Teaching nursing research. Integrating quantitative and qualitative methods

In the belief that graduate nursing students should be able to analyze, evaluate, and critique both qualitative and quantitative research methods and should be able to design their own research projects, two faculty members developed a two-course sequence integrating the two methods. The authors, each an expert in one of the methods, describe how they designed and co-taught these innovative courses.

Evaluation of Traditional Classroom Teaching Methods Versus Course Delivery Via the World Wide Web

Higher education is moving with deliberate speed to an electronic classroom. Much has been published on faculty experiences with World Wide Web (WWW) course delivery. However, little research exists on the evaluation of these methods. The purpose of this study was to evaluate students' perceptions of two approaches to teaching: classroom and WWW modules. Classroom methods were rated significantly higher in relation to content, interaction, participation, faculty preparation, and communication. Technical skills were rated higher for WWW modules. Critical thinking and time allotted for assignments were not significantly different between classroom and WWW instruction. Open-ended comments were rich and supported both positive and negative aspects of classroom and WWW-based modules. Implications call for creativity in course development, course redesign and orientation, active communication with students, support for technical problems, faculty development, and university-wide planning through partnerships.

Beyond Correspondence, Video Conferencing, and Voice Mail: Internet-Based Master's Degree Courses in Nursing

The changing health care system and increasing demands for primary care providers have prompted an increase in nurse practitioner programs in the United States. Nurses in rural areas that are underserved by primary care practitioners often are faced with time and distance barriers to returning to school for advanced education. This article describes Internet-based courses as a unique distance learning platform for preparing primary care nurse practitioners at the University of Kansas (KU) School of Nursing. Discussion includes course development process, matching methods to course content, and other information on promoting interaction between students and faculty.

Effects of Web-based instruction on learning behaviors of undergraduate and graduate students

Web-based instruction requires transformation from traditional teaching strategies to directed independent learning. Careful attention must be given to the creation of effective interactive learning experiences that foster student-to-student and student-to-faculty interactions (l). How content is learned, the effects of the use of computers on learning, and perceived barriers to learning must all be evaluated. Students' responses to Web-based education must also be considered. This article describes the response of 58 undergraduate and 13 graduate students to their initial experiences with Web-based instruction (WBI). While the educational levels of the students and the courses in which the transition to WBI took place differed for the two groups, their computer expertise did not, and similar responses to Web-based learning were noted. Differences in the types of courses and the expertise of the two faculty with regard to WBI also contributed to the production of some dissimilar responses.

Storytelling as a teaching tool

This article discusses the revival of the ancient use of storytelling as a teaching tool and how it can be used in teaching values and in promoting learning for nurse practitioner students and for clients of all ages. Stories are better able to illustrate values and may therefore have a greater impact on learning. Differences between stories and case studies are examined. Examples of stories the reader can use with students and clients are given.

[The thesis of the university nursing diploma. Experience at the University of Padova, Italy]

The new didactic organization of University degree of health areas considers a final qualifying examination composed, among other exams, by a written dissertation (thesis) dealing with technical-operative-experimental matters. At the faculty of Medicine and Surgery of Padua University, the council of the Degree in Nursing proposed a document about finalities, arguments, methods and operative rules for the production of the thesis as an instrument for students and teachers. During academic year 1996/97, 49 students had been graduated, for the first time in Italy. About 63% of theses were highly congruent with council's methodological instructions. When the matter of the theses was a technical aspect of an assistance problem, the theses were correct from a methodological point of view. Many professional figures supplied support to the students for the thesis, giving them a complete experience of professional application. The dimension of the thesis suggested by the Council's instruction was unrespected, the average length of the theses (30.3 pages) was significantly (p < 0.01) higher than that proposed (20 pages). This suggests that students could have an insufficient synthetic capability.

Keeping them in stitches: humor in perioperative education

Humor is one of the most effective teaching strategies available to perioperative nurse educators. Humor can be used to teach nursing students, surgical staff, and patients. This article describes the incorporation of humor into perioperative education and presents examples of specific humorous teaching strategies.

[A specialization course for clinical tutors: experience of the specialty course no. III at the University Campus of Biomedicine, Rome, Italy]

Clinical tutoring meant as guidance and support for the achievement of professional competency (which includes attitudes, knowledge, and skills) has proved itself as a critical opportunity for nursing students' clinical learning. The tutor's skill develops itself especially through the acquisition of clinical and psychopedagogical expertise unquestionably necessary to meet students' educational needs. For the third year the Università "Campus Bio-Medico" di Roma, has started a Specialisation course for Clinical Tutors. The course objective is to achieve psychopedagogical, clinical, ethical and managerial competency. Although the course always maintains the same cultural, methodological, and managerial setting, each year it develops different key aspect linked to the participants' interests and educational needs. In fact, the students as active participants of their learning and well aware of the tutors' role, determine themselves such objectives. This paper is based on the principal themes of this year's course as they have been discussed and developed in final papers by the students.

Close encounters: the use of critical reflective analysis as an evaluation tool in teaching and learning

Teaching and learning are complex activities which, when combined with professional practice-based activity, take on additional dimension and depth. This makes the use of traditional, product-based evaluation problematic in that a purely empirical approach does not facilitate thorough evaluation of every facet of such an encounter. This paper describes the use of critical reflective analysis as an alternative method of evaluation. The reflective framework facilitating this process has been adapted from three key sources: patterns of nursing knowledge; evaluative paradigms based upon knowledge - constitutive interests; descriptors for a reflective practicum. The reflective activity is structured around a teaching and learning encounter in a care-based setting and focuses on 'doing the drug round'. Descriptive vignettes are used to facilitate reflection-on-action and, through critical reflective analysis, the author identifies the essential value (e-value-ation) of the encounter in terms of credibility, utility and worth.

Strengthening clinical reasoning in graduate nursing students

Clinical reasoning skills are the cornerstone of successful nursing practice. To strengthen the clinical reasoning skills of graduate nursing students, faculty at one university developed an innovative course focusing on theoretical knowledge about clinical decision making and reflective exercises to foster student thinking.

A Survey of the Ways Master's Level Nursing Students Learn the Research Process

Because of the need for advanced practice nurses to perform more outcome measurement, a survey was conducted in the fall of 1997 to determine how master's level students learned the research process. Three hundred four surveys were mailed to schools with master's programs, and 222 were returned for a return rate of 73%. Sixty-six percent of the programs surveyed required a thesis and/or a research project. However, there was great variation in the research projects. A comprehensive examination was used to measure research ability by 36 programs (16%), either in conjunction with a thesis or research project or alone. One hundred forty-six programs (66%) offered only one option, be it a thesis, research project, comprehensive examination, or the many other alternative activities described by respondents. Seventy-six programs (34%) offered a variety of options from which students could select. The major differences between the thesis and the research project were related to three issues: a) the nature of the supervision; b) whether the activity was an individual or group project; and c) the amount of participation of the students. Because of the variability of expectations and the ways students are taught research, it was recommended nurse educators determine whether master's level nurse graduates were prepared to conduct outcome measurement and whether the means used to teach the research process were effective considering that endeavor.

Teaching, learning, and leading

Instructional systems design is a process for assessing learning needs, creating instructional programs, and evaluating effectiveness of learning. We discuss the benefits of including instructional systems design theory and practice in the curriculum, with an emphasis on making the process relevant for student nurse anesthetists.

Reflective education for professional practice: discovering knowledge from experience

To continually develop as a discipline, a profession needs to generate a knowledge base that can evolve from education and practice. Midwifery reflective practitioners have the potential to develop clinical expertise directed towards achieving desirable, safe and effective practice. Midwives are 'with woman', providing the family with supportive and helpful relationships as they share the deep and profound experiences of childbirth. To become skilled helpers students need to develop reflective skills and valid midwifery knowledge grounded in their personal experiences and practice. Midwife educators and practitioners can assist students and enhance their learning by expanding the scope of practice, encouraging self-assessment and the development of reflective and professional skills. This paper explores journal writing as a learning strategy for the development of reflective skills within midwifery and explores its value for midwifery education. It also examines, through the use of critical social theory and adult learning principles, how midwives can assist and thus enhance students learning through the development of professional and reflective skills for midwifery practice.

Faculty experiences teaching Native Americans in a university setting

Nursing faculty told their stories about the beginnings of a Native American Family Nurse Practitioner Recruitment Program. Through hermeneutical analysis, the authors' findings reveal a strong academic worldview, active in maintaining professional standards. This traditional view tends to override efforts to provide individualized programs that are culturally relevant to the Native American worldviews. By understanding the value conflicts active in this study, nursing faculty can begin dialogue to create new learning experiences that are more culturally relevant.

Development of a computerized database for evaluation of nurse practitioner student clinical experiences in primary health care. Report of three pilot studies

A computerized database for the collection of patient encounter information by nurse practitioner students provides insight into the number and diversity of cases seen. Menu-driven data entry and controlled vocabulary in the form of diagnostic clusters provide a mechanism to categorize and analyze the data. Faculty are able to review student clinical experience by quantitative measures such as number of patient encounters, diagnostic cluster of the encounter, and patient demographic data. Qualitative measures such as student's level of responsibility and student prior experience with stated encounter also are included in the database. Data analysis of two interdisciplinary pilots provided comparisons across disciplines of nursing, medicine, and physical therapy. A subsequent nurse practitioner student pilot provided further refinement and a broadened database terminology more inclusive of a nursing perspective. Educational and clinical issues involved in development, maintenance, and future use of the database are discussed.

Fulfilling regional needs for specialty nurses through limited-cohort graduate education

The University of Minnesota has developed a limited-cohort distance education graduate program to overcome geographic barriers and address the shortage of master's-prepared specialty nurses in rural areas of the upper Midwest. Such a program offers graduate nursing education in various specialty areas to distance sites for a predetermined, relatively short period.

Preserving writing in doctoral education: exploring the concernful practices of schooling learning teaching

Many contemporary scholars have challenged the current culture of graduate education and have suggested a need to reform nursing scholarship. The purpose of this study was to describe and analyse the common practices and shared lived experiences of nurses who are students or teachers in doctoral education. Participants recruited from across the United States included 15 nurses, five of whom were current faculty members in doctoral programmes in nursing and 10 who were currently enrolled as students in doctoral programmes. Data collected from extended, non-structured interviews were analysed hermeneutically using the interpretive phenomenology of Heidegger and Gadamer as the philosophical background. The results of this study reveal that the practices of scholarship, reading, writing, thinking and dialogue are inseparable and belong together. Analysing and describing how the practices of scholarship belong together will contribute to extending an understanding of how the practices of writing can be preserved in contemporary doctoral education. 'Preserving' refers to how teachers and students perpetuate and sustain these practices in ways that are meaningful and transformative and in ways that are oppressive. This study explores the experiences that are central to becoming a scholar and suggests how their meaningfulness can be sustained and extended into the next millennium.

Using forensic autopsies to teach advanced pathophysiology

Forensic autopsies can be used to help teach advanced pathophysiology. Currently, most faculty use commercially available slides and overheads, but these are poor substitutes for actual tissue, organs, and systems. Student participation in cadaver dissections or observation of hospital autopsies may be preferable, but these options are not always available in many schools of nursing. The forensic autopsy, however, allows students to directly observe a variety of pathologies and their sequelae, while exploring the multiplicity of factors that contribute to a person's death. In addition, students enhance their physical assessment skills and learn forensic content that can be applied to nursing practice. Bringing such real-world experiences to lectures and student assignments encourages these adult learners to actively participate in the integration of pathophysiology theory with autopsy observations.

Serendipity. A focus group turned hermeneutic evaluation

When a focus group exploring the influence of feminism on students' lives became a hermeneutic evaluation, we understood students' lived experience, gained a retrospective view of students' developing feminist voice, and learned how feminist education influenced students' personal and professional lives. Nurse educators in programs espousing phenomenological, practice-driven, dialogic education are encouraged to integrate hermeneutic evaluation strategies so faculty-student groups can make courses and curricula relevant and meaningful.

Inquiry-based learning and critical thinking in an advanced practice psychiatric nursing program

The advanced practice psychiatric nurse must be prepared to meet the changing demands being placed on the nursing profession. Some changes are the product of health care reforms, especially managed care. Others are more fundamental, because continuing scientific advances drive rapid changes in the knowledge base required of mental health nurses. Curricular reforms initiated earlier this decade were intended to equip nurses with the problem-solving and critical-thinking skills required to deal with novel and complex situations in a rapidly changing healthcare system. This article describes how the Inquiry-Based Learning tutorial method attends to the mental processes of graduate students and fosters critical-thinking skills.

Integrating Nursing Outcomes Classification in nursing education

The importance of standardized language to communicate the contribution of nursing to the health of patients is beginning to be recognized and embraced by the profession. As we move to make standardized language part of nursing practice, it is essential to reach nursing educators who prepare future generations of nurses for the practice realities of the next century. The Nursing Outcomes Classification (NOC) is a valuable tool in nursing education and needs to be integrated into the curriculum at all levels. The current emphasis on evidence-based practice demands that graduates have the skills and mechanisms to measure the outcomes of nursing care.