Nursing programs have traditionally used teacher-developed multiple-choice (MCQ) examinations to prepare students for licensure. Researchers have determined that poorly constructed MCQ tests used as formative and summative evaluations may penalize nursing students and impact progression and retention in nursing programs. The purpose of this exploratory case study was to examine issues related to the use of teacher-developed MCQ examinations as the only method of student assessment in the theory component of nursing courses. The National League for Nursing Core Competencies for Nurse Educators and the revised Bloom's Taxonomy were used as the conceptual frameworks for this study. The Director of the Nursing Program and 9 faculty members participated. Data were collected from a review of documents, 2 focus groups, faculty-maintained diaries, and an interview. During data analysis, categories were identified and themes emerged, revealing the key findings. Using a single method alone to assess student learning limited the opportunity for formative assessment, the ability to assess higher order thinking, and the development of metacognition on the part of students. To assist faculty in creating assessments of student learning that would address these themes, a 3-day faculty professional development project followed by 4 monthly lunch and learn sessions was designed. Providing additional faculty development in assessment methods may promote positive social change as it may ultimately increase the retention of qualified students to meet the demand for registered nurses within the community.

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when delivering culturally appropriate diabetes care, so a focus on cultural knowledge, intercultural patient-provider communication skills, and cultural assessment were key to this case study. One pilot study was conducted to test the focus group questions with 3 diabetes providers (i.e., certified nurse diabetes educator [CDE], registered nutritionist, and dietitian) who help patients to self-manage their diabetes. The second pilot study was conducted with 5 African immigrant patients who had been diagnosed with Type 2 diabetes. The primary focus groups were conducted with 5 CDEs and 10 patients. The transcribed responses were analyzed and categorized to identify the 17 themes that emerged (9 from the CDEs and 8 from the patients). One implication for social change is that a patient-centered approach to patient-provider communication will mean better health outcomes. To ensure culturally appropriate patient-provider communication, a change in health care delivery is required to incorporate cultural constructs as part of diabetes care and education to accommodate various ethnic and racial groups.

The Improving Head Start for School Readiness Act of 2007 required teacher assistants (TAs) to obtain their child development associate (CDA) credential by September of 2015. TAs who had not obtained their CDA within the required timeframe were either demoted or terminated from their positions. However, with the increase of working parents, the need for quality early childhood education has risen. In this project study, the barriers TAs confront in regards to their decision to continue their schooling to obtain a CDA credential were examined, as were the factors that deterred or prevented them from enrolling in or completing a higher education program. The purpose of the study was to inform the development of a plan outlining how childcare administration can mentor and encourage TAs in the completion of their CDA program. Knowles's theory of adult learning and Kolb's experiential learning theory provided the theoretical basis and framework for this qualitative case study. Cluster random selection was used to identify 9 participants who were interviewed using a semistructured process. Interview responses were recorded, transcribed, and broken down into 6 themes. Findings showed that 7 out of 9 participants experienced barriers to continuing their education, and 8 of the 9 partipants expressed a desire to participate in a mentoring program. Raising the educational requirements and completion rate of TAs positively affects social change through increased quality of instruction, improved teaching strategies, and enhanced and developmentally appropriate support provided to young children.

A midsize nonprofit blood bank organization is experiencing a high percentage of supervisors and managers not transferring skills taught in leadership development training programs back to the workplace. The purpose of this mixed methods, sequential, explanatory study was to understand the relationship between supervisor support or opposition and trainees' perception on factors that influence transfer of training and to identify strategies to improve transfer of training in the organization. Baldwin and Ford's Model of the training transfer process laid the framework for this study. Quantitative data were collected from trainees (N = 60) who attended leadership development programs between January 2012 and June 2014 and were analyzed using descriptive analysis, correlational analysis, and multiple regression. The correlation analysis indicated positive relationships between transfer of training and supervisor support. Qualitative data, collected during interviews (N = 8) that focused on trainees' perceptions on how to enhance transfer of training in the organization, corroborated the quantitative results. According to thematic analyses of the interview data, supervisor support, training design, opportunity to use skills on the job, and performance coaching and mentoring have the potential to improve training transfer. Policy recommendations were created to increase transfer of training back to the workplace. The findings of the study could help supervisors and managers increase training transfer, which could improve the organization's profits and create collaborative learning environments that benefit the participants and the communities where these participants live and work.

Researchers have found low online course completion rates to be a complex problem in higher education. Meanwhile, theory on adult learners' online persistence highlights the importance of a sense of school community. At the small, rural focus community college (FCC) for this study, general education online course completion rates are lower than the national average. FCC has not addressed the low online course completion rates. Using Rovais' composite persistence model as the conceptual framework, this instrumental case study examined how students' experiences and perceptions of a sense of school community contribute to their ability to complete online general education courses. Semistructured interview data were gathered with a purposeful, criterion-based, sample of 9 adult online students taking online general education courses. The inductive data analysis utilized case and cross-case analysis, marking, cutting, and sorting of text until 4 themes emerged: interaction, sense of belonging, support, and educational values. The results led to a white paper recommending an orientation and community space, asynchronous video technology, and an online curriculum instructional designer. This study contributes to positive social change by providing FCC with program and policy change recommendations that support the colleges' goals of increasing access and success. Increased educational access and success for the local adult population creates informed citizens, contributes to economic growth, and provides a higher quality of life for the community.

Most Kenyan high school dropouts do not have a school reentry option, and without a high school diploma, they lack access to tertiary or higher education institutions for training and career development. This case study was an investigation of how an adult learning center in Kenya educated high school dropouts and helped them to gain access to vocational training or higher education. The research questions addressed the pedagogy, learning experiences, and curriculum of the Baraka Adult Learning Center (BALC) and also focused on how the BALC met students' aspirations, needs, and goals based on the perceptions of teachers and adult learners. The conceptual framework was based on liberatory education theory, transformative learning theory, and andragogy. Data collected from classroom observation s, curriculum review, and interviews with 9 current students, 3 former students, 5 teachers, and the principal were analyzed inductively by sorting and coding to generate emergent themes. The results of the study indicated that instructors followed the regular high school curriculum with little adaptation and lacked training about teaching adult learners and self-directed learning approaches. The adult learners perceived returning to school as getting a second chance. A professional development project for BALC instructors was developed to address some of the needs identified in the study. This training could have an impact on the adult learners by better assisting them to gain access to vocational training and higher education.

This qualitative study was designed to understand the experiences of General Educational Development (GED) graduates enrolling into a community college. Research had not been conducted to explore the experiences of GED graduates completing the 2014 version of the exam and transitioning to college. Guided by Schlossberg's college transition theory and Bandura's theory of self-efficacy, this phenomenological study included 11 participants who described their experiences through written narratives and interviews. Participants described their experiences of being an adult education student while preparing for the exam, the steps within the GED test preparation they considered important to matriculation toward college enrollment, and their points of view of the enrollment experience into a community college. Data analysis included analytic induction and participatory analyses for discovering patterns and clarification of statements made by the participants. Narratives, interviews, and field notes were transcribed, member checked, and reviewed for interaction, continuity, and situation prior to coding. The realization of motivation, determination, and self-efficacy, established around supporting relationships assembled during the transition to college, were common experiences among these participants. A deeper understanding of these factors for adults matriculating through GED and into college hopefully instills awareness and sparks discussion for improvements in educational support services.

This qualitative case study addressed the problem at a West Indies theological college that lacked the ability to provide courses for spiritual care training by using the teaching methodology of clinical pastoral education (CPE). CPE is an experiential process using a clinical method of learning to interpret human conditions. Spiritual care training through CPE teaches clerics how to help persons find meaning in life's situations and make connections with their God. Guided by the frameworks of transformative learning and critical theological reflection, this study explored the lived experiences of 5 purposefully selected CPE students who participated in 1 unit of CPE training at the college. Interview data were coded and analyzed to uncover emergent themes. The findings revealed these overarching themes: (a) personal empowerment, (b) increased pastoral care competencies, (c) increased sensitivity to suffering, and (d) connectivity to self-care and ministry. The interview data provided the impetus for the developed CPE Orientation (CPEO) to help students obtain basic skills in pastoral/spiritual care and critical theological reflections. It is recommended that persons with advanced CPE training could conduct the CPEO training, negating the need for a certified CPE supervisor expertise. Positive social change may occur when pastoral/spiritual care training is provided to clergy and laity to improve basic pastoral/spiritual care skills by helping clergy and parishioners respond to stressors in a healthy manner. Theological education that promotes spiritual care for persons in crisis may benefit the world and presents an avenue for social change to occur in the communities where clergy serve.

Increased demand for culturally sensitive healthcare services suggests that interprofessional beginning healthcare students need to gain the necessary cultural competency skills to be successful in delivering positive health outcomes for diverse patients. Bandura's theory of observational learning, Mezirow's theory of transformative learning, and Purnell's and Paulanka's model of cultural competence informed the framework for this research. The purpose of this quasi-experimental quantitative study was to determine the relationship between mode of instruction (observing role models in videotaped role-play simulation) and increased transcultural self-efficacy in cultural competence instruction. A convenience sample of 196 students enrolled in an interprofessional education (IPE) course was randomly assigned at the time of course enrollment to either control or experiment course sections. Pretest and posttest data were collected anonymously through paper-and-pencil administration of the Transcultural Self-Efficacy Tool-Multidisciplinary Healthcare Provider (TSET-MHP). Paired-samples t test showed that students in the intervention group had statistically higher (p < .05) posttest scores in perceived transcultural self-efficacy after observation of standardized patient actors in a videotaped role-play simulation than did students in the control group. These results support the use of videotaped role-play simulation for cultural competence instruction as a means to achieve improved patient care within the culturally diverse population in the healthcare system.

Counselor resilience is the ability to transform adversity into growth opportunities that become part of the professional's identity and the core values of a counselor. However, researchers have yet to identify why some counselors exhibit higher levels of resilience while others exhibit less. Counselor resilience can be learned and nurtured at any point of an individual's development. The purpose of this study was to examine how differences within the foundational edification of a research-embedded curriculum impact a counselor's level of resilience. Participants included practicing counselors who received their counseling degrees from a 2014 U.S News and World Report (USNWR) Nationally Ranked Best University\Colleges. Using a quantitative, comparative design, 123 counselors were surveyed using a demographic questionnaire and the modified CD-RISC (CD-RISC-27). An analysis of variance was used to examine the impact of differences among counseling professionals' levels of therapeutic resilience based on the ranking of the institutional and research emphasis within their respective counseling programs. The results from this study indicated that research-embedded curriculum had no significant difference in a counselor's level of resilience (p >.05). Outcomes for this study provide statistical evidence that curricular differences and university ranking do not explain the variance in counselors' demonstrated resilience. These findings validate the academic and clinical application of non-research based training programs and non-traditional learning environments.