Professional knowledge, midwifery and the role of the external examiner

Following the move of midwifery education into institutions of higher education (IHE), professional sources have voiced some concern over the apparent 'cultural conflict' between IHE and the midwives. In order to investigate this, a 1-day conference was convened for midwife teachers and external examiners in the south of England, during which data were collected from recorded discussions and interviews. The findings confirm the existence of conflict which polarized around two issues: first, the centrality of practice for midwives and the perceived undermining of that practice by the academically orientated IHE; and second, the somewhat ambiguous role of the external examiner. These findings are explained in terms of recent work on professionalization which suggests that professional knowledge can be legitimized where the emphasis is placed on the indeterminate elements of the work and where knowledge originates from abstractions and conceptualizations derived from working practice. Such a knowledge base would be rather more resistant to undermining by the deductive, rationalist approach employed by IHE academics. It is suggested that external examiners are best placed to represent practice based knowledge to IHE examiners.

Nursing informatics education for advanced nursing practice

This paper describes how nursing informatics content will be integrated into the education of Advanced Nursing Practitioners at Masters level. Changes in health care, especially the need to deliver evidence based nursing care and the growing amount of health data, information and knowledge, require well educated Advanced Nurse Practitioners to lead the nursing profession. The nursing informatics content for this level of nursing education is described and compared with national and international curriculum guidelines, including Nightingale work.

Teaching practice as a testbench of learning in master's degree education for nurse teachers in Finland

This article presents the approach and procedures used in a Finnish developmental study on nurse teacher education. The teaching practice period was organized by dividing student teachers into small study groups and assigning the group an entire course to be planned and carried out in teacher/student collaboration. The work process of the groups was videotaped and analysed qualitatively. Preliminary results and ideas concerning the developmental needs of nurse teacher education are presented.

Developing a framework for the future: a qualitative perspective on postgraduate nursing education in Hong Kong

This paper addresses some of the issues related to determining the postgraduate education needs of nurses and the development of a locally appropriate framework for postgraduate nursing education in a country newly embarking on tertiary education for nurses. It reports part of a survey conducted among graduate nurses in Hong Kong, with reference to their expectations for locally prepared and presented higher education that will equip them for expert practice in their chosen specialty. Over 700 nurses participated in the survey, representing almost 50% of the graduate nurse population. The findings reported here provide a qualitative insight into the reasons underlying their preferences, the difficulties they experience in pursuing further education and the reasons why pragmatic rather than preferred choices must be made. It will be argued that these are important considerations in planning for future developments in postgraduate education in Hong Kong. They may also prove useful to countries facing similar developments.

Teaching pharmacology by case study

This paper describes why case studies deserve a place in the centre of the bioscience curriculum, and how they have been used as a vehicle to improve care and save lives. A knowledge of drugs, their side-effects and interactions is becoming increasingly important to nurses. One powerful way to convey this information is the case study, which, despite its limitations, has the potential to endow difficult topics in therapeutics with the power of the narrative. The author suggests that case study projects encourage students to forge theory-practice links, related to their own specialist areas. When shared with their colleagues, these encourage the class by illustrating 'bioscience in action' and endowing the subject with the 'reality factor'. They also provide rich qualitative data for evaluating and delineating the curriculum. These case studies demonstrate the value of evidence-based practice; although case data is part of the evidence, it can never substitute for evidence-based practice. This paper builds on the findings of the author's PhD in postregistration nurse education; the examples described here are typical of 151 such cases in the research project.

Menopause on the Internet: building knowledge and community on-line

Computers are ubiquitous throughout the developed world. Diverse discourses address the pros and cons of using this technology in higher education. Nursing has extensively used informatics but has not, as yet, been involved to any extent in teaching on the Internet. I argue that nurse educators should use computer technology to present substantive and rigorous courses that deal with complex issues, using menopause as an example. A for-credit menopause course I taught via e-mail is used to illustrate the possibility of building knowledge and a sense of community on the Internet.

The clinical reasoning case study: a powerful teaching tool

This article describes the limitations of typical published case studies with respect to their congruence with actual clinical practice and their utility in teaching clinical decision making to novice or student health care providers. The authors propose a Clinical Reasoning Case Study that closely resembles an actual patient encounter, yet is also a rigorous academic exercise. In which health care providers must think aloud as the encounter unfolds. The Clinical Reasoning Case Study explicates and substantiates health care providers' thought processes underlying each decision to collect objective and subjective data. Other unique characteristics of this case study include a discussion of the working diagnosis and the provider's relative certainty about that decision; selection of the single most important objective and subjective finding that led to the diagnosis; a chronological list of diagnostic hypotheses that were generated throughout the patient encounter; and an analysis of costs, including the office visit, diagnostic tests, medications, and treatments. The Clinical Reasoning Case Study is a powerful tool for teaching and evaluating the clinical reasoning process. Two sample case studies are provided: "A Child with a Heart Murmur" and "An infant with Diaper Rash."

Using national data sets on CD-ROM to teach nursing research

PURPOSE

To explore the use of national data sets on CD-ROM for teaching graduate nursing research.

SIGNIFICANCE

Secondary data analysis of national health data sets is economical and provides a useful experience for students learning research.

SCOPE

The advantages and disadvantages of using national health data sets on CD-ROM are described. Students in three majors in nursing worked in groups to address research questions that could be answered using variables in the National Health Interview Survey. Several computer laboratory sessions were held to teach students how to extract the data and apply SPSS to analyze data.

FINDINGS

The pilot program was a success, but not without problems. Ten steps to ensure better attainment of objectives were formulated.

CONCLUSIONS

National data sets on CD-ROM are an inexpensive, rich data source that allow flexibility for students and faculty. Secondary data analysis using national health data sets is an underused approach in nursing. Graduate students can have a significant research experience while curbing the costs-to organizations and themselves-associated with primary data collection.

Preparing advanced practice nurses for clinical decision making in specialty practice

Dramatic changes in the delivery of healthcare have placed an increased emphasis on developing critical thinking skills and clinical decision making abilities of nurses on both the undergraduate and graduate levels. The authors discuss teaching-learning strategies that promote clinical decision making skills of advanced practice nurses. Particular attention is paid to advanced practice nurses who are being prepared to work within specialty practice settings. An algorithm to guide educators to teach clinical decision making is presented.

Teaching pharmacology to advanced practice nursing students: issues and strategies

A pharmacology course should prepare the advanced practice nursing student to understand the cellular mechanisms of drug action and physiologic outcomes (pharmacodynamics); mechanisms of absorption, distribution, metabolism, and excretion of drugs (pharmacokinetics); and the clinical use of drugs in the diagnosis, prevention, and treatment of disease (pharmacotherapeutics). The goal of a pharmacology course for advance nursing practice is to provide practitioners with knowledge that provides a rational basis for pharmacologic management of patients with complex health problems. A pharmacology course should teach the student the principles of pharmacology along with the process of pharmacologic reasoning.

Use of Meta-analysis as a Teaching Strategy in Nursing Research Courses

In order to become knowledgeable consumers of nursing research, nursing students must be able to critically read research and determine the study's value for nursing practice. As the number of nursing intervention studies rises and research topics are studied more extensively, the use of meta-analysis in the discipline of nursing will also increase. The same scientific rigor demanded of other types of research must be applied to meta-analysis. In this article two teaching strategies using meta-analysis are shared for sharpening both undergraduate and graduate nursing students' critiquing skills. On the undergraduate level, nursing students can assess the quality of the studies included in a particular meta-analysis. On the graduate level, students can use an appraisal checklist of criteria for evaluating the actual meta-analysis.

An innovative curriculum plan for advanced practice in oncology nursing

BACKGROUND

The Advanced Practice in Oncology Nursing Program was designed to prepare graduates to manage the cancer experience through the delivery of comprehensive, holistic, oncology-focused care to individuals, families, and communities in a variety of settings.

METHODS

Theoretical course work and clinical practicum are required to complete the degree plan. Students are actively recruited from urban, rural, and underserved population settings. The program is committed to fostering a teaching-learning paradigm that facilitates self-directed learning. The program's basic tenet is that all course offerings will be designed in a distributed learning/distance learning method. Clinical experiences are accomplished in or near the student's home community.

RESULTS

Development and implementation of the program are in process. Shaping a curriculum and learning environment to be consonant with a health care system in a constant state of reform flux is a challenging task.

CONCLUSION

This program's long-term challenge is to remain flexible, collaborative, and futuristic while promoting the expansion of advanced practice in oncology nursing.

Creative strategies for teaching statistical concepts in nursing education

Helping students efficiently learn critical concepts and understand the personal and professional relevance of statistics are important activities when teaching nursing research or related courses. The authors describe some creative teaching approaches used to elucidate abstract concepts and promote optimal learning of statistical analytic procedures. Appropriate for both undergraduate and graduate levels, these strategies are designed to influence the attitude that many students have about statistics, support active learning, and ignite the metacognitive abilities nursing students bring to the learning experience.

Performance support concepts for Web-based informatics instruction

Duke University first offered World Wide Web (WWW) based courses in Nursing Informatics in January of 1997. The first class enrolled 18 nurses who were completing either a Post-Master's Certificate Program or were near completion of their Master's degree. Courses were designed around principles of advanced nursing practice, performance support, mastery learning, and virtual learning communities. Extensive learning assessment included traditional papers, real-world application projects, and a variety of pre and post-test measurements.

Use of Iliad to Improve Diagnostic Performance of Nurse Practitioner Students

Nurse practitioners (NPs) have dual goals as primary care providers, combining the traditional goals of nursing with extended goals as diagnosticians. Diagnostic reasoning, therefore, is a critical component of NP education. Iliad, a computerized diagnostic reasoning expert system, has been used effectively to teach diagnostic skills to medical students. A pilot study was undertaken to determine the effects of Iliad training on NP students' diagnostic skill performance and to identify technical and instructional issues of implementation. The study found that the use of Iliad improved NP students' diagnostic reasoning, and that the training effects were modified by prior nursing experience. Successful use of Iliad required planning, faculty commitment, and technical support.

The learning collaboratory: a knowledge-building environment for nursing education

As we approach the 21st century, higher education must face many challenges. One challenge is the transformation of education from a teacher-focused to a learner-centered model. To accomplish this learner-centered model, several learning strategies are proposed to create socially relevant, distributed, and modular courses. This project creates a Learning Collaboratory whose overall goals are to build a knowledge-building environment for students to learn about nursing and to serve as a future global model for nursing education and interdisciplinary coursework. To begin this transformation, the research sequence for the graduate program was selected as the first pilot. This paper describes the analysis, redesign and implementation of the existing research courses during the 1996-1997 academic year.

Using the Internet as a teaching strategy: informatics at work

Development of the World Wide provides educators with an enormous library of teaching tools. The purpose of this presentation is to share the results of introducing over 60 graduate students to use e-mail, internet mailing lists, computer conferences, and the World Wide Web as teaching strategies. Data were collected from students through questions and Electronic Communication Logs. Response of the students was categorized into 6 phases: 1) fear and trepidation, 2) excitement, "this is great!", 3) "help, my mail box is full", 4) venturing forth independently, 5) this is easy, and 6) accepting the internet as a useful tool. Identification of these phases provided a basis for developing teaching strategies specific to internet uses. Feedback between students and instructor increased and was far more timely than occurs in the classroom setting. The student responses to these experiences were overwhelmingly positive.

An evolutionary concept analysis of mentoring in nursing

Despite widespread evidence of the concept of mentoring in nursing, it has been largely undefined, borrowed from other disciplines, viewed as static, and/or confused with related terms. Building on the work of Yoder and using a literature-based method developed by Rodgers, an evolutionary concept analysis is presented to provide an understanding of the meaning of mentoring in nursing, its current status, and the conceptual clarity necessary for additional systematic and rigorous inquiry. A random sample of 82 research abstracts and journal articles, representing 26 per cent of the total population of literature, was used to extract six essential attributes of the concept: a teaching-learning process, a reciprocal role, a career development relationship, a knowledge or competence differential between participants, a duration of several years, and a resonating phenomenon. These attributes form the theoretical definition of mentoring in nursing. Antecedents, consequences, related concepts, and empirical referents are presented. A model case, encompassing all of the critical attributes, depicts the Investigators' mentoring experience. Major changes in mentoring are viewed within the context of nursing as a learned profession, a legitimate academic enterprise, and a clinical science. Implications for further development are posed to further mentoring as a process for the socialization of nurse scholars and scientists and the proliferation of a body of professional knowledge.

[Education in rehabilitation: expectations by nursing students]

This article shows the nursing student's expetance about rehabilitation teaching during nursing graduation course, 8th semester students and 2nd semester of nursing graduation course answer a specific questionnaire for each grup and they show spectatives characterizing a proposal for the nursing rehabilitation teaching.

Empowerment of graduate nursing students: a dialogue toward change

This article represents the first phase in exploration of empowerment of graduate advanced practice nursing students. This phase includes a review of the relevant literature on empowerment and discusses the applicability of this literature to current educational practice. The authors suggest that creating an empowering environment for learning necessitates dramatic change in teaching methodology and in faculty-student perspective about their roles. An ongoing dialogue among faculty and between students and faculty is proposed to begin to conceptualize this change. This article also presents a synopsis of a dialogue between the two authors intended to stimulate further discussion.

Student to nurse-midwife role transition process. Smoothing the way

The purpose of this article is to describe how the graduate-level nurse-midwifery education program at the University of California, San Diego, has operationalized the nursing concept of role transition for nurse-midwifery students. A theoretical background of role transition is presented. Specific strategies used to facilitate role transition are discussed. Evaluation of the current strategies in use are presented.