Thesis (Ph.D.)--Ohio University, August, 2009. / Title from PDF t.p. Release of full electronic text on OhioLINK has been delayed until September 1, 2013. Includes bibliographical references (leaves 289-313)

Thesis (M.A.)--Ohio State University, 1952. / Available online via OhioLINK's ETD Center

<p> High fidelity human simulation (HFHS) has become a common feature in nursing education in recent years. This case study explored the practices and perceptions of nursing directors, faculty, and students regarding the integration of HFHS in associate degree RN and LPN programs. The course of study in these particular programs is two years or less in length, presenting added challenges for faculty to introduce new pedagogies into an abundantly full curriculum. Multiple data sources were used and included 41 participants through interviews with nursing directors and instructors, observation of instructors and students during HFHS scenarios and debriefing sessions, and student focus group interviews at four nursing schools in two Midwestern states. Data analysis resulted in the emergence of four major themes: time limitation, limited resources, instructional disconnect, and student perspectives. These findings were consistent with much of the current literature. Findings also demonstrate the negative effects of limited time, resources, and faculty practices on the ability of nursing students to suspend disbelief and fully engage in the learning scenarios. Given the financial investments in HFHS, achieving best use through supporting student participation in active learning and facilitating the development of clinical judgment are goals which should be considered.</p>

<p> The problem addressed in this study was the need for evidence-based teaching strategies that prepare nursing students to enter practice at graduation with the competencies to provide safe patient care. The purpose of the study was to investigate whether the addition of a patient safety focused human patient simulation (PS-HPS) learning activity during the final senior semester of a nursing program in southeast Michigan changes students&rsquo; perceptions of patient safety competence learning. For the pre-test post-test quasi-experimental study, a convenience sample of 48 undergraduate senior nursing students who engaged in the simulation was compared to 50 senior nursing students from the previous semester that did not receive the intervention. The Health Professional Education in Patient Safety Survey (H-PEPSS) was administered to both groups of nursing students during the second week of the final semester of a baccalaureate nursing program and again at the end of the semester. For the first research question, the ANCOVA test determined that there was no significant difference in post-test classroom learning scores between the comparison and treatment groups, controlling for pre-test classroom learning H-PEPSS scores, F (1, 95) = .000, p = .983, partial eta squared = .000. For the second research question, the ANCOVA test determined that there was no significant difference in post-test clinical learning H-PEPSS scores between the comparison and treatment groups, controlling for pre-test clinical learning scores, F (1, 95) = .496, p = .483, partial eta squared = .005. Implications for nursing education practice include: (a) simulation learning may not be more effective than traditional classroom learning strategies and (b) educators should continue to explore both classroom and clinical teaching strategies to advance students&rsquo; patient safety competence learning. One recommendation is to replicate the study with other nursing students from different locations. Secondly, the simulation scenario presented in this study could be modified by other instructors to effectively facilitate students&rsquo; patient safety learning. Additionally, a mixed methods research design may yield student responses that better reflects student learning within simulation. The proposed study adds to the nursing educational research about the effectiveness of simulation for students&rsquo; patient safety competence learning.</p>

<p> The goal of this dissertation was to contribute to research on practical nursing students&rsquo; self-efficacy and the sources that build self-efficacy including mastery experience, vicarious learning, social persuasion, and physiological and affective states (Bandura, 1986). Specifically, the focus in this study was on students&rsquo; self-efficacy change and development through the measurement of students&rsquo; confidence in ability to engage in medical surgical simulations during the last semester of a practical nursing program. The results of this study revealed perceived self-efficacy did not change, but participants indicated an overall strong sense of efficacy to engage in medical surgical simulations. Additionally, students relied on all four sources that build self-efficacy (Bandura, 1986). In other words, students relied on personal perseverance in facing obstacles, sought the nursing faculty&rsquo;s assistance and encouragement to perform well, observed and modeled their teachers&rsquo; behaviors, and successfully managed their physiological and emotional states. Strong self-efficacy was concluded to be a key factor in the success of practical nursing students. Thus, there is a need for future experimental and theory-driven studies that utilize the self-efficacy approach to reduce student attrition and contribute to academic and professional accomplishment of practical nursing students. </p>

<p> The purpose of this study was to identify whether a correlation exists between perceived online incivility experiences and RN-BSN student program satisfaction. This study used a cross-sectional, quantitative (correlational) survey method. There were 85 participants, 93% female and 7% male, with 89% of the respondents identifying as Caucasian, 6% Asian, 4% African American, and 1% as Pacific Islander. The age range was 20-64 years, with a mean age of 41.4 years. Of the participants in this study, 32% reported experiencing one or more occurrences of online incivility from faculty, primarily through emails. Online incivility and RN-BSN program satisfaction were found to produce a correlation coefficient of -0.32, which was significant and indicates a relationship of medium strength. Limitations of this study include a small sample size, the sensitivity of the topic, and survey responses based on memories of perceived experiences. Implications for practice include development of clear expectations with respect to faculty conduct, including a zero tolerance policy and an avenue through which students can freely report incivility. Further research should focus on identifying other variables that may contribute to online incivility and RN-BSN program satisfaction.</p>

<p> <u>Objectives.</u> Despite a child restraint system (CRS) law in the Kingdom of Saudi Arabia (K.S.A.), compliance has been minimal. We explored the salient behavioral, normative and control beliefs, which may predict intentions of CRS use in K.S.A; identified which of them independently predicted attitude, subjective norms (SN), and perceived behavioral control (PBC); and tested the effect of attitude, SN, and PBC on the intent for CRS use. </p><p> <u>Methodology.</u> This study was conducted in two stages. During the qualitative stage two focus groups were conducted (n=25). The identified beliefs were incorporated into a survey following Ajzen's guidelines. 196 pregnant women completed surveys at Dallah Hospital, Riyadh during June, 2013. In a separate observation to measure the CRS usage, two nurses discretely monitored 150 women leaving hospital following maternity stay. Logistic regression was used to determine the association between intent and TPB constructs; and salient beliefs and respective composite belief scores. </p><p> <u>Results.</u> Lack of health education and law enforcement, cultural pressure, advice from family, desire to stay close to the child, family size were key factors stated. Logistic regression model with TPB constructs and covariates as predictors of CRS usage intent was statistically significant (&chi;2=64.986, p&lt;0.0001, df=11) and correctly classified 72.4% of the cases. There was an increase in odds of intent to use CRS for attitudes (31.5%, p&lt;0.05), SN (55.3%, p&lt;0.001), and for PBC (76.9%, p&lt;0.001). The logistic regression models testing the association of the relevant set of composite belief scores were also statistically significant for attitudes (&chi;2=16.803, p&lt;0.05, df=6), SN (&chi;2=29.681, p&lt;0.0001, df=5), and PBC (&chi;2=20.516, p&lt;0.05, df=8). The behavioral observation showed that none of 150 women observed used CRS for their newborn. </p><p> <u>Conclusion.</u> Attitude, SN, and PBC were significantly and independently associated with higher intent for CRS usage. Three beliefs were found to be significantly and independently associated with respective TPB constructs. While TPB appears to be useful in identifying beliefs related to CRS usage intentions in K.S.A., the results of the behavioral observation indicate that intentions may not be related to the actual usage of CRS in K.S.A. Further studies are recommended to examine this association.</p>

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