Donald D. Kautz

Promoting Clinical Reasoning in Undergraduate Nursing Students: Application and Evaluation of the Outcome Present State Test (OPT) Model of Clinical Reasoning

Promoting clinical reasoning in undergraduate nursing students through application of the Outcome Present State Test (OPT) Model of Clinical Reasoning, is a challenge that can be successfully managed through effective teaching-learning strategies. Empirical evidence to support teaching strategies that foster both cognitive and metacognitive skill acquisition is limited. The purpose of this research was to evaluate the development of clinical reasoning skills among nursing students through the application and evaluation of teaching-learning strategies associated with self-regulated learning and the OPT model (Pesut & Herman, 1998; 1999; Pesut, 2004). The model and self-regulated learning prompts were used to structure learning with junior level baccalaureate nursing students during a ten-week, medical-surgical clinical experience in acute care telemetry units. Data analysis revealed students effectively made gains in learning associated with the OPT model. Qualitative analysis of self-regulated learning prompt journal data revealed students made significant gains in self-observation, self-judgment, knowledge work and use of health care personnel resources during clinical experiences. Results indicated the intentional use of guided reflection coupled with structure and learning tools of the OPT model significantly enhanced clinical reasoning skill acquisition, and provided evidence for the effectiveness of structured teaching learning strategies.

Using research to identify why nurses do not meet established sexuality nursing care standards

ALTHOUGH A main objective of quality assurance (QA) activities is to improve the nursing care given to patients. many QA activities focus on uncovering deficiencies rather than on developing strategies to assist nurses in meeting quality patient care standards. Intervention strategies may be quickly and poorly planned and often result in no improvement or only a temporary rise in monitoring scores. This article will examine a recurrent nursing QA problem experienced at the University of Kentucky Hospital and the research activities taken to discover the underlying reasons for failure to meet the departments care standards in the area of sexuality. The results of this research then served as the basis for developing a comprehensive intervention plan to change the practice of nurses within the institution.

Promotion of Family Integrity in the Acute Care Setting: A Review of the Literature

The acute illness of 1 family member can then negatively affect all family members and lead to the disruption of family functioning and integrity. During the patients hospitalization, nurses are in a key position to support family members, maintain family integrity, and ready them for assuming the role of caretaker during the patients recovery and management of health at home. This article reviews current research findings that provide empirical support for activities that promote family integrity. Strategies for nurses to support family members during the hospitalization of an adult family member and suggestions for future research are provided.

Promoting the Self-Regulation of Clinical Reasoning Skills in Nursing Students

Aim: The purpose of this paper is to describe the research surrounding the theories and models the authors united to describe the essential components of clinical reasoning in nursing practice education. The research was conducted with nursing students in health care settings through the application of teaching and learning strategies with the Self-Regulated Learning Model (SRL) and the Outcome-Present-State-Test (OPT) Model of Reflective Clinical Reasoning. Standardized nursing languages provided the content and clinical vocabulary for the clinical reasoning task. Materials and Methods: This descriptive study described the application of the OPT model of clinical reasoning, use of nursing language content, and reflective journals based on the SRL model with 66 undergraduate nursing students over an 8 month period of time. The study tested the idea that self-regulation of clinical reasoning skills can be developed using self-regulation theory and the OPT model. Results: This research supports a framework for effective teaching and learning methods to promote and document learner progress in mastering clinical reasoning skills. Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness. Recommendations and Conclusions: Thinking and reasoning about the complexities of patient care needs requires attention to the content, processes and outcomes that make a nursing care difference. These principles and concepts are valuable to clinical decision making for nurses globally as they deal with local, regional, national and international health care issues.

IMPLEMENTATION AND TESTING of the OPT MODEL as a Teaching Strategy in an Undergraduate Psychiatric Nursing Course

ABSTRACT Teaching undergraduate nursing students to think critically and reason clinically is a challenge for nurse educators, yet these skills are essential for the professional nurse.The Outcome‐Present State‐Test (OPT) Model of Reflective Clinical Reasoning (Pesut & Herman, 1999) provides a framework for teaching clinical reasoning skills to nursing students.This article describes how the model can be used in clinical teaching of undergraduate students in psychiatric and mental health settings and presents some findings from an evaluation of the model. Strategies employed in the model implementation are described, along with the benefits and limitations of this teaching method in a psychiatric clinical setting.

A Writing Intensive Introductory Course for RN to BSN Students

This article describes learning strategies used with RN to BSN students in their 1st nursing course to successfully learn how to write formal papers using the American Psychological Association (APA) format. This 1st nursing course, a writing intensive, requires 4 short papers with self, peer, and teacher critiques and opportunities to rewrite. Students learn the style of professional nursing discourse, mastery of APA format, and development of additional skills in following directions and in critiquing their own work. An additional benefit is to enhance learning about professional nursing topics. By mastering writing skills in this initial course, students are able to successfully complete writing assignments in future courses and, in some cases, move on to publication.

Teaching Pathophysiology: Strategies to Enliven the Traditional Lecture

The depth and breadth of pathophysiology content, foundational for nursing practice, is well suited for traditional lecture delivery. Use of creative strategies can deepen students’ understanding while respecting students’ diverse talents and ways of learning. The authors discuss strategies they used, including case studies, questions asked during lecture using immediate feedback technology, creative visual demonstrations, group pathophysiologic theory projects, short videos, and games, to enhance students’ understanding and retention of content.

Better pain management for elders in the intensive care unit.

By 2040, there will be 70 million people older than 65 years in the United States. Approximately 50% have pain on a daily basis, and research shows that their pain is often underdiagnosed and undertreated. Nurses have an obligation to provide state-of-the-art care and advocate for vulnerable older adults in the intensive care unit (ICU). Untreated pain can complicate an ICU stay and delay discharge. This article briefly reviews difficulties in managing pain in ICU patients, suggests creative methods to properly assess pain, and discusses approaches for encouraging elders in ICU to manage their pain effectively.

A Caring Leadership Model for Nursing's Future

This article describes the McDowell-Williams Caring Leadership Model that brings together the caring theory of Watson (2008) and the leadership theory of Kouzes and Posner (2007). This model provides institutional guidance for continuing the effective shared governance by the nurses at Wake Forest University Baptist Medical Center (WFUBMC), as well as strategies for leaders to use with staff as they make their workplace the best place to work and the best place to receive care.

Prevention of Posttraumatic Stress Disorder in Intensive Care Unit Patients

The need for critical care and the experience of being treated in the intensive care unit may be a traumatic event with long-lasting psychological consequences for the patient and family. Research has identified patients who are at risk of developing posttraumatic stress disorder after an intensive care unit stay. This article reviews pharmacologic and nonpharmacologic strategies, including the use of diaries or journals, that have been shown to prevent posttraumatic stress disorder in intensive care unit patients and their families.