<p> This mixed methods participatory action research study investigated student perceptions of stress within the context of a high stakes testing environment. Participants were prelicensure baccalaureate nursing students enrolled in the final semester of their nursing program. The quantitative method, a prospective correlational research design using the Student Nurse Stress Index (SNSI) provided a quantitative measure of stress. Phenomenography, the qualitative method, was used in order to capture the various ways students experience stress. The combination of these two methods provided a rich understanding of student perspectives regarding the use of high stakes testing nursing as a measure of progression toward graduation. Analysis of the research findings revealed all students experience stress while preparing for high stakes testing. However, students perceived the experience of stress in a myriad of ways suggesting that students view high stakes testing as a threat rather than a challenge.</p>

<p> Health literacy has been identified as a significant factor in health care disparity and access to health care, and must be addressed in health care reform. Although patient education has long been considered an independent role of nursing, nurses often lack the knowledge and skills needed to be effective educators. Nursing as a profession is poised to assume a leadership role in health care reform and in promoting the national goals of health promotion and disease prevention of Healthy People 2020. The purpose of this quasi-experimental quantitative study is to determine if a formal course of education and learning theory in undergraduate pre-licensure nursing programs increases knowledge of health literacy and self-efficacy related to patient teaching. A sample size of 322 senior level undergraduate nursing students from a multi-campus private undergraduate baccalaureate school of nursing were surveyed to assess their knowledge of health literacy and their self-efficacy related to patient education. A 38-item multiple choice questionnaire with a Likert-type scale was utilized to measure the health literacy knowledge and experiences of participants, and a multi-item Likert-type scale measures nursing process steps of self-efficacy related to patient education. In this study, the experimental group had completed a formal course of educational and learning theory, while the control group had not. The experimental group demonstrated more knowledge about health literacy, however, the difference was not statistically significant. They did, however, demonstrate statistically significantly more self-efficacy related to patient health education activities in some areas compared to the control group, but not in all areas of the teaching and learning process. Recommendations for further studies are to conduct the study earlier in the nursing program, before the students complete multiple clinical courses, which require patient education activities, and to expand the study to multiple nursing programs in the region teaching a formal course in education and learning theory for patient education to see if results are consistent regionally.</p>

<p> This quantitative, retrospective, multivariate, non-experimental study examined the first-time performance of 2,673 academic nurse educators who took the CNE examination between September 28, 2005 and September 30, 2011. Post-positivism and Abbott's system of the professions theory served as the philosophical and theoretical underpinnings of this original research which attempted to determine if a relationship existed between educational preparation or years of full-time faculty employment (independent variables) and first-time pass/fail performance on the CNE examination and in each of content areas (dependent variables). The Chi-square test of independence revealed the lack of a statistically significant relationship between educational preparation and first-time pass/fail performance on the CNE examination. Independent t-tests revealed a statistically significant relationship between Option B study participants and content area three (use assessment and evaluation strategies), (<i> t</i>[2,671] = -2.20, <i>p</i> = .03); four (participate in curriculum design and evaluation of program outcomes), (<i>t</i>[2,671] = -2.06, <i>p</i> = .04); and six (engage in scholarship, service, and leadership), (<i>t</i>[2,671] = -2.34, <i>p</i> = .02). Binary logistic regression revealed that a one year increase in full-time employment resulted in a 1.05 times greater likelihood of passing the CNE examination (OR = 1.05; 95% CI 1.03, 1.06; <i>p</i> = .00). Last, simple linear regression revealed that years of full-time faculty employment contributed to 3.2% of the variability within content area four, 2.8% within content area six, and 2.1% within content area three. The results of this study provide insight about faculty development and mentoring needs, present evidence to policy makers and nursing education leaders, and offer guidance to curricula developers.</p>

<p>Instructors are being challenged to evaluate their courses and the manner in which course materials are distributed. Lecture capture technology has enabled nursing instructors to deliver classroom lectures even when class is not in session. This form of technology allows instructors to record lectures as they are being presented or instructors may choose to pre-record lectures prior to class. The purpose of this descriptive qualitative study was to determine how lecture capture technology has been integrated into associate degree nursing programs in Alabama. Nursing instructors were recruited from two-year colleges in the state of Alabama. Instructors selected were asked to complete a demographic survey and participate in detailed interviews that helped determine what factors influenced them to incorporate lecture capture technology into their courses. A purposive sample of nursing instructors, who had utilized lecture capture technology in their courses, was sought. The findings from this study may be used to help other nursing instructors navigate through the process of implementing lecture capture or other technology into their courses. The data collected may serve as a resource to help instructors and institutions overcome barriers and to effectively use time and resources in educating future nurses. This study has implications for nursing practice and policy related to establishing procedures that can assist instructors in adopting technology tools that will be beneficial in presenting course materials. In addition, instructors can determine which method of implementation is best for their work environment.

<p> Professional confidence is an essential trait for new graduate nurses to possess in order to provide safe and effective patient care in today's complex hospital setting. However, many new graduate nurses are entering the workforce with a lack of professional confidence and it was unclear why this is so. The purpose of this basic qualitative study was to find out and understand how new graduate nurses accounted for their lack of professional confidence during their first year of practice in the hospital setting. The primary research question asked about new graduate nurses' experiences during their first year of practice related to the development of professional confidence in the hospital setting. Two sub-questions were used to address circumstances that hindered and promoted the development of professional confidence. Data collection involved two individual, semi-structured, audio recorded interviews which were transcribed verbatim. Each transcript was analyzed through a manual content analysis approach and ultimately, seven themes emerged which answered the research questions. Findings confirmed that seven themes related to a lack of professional confidence in new graduate nurses' experiences: (a) "communication is huge," (b) "making mistakes," (c) "disconnect between school and practice," (d) " independence," (e) "relationship building," (f) "positive feedback is important," and (g) "gaining experience." These findings revealed that new graduate nurses lacked professional confidence upon entry into practice which had implications for both undergraduate nursing education programs and workplace support for new graduate nurses in the hospital setting. Undergraduate nursing education programs may have a duty to improve strategies that prepare graduates for entry into professional practice. Nurse leaders in practice, specifically, nurse managers and preceptors must be mindful of the fact that new graduate nurses are entering the workforce with a lack of professional confidence and that it is in their power to promote the development of professional confidence during the first year of practice.</p>

<p> The focus of recent attention in healthcare is the increasing population of people with chronic condition and the increasing cost of managing the health of this population. To improve care outcomes and increase cost effectiveness of managing the health of these patients their care needs to be directed by evidence-based approaches. One of these approaches could be wellness health coaching directed toward helping patients self-manage their chronic condition. The problem however, is that the research on the role of wellness health coaches with helping patients self-manage their chronic condition is limited. Therefore, research that focuses on the role of wellness health coaches and their approaches to facilitate self-management are needed. </p><p> To gain understanding of the role and approaches of these wellness health coaches a phenomenological method was used. By personal interviews with six wellness health coaches, the researcher sought to answer the two research questions by describing their perceived role and their approaches to facilitate self-management of individuals with chronic conditions. </p><p> Wellness health coaches in this study perceived their roles as educators, motivators, guides, supporters, facilitator, collaborator, and coordinator. With all their clients they help set goals and develop a plan to meet their goals. The wellness health coaches' approaches to help improve their clients' self-management skills include providing them with written educational materials, resource information, and other tools such as websites on health information. All of these wellness health coaches' activities are aimed at empowering their clients to be able to improve their lifestyle and overall health.</p>

<p> This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses' decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit's expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses' experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates.</p>

<p> The purpose of this study was to examine the effectiveness of the most frequently utilized teaching strategy of lecturing followed by discussion and to compare it with lecturing followed by role playing to determine how to best prepare nursing students both in terms of knowledge and self-efficacy. The primary goal of the study was to learn how to educate nursing students who will be better prepared to meet societal needs by learning to become confident, knowledgeable, and therefore competent healthcare providers. The study revealed there was not a statistically significant relationship between type of teaching strategy to which the students were exposed and either of the final self-efficacy or knowledge posttest scores of the students. This was true even after controlling for pretest scores as well as for any other potentially influential demographic variables. There were significant increases in both the knowledge and self-efficacy scores of the students for both of the teaching strategy groups. Three associate nursing programs were utilized and all the participants completed two pretests and two posttests, one for self-efficacy and one for knowledge, related to geriatric care. Analysis of covariance was utilized because significant extraneous variables were considered in this quantitative nonrandomized quasiexperiment. For example, the number of years of college education was not a significant predictor of pretest or posttest scores. Demographic data were analyzed in this study to investigate if they affected the results in any way. The study revealed that an individual's age, school, and exposure to geriatric care in a work environment were related to pretest knowledge scores. In addition, self-efficacy posttest scores were not different according to the research groups, even after adjusting for any potential demographic or pretest influences. Both of the research groups increased their knowledge and self-efficacy tests significantly even after adjusting for any potential demographic and pretest influences. The study revealed the pretest scores were predictors of the posttest scores.</p>

<p> The purpose of this case study was to determine which activities factor into transformational learning that may occur as a result of completing a perioperative preparation program for registered nurses. Through the process of describing the lived experiences of the participants who have completed a perioperative nurse training program, it also assisted in informing pedagogical practice by helping to establish the extent of transformational learning that occurs. The role of a perioperative nurse is one that is demanding, knowledge intensive, and highly collaborative. Perioperative nurse educators need to understand the process of transformation in order to assist new perioperative nurses in successfully completing a perioperative nurse-training program. The Learning Activities Survey, a follow-up survey, and individual interviews were used to accomplish a mixed method sequential study design. The research established that half of the participants had experienced transformational learning while half did not.</p>

Thesis (M.H.A.)--University of Michigan, 1961.