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Waters, Donna. "Evidence : the knowledge of most worth." University of Sydney, 2006. http://hdl.handle.net/2123/1903.
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Doctor of PhilosophySimilar to their colleagues throughout the world, nurses and midwives in New South Wales (NSW), Australia, welcome evidencebased practice (EBP) as a means to improve patient or client outcomes. This thesis explores the way nurses and midwives understand evidence for EBP and aims to determine whether members of these professions currently have the knowledge and skills necessary to implement evidence‐based care. Three separate studies were conducted to explore NSW nurses’ readiness for EBP. Attitudes, knowledge and skill were investigated using an EBP questionnaire returned by 383 nurses. The views of 23 nursing opinion leaders were elicited during qualitative in‐depth interviews, and their ideas on maximising the potential for future nurses to confidently engage in EBP were explored. Current approaches to teaching EBP in undergraduate nursing programs were investigated by examining documents issued by NSW nursing education providers. The results demonstrate many differences between the ways NSW nurses currently understand evidence for EBP, and a range of approaches to teaching EBP in undergraduate nursing programs. Under current conditions, nurses graduating from universities in NSW commence practice with varying levels of preparation for EBP and enter into a professional arena that is itself struggling to cope with the concepts and language of this approach to improving healthcare. v Evidence for the effectiveness of EBP is slowly accumulating and despite some small positive signs, the collective results of this thesis suggest that current educational approaches are not capable of producing the kind of results that are both necessary and desirable for the promotion of evidence‐based nursing practice in NSW. Articulating a commitment to EBP, using a common language and a consistent approach are among the recommendations made for the future promotion of EBP in nursing education.
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Breytenbach, Cecile. "A best practice guideline for evidence based teaching strategies for nurse educators." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/4831.
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Evidence based practice (EBP) is a worldwide phenomena defined as the “conscientious explicit and judicious use of current best evidence in making decisions about the patient’s care”. The evidence based practice concept’s aim is to effectively guide health care professionals to build knowledge that will be supported by evidence. Evidence based practice must be supported by evidence based teaching. Nurse educators must be up to date with evidence based teaching as well as the latest evidence based teaching strategies, in order to teach the new millennial nursing students and for the new qualifications structure. Teaching the concept of evidence based practice by implementing evidence based teaching to nursing students will enable them to transform the future of healthcare by delivering high quality care practice. A paucity of evidence is available on evidence based teaching and teaching strategies in the South African context. Therefore the researcher used a systematic review methodology to explore and describe the best available evidence based teaching strategies and to develop a guideline on evidence based teaching strategies for nurse educators. The data bases searched included: MEDLINE, CINAHL, PubMed and Google Scholar. Manual searches were done and completed with the assistance of librarians. A total number of n=50 studies were identified as potentially relevant to the study. The number or articles included for critical appraisal were 20. On completion of the critical appraisal n=17 articles were identified for the review. The included studies for the review were n=7 Level 1, systematic reviews and n=10 Level 2, quasi-experimental studies. Three studies were excluded after critical appraisal from two reviewers, appraisal was done independently, and consensuses were reached between the two reviewers. The Joanna Briggs Institutes critical appraisal and data extraction instruments were used for the study. The descriptive data synthesis was done of the included studies as well as a comparison of teaching strategies to determine which one to better than the other one. Although n = 4 of the teaching strategies (concept mapping, internet-based learning, evidence based interactive strategy and cultural competence) significantly increased knowledge, the overall results found that a variety of teaching strategies to be implemented to increase the knowledge outcomes of the nursing students. The different teaching strategies found were: e-learning, concept mapping, internet-based learning, web-based learning, gaming, problem-based learning, and case studies, evidence based learning and cultural competence. However, more research is needed to investigate the best use of the different teaching strategies and compare the impact of a variety of teaching strategies on increasing knowledge of the nursing student.
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Chan, Yung-kwan Albert, and 陳容坤. "Hong Kong nursing students' learning approaches: why and how do hospital-based general nursing students learn?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1994. http://hub.hku.hk/bib/B31957055.
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Phillips, Janet Martha. "Clinical educators' adoption of socioculturally-based teaching strategies." Thesis, Connect to resource online, 2009. http://hdl.handle.net/1805/1902.
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Thesis (Ph.D.)--Indiana University, 2009.Title from screen (viewed on August 28, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). Advisor(s): Pamela Ironside, Anna McDaniel. Includes vita. Includes bibliographical references (leaves 177-197).
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Ring, Nicola A. "A critical analysis of evidence-based practice in healthcare : the case of asthma action plans." Thesis, University of Stirling, 2013. http://hdl.handle.net/1893/13061.
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Evidence-based practice is an integral part of multi-disciplinary healthcare, but its routine clinical implementation remains a challenge internationally. Written asthma action plans are an example of sub-optimal evidence-based practice because, despite being recommended, these plans are under-issued by health professionals and under-used by patients/carers. This thesis is a critical analysis of the generation and implementation of evidence in this area and provides fresh insight into this specific theory/practice gap. This submission brings together, in five published papers, a body of work conducted by the candidate. Findings report that known barriers to action plan use (such as a lack of practitioner time) are symptomatic of deeper and more complex underlying factors. In particular, over-reliance on knowledge derived from randomised controlled trials and their systematic review, as the primary and sole source of evidence for healthcare practice, hindered the implementation of these plans. A lack of evidence reflecting the personal experience of using these plans in the real world, rather than in trial settings, contributed to a mismatch between what patients/carers want from asthma action plans and what they are currently being provided with by professionals. This submission illustrates the benefits of utilising a broader range of knowledge as a basis for clinical practice. The presented papers report how new and innovative research methodologies (including meta-ethnography and cross-study synthesis) can be used to synthesise individual studies reporting the personal experiences of patients and professionals and how such findings can then be used to better understand why interventions can be implemented in trial settings rather than everyday practice. Whilst these emerging approaches have great potential to contribute to evidence-based practice by, for example, strengthening the ‘weight’ of experiential knowledge, there are methodological challenges which, whilst acknowledged, have yet to be fully addressed.
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Van, Belkum Corrien. "A process of quality improvement for outcomes-based critical care nursing education." Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52125.
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Dissertation (PhD) -- University of Stellenbosch, 2001.ENGLISH ABSTRACT: A thoughtfully planned learning program provides a blueprint for critical care nursing and gives direction to theory and clinical practice. The design of a learning program for critical care nursing that is adaptive, learner focussed and integrated, helps nurses acquire the necessary competencies (knowledge, technical skills and attitudes/values) needed for critical thinking. It also enables critical care nurses to grow professionally and to develop expertise in critical care nursing. Outcomes-based education has become the "new buzz word" in South Africa, and a paradigm shift from content-based to outcomes-based education has become essential. Institutions are concerned with efficient and effective approaches to critical care nursing delivery. The institution (nursing department) proves its worth by anticipating patient care needs and planning its learning program cognizant of the need to correlate activities with the institution's (nursing department) mission and outcomes. Planning that meets the learning needs of the critical care nursing learners not only provides the ability to meet job expectations, but also experiences for professional growth and satisfaction. In an age of nursing shortage, a well planned, integrated and outcomes orientated critical care learning program is essential. The outcome of the research was identified as a process of quality improvement for outcomes-based critical care nursing education, which included validated standards to facilitate quality critical care nursing education. This was researched by utilising an adapted Laing and Nish Model for Quality Assurance (1981) as the research strategy. Seven (7) steps were identified, namely: Step one included the identification and clarification of values; step two determined criteria, established standards for outcome, structure and process; step three ratified criteria and validated standards; step four identified and analysed factors influencing the results; step five selected appropriate actions to maintain or improve critical care nursing education; step six implemented the selected actions and in step seven, assessment (testing) was done. In steps two and three of the quality improvement process the Muller's (1996) Three Phase Model for Standard Development was implemented. Seven (7) standards were identified and formulated, namely: Standard one - Quality improvement; Standard two - Standard formulation; Standard three - Philosophy; Standard four - Legislative framework; Standard five - Curriculum development (learning program development); Standard six - Outcomes-based education; and Standard seven - Critical care nursing education. During the process of validation of the standards, standards five and six were combined and became Standard five - Outcomes-based learning program development. In step three the Delphi technique as part of the second phase of Muller's model (1996), was utilised to gain expert opinions / validation of standards. Operationalisation and assessment of the validated standards as part of a process of quality improvement for outcomes-based critical care education were done in a higher education institution. The results of this pilot study that was done supported the central theoretical assumption, namely that outcomes-based critical care nursing facilitates quality critical care nursing. The uniqueness of the research lies in the fact that in outcomes-based critical care nursing education there is no formal process of quality improvement for outcomes-based critical care nursing education. In this research, standards were developed and presented as part of a process of quality improvement for outcomes-based critical care nursing education. These standards should guide the developer of an outcomes-based critical care nursing education program during the development of the learning program (meso curriculum) and could be utilised to judge the quality of the current learning programs' quality. Five of the six standards are generic and could be utilised with minor adjustments in any higher education learning program.
AFRIKAANSE OPSOMMING: 'n Weldeurdagte leerprogram dien as 'n bloudruk vir kritiekesorg-verpleging, en rig beide die teorie en die kliniese praktyk. Die ontwerp van 'n leerprogram vir kritiekesorg-verpleging wat ge"integreerd,leerder-gefokus en aanpasbaar is, help verpleegkundiges om die nodige vaardighede (kennis, tegniese vaardighede en houdings/waardes) vir kritiese denke te ontwikkel. Dit stel kritiekesorg verpleegkundiges ook in staat om professioneel te groei en om kundigheid in kritiekesorg-verpleging te ontwikkel. Uitkoms-gebaseerde onderrig is die "nuwe wagwoord" in Suid-Afrika en het 'n paradigmaskuif van inhoud-gebaseerde- na uitkoms-gebaseerde onderrig genoodsaak. Instellings is begaan oor doeltreffende en effektiewe benaderings vir die lewering van kritiekesorg verpleging. Die verrnoe van 'n instelling (departement verpleging) om pasientsorq-behoeftes te voorspel en om die kritiekesorg leerprogram se aktiwiteite in ooreenstemming met die instelling (departement verpleging) se missie en verwagte uitkomstes te beplan, bewys die waarde van die instelling (departement verpleging). 8eplanning wat aan die leerbehoeftes van die kritiekesorg-Ieerders voldoen, bevredig nie aileen hul werksverwagtinge nie, maar het ook professionele groei en genoegdoening tot gevolg. In Goed-beplande, ge"integreerde en uitkoms-georienteerde kritiekesorg leerprogram is essensieel in 'n tyd waar verpleegtekorte aan die orde van die dag is. Ten einde gehalte-verpleegonderrig te fasiliteer, is die uitkoms van die navorsing as 'n proses van gehalteverbetering vir uitkoms-gebaseerde kritiekesorgverpleegonderrig, wat gevalideerde standaarde insluit, ge"identifiseer. 'n Aangepaste Laing en Nish Model vir Gehalteversekering (1981) is as navorsingstrategie vir hierdie navorsing gebruik. Sewe (7) stappe is ge"identifiseer, naamlik: Stap een sluit die identifisering en verduideliking van waardes in; stap twee bepaal kriteria en skep standaarde vir uitkoms, struktuur en proses; stap drie bekragtig en valideer die standaarde; stap vier identifiseer en ontleed faktore wat die resultate belnvloed; stap vyf selekteer toepaslike aksies om kritiekesorg-verpleegonderrig te handhaaf of te verbeter; stap ses implementeer die geselekteerde aksies en in stap sewe is assessering (toetsing) gedoen. Muller (1996) se Drie Fase Model vir Standaardontwikkeling is in stappe twee en drie van die gehalteverbeteringsproses ge"implementeer. Sewe (7) standaarde is ge"identifiseer en geformuleer, naamlik: Standaard een - Gehalteverbetering; Standaard twee - Standaardformulering; Standaard drie - Filosofie; Standaard vier - Wetlike raamwerk; Standaard vyf - Kurrikulumontwikkeling (Ieerprogramontwikkeling); Standaard ses - Uitkoms-gebaseerde onderrig; en Standaard sewe - Kritiekesorg-verpleegonderrig. Tydens die valideringsproses van die standaarde, is standaarde vyf en ses gekombineer as Standaard vyf - Uitkomsgebasseerde leerprogramontwikkeling. Gedurende stap drie is die Delphitegniek tydens die tweede fase van Muller (1996) se model gebruik om deskundige opinies te verkry I die standaarde te valideer. Operasionalisering en assessering van die gevalideerde standaarde as deel van In sisteem van gehalteverbetering vir uitkoms-gebaseerde onderring is in 'n hoeronderwysinstelling gedoen. Die resultate van hierdie toetsstudie het die sentrale teoretiese aanname, naamlik dat uitkoms-gebaseerde kritiekesorg-verpleging gehalte kritiekesorg-verpleging fasiliteer, ondersteun. Die uniekheid van hierdie navorsing is gelee in die feit dat daar in uitkomsgebaseerde kritiekesorg-verpleegonderrig, geen formele proses van gehalteverbetering vir uitkoms-gebaseerde kritiekesorg-verpleegonderrig is nie. In hierdie navorsing is standaarde ontwikkel en aangebied as deel van In sisteem van gehalteverbetering vir uitkoms-gebaseerde kritiekesorg-verpleegonderrig. Hierdie standaarde kan tydens die ontwikkeling van die leerprogram (mesokurrikulum), die ontwikkelaar van In uitkoms-gebaseerde kritiekesorgverpleegondderigprogram begelei, en kan gebruik word om die gehalte van huidige leerprogramme te beoordeel. Vyf van die ses standaarde is generies en kan, met minimale veranderinge in enige hoer onderwys leerprogram gebruik word.
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Oosterbroek, Tracy Ann, and University of Lethbridge Faculty of Health Sciences. "Preparing to care : creating a culture of caring in problem based learning tutorial groups." Thesis, Lethbridge, Alta. : University of Lethbridge, School of Health Sciences, c2009, 2009. http://hdl.handle.net/10133/1295.
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The purpose of this study was to explore with fourth year nursing baccalaureate students, their perceptions of experiences of caring using ethnographic design, and examine the phenomenon of caring and whether the development of caring relationships occurs among students and faculty members. Furthermore, the study sought to understand how nursing students perceive these relationships as influential in their learning, and ability to cope with stress. The sample consisted of ten fourth year nursing students who volunteered to be interviewed as well as one focus group of seven faculty members. The major findings of the study illuminated five general constructs: (1) The caring art of nursing in large part is a way of being in the world, an attitude that is inherent in the personality; (2) the caring science of nurse doing can indeed be taught and learned; (3) non-caring behaviors, experiences and relationships negatively impact the learning environment and therefore the learning outcomes for students; (4) Problem Based Learning (PBL) method cultivates a safe and caring learning environment; (5) caring is valued by students and positively impacts their educational experience, including learning outcomes, clinical experiences and their ability to cope with stress. The findings of the study may be utilized as a component of faculty growth and development as well as internal curriculum review.x, 131 leaves ; 29 cm
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Wilkie, Margaret C. K. "Actions, attitudes and attributes : developing facilitation skills for problem-based learning." Thesis, Coventry University, 2002. http://curve.coventry.ac.uk/open/items/579668cc-9ec4-2005-ac69-eaab234c1396/1.
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Problem-based learning (PBL) is being adopted increasingly as a learning and teaching strategy within the United Kingdom. Although facilitation is recognised as being central to PBL, much of the current literature on facilitation in PBL is conflicting. This study explored the espoused and actual conceptions of PBL adopted by facilitators on a newly-developed pre-registration nursing diploma programme that employed PBL. To explore the lived experience of the PBL curriculum, a constructivist interpretist qualitative research design was adopted. For facilitation in PBL to be effective in promoting independent learning and developing critical thinking, teachers were required to sustain the newly espoused pedagogy and to adapt their actions to match. All participants possessed facilitation skills before the start of the study, however expertise in PBL facilitation took time and practice to acquire as existing skills had to be applied in new ways. Findings identified four broad approaches to facilitation: directive conventionalist, liberating supporter, nurturing socialiser and pragmatic enabler. Over time, most facilitators converged from a directive conventionalist approach towards that of a pragmatic enabler. The transitions were influenced by the need to resolve dissonance between espoused theories and theories-in-use; increased understanding of the dialogic nature of PBL; the use of communicative spaces to share and reflect on experience and an enhanced awareness of student diversity. While the findings relate specifically to PBL facilitation, they also contribute to the understanding of the types of teaching and learning strategies required by the large and increasingly diverse student body.
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Yeung, Hiu-hung, and 楊曉紅. "From hospital based training to tertiary education: issues concerning an initial implementation of newnursing education policy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31962075.
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Julie, Hester. "Community- based service-learning through reflective practice." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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The purpose of the study wass to describe the professional and personal development of nursing students who were placed at the Saartjie Baartman Centre for Abused Women and Children for the service-learning trial run of this Gender-Based Violence module i
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Van, Schyndel Jennie L. "Nursing students' perceptions of presence in online courses." Thesis, Indiana University - Purdue University Indianapolis, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3737835.
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Lack of presence in online courses can result in perceived isolation leading to student dissatisfaction with the learning experience. The purpose of this study was to measure nursing students’ perceived extent of teaching, social and cognitive presence and course satisfaction in an online undergraduate nursing course, and whether relationships and associations existed between the three presences, course satisfaction, student demographic, academic, and technology variables, and selected instructional strategies.
The Community of Inquiry theory was the framework used in this descriptive correlational study of RN-BSN students (n= 76). Variables were measured using the Community of Inquiry Survey and the Perceived Student Satisfaction Scale instruments, and a researcher developed survey.
Findings indicated students’ perceived teaching and cognitive presence were present to a greater extent than social presence. Significant positive correlations (p < .01) were found between teaching and cognitive presence (r =.79), cognitive and social presence (r =.64), teaching and social presence (r =.52), satisfaction and the teaching (r =.77), social (r =.63), and cognitive (r =.52) presences. There were no significant findings associated with age, ethnicity, race, number of online courses taken, expected course grade or GPA and perceptions of the three presences and course satisfaction. There was a significant difference (p ≤ .05) with gender and perceived social presence with male students reporting stronger levels. Students experiencing course technology difficulties reported significantly ( p ≤ .05) lower perceptions of teaching presence than those experiencing no difficulty. Significant differences (p ≤ .05) were found between specific course instructional strategies and each presence and course satisfaction. The findings provide faculty with an understanding of online course management and teaching/learning strategies that may increase students’ perceptions of presence in online courses and improve student satisfaction with online learning.
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Jetha, Farah Shirazdin. "Teaching needs and evidence-based strategies to support novice nursing clinical teachers: a rapid evidence assessment." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/44317.
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Clinical education is the cornerstone of nursing curricula and comprises almost half of many current nursing curricula. It is through this practice that students learn to apply their theoretical knowledge to practice and socialize into the nursing profession. The clinical teacher is pivotal in this process. The current nursing profession is challenged with a decreasing supply of competent clinical teachers due to an aging nursing workforce, and economic barriers which impacts the quality of nursing education. To meet this increasing demand for competent clinical teachers, members of academic institutions are resorting to hiring expert nurses who are mostly novice teachers. These novice clinical teachers are in need of support during their transition from practice to teaching. An assessment of the evidence-based scholarly literature was conducted to identify the teaching needs and strategies to support this unique group of expert nurses transitioning as novices into teaching practice.
By means of a rapid evidence assessment (REA) method and a reflective framework, 29 research studies were reviewed. A comprehensive view of what is described in the evidence-based literature as the needs for novice clinical teachers’ teaching practice as well as current recommendations of best practices to support and prepare novice clinical teachers are presented.
Teaching needs for novice clinical teachers identified in the REA are socialization into the culture of teaching, professional development, and the need to self-reflect and be self-confident. Supportive strategies that are highlighted include working in familiar environments, having prior exposure to students, participating in a comprehensive orientation process using principles of adult learning theory, building relationships and creating a new identity. The main recommendations to support novice clinical teachers’ needs include strategies to enhance socialization into the teaching role, the development of a comprehensive orientation process, ongoing professional development sessions, mentorship programs, and self-reflective strategies.
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Baxley, Michelle. "School nurse's implementation of evidence-based practice| A mixed method study." Thesis, University of Phoenix, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10257368.
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Evidence-based practice (EBP) ensures excellent nursing care; however, limited literature exists for implementing EBP within schools. This mixed method study, using the Promoting Action on Research Implementation in Health Services (PARIHS) framework, explained EBP implementation within three school districts. Quantitative results identified the level of implementation and nursing characteristics predictive of EBP implementation. The mean EBP Implementation score (n = 64) was 8.36 (SD 9.75), indicating a low level of EBP implementation. EBP Belief scores was the only nursing characteristic that explained 34% of the variance. Qualitative results explained survey results, using a multiple case study design with interviews with six school nurses with high or low EBP Implementation scores. Analysis included pattern matching to propositional statements derived from PARIHS evidence, context, and facilitation concepts. Individual case stories varied and demonstrated both positive and negative patterns. Data synthesis examining propositions and themes indicated all cases supported four evidence propositions. No cases supported the evidence proposition about collecting and using routine student data. Three cases (n =3) with high EBP Implementation scores supported six evidence and context propositions. Three cases (n = 3) with low EBP Implementation scores supported thirteen propositions for the evidence, contest, and facilitation concepts. Common themes across cases were using evidence, cultural influences, structural supports, and impeding implementation. When integrating findings only three EBP Implementation scale items indicated routine implementation of evidence, which matched with evidence propositions supported across cases and the theme using evidence. Context and facilitation propositions and themes primarily explained low EBP Implementation items.
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Smith, Amy L. "Evidence-Based Practice Self-Efficacy and Outcome Expectancy in the Nurse Resident." Otterbein University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1596206174965756.
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Chang, Hui-Chen. "Evidence-based practice in nursing homes a study of Taiwanese nurses' and nursing managers' perceptions /." Connect to full text, 2008. http://hdl.handle.net/2123/3572.
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Thesis (Ph. D.)--University of Sydney, 2008.Title from title screen (viewed 11 February 2009). Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliographical references. Also available in print form.
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Norman-Marzella, Nancy L. "Evidence-Based Practice Self-Study Education Program for Staff Nurses on Genomics." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7416.
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Nurses routinely obtain genomic data when collecting family health histories. However, they report low confidence in their knowledge and understanding of genomics and the genetically engineered medications prescribed for their patients. The purpose of this project was the development and implementation of an evidence-based online education program about genetics and genomics to increase the nurses' understanding and ability to provide competent care for their patients receiving treatments based on the science of genomics. Knowles's principles of adult learning theory guided the development and delivery of the online education project to 12 medical-surgical registered nurses employed in a hospital in the northeastern United States. The Johns Hopkins nursing evidence-based practice model provided a guideline for organizing and evaluating the level and quality of evidence. A 2-tailed paired t test showed that the nurses' knowledge and understanding about genetics and genomics increased after participating in the evidence-based education program. The increase in nurses' knowledge on genomics has the potential to provide nurses with the competence and confidence to collaborate with physicians and pharmacists regarding treatment plans incorporating genomics, resulting in effective team collaboration and a positive social change that could improve patient outcomes.
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Pye, Sherry Elaine. "Making a Difference: Evidence Based Palliative Care Education for Neonatal Nurses." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2329.
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The death of a neonate is a life-changing and tragic experience for the individuals involved in the final moments of the infant's life. As the frontline provider in this clinical scenario, the bedside nurse supports the patient and family through their individual journey of loss. If the nurse does not possess the palliative care educational background and communication skills to support this unique care delivery process, the journey of death can evolve into a particularly negative experience for the parents and the nurse. This specific delivery of care concern was identified and gleaned from a parental bereavement exit interview after the loss of an infant in the neonatal intensive care unit (NICU) at Arkansas Children's Hospital (ACH). Due to the lack of educational preparation, the NICU nursing staff members had demonstrated inexperience, awkwardness, and insecurity in their provision of the end-of-life care activities and family support interventions. The purpose of this doctor of nursing practice project was to develop an evidence-based neonatal palliative care educational program to support the NICU nursing staff and families at ACH. The educational program is multimodal in approach to address the cognitive, affective, and psychomotor domains of adult learning through the use of palliative care informational modules, videos, and simulation training. The clinical outcome of this new palliative care educational program will promote a positive change in the NICU nursing staff's clinical practice during the provision of nursing care when faced with neonatal end-of-life situations at ACH. This capstone project on adult education should be read by professional frontline nursing staff who care for these fragile patients in the specialized intensive care world of neonatology.
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Curtis, Jessica Marie, and Jessica Marie Curtis. "Oncology Providers' Use of Evidence-Based Fatigue Assessment in Patient Care: A Descriptive Study." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/621309.
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Cancer-related fatigue (CRF) is a subjective, distressing symptom for a majority of cancer patients and survivors. CRF is commonly an under-diagnosed, under-treated, and underreported symptom that negatively affects the lives of patients causing decreased quality of life,impairment, and negative socioeconomic consequences (NCCN, 2014; Weis & Horneber, 2015). The purpose of this study is to determine whether oncology providers are assessing for CRF utilizing an evidence-based tool and understanding their attitudes towards CRF assessment inpractice. The aim of this project is to evaluate and potentially improve the awareness and assessment of CRF in the cancer patient population by utilizing an evidence-based assessment tool. A survey was administered to oncology providers (Advanced Practice Registered Nurses(APRNs), MDs, DOs, and PAs) in the state of Arizona via emails and flyers. Data collected included demographics of participants, practice characteristics, CRF assessment and use of evidence-based tools, CRF assessment barriers, CRF interventions, and CRF assessment attitudes and beliefs. Data from 31 surveys were used for analysis. A majority of the respondentswere female (84%, n=26) and APRNs (76%, n=22). All of the providers surveyed reported assessing for CRF in practice; however, 62% (n=18) of providers did not utilize an evidence based tool for CRF assessment. Every provider agreed they felt comfortable assessing for CRF,that it was important, and their responsibility in practice. Sixty-two percent of providers (n=18)stated they were likely to research more information on CRF assessment for use in their practice after the survey. A Fisher's exact test was completed to determine if there was a relationship between the type of provider and use of an evidence-based CRF assessment tool. With the alpha set at 0.05 the p-value was 0.677, not significant, meaning there was no relationship between the type of provider and use of an evidence-based CRF assessment tool. After analysis of results, it was concluded that further education would be beneficial to enhance provider knowledge of evidence-based CRF tools and available clinical practice guidelines on CRF. The continued education would work to improve patient CRF assessment and treatment in cancer patients. Further research is also needed to improve knowledge of CRF evidence-based tools and barriers to their use in practice.
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Culyer, Linda. "Nursing Faculty Knowledge, Beliefs in Effectiveness and Use of Evidence-Based Teaching Strategies that Facilitate Student Transfer of Knowledge Between Theory and Practice." Thesis, Sage Graduate School, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10289054.
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Despite the need for nursing education to emphasize active, innovative evidence-based teaching strategies that facilitate transfer of knowledge, there is a dearth of research regarding faculty teaching practices. This mixed-method descriptive study explored pre-licensure nursing faculty in New York State about their knowledge, beliefs in effectiveness, and use of evidence-based teaching strategies as well as both facilitators and obstacles to their use.
Faculty had the most knowledge about 1) problem-based learning, 2) simulation, 3) reflection, 4) small group work, and 5) case-based learning. The five top strategies that they believed to be most effectiveness were 1) simulation, 2) case-based learning, 3) problem-based learning, 4) unfolding case study, and 5) small group work. The five top strategies used most were 1) reflection, 2) problem-based learning, 3) case-based learning, 4) small group work, and 5) unfolding case study. Correlations revealed that the relationship between the 10 evidence-based teaching strategies and knowledge, belief in effectiveness and use of the strategies was significant (p < .01).
A major theme of facilitators revealed a “culture of support” which included support of administration, other faculty, technology, classroom capabilities, access to case studies, and small student groups. Conversely, the obstacles described included lack of time, resources, support from administration, other faculty, and technology.
To foster use of active, evidence-based strategies in nursing education, it is crucial to create an educational environment which includes faculty development programs and support.
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Coombs, Claude. "Pilot study to evaluate an evidence-based pain management protocol for adults with Sickle cell disease." NSUWorks, 2014. https://nsuworks.nova.edu/hpd_con_stuetd/23.
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Stevenson, Patricia. "Education Plan to Empower Wound Care Nurses for Evidence-Based Practice." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6131.
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Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also included a panel of expert wound care nurses using a 5-point Likert questionnaire to provide feedback on the biofilm education module, including evaluating the content, context, relevance, and use in the practice setting. Descriptive analysis provided evidence to inform the revision of the education module. Results of the Likert questionnaire ranged in mean score from 4.6 to 5.0, indicating there was strong agreement among the panel members that the education module met the objectives. The completed education module has been presented to the organization leadership for future implementation. This project supports positive social change by improving nurses' preparation to provide early clinical assessment, intervention, and definitive biofilm eradication treatments, ultimately improving patient outcomes.
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Sin, Lok-man Raymond, and 冼樂文. "Simulation for training of clinical anaesthesia : is it an evidence-based or a fashionable practice?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193781.
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Introduction
Simulation training is widely adopted in clinical medicine. Simulated environment provides a safe condition for participants to practice without any harm inflicted on patients. Within the spectrum of clinical anaesthesia, simulation mannequin was first developed in 1960. The first journal article with description about the use of simulator to teach intubation to anaesthesia residents occurred in 1969. The first report about simulated anaesthesia training was in 1988. Since then, there has been a flourishing trend of adopting this simulation training in clinical anaesthesia, across various subspecialties including obstetric anaesthesia, cardiac anaesthesia. For individual perspective, simulation training expanded beyond skill development into non technical skill training.
This article is to review the impact of simulation training for individual development for anaesthesia residents or trainees. The aim is to evaluate the evidence of simulation training on individual anaesthesia resident performance and improvement on patient outcome. As a result, more vigorous use of simulation is adopted in modular subspecialty anaesthesia and also non-technical skill training for residents.
Methods
A search of literatures through search engines of Pubmed, Google Scholars, EMBASE, Cochrane library for ‘Simulation for training of clinical anaesthesia’ was done. After limit the search for English language and past 10 years, there are 223 articles. With appropriate exclusion criteria, 25 articles are selected for detail evaluation.
Results
Simulation has good effects in various aspects. For various anaesthesia subspecialties, simulation-based training can improve trainees’ confidence and capability in handling rare but life-threatening peri-operative crises. For assessments, simulation is an essential part of Israeli Board Examination in Anesthesia with good discriminating power. For technical skill development, simulation-based training can reduce residents’ time requirement to perform cricothyroidotomy and improve successful rate of central line insertion. The specific skill developed can retain for long period of time such as 12 months. For non-technical skills, there are conflicting results in behavioural scores. For patient safety and outcome perspective, there lacks the result from individual simulation-based training study.
Conclusions
Simulation in anaesthesia residents training is a worldwide practice. These simulation training allow residents to have exposure in various anesthesia subspecialty including cardiac, obstetrics, liver transplant. There are specific technical and non-technical skill development. Individual performance particularly time to complete cricothyroidotomy and confidence, understanding of procedures and anatomy by residents are also enhanced. Thus, simulation should be allocated more proportion of anaesthesia resident training in Hong Kong. Although there remains no study showing better patient outcome after simulation-based individual training, future studies should be done to confirm such presence and degree of association with simulation training.published_or_final_version
Community Medicine
Master
Master of Public Health
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Blanié, Antonia. "Evaluation expérimentale du raisonnement clinique dans le cadre des jeux sérieux pour la formation des professionnels de santé. Comparative value of a simulation by gaming and a traditional teaching method to improve clinical reasoning skills necessary to detect patient deterioration: a randomized study in nursing students Assessing validity evidence for a serious game dedicated to patient clinical deterioration and communication." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASS092.
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L’amélioration du raisonnement clinique (RC) est un enjeu essentiel pour la Médecine de demain car il est établi que son utilisation imparfaite conduit à des résultats de soins insuffisants. Le RC est un processus cognitif complexe. Cette activité intellectuelle synthétise l’information obtenue à partir de la situation clinique et l’utilise pour faire une analyse diagnostique et prendre une décision de prise en charge du patient en intégrant les connaissances et expériences antérieures. La formation à cette compétence est donc essentielle. Pour améliorer le raisonnement, une connaissance des mécanismes qui le constituent est nécessaire et une revue de ces mécanismes constitue la partie initiale de cette thèse.La formation des professionnels de santé par la simulation se généralise avec pour objectif « jamais la première fois sur le patient ». En plein essor, le jeu sérieux (JS) représente un outil pédagogique intéressant. Une revue de la littérature sur l’efficacité des JS et plus particulièrement dans le cadre du RC est également incluse dans la partie initiale de cette thèse. Ainsi, les JS sont efficaces et peuvent, entre autres, cibler certaines compétences dont le RC. Cependant, la plupart des études sur le RC dans le cadre des JS, restent subjectives avec des évaluations qualitatives ou des autoévaluations des apprenants ou concernent uniquement le résultat (prise de décision). Par conséquent, la valeur éducative et les modalités des JS dans la formation du RC restent à approfondir.Le JS LabForGames Warning a été développé dans le centre de simulation LabForSIMS pour les étudiants infirmiers et cible la détection de l’aggravation d’un patient et la communication. Cette thèse a pour objectif de tester un mode d’apprentissage utilisant la simulation par les JS afin d’améliorer le RC chez les professionnels de santé.Une 1ère étude a évalué la validité du JS LabForGames Warning selon le cadre théorique proposé par Messick. Elle a démontré que les scores et le temps de jeu ne pouvaient pas différencier le niveau des compétences cliniques des infirmiers.Cependant, les preuves de validité étaient obtenues pour le contenu, le processus de réponse et la structure interne. Même si cette version du jeu ne peut donc pas être utilisée pour une évaluation sommative des étudiants, notre étude montre que ce JS est bien accepté par les étudiants et qu’il peut être utilisé pour la formation au sein d’un programme éducatif.Une seconde étude a évalué l’efficacité de 2 modalités pédagogiques sur l’apprentissage du RC à la détection de l’aggravation clinique d’un patient en comparant un groupe d’étudiants infirmiers formé par simulation avec LabForGames Warning par rapport à un groupe formé par un enseignement traditionnel. Le RC a été évalué par les tests de concordance de script immédiatement et 1 mois après. Cette étude multicentrique randomisée a inclus 146 étudiants infirmiers volontaires. Aucune différence significative n’a été observée sur le RC entre la formation par la simulation avec JS et l’enseignement traditionnel. Cependant, la satisfaction et la motivation étaient meilleures avec l’enseignement par simulation.En conclusion, nous avons tout d’abord confirmé la validité du JS LabForGames Warning en tant qu’outil pédagogique à visée formative et non sommative. Puis, bien qu’aucune différence d’apprentissage du RC n’ait été observée entre la formation par la simulation avec JS et l’enseignement traditionnel, la satisfaction et la motivation étaient meilleures avec l’enseignement par simulation avec le jeu. Les études sont à poursuivre pour préciser les modalités et stratégies pédagogiques des JS dans la formation des professionnels de santé, comme par exemple la place du débriefing, le rôle de la motivation. En effet, en plein essor, les développements technologiques telle que l’intelligence artificielle vont transformer la formation au RC ainsi que les outils pédagogiques disponibles dans les années à venirImprovement of clinical reasoning (CR) is a key issue for the future of medicine because it has been established that imperfect reasoning leads to insufficient care results. CR is a complex cognitive process which synthesizes information obtained from the clinical situation, then uses it to make a diagnostic analysis and take a decision on patient management by integrating previous knowledge and experience. Training for this skill is therefore essential. To improve reasoning, knowledge of the mechanisms which build it up is necessary and a review of these mechanisms constitutes the initial part of this thesis.Training of healthcare professionals through simulation is becoming widespread with the objective of "never the first time on a patient". In rapid expansion, the use of serious games (SG) represents an interesting pedagogical tool. A review of the literature on the effectiveness of SG and more particularly in the context of CR is also included in the initial part of this thesis. Thus, SG is effective and may, among other things, target certain skills, including CR. However, most studies dealing with CR by using SG include qualitative assessments or self-assessments of learners or focus only on the outcome (decision making). Therefore, the educational value and modalities of SG in the training of CR of health professionals remain to be further explored.The SG LabForGames Warning was developed in the LabForSIMS simulation center for nursing students and targets detection of patient deterioration and the ensuing communication. The objective of this thesis is to test a learning mode using SG simulation in order to improve CR in healthcare professionals.The first study evaluated the validity of the SG LabForGames Warning according to the Messick’s Framework. This study showed that scores and playing time could not differentiate the level of clinical skills of nurses. However, evidence of validity was obtained for content, response process and internal structure. Although this version of the game cannot therefore be used for summative evaluation of students, our study shows that this SG is well accepted by students and can be used for training within an educational program.A second study evaluated the effectiveness of 2 teaching modalities on learning CR for the detection of clinical patient deterioration by comparing a group of nursing students trained by simulation with LabForGames Warning compared to a group trained by traditional teaching. CR was assessed by script concordance tests immediately and 1 month later. This randomized multicenter study included 146 volunteer nursing students. No significant difference was observed in CR change between simulation training with SG and traditional teaching. However, satisfaction and motivation were better with simulation instruction.In conclusion, we have confirmed the validity of SG LabForGames Warning as an educational tool with formative and not summative aims. Then, although no difference in learning about CR was observed between simulation training with SG and traditional teaching, satisfaction and motivation were better with simulation teaching with the game. Further studies are needed to clarify the modalities and pedagogical strategies of SG in the training of healthcare professionals, such as the place of debriefing and the role of motivation. Moreover, technological developments such as artificial intelligence might transform CR training and the available pedagogical tools in the coming years
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Chung, Lisa. "AN EXPLORATION OF SELECTED CHARACTERISTICS OF REGISTERED NURSES AND THEIR USE OF EVIDENCE-BASED PRACTICE IN ACUTE CARE SETTINGS." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1430143066.
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Chandler, Erol. "Increasing Evidence Based Reasoning in an 8th Grade Classroom Through Explicit Instruction." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1474.
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This study investigates the effectiveness of an instructional strategy that uses students' prior understanding of informal evidence based reasoning (EBR) to build an understanding of scientific EBR. A pre and post instructional strategy survey revealed that students' understanding of EBR increased over the length of the study. Data collected from pre and post instructional discussions also showed increases in the amount of EBR students used.
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Berrick, Richild. "Use of Evidence-Based Test Development in Pre-Licensure Nursing programs: A Descriptive Study of Faculty Beliefs, Attitudes and Values." Diss., NSUWorks, 2019. https://nsuworks.nova.edu/hpd_con_stuetd/56.
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Background: Effective testing in pre-licensure nursing programs is a challenge in nursing education. Implementing evidence-based test development is essential to successful assessment of students’ competence and preparation for licensure. Purpose: Identifying the beliefs, attitudes and values of nursing faculty will contribute to the use of best practices in student assessments, ultimately contributing to increased retention of competent students and increasing the workforce within the healthcare industry. Theoretical Framework: This study is based on Rokeach’s theory of beliefs, attitudes and values. Methods: A quantitative descriptive research methodology was used in this study using survey data collection. A purposive, non-probability, convenience sample was the sampling strategy. The instrument utilized was developed and validated in a previous study and additional researcher-developed items were added. These additional items were field tested for readability and structure by current nursing educators. Results: The results revealed that nursing faculty are not consistent with utilizing evidence-based test development practices within their nursing programs. The beliefs and attitudes identified from the data indicate a concern with the understanding and confidence towards evidence-based practices. Several challenges were identified in implementing test development practices such as addressing linguistic and cultural biases, faculty time constraints, and utilization of test banks. Conclusions: Identifying faculty beliefs, attitudes, and values of evidence-based test development practices offers insight into the challenges facing nursing faculty, nursing programs and nursing students. These challenges affect and influence the retention and persistence of nursing students in prelicensure programs which ultimately affects diversity in the nursing workforce.
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Al, kalaldeh Mahmoud. "Enteral nutrition in the critically ill : a mixed-methods study of adherence to evidence-based protocols, nursing responsibility and teamwork." Thesis, University of Sheffield, 2011. http://etheses.whiterose.ac.uk/2007/.
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Objectives: this study aimed to assess nurses' practice and perception of their knowledge, responsibility and documentation in relation to enteral nutrition in the critically ill and to explore nurses' attitudes towards establishing evidence-based practice and teamwork in three health care sectors in Jordan. Background: poor nursing adherence to evidence-based guidelines has negative consequences leading to higher mortality rates, delayed recovery and longer length of stay. Evidence-based practice and team working is the key to minimising complications and discrepancies between nurses. Design and methods: mixed-methods strategies were employed. A cluster randomised sample recruited 253 ICU nurse for the survey. Fourteen nurses were selected purposively for the interviews and fifty five patients were involved in bedside observations. Both statistical and thematic analysis findings were integrated and discussed together. Results: Nurses revealed a tendency to undertake nutritional care despite the recognition clinical nutrition is a secondary role. In terms of nursing processes, nurses showed greater levels of knowledge and responsibility for ‘preventing complications' and ‘evaluation' more than ‘assessment' and ‘identifying goals'. However, female nurses scored higher in taking responsibility for ‘assessment' and ‘planning' than male nurses. The internet and clinical experience were the most effective sources of knowledge along with university education and colleagues. Nurses showed inconsistency in assessment tasks such as controlling gastric residual volume and confirming tube placements. Diarrhoea was the most frequent complication followed by abdominal pain, vomiting, tube dislodgment, weight loss. However, nurses realised that the incidences of complications is less likely when applying such evidence-based protocol for enteral nutrition. Multidisciplinary team work was introduced as a source of evidence-based practice and establishing a nutritional team contributes to a greater nursing involvement in decision making. Poor cooperation and interaction within the team prohibits standardized care and increases the imparity in nursing practice. Conclusion: increased nursing awareness of nutritional assessment through providing training programs and surveillance of clinical performance is necessary. Management should be concerned with offering an accessible source of knowledge, the required equipment and documentation systems. Enhancing collaboration between health care providers and offering appropriate counselling should also be emphasized.
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Nesbitt, Jason L. "Journal Clubs: A Two-Site Case Study of Nurses' Continuing Professional Development." Thèse, Université d'Ottawa / University of Ottawa, 2011. http://hdl.handle.net/10393/20309.
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Aim: This paper is a report on a study that explored the professional development of intensive care unit nurses in journal clubs.
Background: Evidence-based practice is important in nursing care (Krom, Batten, & Bautista, 2010). However few nurses feel comfortable using evidence to guide their practice (Pravikoff, Tanner, & Pierce, 2005). Journal clubs are a way to establish science as conversation (Wright, 2004) and foster knowledge translation for evidence-based nursing practice (Goodfellow, 2004).
Methods: Monthly journal club meetings were held with the participation of a total of 71 healthcare professionals (65 nurses, 2 physicians, 2 pharmacists, 1 physiotherapist, and 1 respiratory therapist), who worked in two intensive care units of an Ontario hospital. After six months of meetings, 21 individual interviews were conducted with nurses, physicians, pharmacists, and nurse educators. Additional data collection included two focus groups, surveys, a review of staff meeting minutes, and researcher field notes.
Findings: Journal clubs provided nurses with incentive to read research articles, improved nurses’ confidence in reading research, created a community of peers who worked collaboratively to improve clinical practice, provided a structure for nurses to reflect-on-practice, and led to reported changes in clinical practice. However, the data suggests that any gains in competence of nurses with the critical appraisal of research articles were probably modest. Barriers to participating in journal clubs and evidence-based practice are also identified.
Conclusion: Journal clubs can foster knowledge translation and evidence-based practice through creating a community of practice and by providing nurses with motivation, structure, and confidence to read research articles. However, nurses reported a lack of critical appraisal skills and uncertainty about how to implement evidence into practice. Journal clubs may have a greater impact when implemented alongside other knowledge translation strategies such as working with clinical nurse specialists in order to enhance evidence-based practice.
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Macedo, Vanessa Luciana. "Validação de conteúdo das intervenções de enfermagem “Ensino Pré-operatório” e “Ensino: Procedimento/Tratamento” da Classificação das Intervenções de Enfermagem, para procedimento percutâneo em hemodinâmica /." Botucatu, 2016. http://hdl.handle.net/11449/138121.
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Orientador: Rodrigo JensenResumo: Introdução: O ensino pré-operatório traz benefícios diretos ao paciente submetido a procedimento percutâneo, tanto no procedimento como na recuperação pós-operatória. Objetivo: Realizar a validação de conteúdo das intervenções de enfermagem “Ensino: Pré-operatório” (5610) e “Ensino: Procedimento/Tratamento” (5618) da Classificação das Intervenções de Enfermagem (NIC), para procedimento percutâneo em hemodinâmica. Desenvolver um protocolo para a realização do Processo de Enfermagem na consulta pré-operatória em hemodinâmica. Método: Estudo descritivo, tendo por população expertos em cardiologia ou hemodinâmica, em uma amostra por conveniência. Foi critério de inclusão a experiência clínica de, pelo menos, quatro anos em hemodinâmica ou cardiologia. Os expertos foram convidados a responder um instrumento que avaliou as 31 atividades de enfermagem da intervenção “Ensino: Pré-operatório” e as 28 atividades de enfermagem da intervenção “Ensino: Procedimento/Tratamento” da NIC, considerando sua pertinência para a consulta de enfermagem pré-operatória em hemodinâmica. Foram atribuídos pelos expertos, para cada atividade de enfermagem, por meio de escala tipo Likert, os seguintes níveis: 1 – muitíssimo pertinente; 0,75 – muito pertinente; 0,50 – de algum modo pertinente; 0,25 – pouco pertinente; 0 – nada pertinente. As atividades foram classificadas segundo a média ponderada apresentada, como: média ponderada maior ou igual a 0,80 - principais; médias ponderada entre 0,50 e 0,79 - se... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: Preoperative teaching brings direct benefits to patients undergoing percutaneous procedure, both in procedure and in the postoperative recovery. Objective: Perform content validation of the nursing interventions “Teaching: Preoperative” (5610) e “Teaching: Procedure/Treatment” (5618) of Nursing Interventions Classification (NIC), to percutaneous procedure in hemodynamic. Develop a protocol for carrying out the nursing process in the preoperative consultation in hemodynamic. Methods: Descriptive study, with the population experts in cardiology or hemodynamics, a convenience sample. Were the inclusion criteria, clinical experience of at least four years in hemodynamic or cardiology. Experts were asked to respond an instrument on which evaluated 31 nursing activities of intervention “Teaching: Preoperative” and 28 nursing activities of intervention “Teaching: Procedure/Treatment” of NIC, considering their pertinence to the preoperative nursing consultation in hemodynamic. Experts attributed for each nursing activity through Likert scale, the following levels: 1 - highly pertinent; 0.75 - very pertinent; 0.50 - of any pertinent; 0.25 - little pertinent; 0 - nothing pertinent. The activities were classified according to the weighted average presented as: weighted average higher or equal to 0.80: Major; weighted averages between 0.50 and 0.79: Secondary; and less than 0.50: irrelevant. The project was approved by the Research Ethics Committee of the Botucatu Medical S... (Complete abstract click electronic access below)
Mestre
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Abdullah, Ghadah Mubarak. "Mentoring as a Knowledge Translation Intervention to Inform Clinical Practice: A Multi-Methods Study." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32497.
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Background: Mentoring is an intervention for implementing evidence into practice, but little is known about this intervention. The overall aim of this dissertation was to examine mentoring as a knowledge translation (KT) intervention to inform clinical practice.
Methods: 1) A systematic review was used to determine the effectiveness of mentoring as a KT intervention. 2) An interpretive descriptive qualitative study was conducted to explore the use of mentoring in the Registered Nurses' Association of Ontario’s Best Practice Guidelines Implementation/ Knowledge Transfer Fellowship program.
Findings: 1) Of 10,669 citations from 1988 to 2012, 10 studies were eligible. Findings showed that mentoring alone (n = 1 study) improved one behavioral outcome. When mentoring was used as part of a multi-faceted intervention (n = 9), there were various effects on knowledge, beliefs/attitudes, use of research evidence in clinical practice, and the impacts on healthcare professionals, patients and organizations. 2) Qualitative interviews with 6 fellows, 8 mentors and 4 program leaders revealed that mentoring involved building relationships, establishing a learning plan, and using teaching and learning activities. Mentors were described as accessible, dedicated, and having expertise; fellows were described as dedicated, self-directed, and having mixed levels of expertise. Mentoring was described as positively impacting upon mentoring relationships, fellows, mentors, and organizations. Participants reported no negative outcomes.
Conclusion: Mentoring was used as a KT intervention to support the implementation of evidence into clinical practice. The systematic review and qualitative study findings informed the Mentoring for Guideline Implementation model. Mentoring involved mentees selecting more experienced mentors who provided individualized support based on mentees’ learning needs, which resulted in mutual benefits for mentees and mentors. Future research is required to validate this new mentoring model, develop an instrument to measure the mentor-mentee relationship, and evaluate the effectiveness of mentoring as a KT intervention for guideline implementation in nursing.
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Douglas, Natalie Franko. "Supporting Speech-Language Pathologist Evidence-Based Practice Use: A Mixed-Methods Study in Skilled Nursing Facilities within the Promoting Action on Research Implementation in Health Services Framework." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4663.
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As the management of dementia is a significant public health concern, efforts to increase access to effective treatments to a greater number of residents with dementia in skilled nursing facilities (SNFs) are warranted. The treatment addressed in this study, non-electronic external memory aids, is an evidence-based practice that has been found to increase positive communicative interactions and decrease negative behavioral problems of residents with dementia in SNFs.
Although use of memory aids is recommended, there are significant barriers such as lack of time and resources that inhibit the use of effective treatments in typical clinical settings. To address such barriers to evidence-based practice (EBP) implementation, the Promoting Action on Research in Health Services (PARIHS) framework is available. The PARIHS framework accounts for elements outside of the clinician knowledge base that may impact EBP delivery such as perceptions of the specific EBP and the specific context in which the EBP will be delivered. Organizational variables such as culture, leadership priorities, and resource availability are considered. Although the PARIHS framework has been used to successfully study and support EBP uptake in other areas of health care such as nursing, this framework has not to date been used in the field of Speech-Language Pathology, the clinician group of interest in this study.
This study utilized a transformative, mixed-methods design within the PARIHS framework to investigate potential impacts of Speech-Language Pathologists' (SLPs) and Facility Rehabilitation Directors' (FRDs) perceptions of the evidence and organizational context on the use of non-electronic external memory aids in SNFs. The project explored differences between FRDs' and SLPs' perceptions of such variables, as well as the relationship between those variables and the SLPs' reported percentage of use of non-electronic external memory aids. Qualitative methods through semi-structured interviewing of SLPs further provided contextualized and detailed data regarding facilitators and barriers to the use of memory aids in SNFs.
Results of the study indicated that there were statistically significant differences between SLP and FRD groups in terms of perceptions of the organizational context in the SNF, with the FRDs viewing the organizational context more favorably. There were no significant quantitative differences between SLPs and FRDs in terms of perception of the evidence for the practice of non-electronic external memory aids. Both groups demonstrated relatively favorable perceptions of the practice (3.8 on a 5-point scale with 5 being strongly favorable). Each additional point regarding favorable perceptions of SLPs in terms of the evidence for non-electronic external memory aids were associated with a 24% increase in percentage of use of the practice. Perceptions of the organizational context in the SNF were not significantly associated with higher percentages of SLP use of the practice; however, issues of organizational context were heavily present in the qualitative data. Analysis of the interview data yielded a total of 318 codes and 191/318 (60%) of those codes addressed issues of organizational context. Qualitatively, the most common codes related to issues of lack of necessary staff to both implement and sustain the use of non-electronic external memory aids. Further, lack of physical materials and time to create memory aids was also a frequently reported barrier in the interview data. There was not mention of local performance data or systems for which to evaluate performance in relationship to non-electronic external memory aid usage in the interview data.
Results of this study may contribute to the acceleration of a successful, systematic uptake of non-electronic external memory aids for residents with dementia in SNFs by considering SLPs' perceptions of evidence and by engaging the end organizational context. This project may also serve as a model to contribute to the successful implementation of other EBP for patients with cognitive-communicative impairments.
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Nadalin, Penno Letitia. "Understanding the Sustainability of Selected Recommendations for a Nursing Best Practice Guideline within an Acute Care Context." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42666.
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Background: To date, little attention has focused on what the factors are and how Best Practice Guidelines (BPGs) are sustained in acute care over time.
Problem: For ten years, a multi-site acute care center supported the use of a Pain Assessment and Management Policy and Protocol (Pain P/P), placing the decision to use it with point of care nurses. Despite early implementation success, the nursing department identified an evidence-based gap on Medicine care units.
Purpose: To (i) identify factors influencing nurses’ use (or not) of the Pain P/P over time, and ten years post-implementation; (ii) examine related knowledge translation interventions (KTIs) used over time, and ten years post-implementation; (iii) validate unit nurses’ use of the Pain P/P ten years post-implementation; and (iv) identify relevant sustainability frameworks/models/theories (F/M/Ts), constructs and factors for sustained use of BPGs in acute care.
Methodology: A case study of an organization-wide nursing BPG was conducted ten years following initial implementation using mixed methods guided by the Dynamic Sustainability Framework (Chambers, 2013). The case study setting was a 1122 bed acute care center in Canada. I examined BPG sustainability at the (corporate) department and unit levels (two embedded subcases). Data sources included 19 informant interviews (3-corporate, 16-unit level), 200 chart audits (100/subcase), and 29 documents. I concurrently conducted a systematic review to identify sustainability concepts and factors for use in acute care to compare case study results.
Results: I identified 7 constructs, 49 factors, and 29 KTIs influencing sustained use of evidence-base practices (EBPs) in acute care. Three factors and eight KTIs had a continuous influence during implementation and sustained use phases. Findings confirm the concept of sustainability is a dynamic ‘process’ or ‘ongoing phase’.
Conclusions: This thesis provides a novel resource to support future practice and research aimed at sustaining EBPs to improve nursing practice and related patient outcomes. Attention to the level of application and changing conditions over time impacting factors that influence EBP use is required for sustainment. Use of a participatory approach to engage users in designing remedial plans and link KTIs to target behaviors that incrementally address low adherence rates promotes sustainability.
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Volpato, Marcia Paschoalina. "Ensino clínico sob o paradígma da prática embasada em evidências: integração da teoria e prática para a prevenção da úlcera por pressão." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-09022015-201722/.
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A úlcera por pressão, considerada um evento adverso, compromete a segurança do paciente sob os cuidados dos profissionais de saúde. Uma das formas de proporcionar segurança é por meio da prática baseada em evidência que pode ser implementada com estudantes pelo uso de metodologias ativas de ensino- aprendizagem. O objetivo geral do estudo foi propor uma metodologia de ensino para estudantes do curso de Enfermagem da Universidade Estadual de Londrina, pela avaliação do risco de desenvolvimento da úlcera por pressão em pacientes internados em uma unidade médico-cirúrgica e pela identificação das prescrições de enfermagem para a prevenção nos registros em prontuários. A pesquisa foi aprovada pelo Comitê de Ética e Pesquisa institucional e realizou-se utilizando métodos quantitativos e qualitativos, com delineamento descritivo, ocorrendo em três fases. A primeira foi um workshop sobre prática baseada em evidência. A segunda foi desenvolvida pelos estudantes e pesquisadora e a coleta de dados foi realizada com 21 pacientes hospitalizados em unidade médico-cirúrgica durante 15 dias sequenciais, em que avaliou-se o risco para úlcera por pressão por meio da Escala de Braden e os registros das prescrições de enfermagem relacionados ao uso das evidências para prevenção de úlcera por pressão. A terceira foi desenvolvida com os estudantes para investigar o significado da experiência com a metodologia de ensino. Os 21 pacientes avaliados tinham a média de idade de 44,76 anos e diagnósticos médicos mais frequentes de doenças do sistema osteomuscular e do tecido conjuntivo (42,86%). No primeiro dia de avaliação, considerando a escore total da Escala de Braden, 17 pacientes (80,95%) tinham risco entre moderado e muito alto. Na inspeção da pele foram identificadas 25 úlceras por pressão, sendo a localização mais frequente na região sacral (44%) e as classificações predominantes foram no estágio I e II. Na análise dos prontuários, não foram identificadas anotações dos enfermeiros referentes à avaliação do risco e nem ao uso da Escala de Braden. As prescrições de enfermagem mais frequentes para a prevenção da úlcera foram mudança de decúbito, uso de coxins, proteção contra a umidade e uso de cremes hidratantes, e a menos frequente foi a manutenção da cabeceira até 30 graus. Não foi encontrada associação entre as medidas de prevenção prescritas e os subescores da escala de Braden. O significado das experiências de oito estudantes que participaram da pesquisa foi investigado pela análise de conteúdo das falas obtidas nas discussões em grupo e identificaram-se duas categorias: aprendendo sobre o tema úlcera por pressão e conhecendo a realidade da instituição e da enfermagem sobre a úlcera por pressão. Concluiu-se que os estudantes relacionaram a teoria à prática, identificaram as competências do enfermeiro na avaliação do paciente com risco para úlcera por pressão, aprimoraram o conhecimento nos estágios da úlcera por pressão e identificaram a Escala de Braden como suporte para avaliação de risco para a úlcera por pressão. Os estudantes, ainda, identificaram a falta de cuidados pela equipe de enfermagem e a importância da presença da família e perceberam a necessidade da prática segura em relação à úlcera por pressãoPressure ulcers, considered an adverse event, compromise the safety of patients under the care of health professionals. One way to provide safety is through evidence-based practice, which can be implemented with students through the use of active teaching-learning methods. The general study objective was to propose a teaching method for students from the Nursing program at the Universidade Estadual de Londrina, to assess the risk of pressure ulcer development in patients hospitalized at a medical-surgical unit and to identify the nursing prescriptions for this prevention in the records in patient files. Approval for the research was obtained from the institutional Research Ethics Committee and quantitative and qualitative methods were applied, with a descriptive design, involving three phases. The first was a workshop on evidence-based practice. The second was developed by the students and researcher and the data were collected with 21 patients, hospitalized at the medical-surgical unit for 15 continuous days, in which the risk of pressure ulcer was assessed through the Braden Scale and the records of the nursing prescriptions related to the use of evidences to prevent pressure ulcers. The third was developed with the students to investigate the meaning of the experience with the teaching method. The 21 patients assessed had a mean age of 44.76 years and the most frequent medical diagnoses were diseases of the musculoskeletal system and connective tissue (42.86%). On the first assessment day, considering the total score on the Braden Scale, 17 patients (80.95%) had a moderate to very high risk. In the skin inspection, 25 pressure ulcers were identified, with the sacral region as the most frequent location (44%) and stages I and II as the predominant classifications. In the analysis of the files, no nursing notes were identified with regard to the risk assessment, nor related to the use of the Braden Scale. The most frequent nursing prescriptions to prevent ulcers were decubitus change, use of cushions, protection against humidity and use of hydrating creams, and the least frequent was the maintenance of the headrest at 30 degrees. No association was found between the prescribed prevention measures and the subscores of the Braden scale. The meaning of the experience of the eight students who participated in the research was investigated by means of the content analysis of the statements obtained in the group discussions and two categories were identified: learning about the theme pressure ulcer and getting to know the reality of the institution and nursing with regard to pressure ulcer. In conclusion, the students related the theory with the practice, identified the nurses\' competences in the assessment of patients with risk of pressure ulcers, improved the knowledge on the pressure ulcer stages and identified the Braden Scale to support the risk assessment for pressure ulcer. The students also identified the lack of care by the nursing team and the importance of the family\'s presence and perceived the need for safe practice with regard to pressure ulcers
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Starling, Roosevelt Riston. "Prática controlada: medidas continuadas e produção de evidências empíricas em terapias analítico-comportamentais." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-29032010-163308/.
Full textAbstract:
Buscando estabelecer controles públicos e empiricamente indexados para o comportamento verbal clínico do terapeuta de serviços, um modelo de Prática Psicológica por Evidências, chamado Prática Controlada, foi adaptado, testado e explorado quanto a algumas de suas possibilidades, em condições reais de aplicação. Esse modelo se fundamenta num arranjo específico dos procedimentos terapêuticos e em cinco instrumentos utilizados para a coleta de informações qualitativas e quantitativas pré-intervenção e na coleta continuada de dados empíricos referentes ao nível de perturbação psicológica do cliente, à qualidade da relação terapêutica e ao seu nível de engajamento nas tarefas terapêuticas, ao longo das primeiras 20 sessões de tratamentos de orientação analítico-comportamental para 34 clientes (10 homens, 33,3 ± 14,2 anos, e 24 mulheres, 35,6 ± 9,9 anos) em três cidades diferentes. As terapias foram conduzidas por três terapeutas experientes e quatro inexperientes. Os resultados indicaram que esse modelo de prática controlada produz indexadores empíricos que podem ancorar o comportamento verbal do terapeuta de serviços (suas interpretações e julgamentos teóricos e clínicos) e que são sensíveis à evolução de curto, médio e longo prazo da terapia, além de permitir a produção de evidências públicas clínica e socialmente relevantes dos resultados intermediários e finais do tratamento. Através da análise das séries temporais obtidas, os resultados também sugerem que a avaliação do cliente do seu nível de perturbação psicológica, do seu engajamento nas tarefas terapêuticas e na sua apreciação da qualidade da relação terapêutica pode responder a controles independentes e/ou a variáveis idiossincráticas. Apresenta-se uma discussão sobre teoria da mensuração, escalas de medidas e medidas em psicologia e em psicoterapia e algumas sugestões para pesquisas futuras são oferecidas.Aiming to establish public and empirically based controls for the therapist-practitioner\"s clinical verbal behavior, a model of Evidence Based Psychological Practice, called Controlled Practice, was adapted, tested and explored in real-world conditions of application. This model is based on a specific arrangement of the therapeutic procedures and on five instruments for collecting qualitative and quantitative pre-intervention information and empirical data and for collecting continued empirical data on the client\"s level of psychological distress, on the therapeutic relationship\"s quality and on the client\"s level of performance at therapeutic tasks along the first 20 sessions of behavior-analytic oriented psychological treatments of 34 clients (10 males, 33,3 ± 14,2 yrs., and 24 females, 35,6 ± 9,9 yrs.) in three different towns. The therapies were delivered by three experienced therapists and four inexperienced. Results indicates that this model of controlled practice may anchor the practitioner verbal behavior (his/her clinical and theoretical interpretations and judgments) on empirically based indexers that are, at the same time, sensitive to the short, medium and long-term evolution of the therapy and may provide clinically and socially relevant public evidences of the treatment\"s intermediate and outcome results. Through the analysis of the time-series collected results also suggested that the client\"s evaluation of his/her level of psychological distress, his/her engagement in the therapeutic tasks and his/her appraisal of the therapeutic relationship may respond to independent controls and/or to idiosyncratic variables. A discussion of the theory of measurement, measurement scales and measures in psychology and psychotherapy is presented and some suggestions for future researches are offered.
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Alexander-Goreá, Trenika. "Development of a Guideline for Hospice Staff, Patients, and Families on Appropriate Opioid Use." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4496.
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There is an identified problem with patients receiving suboptimal pain management at a hospice agency in the northwestern United States. At this agency, undertreatment of pain is prevalent. Evidence indicates that this may be a result of a lack of guidelines, education, and knowledge of appropriate prescribing. Known barriers to the correct prescription and administration of potent opioids in the hospice setting include prevailing beliefs, knowledge, skills, and attitudes, all of which can impact care negatively. Contextually, hospice principles mandate patient comfort and caregiver involvement in continuous quality improvement, which includes adequate and informed pain management. Moreover, hospice metrics demand requisite knowledge, skills, and attitudes for optimal care, including pain management at the end of life. The Academic Center for Evidence-Based Practice (ACE) star model was used to guide the development of an evidence-based, guideline-supported educational program that will improve pain management at the hospice agency when implemented. The purpose of this project was to use transdisciplinary expertise and team collaboration to develop the program and then to conduct a formative and summative evaluation utilizing experts to prepare the guidelines and process for implementation. Ten experts reviewed the guideline, the educational materials, the process, and the evaluation plan and conducted reviews using the AGREE II tool. The panel of experts agreed within the 6 AGREE domains. Future implementation of this guideline, translation process, and evaluation tool will impact social change through the empowerment of the clinical staff, patients, and caregivers to provide the best pain control and comfort at end of life, a vulnerable time for all patients.
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Jayasekara, Rasika Sirilal. "The development of an evidence-based conceptual framework for undergraduate nursing curricula in Sri Lanka." 2008. http://hdl.handle.net/2440/47521.
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Background In Sri Lanka, nursing education is moving from a 3-year general nursing certificate to a 4-year university bachelor degree. In this transitional stage, the development of a conceptual framework that uses evidence to underpin undergraduate nursing education is a crucially important step to improve nursing education and nursing service in Sri Lanka. However, there is no evidence to support the contention that existing and proposed undergraduate nursing curricula in Sri Lankan universities are based on a common philosophy or an acceptable needs assessment. Purpose The overall purpose of this study was to develop an evidence-based conceptual framework for undergraduate nursing curricula in Sri Lanka. Method This study has involved conducting critical reviews of literature, two systematic reviews, developing a draft conceptual framework, testing its appropriateness and feasibility with key stakeholders (nursing academics, administrators, clinicians) via focus group discussions in Sri Lanka, and formulating the final conceptual framework for nursing curricula in Sri Lanka. Findings The systematic reviews revealed that the evidence regarding the effectiveness and appropriateness of undergraduate nursing curricula is notably weak and direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. The conceptual framework, which was developed using the finding of systematic reviews and literature reviews, consists of widely recognised nursing concepts in international and local contexts. However, some concepts can not be directly applicable because of cultural and economic impediments. Discussion The cultural, social, political and economic contexts of a country have a direct impact on its health and education systems. This study identified several factors that shape the approach to nursing curricula in Sri Lanka. These factors include: Western influence; Sri Lanka’s cultural influence; the current healthcare system and demand for healthcare; nursing systems and regulation; medical dominance; financial support; and Sri Lanka’s education system. All of these factors influence the conceptualisation of nursing and educational strategies needed to effectively and appropriately prepare nurses in Sri Lanka. I propose seven recommendations to support the implementation of the study findings into practice in Sri Lanka.http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317073
Thesis(Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008
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Mthiyane, Gloria Nozipho. "The experiences of nurse educators in implementing the evidence-based practice in teaching and learning." Diss., 2018. http://hdl.handle.net/10500/24763.
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The purpose of this study was to determine the nurse educators’ experiences in implementing the evidence-based practice (EBP) in teaching and learning, and to describe the importance and benefits of EBP teaching and learning to the nursing profession, especially for nurse educators and student nurses. A qualitative research design and methods were followed in conducting the study. A non-probability purposive sampling technique was used to access the sample of twelve nurse educators from two nursing campuses under KwaZulu-Natal College of Nursing within Umgungundlovu Health District. Data were collected using semi-structured interviews, the interview guide, and the digital voice recorder. Data were analysed manually, following a content thematic data analysis approach. Two themes emerged as follows:
Challenges experienced by nurse educators with the implementation of EBP in teaching and learning.
Benefits/value of EBP in teaching and learning.
Findings revealed that, although most of the nurse educators are supportive and displayed a positive attitude towards implementing EBP in teaching and learning, the level of knowledge and skills was questionable. This was coupled with a lack of motivation and commitment towards research. Therefore, recommendations for nursing education, nursing practice, and future research were suggested, for successful implementation of EBP in teaching and learning.Health Studies
M.A. (Health Studies)
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Mtshali, Ntombifikile Gloria. "A grounded theory analysis of the meaning of community-based education in basic nursing education in South Africa." Thesis, 2003. http://hdl.handle.net/10413/6291.
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An extensive review of literature revealed that although CBE was a familiar concept and a national policy for health professionals' education in South Africa, there was, however, limited understanding of this phenomenon. Most of the existing CBE programmes were a reaction to the inadequacy of traditional nursing education and had emerged without any intellectual discourse on the phenomenon CBE. The aim of this study was to analyse the phenomenon CBE in basic nursing education and the meaning attached to it. Furthermore, the researcher aimed at developing a middle-range theory of CBE. Strauss and Corbin's (1990) grounded theory approach was used to guide the research process. The South African Nursing Council's (SANC) education committee and seven nursing education institutions with CBE programmes were included for participation in the study. Data were collected by means of observation, interviews and document analysis. Purposive and theoretical sampling was used for selecting interviewees, resulting in a total of 41 interviewees. Data collection and initial analysis took place concurrently. Descriptive analysis followed by conceptual analysis was performed using Strauss and Corbin's paradigm for qualitative data analysis. The primacy of the community as a learning environment, timing of first exposure, duration, frequency and sequencing of community-based learning experiences, as well as service provision, emerged as discriminatory core characteristics of CBE in basic nursing education. Irrelevance of traditional nursing education and political change emerged as antecedents of CBE. The need to respond to national health policies and community health needs was seen as conditions under which CBE had to operate in South Africa. The nature of the CBE educative process, which placed emphasis on active learning and curriculum relevance, emerged as essential for the realization of expected outcomes of CBE in basic nursing education. Based on these results, it was concluded that CBE in basic nursing education in South Africa is (a) relevant education, (b) responsive education, (c) education for social justice, (d) a
conscious and deliberate PHC socialisation process and (e) a process and outcomes education. As this was a ground breaking study on the meaning of CBE in basic nursing education in South Africa, a number of further research studies are recommended.Thesis (Ph.D.)-University of Natal, Durban, 2003.
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Madiope, Maria. "Web-based instruction for critical care nursing science." Thesis, 2014. http://hdl.handle.net/10210/11519.
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M.Cur.The study started by establishing that there Is a need for further education for nurses in general. It'was further stated that due to increased technology and the need for patient care, effective further education becomes a priority. But the problem that remains Is how nurses could further their education In the circumstances of the current nature of their work, I.e. the lack of accessibility to flexible learning programmes, long working hours, staff shortfall, low staff morale and institutional constraints. The aim of this study Is to Investigate and report on the Web-based Instruction environment programme in Critical Care Nursing Science Education presented by Technikon Pretoria for nurses. The rationale led to .the formulation of the research question as: "To what extent can Web-based Instruction be used to facilitate a course in Critical Care Nursing Science Education at the Technikon Pretoria?" A literature review of the field of Web-based Instruction was undertaken. It was established that Web-based Instruction is an instructional strategy where the course presenter and the students are not in contact, and it can bridge the gap in tenns of time and space because of its flexibility and accessibility. The students and the course presenter generally reported positive experiences in the Web-based Instruction environment. Web-based Instruction is certainly not the only method for.all our teaching strategies, but it is a strategy that could be used tohelp course presenters to teach more effectively. In terms of the experiences of the students and the course presenter with regard to the Web-based Instruction environment as reported in this study, as well as the technological changes In education. it must be concluded that Web-based Instruction could be considered an acceptable Instructional method and that Critical Care Nursing Science education can be presented in this way...
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Mfidi, Faniswa Honest. "Comparative analysis of the effects of two curricular approaches to the development of clinical reasoning abilities in nursing students following comprehensive basic nursing programmes." Thesis, 2001. http://hdl.handle.net/10413/5443.
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A comparative analysis was undertaken using descriptive survey and cross-sectional design to explore the effects of two curricular approaches ( Problem-based learning and traditional) used in Comprehensive basic nursing programme on the development of, clinical reasoning abilities of nursing students was undertaken, Triple Jump Exercise as the data collection instrument was used to evaluate students' abilities, in clinical reasoning, Using quota sampling technique, a convenience sample of 87 subjects was selected from two nursing institutions using these two approaches, These were student nurses in their 1st, 2nd and 4th year levels of study, Using individual interviews, subjects were required to think aloud and verbalize their clinical reasoning after being presented with a clinical scenario, Subjects' verbalizations were quantified, based on the criteria specified in the evaluation form of the data collecting instrument, and total scores were obtained, Analysis using computer software package (SAS) was done to provide for descriptive and statistical summarisation, Though descriptive analysis through mean scores of clinical reasoning showed slight differences resulting from the curricular approaches used. this was not confirmed statistically as the two factor ANOVA and Tukey's method revealed no significant differences by approaches nor their interaction with level of study, Only levels of study had significant differences at p=O,OOO I, with senior levels outperforming their juniors, These findings therefore conclude that PBL and the traditional approach perfonn on a similar level in clinical reasoning. Nurse educators are therefore challenged to identify effective strategies to enhance and nurture clinical reasoning, One strategy, which this study recommends, is the use of case-based approaches in CBNP.Thesis (M.Cur.)-University of Natal, Durban, 2001.
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Maboe, Kefiloe Adolphina. "Computer assisted instruction in nursing education." Diss., 2006. http://hdl.handle.net/10500/1799.
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A quantitative, descriptive research study was conducted at a nursing college to investigate the nature of nursing learners' exposure to computer assisted instruction and computer-based learning, the perceived benefits of this exposure, and the problems that they had encountered. Learners, who had been exposed to computer assisted instruction and computer-based learning, participated. A self-administered, structured questionnaire was administered to collect data. The research results revealed that the learners had limited exposure to educational computer packages, and computer-based learning activities. They encountered numerous problems. Although the learners derived many benefits from computer assisted instruction, this did not result in effective learning. They indicated that they preferred computer assisted instruction more than traditional teaching methods. This study contributed towards recommendations on improving learners' access to the necessary facilities, equipment and educational computer software. The researcher also recommended strategies to ensure that computer assisted instruction is based on sound educational principles.Health Studies
M.A. (Health Studies)
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Mogale, Noria Mosehle. "Problem-based case study to enhance critical thinking in student nurses." Thesis, 2012. http://hdl.handle.net/10210/8236.
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M.Cur. (Professional Nursing Education)The use of traditional teaching methods, for example the lecture method, does not stimulate ·critical thinking in student nurses. This problem can be solved by the utilisation of problem-based case study in the classroom/clinical setting. The purpose of this study is to describe guidelines for the implementation of problembased case study in dinical setting .among. first year, comprehensive course students at the Northern Province College of Nursing: Sovenga Campus. The research design of this study is qualitative, explorative, descriptive and contextual. The following data is collected: Phase 1: The development and implementation of a program for problem-based case study in the clinical setting; Phase II: The experiences of student nurses who Were. exposed to problem-based case study in the clinical setting; Phase Ill: The perceptions of tutors regarding the implementation of problem-based case study in the clinical setting (focus group), and, Phase IV: Guidelines for the implementation of problem-based case study. The principles were obtained from Phases I, II and Ill and were used to formulate guidelines for the implementation of problem-based case study. The sample group consists of all 69 first year student nurses at the Northern Province College of Nursing: Sovenga Campus and ten tutors teaching clinical courses at the same campus.
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Mthembu, Sindisiwe Zamandosi. "The analysis of knowledge construction in community based service-learning programmes for basic nursing education at two selected nursing schools in South Africa." Thesis, 2011. http://hdl.handle.net/10413/4747.
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Community based service-learning is one of the fastest growing reforms in higher education, especially in the field of health care. The increased interest in this phenomenon is based on the demands by government and society that higher education institutions should be more responsive to the needs of the community. Literature, however, reflects that service learning lacks a sound theoretical base to guide teaching and learning due to limited research in this area. This study was, therefore, aimed at exploring the phenomenon knowledge construction in basic nursing programmes in selected South African nursing schools with the intention to generate a middle range theory that may be used to guide the process of knowledge construction in community-based service-learning programmes. This study adopted a qualitative approach and a grounded theory research design
by Strauss and Corbin. Two university-based schools of nursing were purposively selected to participate in the study. There were a total number of 16 participants. The collection of data was intensified by the use of multiple sources of data (participant observation, documents analysis and in-depth structured interviews). The data analysis process entailed three phases; open, axial and selective coding. The results of the study revealed that the phenomenon “knowledge construction” is conceptualised as having specific core characteristics, which include the use of authentic health-related problems, academic coaching through scaffolding,
academic discourse-dialogue and communities of learners. The findings showed that there are a number of antecedent conditions and contextual circumstances contributing to how knowledge is constructed in a community based service learning programme. The process of knowledge construction emerged as cyclical in nature, with students, facilitators and community members having specific roles to play in the process. A number of intervening variables were identified that had an influence on the expected outcomes on knowledge construction in community based
service learning programmes. These findings led to the generation of a
conceptual model. Knowledge construction according to this model takes place in an environment which is characterised by interactive learning, collaborative learning, actively learning and inquiry-based learning through continuous reflective learning processes. The main concepts in this conceptual model include concrete learning experiences, continuous reflection, problem posing, problem analysis, knowledge deconstruction and knowledge generation, knowledge verification, knowledge generation, testing of generated knowledge and evaluation of generated knowledge. The sub-concepts include learning through senses, an initial situation, health-related triggers, social interaction, reflection-in action,
reflection-on action, hypotheses generation, conceptualisation of learning
experiences, information validation and community interventions.
Recommendations were categorised into education and training of academic staff, application of the model and further research with regard to quality assurance in CBSL programmes as well as the use of other research designs for similar studies.Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.
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Beepat, Somavathy Yvonne. "The influence of peer mentoring on critical care nursing students' learning outcomes." Thesis, 2015. http://hdl.handle.net/10321/1420.
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Dissertation submitted in fulfilment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, 2015.Introduction Critical care nursing is one of the most stressful specialities in the nursing profession that involves caring for patients who are suffering with life threatening illness or injuries. The highly technological environment where critical care nursing is rendered is associated with a great amount of stress, frustration and burnout. The critical care nursing student needs to be prepared, mentored and supported for the role transition from student to professional nurse. Nursing education and training cannot succeed without proper theory and practice integration. Therefore, the critical care nursing environment should be supportive of the improvement of teaching and learning. Peer mentoring is one important strategy to help foster an environment that is supportive of the critical care nursing student, allowing them to grow and succeed as experts within the speciality of critical care nursing. Aim of the study The aim of the study was to explore the influence of peer mentoring on critical care nursing students’ learning outcomes in critical care units in KwaZulu- Natal. Methodology A qualitative exploratory research design was used to conduct the study. Ten nurses were recruited from the critical care units in five private and two public hospitals. Descriptions of their experiences were gained through individual face-to-face interviews. The broad question to the participants was: “What influence does peer mentoring have on the critical nurses’ learning outcomes in the critical care unit?” iii Results The findings of the study revealed that peer mentoring is a vital strategy in helping the critical care nursing students to attain their learning outcomes so that they will be proficient in the critical care unit. Peer mentoring was however, not consistent in all hospitals and the critical care nursing students were not given the necessary support and supervision. There were no structured support systems in place to ensure that peer mentoring was formalized and that all required nursing personnel took on the responsibility to teach and facilitate learning for critical care nursing students. Recommendations Recommendations were made with regards to policy development, service provision, nursing education and research. These include that a formalized mentorship programme should be incorporated into the core competencies of all qualified critical care nurses, and to be reflected in their performance appraisal in order to motivate the registered nurses to fulfil their independent function as teachers. Each unit mentor should familiarize him/herself with the prescribed learning objectives of the critical care nursing student in order to be able to delegate appropriately so that learning outcomes are achieved by the mentee. There should be an allocation of supernumerary time for the critical care nursing student and their mentor to allow time for formal mentoring responsibilities to take place away from the clinical area, to facilitate assessment and feedback, and enhance consolidation. Ongoing evidencebased practice research should be conducted on this topic, to provide more information on how peer mentoring effects the mentee, nursing education and retention of skilled staff.
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Harricharan, Revashnee. "Primary health care nursing students' perceptions of the case-based learning approach employed at a selected nursing education institution in Durban : an exploratory-descriptive study." Thesis, 2013. http://hdl.handle.net/10413/11103.
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Background: Case-based learning (CBL) is one approach which is gaining popularity. The selected School of Nursing adopted this approach to learning in 2000. The school reviewed all the old case studies and introduced new ones in 2010. These new case studies were used for the first time with the 2011 Decentralised PHC programme. Hence, the need for a study that explored students perceptions towards case-based learning.
Research Methodology: A quantitative approach and descriptive exploratory design were adopted in this study. A total number of 101 students were from the three Decentralised Primary health care (PHC) programme participated in this study. Data was collected from three decentralised sites used to offer PHC programme to students; Durban, Port Shepstone and Pietermaritzburg. Data was collected by means of a questionnaire – a self-reporting instrument which included 62 structured questions. Data was analysed statistically for frequency distributions and the relationship between the results from three sites were explored using a Chi Square Pearson Test, with a p value set at .005.
Results: The results of this study show that, overall, students view case-based learning in a positive light. Although the majority reported that cases were distributed in case study booklet form (n=66) 65.3%, other modes such as cases presented to students in each class session using transparencies (n=52) 51.5% as well as through emails was reported. Regarding benefits about (n=90) 90.1% of the respondents stated that cases presented added a lot of realism. The researcher also explored to see if there were any variations of results across the three delivery centres. The findings of this study demonstrated that there was a significant difference for seven items, some of these items included teachers feedback and advise after class was
relevant for students to cope on their own p<.000; case studies preparing student for working in PHC institutions in South Africa p<.042; preferred lectures more than CBL p<.003 and CBL was too demanding in terms of preparation and the content p<.004.
Discussion: Students enjoyed the experience but also identified their own limitations and mistakes. They were able to plan their own learning needs. The students experienced personal and professional growth using cases which represented the real-life challenges. They had the opportunity to apply the theory, their experiences and their newly developed skills from the use of CBL in there clinical practice. The end product was visible and of benefit to the clinical settings as students was now competent in analyzing cases and solving practical problems systematically. Providing a real-life challenge to students in CBL instead of teaching a predominantly theoretical course proved to be beneficial.
Recommendations: The researcher felt that a follow-up study, taking into account all six sites where students are placed could result in a difference in the students’ perceptions of CBL as a teaching methodology, as the students in the other three sites are in the more rural areas which limits their resources. There was some inconsistency with presentation and distribution of cases also feedback to students, staff may require development with teaching skills to co-ordinate all centres in a similar way. Port Shepstone and Pietermaritzburg struggle with CBL, maybe they are not incline with Self directed learning (SDL), therefore a follow up study in these centres would assess in students are inclined with SDL.Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2013.
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de, El-Kantar Lina Abi Faker. "Critical thinking skills development among the diploma nursing students in a case-based curriculum." Thesis, 2001. http://hdl.handle.net/10413/5244.
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Faculty members in many schools of nursing have been urged to include critical thinking in all aspects of the nursing curriculum. The faculty at the Institutes of Nursing in the United Arab Emirates, have adopted in the academic year I998 a case-based curriculum that teaches nursing courses by using case studies, which represent a terrific and non-threatening method to use to teach and learn either critical thinking skills or clinical decision-making (Robinson, 1998; Glendon and Ulrich, 1992, 1997). The development of critical thinking skills in a case-based
curriculum was investigated. A randomly selected, cross-sectional sample of nursing students at the Abu Dhabi Institute of Nursing (N= 88) was studied. Three groups (n=30) from each level of a three-level-diploma nursing program were measured for development of critical thinking skills using the Test of Everyday Reasoning (TER). Relationships were investigated between TER scores, the level of the program and other socio-demographic and academic achievement determinants. Critical thinking ability did not change significantly among the three levels during the educational experience in a case-based curriculum; however, the participants in the highest level of the program were able to get a higher mean TER scores from the other two levels. One of the conclusions that
could be drawn from this study was that critical thinking might not change as an associated factor with a case-based curriculum at this premature phase of its implementation until some time after the graduates of this program become practicing nurses where clinical decision-making would be in action. The other conclusions focused on the necessity of unfolding the utilized cases in the curriculum and on determining whether the construct of critical thinking has been incorporated in them.Thesis (M.Cur.)-University of Natal, Durban, 2001.
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Kaddoura, Mahmoud Ali. "Critical thinking in a case-based and a traditional nursing education program." Thesis, 2001. http://hdl.handle.net/10413/8970.
Full textAbstract:
Up to 1998, the Institutes of Nursing in the United Arab Emirates have been using the
traditional lecture-based teaching/learning process in their graduate-nursing program. In
1998, however, these Institutes adopted a new approach; namely, the case-based learning
(CBL) for the education of their nursing students. This approach emphasizes the use of
self-directed and cooperative learning that is supposed to help students increase their
critical thinking (CT) level. As the students were experiencing changes in the teaching
practices, it was important to determine the effect of the teaching and learning approaches
on students' CT abilities, and to describe suggestions needed for improvement.
Empirically, very little is known regarding the influence of CBL on a student's CT. The
question then remains, as to whether students who have undergone case-based learning,
differ significantly in their CT abilities from those who studied in the traditional method.
This study investigates the critical thinking skills in relation to two types of nursing
educational programs: (a) the traditional teaching and (b) the case-based learning. The
professed purpose of the study in hand is to measure and compare the level of critical
thinking in participants from each of the two programs. The instrument of measurement
guiding this study is the model developed by Facione and Facione (1998). The design has
been a comparative descriptive survey. The critical thinking abilities were measured by
the CCTST, which was administered to 38 participants from the traditional curriculum
and 65 from the case-based learning curriculum who agreed to participate in the study.
When the scores were analyzed by using the independent sample 1- test, this study found
that, in general, participants from both programs performed badly on the CCTST.
Nevertheless, the CBL program participants performed significantly better when
compared to the traditional program participants in all aspects of the CCTST.Thesis (M.Cur.)-University of Natal, Durban, 2001.
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Arunachallam, Sathasivan. "Community based curriculum in psychiatric nursing science." Thesis, 2012. http://hdl.handle.net/10210/6328.
Full textAbstract:
M.Cur.The purpose of this study is to describe guidelines for a Community Based Curriculum in Psychiatric Nursing Science for a nursing college in KwaZulu Natal. The study consists of 4 phases. To reach the purpose of the study, a situational analysis was done in 3 phases to identify the principles for a Community Based Curriculum in Psychiatric Nursing Science. In Phase I - a document analysis of relevant government policies and legislation was conducted to obtain the principles of mental health care. In Phase H - the statistics of the psychiatric diagnoses of patients from two community psychiatric clinics and one psychiatric hospital admission unit were collected. From the prevalence of the mental disorders, the mental health needs and problems were identified. These were the principles of Phase II. Phase III - was the focus group interviews with the psychiatric nurse educators of a nursing college in KwaZulu Natal to ascertain their viewpoints on a Community Based Curriculum in Psychiatric Nursing Science. From the findings of the focus group interviews, a literature control and conceptual framework were done. Thereafter, the principles of mental health care from this phase were identified. The principles of Phase I, II and III were used to formulate Phase IV, which was the guidelines for the operationalisation of Community Based Curriculum in Psychiatric Nursing Science. The outcomes based approach was used in the Community Based Curriculum in Psychiatric Nursing Science in accordance with the National Qualifications Framework of the South African Qualifications Authority. Recommendations concerning nursing practice, nursing education and further study were made at the end of the study including the limitations affecting the study
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Mthembu, Sindisiwe Z. "A survey of the assessment of clinical learning in selected nursing education institutions in KwaZulu Natal within an outcomes-based education (OBE) context." Thesis, 2003. http://hdl.handle.net/10413/4193.
Full textAbstract:
Assessment of clinical learning as a process for determining competence in practice is one of the underpinning principles of establishing and measuring student progress III nurse education. Literature reviewed for this study revealed that assessment of clinical learning in nursing education has been a problem for many years in the profession and it still is even today. This study was therefore aimed at investigating the current methods of assessing clinical learning used in nursing education institutions specifically as these relate to the South African Qualification Authority {SAQA)'s call for
applied competence. The study was an exploratory descriptive survey. Data were collected through the use of questionnaires. Questionnaires were mailed to those institutions that were not
easily accessible owing to their geographic location and questionnaires were delivered by the researcher to the geographically accessible institutions. All nurse educators employed
in five nursing colleges, two university nursing departments and one technikon in KwaZulu-Natal (KZN) were asked to participate in the study. The total number of nurse educators in the above-mentioned institutions was 195. The return rate of completed questionnaires was 56%. The results of this study revealed that the Objective Structured Clinical Examination (OSCE) and continuous clinical assessments were the two methods currently most commonly used in nursing education for assessing clinical learning, The results also revealed that triangulation of assessment methods of clinical learning was prevalent in nursing education institutions, with the OSCE and continuous clinical assessments being the most favoured combined strategies in assessing clinical learning. Very few participants mentioned the non-traditional clinical assessment methods (such as the triple jump and portfolio assessments) as strategies of assessing clinical learning that were used in their institutions. This study also revealed that continuous clinical assessment as a method of assessing clinical competence allowed nurse educators to assess applied competence and was generally believed to provide a more valid, reliable and realistic form of assessment. Continuous clinical assessments were also favoured for their authenticity because they were undertaken in a real clinical setting. Within the era of outcomes-based education, the focus in assessment moves from judgmental assessment methods to developmental assessments with extra emphasis on authentic and integrated assessment methods.Thesis (M.N.)-University of Natal, Durban, 2003.
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Hassanein, Nada Abou. "The relationship between learning styles, stages of self-direction in learning and academic performance in a case-based nursing program." Thesis, 2001. http://hdl.handle.net/10413/5320.
Full textAbstract:
The Institutes of Nursing in the United Arab Emirates adopted a new approach for educating and training the Diploma Nursing students in 1997. This approach emphasized the use of case-based learning, which was characterized by self-directed and cooperative learning. As the students were experiencing changes in the educational setting and teaching practices it was important to determine the impact of the teaching and learning approaches on students' learning, and to describe suggestions needed for improvement. The purposes of this study were to determine the learning styles and stages of self-direction in learning for students at Abu Dhabi Institute of Nursing, and to investigate whether there was a relationship between learning style, stage of self-direction and academic performance in courses taught by the case-based method. This study was guided by Kolb's theory of Experiential Learning, and Grow's theory of the Staged Self-Directed Learning Model. Kolb's learning style inventory and a self designed tool to measure stages of self-direction were administered to 186 students, who agreed to participate in the study. The design was a descriptive correlational one, and data was analyzed by descriptive, correlation, and inferential statistics methods. The assimilator learning style was the most predominant learning style (35.5%) followed by the converger (29.6%). Accommodators and divergers had equal percentage (17%) for each. As for the stages in self-direction, most of the students rated themselves in the moderate stages of self-direction (67.2%), however, Diploma III had the higest percentage of high self-directed learners (57%). Significant relationship was found between learning styles and academic performance, where convergers and divergers scored higher than assimilators and accommodators. Also a significant relationship was found between the stage of self-direction in learning and academic performance, where students in higher stages of self-direction had higher mean scores compared to students in low and moderate stages of
self-direction.Thesis (M.Cur.)-University of Natal, Durban, 2001.