Thesis (PhD (Education))--University of Stellenbosch, 2006. / During the past twelve years of democracy health care services in South Africa have been influenced by political, social and economic change. As a result of the transformation of health care services and the change of political policy, the focus on primary health care increased. During the early stages of the transformation of health care services stakeholders realized that in order to provide an extensive health care service specialized training is required. Various educational institutions provided formal and informal programmes in order to meet the new challenges of the nursing profession. Although minimum requirements of the content and clinical practice have been established by the nursing council, the mode of presentation, costs, duration and type of qualification awarded to clinical nursing practitioners differed substantially. Uniformity in terms of programme content was lacking, neither were any scientifically founded attempts made to establish whether these programmes fulfilled the needs of the student in the rural community. Although a variety of training programmes exist the number of trained clinical nursing practitioners is still inadequate. In addition training is focused on the urban community. The objective of the research was to determine the opinion of the rural nurse on clinical nursing education, and to develop a training framework based on their input which would meet their needs. This research was conducted from an explanatory-descriptive paradigm. The case study was used as research design. A literature study on the development of primary health care both internationally and nationally was done. The literature study revealed the development of training programmes for clinical nurses. Chapter three of the literature study is dedicated to the theoretical aspects of the design of a student centered training framework for the adult student. A student centered training framework has created from data gathered via questionnaires completed by clinical nurses and semi-structured interviews with semi-qualified nurses. Semistructured interviews have also been conducted with the supervisors of nurses working in clinics and community health centres in the Northern Cape. The conclusion that respondents showed a positive attitude towards training in clinical nursing was encouraging. The majority of respondents indicated that they would welcome an additional qualification which will improve their knowledge and would result in better patient care. The respondents highlighted staff shortages, financial constraints and family responsibility as the main obstacles towards these qualifications. During the research it became clear that no formal training is currently available in Kimberley. This is as a result of the absence of mentors. Although the respondents have limited access to computers they indicated that they would prefer computer supported training in conjunction with physical contact sessions. The research indicated that no formal policy on the training of clinical nurses exists in the rural Northern Cape. In the absence of a training framework the research further contributed towards the development of a student centered training framework for clinical nurses in rural Northern Cape. The research succeeded in highlighting the necessity for formal policy on the training of clinical nurses in rural Northern Cape.

Background: The human secondary sex ratio has been the subject of long-standing medical, environmental and social scientific curiosity and research. A decline in male birth proportion in some industrialised countries is linked to endocrine disruption and is validated by some empirical studies. Increasing parental age and population stress and associated decreases in sex ratio have also been demonstrated. A thorough literature review of 123 relevant and diverse studies provides context for these assessments. Methods: A spatial-temporal investigation of birth sex ratio in Scotland and potential determinants of endocrine disruptor pollution, socio-economic factors including neighbourhood stress, deprivation, smoking, and maternal age, was conducted. This involved review of national and regional sex ratio time trends, and stratified/spatial analysis of such factors, including the use of GIS tools. Secondary data were sourced from Scottish Government web portals including Scottish Neighbourhood Statistics and the Scottish Environmental Protection Agency. Results: Regional differences in sex ratio between 1973 and 2010 are observed which likely lever the national male birth proportion downwards, with the region of poorest air quality from industrial emissions, the Forth Valley, displaying the greatest sex ratio reduction. Further analysis shows significant upwards skewing in sex ratio for the population cohort experiencing the least and 2nd most deprivation. Localised reductions in sex ratio for areas of high modelled endocrine disruptor pollution within the Central Region in Scotland are also displayed. Discussion: Limitations of the analyses include the danger of ecological fallacy in interpreting from area-based measurement and the simplified pollution modelling adopted. Despite this, and given elevated incidence of testicular cancer in Scottish regions mirrors the study’s results, tentative confirmation of the endocrine disruptor hypothesis can be substantiated. Further, elucidation on advanced parental age as a contributory factor to secondary sex ratio change is also given. Recommendations are made with respect to environmental monitoring and health protection, and preventative health strategies in Scotland.

Each vocational nursing program in Texas was surveyed to determine the faculty and media costs per student classroom instructional hour. Data were obtained from 131 schools, or 99 per cent of the population. These schools taught a total of 4,718 students. The average faculty cost was $1.72 per hour. Faculty cost ranged from $0.17 to $7.75. The average media cost was $0.12 per student hour with a range from no media expenditure to $7.55. The reliability of these costs was not demonstrated. Each program director was asked to identify a principal textbook representing the content taught for each content area in their program. A total of 75 textbooks were identified by two or more programs. A cross tabulation analysis procedure yielded 1,582 combinations of 2 or more textbooks from 2 or more schools. Twenty-five per cent of the schools used the most frequently identified combination of two textbooks. Computer hardware and operating expenses were subtracted from the combined faculty and media cost per student classroom instructional hour. The amount remaining for software purchase was identified as $1.61 with a range of from $0.03 to $7.85 per hour for teaching the required 600 hours. The twenty textbook combinations with the greatest remainder for software utilization were identified. The combination with the largest arithmetic mean remainder was used by 624 students. It was $1.61 per hour. This combination consisted of Ingalls and Salerno's Maternal and Child Health, used to teach maternal and child health, and Hood and Dincher's Total Patient Care, used to teach Medical-Surgical Nursing.

O presente estudo teve como objetivo analisar o processo de avaliação da educação superior da Enfermagem brasileira na perspectiva da Comissão Assessora de Avaliação para a Enfermagem - INEP. A partir da análise realizada com base nas entrevistas com os membros da referida comissão para a área de Enfermagem foi possível discutir questões referentes às políticas de avaliação da educação superior, levando-se em consideração a expansão e a diversificação desse nível de ensino, a instituição de procedimentos de avaliação estruturados em princípios de flexibilidade e de competitividade, bem como as políticas de saúde, definidas a partir das diretrizes do Sistema Único de Saúde (SUS) com ênfase na saúde pública. Evidencia-se que o Sistema Nacional de Avaliação da Educação Superior (SINAES), além de apresentar componentes de regulação, possibilita realizar uma avaliação qualitativa, de forma a superar o modelo anterior, determinado pelo Exame Nacional de Cursos (ENC), caracterizado pela tendência a estabelecer ranking para o setor. A utilização de instrumento único para a avaliação de cursos, embora evidencie a falta de especificidade para a formação de Enfermagem, assegura a avaliação qualitativa. O avaliador é destacado como elemento central do processo de avaliação de cursos, pela possibilidade de diálogo com as instituições, traduzida em uma modalidade de avaliação formativa. Embora a comissão não estabeleça relação entre avaliação e emprego, a oferta e a ampliação de cursos e vagas determina a necessidade de novos postos de trabalho. A expansão da educação superior apresenta maior crescimento no setor privado, ficando a oferta de vagas no setor público praticamente estagnada, caracterizando a transferência da responsabilidade social do Estado para a livre iniciativa. Apontam-se as Diretrizes Curriculares e as diretrizes do SUS como eixos norteadores para a avaliação da educação superior em Enfermagem, definidoras de um novo paradigma de formação em saúde. Ainda que a intenção da avaliação não seja a de focalizar as especificidades da saúde pública, isso torna-se inevitável, pois o SUS constitui-se neste bojo. Deve-se considerar, também, que o sistema possui componentes de caráter regulatório, que são utilizados para conter a abertura mercantilista de cursos e para zelar pela qualidade da formação. Quanto ao caráter formativo da avaliação, o desafio está em que ela exerça real contribuição na elaboração e desenvolvimento de projetos político-pedagógicos para formar o futuro trabalhador do SUS. / This essay has the objective of analyze the process of evaluation of the higher education on the Brazilian nursing studies under the perspective of the Adviser Committee of Evaluation for Nursing Studies - INEP. From the analysis fulfilled based on the interviews with the members of the so called committee for the nursing field it was possible to open debates on issues concerning to the policies of the higher education evaluation, taking into consideration the expansion and the diversification at this level of education, the settlement of the procedures for evaluation, established on principles of flexibility and competitiveness, as the health policies, determined from the conductresses of the Sistema Único de Saúde (SUS) with emphasis on the public health. It becomes clear that the Sistema Nacional de Avaliação da Educação Superior (SINAES), besides presenting elements of regulation, makes possible accomplish a qualitative evaluation, in order to overcome the former model, determined by Exame Nacional de Cursos (ENC), characterized by the trend of setting a ranking for the sector. The use of a single instrument for evaluation of the courses, although makes clear the lack of speciousness for the nursing graduation, assures the qualitative evaluation. The rater is highlighted as a central element of the evaluation process of courses, due to the possibility of dialog within the institutions, translated into a modality of formative evaluation. Moreover the committee does not establish relationship between the evaluation and employment, the offer and enlargement of courses and openings; it determines the need of new working positions. The expansion of bachelors degrees show a greater growth in the private sector, being the offer of openings in the public sector fairly stagnated, characterizing the transfer of the social responsibility from the government to the private enterprise. It is brought forward the Curriculum conductresses and the - SUS - conductresses as the guiding axles for the evaluation of the higher education on nursing studies, definer of a new paradigm of graduation in health. Even that the primary intention of the evaluation is not to focalize the specificities of the public health, this becomes undeniable, due - SUS - is based on this values. It is also proper to consider, that the system has elements of regulation character, which are not used to detain the creation of mercantilist courses and care for the graduation quality. Due to the formative character of the evaluation, the challenge is settled in the fact that it leads to real contributions on the elaboration and development of politic-pedagogical projects to form the - SUS - workers-to-be.

Este estudo teve como objetivo geral analisar a eficácia da aprendizagem dos discentes, imediatamente, 15 e 30 dias após a aula expositiva dialogada e a aula simulada em laboratório de enfermagem. Tratou-se de um estudo longitudinal de abordagem quantitativa, tipo experimento antes e depois, que se constitui de um método experimental verdadeiro para a comparação da apreensão do conhecimento dos alunos na aula expositiva dialogada e na aula simulada no laboratório de enfermagem, tendo hipótese que a aula simulada é mais eficaz do que a aula expositiva dialogada para a apreensão do conhecimento em AVC na enfermagem. A população deste estudo foi composta por 42 alunos do 6º semestre da graduação em enfermagem da Faculdade de Enfermagem do Hospital Israelita Albert Einstein, que foram randomizados estatisticamente em dois grupos, controle e experimental. Foram consideradas como variáveis intervenientes ao processo de ensino e aprendizagem: idade, atuação profissional na área da saúde, média ponderada das notas do primeiro e segundo anos letivos e a nota da avaliação progressiva do conhecimento de 2009. Ambos os grupos foram submetidos a uma aula sobre o reconhecimento dos sinais e sintomas do Acidente Vascular Cerebral (AVC) e suas condutas assistencias. O grupo controle foi submetido a uma aula dialogada expositiva e o grupo Experimental a uma aula simulada em laboratório de enfermagem. Nas duas intervenções foi utilizado como cenário pedagógico a Teoria da Aprendizagem Significativa. Os resultados da pesquisa demonstram que a estratégia de aula simulada no laboratório de enfermagem é mais eficaz para a apreensão do conhecimento de forma significativa pelos discentes de graduação em enfermagem, com diferença estatística significante de p<0,05 do momento pré para o momento imediatamente pós intervenção sobre os sinais e sintomas do AVC e as condutas assistenciais. Dessa forma a hipótese do presente estudo de que a aula simulada é mais eficaz do que a aula expositiva dialogada para a apreensão do conhecimento em AVC na enfermagem é verdadeira. Em relação ao seguimento longitudinal após 15 e 30 dias da intervenção, os grupos (controle e experimental) se comportaram de forma muito semelhante ao longo do tempo, ocorrendo um declínio da retenção do conhecimento em ambos os grupos, sem diferenças estatísticas significativas. Entretanto, o grupo experimental comportou-se com nota superior. Quanto a comparação da satisfação dos discentes na aula expositiva dialogada e na aula simulada, o grupo experimental que participou da aula simulada em laboratório de enfermagem evidenciou estar mais satisfeito e motivado para a apreensão do conhecimento sobre AVC. Este fato pôde ser comprovado por meio da comparação da satisfação dos discentes na aula expositiva dialogada e na aula simulada, bem como pelos relatos dos discentes que expressaram a importância da aula para propiciar uma visão real dos objetos de estudo contribuindo para uma aprendizagem significativa. Dessa forma este estudo possibilitou identificar e comparar a eficácia da apreensão do conhecimento na aula simulada em laboratório de enfermagem, bem como propiciou a compreensão da importância do planejamento educacional e da adoção de estratégias de ensino fundamentadas na Teoria da Aprendizagem Significativa, identificando a necessidade da capacitação pedagógica dos docentes de enfermagem / This study aimed to analyze the effectiveness of students\' learning, immediately, 15 and 30 days after the lecture and classroom dialogic simulated nursing lab. This was a longitudinal study of quantitative approach, like before and after the experiment, which consists of an experimental method for comparing the true understanding of students\' knowledge in dialogued lecture in class and in simulated nursing lab, and hypothesis a simulated classroom is more effective than lecture dialogued for the apprehension of knowledge in stroke nursing. The study population consisted of 42 students of 6th semester of undergraduate nursing, School of Nursing of the Hospital Albert Einstein, who statistically were randomized into two groups, experimental and control. Were considered as intervening variables to the process of teaching and learning: age, professional activity in health, the weighted average of grades in the first and second school years and note the progressive assessment of knowledge, 2009. Both groups were subjected to a lecture on the recognition of signs and symptoms of stroke (CVA) and assists their conduct. The control group underwent a dialogic classroom expository and experimental group to a classroom in simulated nursing lab. In the two interventions was used as a pedagogic setting the Theory of Meaningful Learning. The survey results show that the strategy of class in simulated nursing lab is more effective for the acquisition of knowledge significantly by undergraduate students in nursing, with statistical significance of p <0.05 from pre to the time immediately post intervention on the signs and symptoms of stroke care and conduct. Thus the hypothesis of this study that simulated the lesson is more effective than lecture dialogued for the apprehension of knowledge in stroke nursing is true. In relation to the longitudinal follow-up after 15 and 30 days of the intervention groups (control and experimental) behaved very similarly over time, experiencing a decline in knowledge retention in both groups, without statistically significant differences. However, the experimental group behaved with top note. The comparison of the satisfaction of students in the lecture through dialogue and simulated classroom, the experimental group who attended the class in simulated nursing lab showed to be more satisfied and motivated for the apprehension of knowledge of stroke. This fact was proven by comparing the satisfaction of students in the lecture through dialogue and simulated in the classroom as well as by the reports of students who expressed the importance of class to provide a true picture of the objects of study contributing to a meaningful learning. Thus this study allowed to identify and compare the effectiveness of the acquisition of knowledge in the classroom in simulated nursing lab, as well as providing an understanding of the importance of educational planning and the adoption of teaching strategies based on the Theory of Meaningful Learning, identifying the need for pedagogical training of nursing faculty

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-07-21T11:38:24Z No. of bitstreams: 1 Lorena de Godoi Montes.pdf: 3679786 bytes, checksum: c4d7075534f86630ad53467e2bf3f01b (MD5) / Made available in DSpace on 2017-07-21T11:38:24Z (GMT). No. of bitstreams: 1 Lorena de Godoi Montes.pdf: 3679786 bytes, checksum: c4d7075534f86630ad53467e2bf3f01b (MD5) Previous issue date: 2017-06-29 / The formative assessment is one of the most important pedagogical instruments available and one of the tools used is feedback, which is based on scientific grounds. In view of this, the following hypothesis arose: Does the nursing professor from ETEC Darcy Pereira de Moraes (DPM) adequately use the feedback tool in the evaluation process of the students in the supervised practice internship? If not, what is needed to change this reality? Thus, the objectives outlined for this research were: to analyze the opinions and feelings of the professors from the technical course in nursing at ETEC DPM on the use of feedback in teaching of the nursing practice; to identify the preparation for the use of feedback in teaching the nursing practice from the point of view of teachers; to contextually train the nursing professors on the feedback process; and to evaluate the results of the feedback training, through a specific road map. This is an exploratory-descriptive study, with characteristics of action research, with a qualitative approach. Socio-demographic data were collected and the completion of a focus group of seven nurses from ETEC using the following guiding questions: 1) How do you use feedback in the nursing practice assessment process? 2) Do you feel prepared to give feedback to students? What is missing? 3) In your opinion, what is the advantage/benefit of practical nursing activity feedback? The results were that although the majority show in their personal curricula/resume training to educate, they think that feedback is an important evaluation tool and essential in nursing practice, but they do not have the exact size/understanding of its potential, since they see it primarily as a group activity and synonymous with pointing out mistakes. In addition, the difficulty in providing feedback was a universal discussion among the professors. In response to the results, feedback training was given to the focus group participants, using the Problem Methodology through the Arc Method. It is expected/hoped that their training will be reverted in improving the evaluation process at the institution / A avaliação formativa é um dos mais importantes instrumentos pedagógicos existentes e uma das ferramentas utilizadas é o feedback, o qual é baseado em fundamentação científica. Diante disto, surgiu a seguinte hipótese: O professor enfermeiro da ETEC Darcy Pereira de Moraes (DPM) utiliza adequadamente a ferramenta de feedback no processo de avaliação dos discentes na prática de estágio supervisionado? Em caso negativo, o que é necessário fazer para modificar esta realidade? Assim, os objetivos delineados para esta pesquisa foram: analisar as opiniões e sentimentos dos professores do curso técnico em enfermagem da ETEC DPM no uso do feedback no ensino da prática de enfermagem; identificar o preparo para o uso do feedback no ensino da prática de enfermagem sob a ótica dos professores; capacitar de forma contextualizada os docentes enfermeiros quanto ao processo de feedback; e avaliar os resultados da capacitação em feedback, através de roteiro específico. Trata-se de um estudo exploratório-descritivo, com características de pesquisa-ação, com abordagem qualitativa. Foram coletados dados sociodemográficos e realização da técnica de grupo focal com 07 enfermeiros da ETEC utilizando as seguintes perguntas norteadoras: 1. Como você utiliza o feedback no processo de avaliação da prática de enfermagem? 2.Você se sente preparado para aplicar feedback aos alunos? O que te falta? 3.Na sua opinião, qual a vantagem/benefício de um feedback de atividade prática de enfermagem? Os resultados foram que apesar da maioria exibir em seus currículos pessoais capacitação para educar, opinam que o feedback é uma importante ferramenta de avaliação e essencial na prática da enfermagem, mas não têm a exata dimensão de suas potencialidades, pois enxergam-no primordialmente como atividade em grupo e sinônimo de apontar erros. Além disso, a dificuldade na devolutiva foi um discurso universal entre as professoras. Frente aos resultados, aplicou-se capacitação em feedback aos participantes do grupo focal, utilizando-se a Metodologia da Problematização, através do Método do Arco. Espera-se que a capacitação dos mesmos reverta-se em melhoria dos processos de avaliação na instituição

The use of information and communication technologies and computerised training tools in nursing education has gained traction globally and locally. Nursing campuses in KwaZulu-Natal are yet to explore this avenue despite the existence of numerous challenges with conventional methods of teaching and learning, and Integrated Management of Childhood Illness (IMCI) pre-service training. Integrated Management of Childhood Illness Computerised Adaptation and Training Tool (ICATT), an e-learning tool has been identified as an innovative technology that has the potential to strengthen IMCI pre-service training and increase training coverage at nursing campuses. The aim of this study is to investigate the nursing campuses’ readiness for the use of ICATT, and to develop guidelines and a model for improving the use of ICATT at the nursing campuses. This study adopted a sequential exploratory mixed methods design and was conducted in three phases at ten nursing campuses in KwaZulu-Natal. In phases one and two, data was collected sequentially using a semi-structured interview schedule and self-administered questionnaires. The qualitative component involved seven individual administered questionnaires. The qualitative component involved seven individual interviews with campus principals, eight focus groups of nurse educators and eight focus groups of learners. The Interpretative Phenomenological Analysis framework was used to identify themes. In the quantitative component, data was collected from nine campus principals, 35 nurse educators and 235 learners and analysed using SPSS 23. Findings from phases one and two revealed that campus principals, nurse educators and learners had positive attitudes and identified enabling factors regarding ICATT use. Additional findings revealed that pre-existing barriers related to human, material, infrastructural and financial resources could impact on the nursing campuses, nurse educators and learners’ readiness to implement and use ICATT. Findings from phases one and two led to the development of guidelines and a model for ICATT implementation at nursing campuses. Phase three employed the Delphi method to obtain consensus opinion from 11 experts for the refinement of the guidelines. The readiness for ICATT use model and the guidelines can facilitate the successful implementation and use of ICATT. / Health Studies / Ph. D. (Health Studies)

Doctor of Philosophy / Similar to their colleagues throughout the world, nurses and midwives in New South Wales (NSW), Australia, welcome evidencebased practice (EBP) as a means to improve patient or client outcomes. This thesis explores the way nurses and midwives understand evidence for EBP and aims to determine whether members of these professions currently have the knowledge and skills necessary to implement evidence‐based care. Three separate studies were conducted to explore NSW nurses’ readiness for EBP. Attitudes, knowledge and skill were investigated using an EBP questionnaire returned by 383 nurses. The views of 23 nursing opinion leaders were elicited during qualitative in‐depth interviews, and their ideas on maximising the potential for future nurses to confidently engage in EBP were explored. Current approaches to teaching EBP in undergraduate nursing programs were investigated by examining documents issued by NSW nursing education providers. The results demonstrate many differences between the ways NSW nurses currently understand evidence for EBP, and a range of approaches to teaching EBP in undergraduate nursing programs. Under current conditions, nurses graduating from universities in NSW commence practice with varying levels of preparation for EBP and enter into a professional arena that is itself struggling to cope with the concepts and language of this approach to improving healthcare. v Evidence for the effectiveness of EBP is slowly accumulating and despite some small positive signs, the collective results of this thesis suggest that current educational approaches are not capable of producing the kind of results that are both necessary and desirable for the promotion of evidence‐based nursing practice in NSW. Articulating a commitment to EBP, using a common language and a consistent approach are among the recommendations made for the future promotion of EBP in nursing education.

Purpose: Does manikin fidelity affect learning outcomes in neonatal resuscitation simulation? Description: This experimental design accessed and randomly assigned health care professionals (HCP) (N=60), who completed Neonatal Resuscitation Program (NRP) recertification in a simulation lab. The experimental group used a high-fidelity manikin. The control group recertified using a low-fidelity manikin. Dependant variables included learning outcomes of confidence, skill performance, and knowledge. These were measured using the newly developed Neonatal Resuscitation Confidence Tool (NRCT), Megacode Assessment, and NRP written exam. Both groups underwent the same simulated resuscitation scenario. Outcome: A significant increase in confidence with simulation was found (p<.001). HCPs using the high-fidelity simulator did not have a significant increased level of confidence, knowledge or skill performance compared to using the low-fidelity simulator. However, there was a significant increase in confidence with repeated NRP courses (p=.003). Implications: The use of simulation for NRP is important to increase capability with increased practice intervals. / ix, 109 leaves : ill. ; 29 cm. --

In 1998 the Institutes of Nursing in the United Arab Emirates adopted a new approach of Case-Based learning in their three year nursing program. This categorical change created a need to examine the development of nursing students' self-efficacy and motivation under this new curriculum. The aims of this study were to investigate whether the students in the final year of the program will evidence higher levels of motivation and self-efficacy compared to those in the second and first year of the program, and to demonstrate that the higher the level of self-efficacy, the more internal, unstable and controllable the attributions for success and/or failure. This study was based on Bandura's theory of self-efficacy. A randomly selected cross-sectional survey involving nursing students in the three-year diploma nursing program of Abu-Dhabi and AI Ain Institutes was studied (N=178). The participants of this study involved a total of 86 (48.3%) enrolled in year one diploma, 51 (28.7%) enrolled in year two and 41 (23.0%) in year three diploma. On the whole the participants' levels of motivation and self-efficacy were high, but both ANOVA and Kruskall Wallis tests did not support any level increase by year of education as was expected. However, the Spearman's rho (r) test yielded low but positive and significant correlations between the levels of self-efficacy and students attribution for success and/or failure. / Thesis (M.Cur.)-University of Natal, Durban, 2002.