A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements of the degree of Doctor of Philosophy Johannesburg, 2017. / Although simulation has been part of health care education for the last 40 years, there appears to be some resistance to embedding the education methodology in both nursing and medical curricula. Possible reasons for this lack of integration could be the educators’ fear of technology, organizational barriers, such as time for integration, and a lack of support for educators wanting to introduce simulation. In South Africa at present, simulation is only being used in pockets at universities and nursing colleges, with no formal contextually relevant training programme in place, specifically for nursing education, despite evidence that simulation improves student’s outcomes and critical thinking. Nurse educators have expressed anxiety and bewilderment and seem uncertain about the use of simulation. The purpose of this study was to develop a best practice simulation programme for nurse educators wanting to use simulation in their undergraduate nursing curricula. A multi-method design within a pragmatic paradigm was used for this study. The process was divided into four phases. Phase one involved data collection, using the National Council of State Board of Nursing (NCSBN) survey: Use of Simulation in Nursing Education (Hayden, 2010), to describe the prevalence and use of simulation in both university and college undergraduate curricula. Phase two consisted of two parts, conducted consecutively: a scoping literature review to determine simulation best practices in nursing and medical education, followed by a Delphi Study to elicit the perceptions of educators in South Africa regarding simulation and best practice. In the scoping literature review the question asked was: What does the literature identify as simulation best practices in nursing and medical education? Four best practices emerged from the literature, namely the importance of debriefing, identifying learner objectives, the integration of simulation into the curriculum and the inclusion of deliberate practice. A Delphi Study was then conducted to elicit the judgement and perceptions of simulation educators, working in the South African context, of the identified best practices. Phase three was the design of a conceptual framework and the development of a constructivist blended learning programme, using the Assessment, Design, Development, Implementation and Evaluation (ADDIE) instructional design method. The goal of the programme was: Participants will be able to apply simulation knowledge and skills to meet the learning needs of their undergraduate nursing students. The four best practices and the National League of Nurses/Jeffries Simulation Framework guided the programme. The resultant programme was developed in seven Modules building towards the completion of a simulation scenario, including planning for the scenario and post simulation debriefing. Phase four was an expert review of the programme, from an e-learning specialist, nurse educators and a simulation expert. Both an expert review guideline for a written report and interviews were used for evaluation and refinement of the programme, prior to the programme being rolled out to nurse educators. Results: Simulation in South African nurse education institutions is predominantly at a task training level and has been developed into complex patient scenarios using higher fidelity simulations. The programme was well received by the experts as relevant to simulation education in South African undergraduate nursing curricula, either in a university or nursing college educational environment. Limitations: The limitations to the study include the small sample sizes in the data collection phases, due to simulation in South Africa being relatively new in nursing education. Universities were predominantly represented in the data collection findings, despite the researcher reaching out to nursing colleges for their perspectives and inputs. There is a dearth of South African simulation literature and none on best education simulation practices in South African Nursing Education Institutions (NEIs), and therefore the researcher relied on international literature in the scoping review. Conclusion: The blended education simulation programme is based on the needs of nurse educators wanting to include simulation in their education environment, based on their resources, and allows them to work through the programme in their own work space and time. / MT2017

Aims: Empirical evidence demonstrates successful expert nurses appointed as nurse lecturers in higher education find themselves as 'newcomers' to the role and organisation. New nurse lecturers often find their transition to higher education confusing and challenging. Using the conceptual framework of communities of practice, this study aims to provide original research into what induction means for new nurse lecturers, and gain an in-depth understanding of their perceptions and experiences of their induction into working in a multi-sited university. Method: A qualitative research methodology was employed, using the theoretical approach of Interpretive Phenomenological Analysis (IPA) developed by Smith, Flowers, and Larkin (2009). Eight lecturers, with between one to three years' experience as nurse lecturers, were recruited from one university in the North West of England. Purposive sampling was utilised and data was obtained through one-toone semi-structured interviews. Verbatim transcripts were analysed following the principles of IPA. Findings: Three super-ordinate themes emerged (partial transition, dual communities of practice, introduction), along with six sub-ordinate themes (expectations of the nurse educator role, career change, contextual influences, location and culture of sites, tick box exercise, and the limited role of the mentor). New nurse lecturers found transition stressful: key aspects included the culture shock and the career change of adopting their new academic identity. Changing identity from a nurse to an educator, working across the boundaries of both practice and academia, was a struggle, particularly in participants with visiting lecturer experience who had mistakenly perceived this would prepare them for the role. Early role preparation was essential to understanding the different cultures and processes within the university. Formal mentoring supported development of self-confidence, but its value was undermined due to the mentors' workload and lack of understanding of their role, which affected relationship building. Supportive heads of department, and informal mentoring and peer support, were essential in developing new academic identities. Conclusion: This study contributes to practice through the development of an induction framework for new nurse educators. This framework acknowledges the relevance of maintaining a dual community of practice for new nurse educators, in supporting their new identity and their dual continuing professional development. Practical outcomes include: development of an informational resource for new lecturers (including visiting lecturers); development of a community of learning with facilitated workshops and online information resources; development of mentor training and resources for mentors; and mentors being thoughtfully designated by heads of department, with hours attached to their workload for mentoring. A long term online community of practice is needed for new staff to keep in touch and share information. Heads of department need to take ownership of inductions to ensure that their staff feel welcomed and supported in their new environment, with regular evaluation taking place.

Thesis (M.S.)--Boston University

Heart failure (HF) has a global significance for the older population and is the most common reason for hospitalization. Patients with HF can reduce their risk for hospital readmissions and adverse outcomes through self-management of their disease. Nurses are responsible for educating patients about HF self-management; however, nurses at the project site lacked sufficient understanding and confidence to perform adequate HF patient education, creating a gap in practice. This project was guided by Pender's health promotion model and adult learning theory with the goal to increase nurses' knowledge and confidence with the self-management principles of HF. The purpose of this project was to develop an educational program for nurses to increase their knowledge of HF disease management and patient self-management principles. The education program was supported by research literature and recommendations from the Agency for Healthcare Research and Quality, in addition to input from a planning team consisting of 3 nursing leaders from the project site. The planning team provided process evaluation regarding satisfaction with the planning process by completing an anonymous, 10-question, Likert-type survey. Seven project evaluations were completed and all respondents indicated that they agreed or strongly agreed in response to questions regarding the effectiveness of the project, it's planning, and the leader. At the completion of the project, the education program was delivered to the project site, with a plan for later implementation and learner evaluation using assessment tools of HF knowledge and confidence. This project has the potential to achieve positive social change in relation to nurses' commitment to improving patient outcomes through quality initiatives and dedication to the implementation of evidence-based practice, thus, promoting positive patient outcomes.

Vaccinations are important factors in the eradication of most communicable diseases. Tetanus, diphtheria, and pertussis (Tdap) vaccine has been found to decrease the incidence and further spread of pertussis, and even nullify its existence, yet many postpartum mothers opt not to receive the vaccination even if eligible to do so. It was unknown whether clinical nursing staff at the project site had sufficient knowledge about Tdap vaccine to educate postpartum mothers to accept the vaccine. The practice-focused question explored whether an educational program and a toolkit implemented for nursing staff members on the postpartum nursing unit would improve Tdap vaccination rates among postpartum mothers. The health belief model, theory of planned behavior, and social learning theory provided a framework for the project. Evidence obtained from the results of pre- and post-testing of nursing staff on their vaccine-related knowledge and attitudes showed a statistically significant increase in knowledge (z = -3.366, p = .001). Descriptive statistics were used to evaluate the change in Tdap refusal after the education. The use of Tdap vaccine in the postpartum period improved slightly with fewer postpartum mothers refusing the vaccine in the post-education period. Project findings showed that providing Tdap vaccine education to clinical nursing staff could prepare them to teach postpartum mothers about the benefits of Tdap vaccination, which may improve the percentage of postpartum mothers who will accept the vaccine. Higher vaccination rates might contribute to positive social change by decreasing pertussis transmission rates for newborns.

Nursing is essentially a practical discipline and as such, clinical practice plays an important part in the nursing curriculum. Clinical education is a vital component in the curricula of pre-registration nursing courses and provides student nurses with the opportunity to combine cognitive, psychomotor, and affective skills. Clinical field placement is an integral element in the overall pre-registration nursing program. Clinical practice enables the student to develop competencies in the application of knowledge, skills, and attitudes to clinical field situations. However, the time allocation for the clinical component of pre-registration nursing courses can be rather limited. It is, therefore, vital that the short but valuable clinical time be utilised effectively and productively.One of the objectives of this study was to develop and validate an instrument, the Clinical Learning Environment Inventory (CLEI), to assess nursing students' perceptions of hospital learning environment during clinical practice. Data were collected from 138 second year nursing students in a major university school of nursing in South Australia. Both quantitative and qualitative data were collected. The study confirmed the reliability and validity of the CLEI for use in the hospital learning environment.A second objective was to investigate associations of the CLEI with outcomes. Students' perceptions of the outcome of their clinical placement were found to be strongly associated with all five scales of the CLEI namely; Individualisation, Innovation, Involvement, Personalisation, and Task Orientation. The quantitative and qualitative findings reinforced each other. A third objective was to determine whether there were any differences in students' perceptions of the actual learning environment provided and that preferred by students. It was found that there were significant differences in ++ / students' perceptions of the actual clinical learning environment and their preferred clinical learning environment. Findings from the study suggested that students preferred a more positive and favourable clinical environment than they perceived as being actually present.

<p>Konflikter har alltid funnits, men hur man har löst dem har skett på olika sätt. Mitt intresse för detta område är på grund av att jag tidigare arbetat i skolans värld. Där förekom ofta konflikter, men de flesta konflikter var mellan elev och elev. Men ibland förekom även konflikter i personalgruppen. De tog man itu med ganska omgående. När jag böt yrke och började arbeta inom sjukvården märkte jag att det förekom ganska mycket konflikter även här, framförallt i personalgruppen som ingen försökte lösa. Jag har nu med hjälp av litteraturen funnit några olika sätt som chefer löst konflikter på gruppnivå mellan två eller flera personer. Det jag har funnit i litteraturen är att chefer har gett order direkt till kombattanterna att sluta med sitt beteende, undvikit konflikten, kompromissat, medlat, utsett syndabockar, konfronterat, försökt behandla konflikten själv eller tagit hjälp av extern konflikthanterare. Resultatet i min studie visade att om en chef undvek konflikten så riskerade den att bli ett mycket svårlöst problem. Omplacerade man personalen så flyttades ofta bara problemet till ett annat ställe. Då man tog hjälp av en extern konsult, kunde det bli kostsamt men var oftast det bästa alternativet.</p>

Konflikter har alltid funnits, men hur man har löst dem har skett på olika sätt. Mitt intresse för detta område är på grund av att jag tidigare arbetat i skolans värld. Där förekom ofta konflikter, men de flesta konflikter var mellan elev och elev. Men ibland förekom även konflikter i personalgruppen. De tog man itu med ganska omgående. När jag böt yrke och började arbeta inom sjukvården märkte jag att det förekom ganska mycket konflikter även här, framförallt i personalgruppen som ingen försökte lösa. Jag har nu med hjälp av litteraturen funnit några olika sätt som chefer löst konflikter på gruppnivå mellan två eller flera personer. Det jag har funnit i litteraturen är att chefer har gett order direkt till kombattanterna att sluta med sitt beteende, undvikit konflikten, kompromissat, medlat, utsett syndabockar, konfronterat, försökt behandla konflikten själv eller tagit hjälp av extern konflikthanterare. Resultatet i min studie visade att om en chef undvek konflikten så riskerade den att bli ett mycket svårlöst problem. Omplacerade man personalen så flyttades ofta bara problemet till ett annat ställe. Då man tog hjälp av en extern konsult, kunde det bli kostsamt men var oftast det bästa alternativet.

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Thesis (Ph.D.)--Indiana University, Dept. of Educational Leadership and Policy Studies, 2009. / Title from PDF t.p. (viewed on Feb. 10, 2010). Source: Dissertation Abstracts International, Volume: 70-06, Section: A, page: . Advisers: Margaret R. Sutton; Donald R. Warren.