Simulation using computerized patient mannequins may be a useful mechanism to teach safe and effective nursing care, thus improving the quality of education for nurses. As nursing program enrollments grow, clinical placement is becoming more difficult and may not offer consistent learning opportunities that reinforce safe and effective nursing practice. This study applied Ford, Smith, Weissbein, Gully, and Salas’ (1998) model of learning transfer as the theoretical framework to design a simulated obstetric clinical learning experience to augment the current clinical practice model, an approach that may lead to an improved educational experience. The purpose of this study was to compare learning outcomes of two clinical teaching strategies for obstetric clinical content for undergraduate nursing students: standard clinical instruction and a simulation-enhanced clinical experience. A mixed-method approach was used. A randomized cluster design was chosen to compare the learning outcomes for students participating in a simulation-enhanced clinical experience versus students participating in a traditional clinical rotation. From the study population of 124 students, 40 participated in the simulation-enhanced clinical group, with the remainder of students serving as controls. Four instruments (Obstetric Nursing Self-Efficacy instrument, Goal Orientation Scale, Proxy Measure, and examination knowledge items) were used to measure student characteristics or achievement of outcomes. Learning outcomes for self-efficacy, knowledge, skills, and transfer were compared between the groups using ANCOVA, independent sample t-test, iv and chi-square analyses. A qualitative descriptive analysis of clinical evaluations for all students was also conducted. Demographic characteristics between the groups were not statistically different. The analysis of covariance (ANCOVA) revealed no difference in ONSE posttest scores between the groups after adjusting for goal orientation and ONSE pretest scores. An alternative ANCOVA for sequence (time in semester when the simulation occurred) and group was not significant. However, after adjustment for the covariate of ONSE pretest scores, ONSE posttest scores varied with sequencing (p

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.

Due to increasing diversity and shifting demographics nationally, many professional organizations have called upon nursing education to prepare future generations of nurses to provide culturally appropriate care to diverse patient populations. It is crucial to use evidence-based pedagogical strategies to teach nursing students to tailor care to meet the diverse needs of patients. Simulation has been widely used in nursing education as an effective pedagogical strategy. A study was undertaken to explore the differences between using a high-fidelity manikin versus a standardized patient in simulation on cultural humility and cultural self-efficacy in second- and fourth-year baccalaureate nursing students. Second-year (n = 39) and fourth-year (n = 58) students were equally distributed into two groups. The intervention group participated in a simulation using a standardized patient and the comparison group used a high-fidelity manikin. Mean scores on the Cultural Humility Scale (Foronda, 2020) were used to measure cultural humility, and mean scores on the Cultural Self-Efficacy Scale (Bernal & Froman, 1987) were used to measure cultural self-efficacy. A researcher-developed 5-item demographic survey was used to collect demographic information from participants. The simulation sessions were conducted over 7 weeks from the end of February to mid-April in the spring semester of 2024. Students participated in the simulation session as a clinical group of 4-9 students on their assigned clinical day. Participants completed a pretest before the simulation, posttest 1 immediately after the simulation, and posttest 2 at the end of the semester in May. The pretest and posttests consisted of the Cultural Humility Scale, the Cultural Self-Efficacy Scale, and the demographics survey. Data analysis revealed that although there was a statistically significant improvement in cultural humility and cultural self-efficacy immediately and over time after the simulation for both groups, there was no statistically significant difference between high-fidelity manikin simulation or SP simulation on either cultural humility, F(1,95) = 1.26, p = .27, ηp2 = .002, or cultural self-efficacy, F(1,95) = .11, p = .74, ηp2 = .001. Also, there were no differences in cultural humility or cultural self-efficacy based on the year of enrollment before or after the simulation. As no difference was found between using a manikin and using a standardized patient, nursing programs have a choice of using either approach based on the feasibility, cost, and available resources. Future research should include replications of this study as well as comparisons of other teaching modalities in simulation to increase cultural humility and cultural self-efficacy. Keywords: Cultural humility, cultural self-efficacy, nursing education, nursing students, clinical simulation, cultural humility scale, and cultural self-efficacy scale.

Background With growing diversity in the US population, nurses grapple with health care disparities leading to negative patient outcomes. It is crucial to prepare nursing students for how to understand and address cultural differences by instilling cultural humility and cultural competence in nursing curricula. One way to teach cultural humility and cultural competence in nursing education is through simulation. The primary objective of this study was to compare the effect of standardized patients versus high-fidelity manikins on cultural humility and cultural competence in baccalaureate nursing students. Methods A longitudinal, quasi experimental pretest posttest comparison design was used. A convenience, non-random sample of 97 baccalaureate nursing students from one university participated in this study. Out of 97 participants, 39 were in their second year and 58 were in their fourth year of the nursing program. The intervention group (n = 48) attended a culturally immersive simulation with a standardized patient and the comparison group (n = 49) attended cultural simulation with a high-fidelity manikin. Participants from both groups completed Foronda’s Cultural Humility Scale (CHS) and Caffrey’s Cultural Competence in Healthcare Scale (CCCHS) before and after participating in the simulation, along with a demographic questionnaire. Eighty-five students completed a second posttest a few weeks after the intervention. Two theoretical frameworks guided the study: Foronda’s Theory of Cultural Humility, and Purnell’s Model for Cultural Competence. Results A mixed analysis of variance (ANOVA) with repeated measures showed a statistically significant difference within groups from pretest to posttest 1 and from pretest to posttest 2, in both cultural humility (p < .001) and cultural competence (p < .001). However, there was no difference in cultural humility (p = .265) or cultural competence (p = .743) when teaching strategies (standardized patient versus manikin) or year in the nursing program (second versus fourth) were considered. Conclusion Findings suggest that simulation, whether using a standardized patient or high-fidelity manikin, can be effective in enhancing cultural humility and cultural competence in baccalaureate nursing students.

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.