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.

M.Cur. / It is quite explicit that transformation in nursing education on clinical accompaniment of the critical care nursing students in the private hospital critical care units is inevitable. It is needed to accommodate the demands made that nurses should make rapid decisions in the crisis situations, taking responsibility that were previously of those of the physicians resulting in the increased complexity of decision-making. The decision-making skills demands that the nurses should develop the ability for the analytical, critical evaluation, critical thinking and ability of independent judgement of the scientific data as stated by the South African Nursing Council Regulation 2118 (1983:2). It also demands that the registered nurses working in the critical care units be suitably trained by completion of the Intensive Care Nursing Science course as specified by the South African Nursing Council Regulation 85 as amended (Nursing Act of 1978). The critical care nurses are required to integrate both the knowledge of the highly sophisticated technological equipment and also the understanding of the complex patient's problems. It is also explicit that, there is a need to develop the guidelines on clinical accompaniment of the critical care nursing students in the private hospital critical care units as no written guidelines are available. The overall objective of the study is to describe the guidelines on clinical accompaniment of the critical care nursing students in the private hospital critical care units. The guidelines will be utilised as a point of departure for the facilitation of attainment of quality/excellency in nursing education, skills or competency of the critical care nursing students in the private hospital critical care units.

This study investigated current use of American Association of Colleges of Nursing guidelines in preparing the baccalaureate nurse graduate to practice nursing in the community health sector of the healthcare delivery system and use of community based healthcare delivery sites by baccalaureate programs located in non-urbanized and urbanized areas. The extent of guidelines adoption, plans by colleges not currently using them to do so in the future, and impact of accreditation visits on the adoption of the guidelines were also explored. A qualitative survey design was used to describe the use of AACN guidelines in the development of baccalaureate nursing education.

Purpose: The purpose of this study was to develop a visual concept map that could assist nurse educators in explaining the concept ‘nursing’ so that students have a similar understanding, meaning and interpretation thereof. Methodology: An exploratory and descriptive qualitative study was conducted to develop a visual conceptual map that can help in the common understanding and interpretation of the concept ‘nursing’. Research approach: A qualitative research approach was used. The research approach consisted of four phases: Phase 1: A self-designed online questionnaire was used to obtain information from the nurses, registered with South African Nursing Council (SANC) and members of Democratic Nursing Organisation of South Africa (DENOSA), about their interpretation of the meaning of ‘nursing’. Phase 2 included the integrative review that was used to obtain in-depth meaning of the concept ‘nursing’ from relevant literature and documentation. Phase 3: The two sets of analysed data from Phase 1 and Phase 2 were combined and used to develop the visual conceptual map. Phase 4: The developed visual concept map was validated by the nurse educators inaugurated in Sigma Theta Tau International, the Africa Region Chapters, in order to provide a validated visual concept map based on their expertise in Africa. The outcome of the study: A validated visual concept map, agreed upon by nurse educators inaugurated in Sigma Theta Tau International, the Africa Region Chapters, based on their expertise in Africa, is available and may be of great benefit for nurse educators in teaching the meaning of the concept of nursing to student nurses in their institutions. As a teaching tool, this concept map might assist educators in explaining the meaning and interpretation of the concept ‘nursing’. / Health Studies / Ph. D. (Nursing)

Indiana University-Purdue University Indianapolis (IUPUI) / National calls for a better-educated nursing workforce are proliferating. The Institute of Medicine (IOM) challenged the nursing profession by setting the goal of having 80% of the nation's nurses prepared at the baccalaureate level (BSN) or higher by 2020. This is an ambitious goal given that, nationally, only 50% of nurses have a BSN. In fact, only 40% of nurses in Michigan have a BSN, and in the rural North-Central Region of this state, only 29% (the lowest in the state) of the nurses have a BSN. The purpose of this hermeneutic phenomenological study was to understand and interpret the meaning of being an associate degree (AD) nurse, the meaning attaining a BSN has for rural registered nurses who currently have an AD, and the barriers they experience that inform their decisions to return to school (or not). The investigator interviewed 11 AD nurses from rural North-Central Michigan and analyzed interview transcripts to identify common experiences and shared meanings using methods identified by Diekelmann, Allen, and Tanner (1989). Two themes were explicated in this study: "Getting in and Getting out" and "What Difference Does it Make?" The findings in this study challenge many of the common assumptions about academic progression in nursing and provide educators, administrators, and legislators with insight about the strategies that may be most helpful for achieving the IOM goal in rural Michigan.

The purpose of this study was to establish if, and to what extent, management of nursing colleges enhanced personnel development with regard to the professional and personal development of nurse educators and clinical preceptors. From the literature survey, it was concluded that an effective personnel development programme that included all nursing personnel involved in the education and training of student nurses, was imperative for the rendering of continuous quality nursing education. The importance of co-operation between management of nursing colleges and nursing management of clinical facilities regarding the development of personnel involved in the education and training of student nurses, was emphasised. A programme for personnel development in nursing colleges was developed. The programme included suggestions for the educational development of both nurse educators and clinical preceptors/ registered nurses involved in the education and training of student nurses. It was suggested that nursing colleges should initiate the programme. Research consisted of an in-depth literature review about the management of personnel development in the educational milieu and a survey with regard to the management of the development of personnel involved in the education and training of student nurses. Principals of nursing schools, nursing educators, nursing directors of health services and clinical preceptors in clinical settings formed the population for the study. The theoretical framework used in this research with regard to personnel development in nursing schools, was Donabedian's theory on structural, process and outcomes standards as applied to quality improvement, as well as Alspach's theoretical foundation of nursing staff development. The focus of this study was to use data generated through research to develop a personnel development programme for all registered nurses involved in the education and training of student nurses. The most important conclusions of this research were as follows: &#61623; Personnel development was provided for nurse educators and clinical preceptors/ registered nurses involved in the education and training of student nurses in the clinical setting, but it did not necessarily meet the personal and professional developmental needs of these professionals. &#61623; The specific developmental needs of nurse educators and clinical preceptors/ registered nurses were related to educational skills, higher cognitive skill and skills related to research. &#61623; Available resources at nursing colleges did not facilitate and support the development of nurse educators and clinical preceptors involved in the education and training of student nurses. The main conclusion was that the establishment of a Department of Personnel Development at nursing colleges could provide for the educational needs of both nurse educators and clinical preceptors/ registered nurses, would benefit the personal and professional development of all learners involved and, ulitmately, would enhance the quality of patient care rendered by student nurses. / Advanced Nursing Sciences / D.Litt. et Phil. (Advanced Nursing Sciences)

A quantitative, descriptive research study was conducted at a nursing college to investigate the nature of nursing learners' exposure to computer assisted instruction and computer-based learning, the perceived benefits of this exposure, and the problems that they had encountered. Learners, who had been exposed to computer assisted instruction and computer-based learning, participated. A self-administered, structured questionnaire was administered to collect data. The research results revealed that the learners had limited exposure to educational computer packages, and computer-based learning activities. They encountered numerous problems. Although the learners derived many benefits from computer assisted instruction, this did not result in effective learning. They indicated that they preferred computer assisted instruction more than traditional teaching methods. This study contributed towards recommendations on improving learners' access to the necessary facilities, equipment and educational computer software. The researcher also recommended strategies to ensure that computer assisted instruction is based on sound educational principles. / Health Studies / M.A. (Health Studies)

Research has shown that, worldwide the nursing profession is faced with image-related challenges impacting on its status, prestige, power and the ability to attract more young and suitably qualified students to nursing. There is adequate evidence of a link between the image of nursing and the number of young people entering and leaving the profession. A positive image of nursing attracts applicants and the intention to leave nursing correlates positively with holding a negative image of nursing. There is also evidence of poor perception of the image of nursing among student nurses. The study aimed at exploring the potential of appreciative inquiry (AI) as a teaching strategy to transform the image of nursing among 3rd and 4th year, college and university student nurses in the Gauteng province of South Africa. The second aim was to describe student nurses’ experiences regarding their participation in the process of AI. A qualitatively dominant, sequentially embedded, mixed methods design with explorative-descriptive and quasi-experimental features was utilised. Sequential data collection and analysis were conducted during five stages comprising: a pre-test survey, intervention (appreciative inquiry), a post-test, description of the experiences of student nurses of AI and an integration stage. The pre-test results showed more positive than negative perceptions of the image of nursing among student nurses. The negative perceptions of the image of nursing among student nurses that needed intervention included the working conditions of nurses and the perception of nursing as a profession that was not respected and appreciated. The student nurses who took part in appreciative inquiry showed a significant and positive change in their perception of the image of nursing as a respected and appreciated profession. From the individual interviews on the student nurses’ experiences of AI, the themes “experience of positive emotions” and “experiential learning” emerged. The student nurses experiences described their engagement in AI as a positive and enjoyable experience from which multidimensional learning resulted. / Health Studies / Ph. D. (Health Studies)