Christine Pintz

Online teaching strategies to improve collaboration among nursing students.

Collaborative problem-solving is an essential competency for nurses and all health professionals. This paper compares the design characteristics and educational benefits of three online-teaching strategies that nurse educators can use to build the critical thinking and social skills needed for effective collaboration: computer supported collaborative learning, case-based facilitated discussion, and cognitive flexibility hypermedia. These strategies support a critical instructional outcome required for effective collaboration: the ability to examine, assess, and synthesize multiple perspectives to resolve illstructured problems (i.e., problems for which there is no clear-cut solution). Descriptions, examples, and guidelines for implementing each strategy are provided. By integrating these strategies into their online courses, nurse educators can prepare nurses to work effectively with others to solve complex problems in clinical practice and the broader health-care system.

Preparing students for graduate study: An eLearning approach

This paper describes the development and preliminary evaluation of an eLearning program intended to provide incoming nursing students with the basic knowledge, skills and abilities needed to succeed in graduate-level, online coursework. Using Mayers principles (2008) for the effective design of multimedia instruction, an open-access, self-directed, online program was developed. The Graduate School Boot Camp includes five online modules focused on learning strategies and time management, academic writing, technology, research, and library skills. To motivate and engage learners, the program integrates a fun, graphical sports theme with audiovisual presentations, examples, demonstrations and practice exercises. Learners begin with a self-assessment based on the Motivated Strategies for Learning Questionnaire or MSLQ (Pintrich et al., 1993). To assess change in knowledge levels before and after completing the program, learners take a pre-test and post-test. Preliminary findings indicate that the students found the information relevant and useful. They enjoyed the self-paced, multimedia format, and liked the option to return to specific content later. This innovative program offers a way to prepare students proactively, and may prove useful in identifying students at risk and connecting them with the appropriate resources to facilitate successful program completion.

Paediatric nurse practitioner managed cardiology clinics: patient satisfaction and appointment access

AIM This article summarizes a comparative study of patient/family satisfaction and appointment wait times in physician managed vs. paediatric nurse practitioner managed cardiology clinics. BACKGROUND Appointment wait times exceeded 40 days in the outpatient cardiology department at a childrens hospital. To address the gap in available appointments, paediatric nurse practitioner managed cardiology clinics were implemented. METHODS A sample of 128 patients who presented concurrently in physician or paediatric nurse practitioner managed cardiology clinics from December 2009 through February 2010 was recruited for participation. The hospitals ambulatory patient satisfaction survey was utilized to measure level of patient satisfaction with care. Survey responses were evaluated using Fishers exact test. Appointment wait times were compared pre and post implementation of paediatric nurse practitioner managed clinics. RESULTS Sixty-five physician families and 63 paediatric nurse practitioner families completed the satisfaction survey. There was no statistically significant difference in patient satisfaction between clinic types. Appointment wait time decreased from 46 to 43 days, which was not statistically significant. Paediatric nurse practitioner clinics included a statistically higher percentage total of urgent appointments compared to that in physician clinics. CONCLUSIONS Paediatric nurse practitioner managed cardiology clinics are a strategic solution for improving patient access and facilitating high quality patient care while earning high levels of patient satisfaction. This healthcare delivery model illustrates the potential for expanded utilization of advanced practice nurses.

Using preappraised evidence sources to guide practice decisions.

Purpose: The purpose of this article is two‐fold. The first is to describe preappraised evidence sources or a top‐down approach to obtaining the best available evidence. The second purpose of the article is to describe how to incorporate preappraised evidence into clinical decision making with the Best Practice Decision Guide. Data Sources: The Best Practice Decision Guide begins with a query of preappraised and filtered electronic sources to obtain recommended evidence summaries, or a so‐called “top‐down” approach to obtaining the best available evidence. Conclusions: Information on the major issues and dilemmas encountered at each step is presented, including evaluation of clinical practice guidelines and the consideration of relevant studies to particular patients or subpopulations. Implications for Practice: Recommendations for other resources to use in the appraisal process and in making final practice decision are also described in the article.

Systems Thinking and Systems-Based Practice Across the Health Professions: An Inquiry Into Definitions, Teaching Practices, and Assessment

ABSTRACT Phenomenon: Systems thinking is the cornerstone of systems-based practice (SBP) and a core competency in medicine and health sciences. Literature regarding how to teach or apply systems thinking in practice is limited. This study aimed to understand how educators in medicine, physical therapy, physician assistant, nursing, and speech-language pathology education programs teach and assess systems thinking and SBP. Approach: Twenty-six educators from seven different degree programs across the five professions were interviewed and program descriptions and relevant course syllabi were reviewed. Qualitative analysis was iterative and incorporated inductive and deductive methods as well as a constant comparison of units of data to identify patterns and themes. Findings: Six themes were identified: 1) participants described systems thinking as ranging across four major levels of healthcare (i.e., patient, care team, organization, and external environment); 2) participants associated systems thinking with a wide range of activities across the curriculum including quality improvement, Inter-professional education (IPE), error mitigation, and advocacy; 3) the need for healthcare professionals to understand systems thinking was primarily externally driven; 4) participants perceived that learning systems thinking occurred mainly informally and experientially rather than through formal didactic instruction; 5) participants characterized systems thinking content as interspersed across the curriculum and described a variety of strategies for teaching and assessing it; 6) participants indicated a structured framework and inter-professional approach may enhance teaching and assessment of systems thinking. Insights: Systems thinking means different things to different health professionals. Teaching and assessing systems thinking across the health professions will require further training and practice. Tools, techniques, taxonomies and expertise outside of healthcare may be used to enhance the teaching, assessment, and application of systems thinking and SBP to clinical practice; however, these would need to be adapted and refined for use in healthcare.