Background: Health care transition (HCT) for adolescents and emerging adults (AEA) with special health care needs is an emerging field of interdisciplinary field of practice and research that is based upon an intergenerational approach involving care coordination between pediatric and adult systems of health care. Informed understanding of the state of the HCT science pertaining to this group of providers is needed in order to develop and implement service programs that will meet the comprehensive needs of AEA with special health care needs. Methods: The authors conducted a systematic review of the literature on the transition from child to adult care for adolescents and emerging adults (AEA) with special health care needs from 2004 to 2013. Fifty-five articles were selected for this review. An adaptation of the PRISMA guidelines was applied because all studies in this review used descriptive designs. Results: Findings revealed lack of evidence due to the limitations of the research designs and methodology of the studies included in this systematic review. Study findings were categorized the following four types: adult provider competency, provider perspectives, provider attitudes, and HCT service models. The discipline of medicine was predominant; interdisciplinary frameworks based upon integrated care were not reported. Few studies included samples of adult providers. Conclusions: Empirical-based data are lacking pertaining to the role of providers involved in this specialty area of practice. Evidence is hampered by the limitations of the lack of rigorous research designs and methodology.

Background: A better understanding of the needs of adolescents and emerging adults with special health care needs (AEA-SHCNs) is essential to provide health care transition services that represent best practices. The purpose of this systematic review was to evaluate the research on health care transition for AEA-SHCNs from their perspectives. Methods: A comprehensive literature review of research publications since 2005 was performed using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and EBSCO databases. Thirty-five studies met the final review criteria. Results: The process of transition from child to adult for AEA-SHCNs is complex. Individuals experiencing the transition desire to be a part of the process and want providers who will listen and be sensitive to their needs, which are often different from others receiving health care at the same facility. Conclusions: More research that considers the voice of the AEA-SHCNs related to transition from pediatric to adult care is needed.

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Abstract available through the Journal of Nursing and Patient Care.

Preloading student satisfaction and success factors into an online program orientation course can strengthen the potential for student retention and success. The nursing literature is lacking in this area. Much of the information found on retention is focused on the undergraduate student in a face-to-face classroom setting. Less literature can be found on graduate level education retention and the body of knowledge regarding graduate online education retention is even more limited (Perry, Boman, Care, Edwards, & Park, 2008). Retention rates in online graduate education, not specific to nursing, vary widely, but are typically poorer than in face-to-face programs (Barry & Mathies, 2011; Patterson & McFadden, 2009). Increasing student retention and graduation is crucial for maintaining and increasing performance-based funding in educational institutions. Meeting common student needs early in the program can provide the resources and support needed for overcoming future barriers to graduation. Cameron (2013) compiled common student needs: positive social experiences with students and faculty/advisors, course delivery system understanding, asynchronous participation understanding, requirements of e-learning, requirements of graduate and program education, and evidence of institutional commitment through excellence in advising and online resource availability and access. A reduction in overall anxiety about entering graduate education and an increased confidence in the ability to succeed are vital for students entering graduate education. Early access to peers, faculty advisors, and university resources can improve the students’ sense of community and belonging and provide a strong support system. These early steps ease technology frustrations, communication difficulties, and any perceived support inadequacies. A completely online Master of Science in Nursing (MSN) program orientation course was developed to meet the identified common student needs. The program provides early access to the MSN program’s Learning Management System (LMS), access to peer support, faculty advisor, and university resources. Students were taught the basic structure of courses (including content, discussions, quizzes, and drop boxes) to ease the stress of the first few weeks of class. Graduate study requirements and expectations were explained along with the differences between online and face-to-face study. Students received guidance in balancing work, life, and study. Students were given opportunities to practice the most commonly used technologies in the program. Ten newly admitted MSN students participated in the study. A post course phone interview was initiated with each following course completion, using a five-level Likert scale (1 being the lowest score and 5 the highest score) to assess the course and student perceived preparedness for the MSN program. Four categories of questions were used: knowledge regarding graduate online study, resources, and program expectation; proficiency with the LMS; communication access to other students and faculty advisor; and access to university resources. A final question was asked of students regarding their overall anxiety level about starting the MSN program. All students reported decreased anxiety and increased comfort with graduate online education, increased self-confidence, and feelings of support. Students are able to focus more on the course subject matter in the first few weeks of class when they have a clearer understanding of the LMS, graduate school and online learning expectations, and resource/support availability before classes start. A positive early start adds strength for managing future barriers and frustrations of graduate education. These concepts may be applied to meet the specific requirements of other academic programs. Further research is needed to compare the retention rates of those participating in the orientation program and those who did not. The finding in this project support the importance of an orientation program to graduate nursing studies which includes setting realistic expectations, developing a sense of community and support, and practicing for proficiency in the program LMS.

Students are able to focus more on the course subject matter in the first few weeks of class when they have a clearer understanding of the LMS, graduate school and online learning expectations, and resource/support availability before classes start. A positive early start adds strength for managing future barriers and frustrations of graduate education. These concepts may be applied to meet the specific requirements of other academic programs. Further research is needed to compare the retention rates of those participating in the orientation program and those who did not. The finding in this project support the importance of an orientation program to graduate nursing studies which includes setting realistic expectations, developing a sense of community and support, and practicing for proficiency in the program LMS.

Preloading student satisfaction and success factors into an online graduate nursing education program orientation course strengthens the potential for student retention and success. Major components of withdrawal from universities include personal reasons and support system issues. Support system issues often relate to a difference in the students’ anticipatory expectations and the realities of the educational program. Student perspectives on program expectations may be related to their experiences in a face-to-face undergraduate program format and an online graduate program format. Another conflict between student anticipatory expectations and program realities may be related to the level of learning and understanding required of graduate education compared to undergraduate education. A 100% online graduate nursing orientation and guidance program was developed to orient newly admitted students to the expectations of graduate nursing study, the requirements of this specific MSN program, and how to use the learning management system (Desire2Learn). Students were taught the basic structure of courses (including discussions, quizzes, and dropbox assignments). Access to peer support, faculty advisor, and university resources were provided within the course using the same architecture as the program courses. Students were encouraged to introduce themselves to other students. Opportunities were provided for more experienced students to share experiences and bits of wisdom gained from their studies. New students were encouraged to ask questions of fellow students and their advisor and to establish study groups. Ongoing discussion boards were provided for continuous student interaction and peer support throughout their time in the program. Students gained a realistic perception of the program, online graduate study expectations, and helped them to form a realistic understanding of the need to maintain a work-school-life balance. Students reported decreased anxiety and increased comfort with graduate online education, increased self confidence, and feelings of support, which prepared them for success.

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No description available.