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The purpose of this exploratory case study was to describe the culture of clinical teaching through a symbolic interactionist framework, by identifying the rituals, faculty behaviors, and student behaviors and characteristics valued by faculty instructing in clinical settings, using content analysis, interviews and observation. Five faculty, one from each clinical specialty, were chosen using specific criteria. College of Nursing archives were content analyzed to ascertain written valued student behaviors and characteristics and faculty were interviewed to learn their stated beliefs. Faculty/student clinical interactions were observed to assess if faculty written and verbalized beliefs were enacted, and twelve students were interviewed for verification of transmission of the values. Peer debriefing, member checking and an audit trail ensured trustworthiness of the data. Faculty used eight rituals: Preparation, Tracking, Discourse, Closet, Repast, Selection, Maneuver, and Documentation, and three types of actions: Teaching, Role Modeling, and Caretaking to transmit their values. Teaching was utilized 55 percent of the time and involved questioning, instructing, guiding, correcting and observing. Role Modeling, used 22 percent, embodied promoting independence, helping, intervening, kidding and admitting fallibility. Caretaking was evidenced 23 percent of the instructor's time and included caring, praising, diffusing anger, allowing mistakes and sharing self. Over one hundred student behaviors and characteristics that faculty valued were identified and collapsed into six descriptors, listed in descending order: assertive, therapeutic, compliant, knowledgeable, disciplined, and skillful. Faculty placed emphasis on human, interactive skills versus knowledge and psychomotor skills, and responded to students with very caring behaviors. They utilized compassion as a way of effecting conformity, and their use of caring behaviors for the exercise of their power was evident.

A retrospective study was conducted to investigate the relationship between achievement in specific nursing courses and subsequent performance on the NCLEX-RN of students identified as at-risk. A sample of 236 graduates from a baccalaureate degree nursing program in a large midwestern university were divided into two groups, students at-risk and students not-at-risk. Answers to six research questions were sought. Multivariate and univariate analyses of variance and two-tailed t tests at the .05 level of significance were utilized to test the data.Findings indicated that: (1) There was a significant difference in the performance in the first two major nursing courses between not-at-risk students and at-risk students with not-at-risk students scoring higher. (2) There was no significant difference between the grades received by at-risk students with transfer credit and at-risk students without transfer credit in the first two major nursing courses. (3) There was a significant difference in the performance in the first two major nursing courses with not-at-risk students with transfer credit achieving higher grades than not-at-risk students without transfer credit. (4) There was a significant difference in the NCLEX-RN scores between the two groups, with not-at-risk students scoring higher than at-risk students. (5) There was no significant difference in the scores on the NCLEX-RN between the two groups, at-risk students without transfer credit and at-risk students with transfer credit. (6) Not-at-risk students with transfer credit scored significantly higher on the NCLEX-RN than not-at-risk students without transfer credit. / Department of Educational Leadership

Abused women are frequent users of health care services. Yet, battered women often do not identify the health care delivery system as a resource. The present study surveyed 155 female associate and baccalaureate degree nursing students from three mid-Atlantic universities in order to examine how selected personal and relationship variables affected their attitudes toward battered women. It was hypothesized that those students who had an early exposure to family violence combined with high levels of egalitarianism and perceived control over life events would be more sympathetic toward battered women than those who did not. Instruments used to measure the chosen variables included the Sex-Role Egalitarianism Scale, the Conflict Tactics Scale, the Family Violence Scale, the Perceived Control Scale, and the Inventory of Beliefs about Wife-Beating. Data were collected via anonymous self-report questionnaires and analyzed through the use of correlation and hierarchical regression procedures. Nursing students with more egalitarian sex role beliefs and perception of control over their life events were more sympathetic to battered wives than those students with more traditional sex role attitudes and less perceived control over their life. Sex role egalitarianism was found to be the best predictor of attitudes toward victims of domestic violence. Contrary to expectations, there appeared to be little relationship between the level of violence experienced by students in their families of origin or in their current relationships and sympathy for battered wives. Findings from this study will add to the current nursing knowledge base regarding attitudes of one group of health care professionals toward victims of domestic violence by exploring those attitudes and by identifying which of the chosen variables was most predictive of those attitudes. Implications for nursing education include an examination of the impact of gender issues on personal and professional behavior as well as the importance of empowering nursing students through the use of a competency based practice model. / Ed. D.

The purposes of this study are to identify student retention strategies in generic baccalaureate schools of nursing and their supporting institutions to determine if these strategies vary according to identified characteristics of the school of nursing and its supporting institution and to determine the perceived effectiveness of the strategies. Data were collected from 313 administrative heads of schools of nursing that offer generic baccalaureate programs accredited by the National League for Nursing; 217 returned usable questionnaires constituted a national response rate of 69.3 per cent. Frequency distribution and the chi-square test of independence, significant at the .05 level, were used for statistical treatment of the data.

The critical shortage of competent nurses, disillusionment, and high attrition rate among graduates entering the workforce provided the impetus for this investigation. The purpose of this study was to determine the perceived level of empowerment among graduating nursing students of two basic nursing educational programs and the relationship of empowerment to selected variables. The selected variables were self-directed learning readiness, self-esteem, level in the program, and demographics. In addition, predictors of empowerment were investigated. A sample of 294 nursing students of associate and baccalaureate degree programs from five schools of nursing in the Mid-Atlantic region participated in the study. Instruments used were the Vincenz Empowerment Scale, Self- Directed Learning Readiness Scale, and Self-Esteem Inventory and a data sheet for demographics. The survey was completed from June to September 1994. Nursing students in general perceived themselves to have fairly high levels of empowerment, self-directed learning readiness, and self-esteem which was significantly higher for graduating students as compared to freshman students. There were no significant differences among the variables under study between baccalaureate and associate degree students or the type of institution they represented as private or public. Similarly, there were no differences in their perceived levels of empowerment, self-directed learning readiness, or self-esteem based on gender, racial/ethnic background, or affiliation with Student Nurses' Association. The wide variation in age and educational background ranging from high school to graduate degrees were associated with the participants' levels of self-directed learning readiness and self-esteem. In addition, participants who were involved in community organizations reported higher levels of empowerment. Regression analysis indicated self-directed learning readiness and self-esteem contributed significantly to the variance in empowerment. The findings add to the empowerment literature. Implications for nursing education include: (a) enhancing students' level of self-directed learning readiness and self-esteem may assist in empowering them, and (b) the basic educational process plays a significant role in nursing students' perceived levels of empowerment. / Ed. D.

Indiana University-Purdue University Indianapolis (IUPUI) / Despite more than 40 years of research and governmental support, African Americans continue to be underrepresented in the nursing profession compared to the population it serves. Though some progress has been made over the past 20 years, the American Nurses Association (ANA), American Association of Colleges of Nursing (AACN), National Black Nurses Association (NBNA) and Institute of Medicine (IOM) continue to identify increasing diversity as a disciplinary priority. Further understanding of the experiences of African American nursing students is needed to inform decisions about recruitment, retention and successful matriculation of these students. This qualitative descriptive study focused on understanding the experiences, and the meaning those experiences had, for African American students who attended predominately European American schools of nursing. Data were collected through semi-structured interviews with fourteen African American nurses who shared their experiences in pre-licensure nursing programs. Thematic analysis revealed two salient themes: "Standing out" and "It's not just about me." The findings from this study shed new light on this persistent issue and inform faculty members and nursing school administrators about the strategies and ways of framing the educational experience that may create environments that are welcoming to African American students to address the retention of African American students in pre-licensure nursing programs.

Indiana University-Purdue University Indianapolis (IUPUI) / The nursing shortage has reached unprecedented levels in the United States. In a response to meet current educational needs and demands to recruit, retain, and expand enrollment of students in baccalaureate programs in nursing, the growth of online education has been dramatic. As growth continues, graduation rates and program retention are a concern. The purpose of this study is to examine the relationship between student motivation, academic context, cost-benefit appraisal, and intent to persist in RNBS completion online programs. The conceptual model used in this study was Student Online Academic Persistence a researcher developed model which is primarily based on the work of Tinto, Bean & Metzner, and Rosenbaum. Research questions: 1. Among students enrolled in RNBS completion online programs, do motivation and context predict cost-benefit appraisal? 2. Among students enrolled in RNBS completion online programs, what is the relationship between cost-benefit appraisal and intent to persist in the program? Data were collected via a Web-based self-report questionnaire and subjected to descriptive and inferential analyses which included the use of linear regression and correlations. From a population of 3606 students from three schools of nursing who were enrolled in an RNBS completion online program, 704 usable surveys were returned, with a response rate of 19%. Technology self-efficacy correlated positively with goal orientation, goal commitment, satisfaction with institution and faculty, cost-benefit appraisal and intent to persist. Goal commitment to the program and satisfaction with institution were found to be important in the persistence of students. A continual decision making process involving cost-benefit appraisal was also found to impact student intention to persist in the program of study. Recommendations for faculty include assuring student technology self-efficacy and developing an online transition course designed to normalize the experience of adults engaging in online education. Future research which further tests the Student Academic Online Persistence model and explores the lived experience of the online student is suggested.