFSTP學習中最重要的元素。大部份學生在定性訪談中表示滿意這嶄新的學習方法。根據定性數據分析的結果得出四大主題：（1）模擬臨床環境，（2）整體護理經驗，（3）信息和反思的思維，及（4）HFS的用量，研究人員得出結論，參照科爾布的經驗學習週期所研發的高擬真情境模擬訓練課程，是一種有效的教學策略，它能有效地提高學生的學習自信及培養出批判性思維。同時，學生表示滿意這次課程的安排。至於這次研究結果對護理教育，護理實務和高等教育管理的影響將會在這論文的最後部份發表。 / Background: High-fidelity simulation (HFS) has become a popular teaching method in nursing education that allows students to practice their nursing care skills safely and effectively on human patient stimulators. Many studies have reported the positive impacts of nursing students’ learning experience with the use of HFS on their development of self-confidence, problem solving and critical thinking. However, studies done on local nursing students are limited. Acknowledging that there may be cultural differences in the learning styles between Chinese and non-Chinese people, the existing evidence mainly come from western countries, which may have limited generalizability to Hong Kong nursing students. / Aims: This study aims to examine the satisfaction of the higher diploma nursing students on the researcher-developed high-fidelity simulation training program (HFSTP), and the effects of HFSTP on the students’ self-confidence in learning and development in critical thinking. / Methods: A mixed methods study design was used in two phases. In Phase I, a quasi-experimental, one-group pretest-posttest design was employed to investigate the effects of HFSTP on nursing students’ satisfaction, self-confidence, and critical thinking development. A total of 90 year 2 higher diploma nursing students participated in the Phase I study. The Kolb’s experiential learning cycle guided the development of the HFSTP including two 1-hour simulation tutorials and two 1-hour HFS laboratory and debriefing sessions. Four questionnaires including Student Satisfaction and Self-Confidence in Learning (SCL), Critical Thinking Survey (CTS), Simulation Design Scale (SDS), and a Demographic Sheet were employed in the Phase I study. In Phase II, a focus-group interview was conducted to explore students’ perception of HFSTP. A total of 24 students from the highest or lowest scores in the posttest SCL in Phase I were invited for the focus group interview. A self-developed semi-structured interview guide was used to explore the participants’ perception of the HFSTP. Content analysis was used for data analysis. / Results: Results of paired t-test indicated that the mean scores of both SCL and CTS in the posttest were significantly higher than those of the pretest (p = <0.001). With regard to the evaluation of the design of HFSTP, the participants rated the fidelity and debriefing sessions as the most important learning features in the HFSTP. In the qualitative interview, most of the students expressed satisfaction towards the learning of HFSTP. Four main themes (1) A mimic clinical environment, (2) Holistic care experience, (3) Information and reflective thinking, and (4) Dosage of the HFS, emerged from the analysis of the qualitative data based on students’ perceptions of having HFSTP as a new teaching strategy. Researcher concluded that the HFSTP, which is based on Kolb’s experiential learning cycle, is an effective teaching strategy for promoting nursing students’ self-confidence in learning and critical thinking development. Students were satisfied with the program design. Fidelity and debriefing sessions were reported as the two most important learning features of the HFSTP. Implications of the findings for nursing education, nursing practice and higher education administration will be presented at the end of the paper. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Fong, Wan Ching Kathryn. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 154-161). / Abstracts also in Chinese. / Chapter CHAPTER ONE --- INTRODUCTION --- p.1 / Introduction --- p.1 / Background of the Study --- p.1 / Justification for the Study --- p.5 / Research Questions --- p.6 / Conceptual and Operational Definitions --- p.7 / Significance of the Study --- p.9 / Overview of the Study --- p.10 / Chapter CHAPTER TWO --- LITERATURE REVIEW --- p.12 / Introduction --- p.12 / Search Strategy --- p.13 / Development of Simulation --- p.13 / History of Simulation Learning in Nursing Education --- p.16 / HFS used in Nursing Education --- p.17 / Self-Confidence in Learning --- p.25 / Satisfaction with Learning Experience --- p.37 / Critical Thinking --- p.43 / Theoretical Framework: Kolb’s Experiential Learning Cycle --- p.48 / Conclusion --- p.52 / Chapter CHAPTER THREE --- METHODOLOGY --- p.55 / Introduction --- p.55 / Research Questions --- p.56 / Aims --- p.56 / Research Objectives --- p.56 / Research Design --- p.57 / Setting --- p.61 / Phase I Study --- p.63 / Phase II Study --- p.83 / Ethical Issues --- p.90 / Pilot Study --- p.91 / Summary --- p.91 / Chapter CHAPTER FOUR --- RESULTS --- p.93 / Introduction --- p.93 / Research Hypotheses --- p.94 / Phase I Study --- p.94 / Phase II Study --- p.105 / Summary --- p.126 / Chapter CHAPTER FIVE --- DISCUSSION --- p.128 / Introduction --- p.128 / Participant Recruitment and Response --- p.128 / Issues of Dropouts and Participant Non-attendance --- p.129 / Discussion on Study Findings --- p.129 / The Use of Assessment Tools --- p.142 / Limitations of the Study --- p.143 / Implications for Nursing Education --- p.144 / Implications for Nursing Practice --- p.146 / Implications for Higher Education Administration --- p.148 / Recommendations for Future Studies --- p.150 / Conclusions --- p.151 / REFERENCES --- p.154

Community based service-learning is one of the fastest growing reforms in higher education, especially in the field of health care. The increased interest in this phenomenon is based on the demands by government and society that higher education institutions should be more responsive to the needs of the community. Literature, however, reflects that service learning lacks a sound theoretical base to guide teaching and learning due to limited research in this area. This study was, therefore, aimed at exploring the phenomenon knowledge construction in basic nursing programmes in selected South African nursing schools with the intention to generate a middle range theory that may be used to guide the process of knowledge construction in community-based service-learning programmes. This study adopted a qualitative approach and a grounded theory research design by Strauss and Corbin. Two university-based schools of nursing were purposively selected to participate in the study. There were a total number of 16 participants. The collection of data was intensified by the use of multiple sources of data (participant observation, documents analysis and in-depth structured interviews). The data analysis process entailed three phases; open, axial and selective coding. The results of the study revealed that the phenomenon “knowledge construction” is conceptualised as having specific core characteristics, which include the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue and communities of learners. The findings showed that there are a number of antecedent conditions and contextual circumstances contributing to how knowledge is constructed in a community based service learning programme. The process of knowledge construction emerged as cyclical in nature, with students, facilitators and community members having specific roles to play in the process. A number of intervening variables were identified that had an influence on the expected outcomes on knowledge construction in community based service learning programmes. These findings led to the generation of a conceptual model. Knowledge construction according to this model takes place in an environment which is characterised by interactive learning, collaborative learning, actively learning and inquiry-based learning through continuous reflective learning processes. The main concepts in this conceptual model include concrete learning experiences, continuous reflection, problem posing, problem analysis, knowledge deconstruction and knowledge generation, knowledge verification, knowledge generation, testing of generated knowledge and evaluation of generated knowledge. The sub-concepts include learning through senses, an initial situation, health-related triggers, social interaction, reflection-in action, reflection-on action, hypotheses generation, conceptualisation of learning experiences, information validation and community interventions. Recommendations were categorised into education and training of academic staff, application of the model and further research with regard to quality assurance in CBSL programmes as well as the use of other research designs for similar studies. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.

M.Cur. / The purpose of the research study was to describe guidelines to improve the community health clinics as a learning context conducive to learning. The objectives of the study commenced by getting the perception of student nurses, community sisters and college tutors, to explore and describe the problems experienced in relation to community health clinics as a learning context for student nurses, especially when they are allocated for their clinical practicals to prepare them to become competent. The research design and method used, consisted of a qualitative approach to achieve the intended goal of the research study. The design was divided into two phases: Phase one consisted of a field/empirical study and phase two consisted of conceptualization. Phase one has three steps where each step indicates the research method, population and sampling, data collection and data analysis. Population and sampling for step I included all the fourth year students from a nursing college in Gauteng, who are in an educational programme leading to registration as a nurse (general, psychiatric and community) and midwife. Population and sampling for step II consisted of community sisters from ten community health clinics in the Southern Metropolitan Local Council. Population and sampling for step III consisted of community college tutors from a college in Gauteng; the sample size consisted of the whole population. In all the steps follow-up interviews were conducted to confirm the findings. To ensure trustworthiness Lincoln and Guba's (1985) model was implemented, and data analysis were according to Tesch's (1990 in Creswell, 1994:155) method, based on a qualitative approach. The major problems reflected in the research findings based on Step I, II, II indicate similarities and Step III only indicates some uniqueness. The conceptual framework was discussed, indicating a body of knowledge, based on the study and empirical findings from phase I, to give clear meaning and understanding regarding the research study. Problems from all the steps were used in an integrated manner as research findings and were compared with existing literature within the framework, to determine similarities and differences as literature control method. Guidelines were then formulated from phases I and II, to solve the indicated problems, based on the three different sample groups. Guidelines were supported by the conclusion statement from chapter four and the problem statement from chapter three. Essential actions were indicated for operationalisation. Ethical consideration was maintained throughout the research study. The study has been evaluated by means of positive and negative issues related to the actual research process. Recommendations related to nursing education, nursing practice and nursing research were indicated accordingly.