Gail Holland Wade

A model of the attitudinal component of professional nurse autonomy.

This model-testing correlational study was designed to predict a causal model of the attitudinal component of professional nurse autonomy in female baccalaureate nursing students by testing three carative factors embedded in Watsons Theory of Transpersonal Caring. Proportional quota and convenience sampling were used to collect data from 317 senior nursing students enrolled in 20 National League for Nursing-accredited baccalaureate nursing programs. Path analysis revealed that the hypothesized model was not testable. With removal of nonsignificant paths, 19.1% of the variance in perceived clinical competence was explained by self-esteem and perceptions of instructor caring behaviors. Perceptions of instructor caring behaviors, self-esteem, and perceived clinical competence contributed 11.1% to the variance in the attitudinal component of professional nurse autonomy. These findings provide a baseline for understanding the attitudinal component of professional nurse autonomy. A large percentage of the variance in the model was unexplained, suggesting the need for further study of other contributing variables.

A preconception care program for women in a college setting.

Preconception healthcare is a way to enhance positive pregnancy outcomes by encouraging women to engage in healthy lifestyles before they become pregnant. Because approximately 50% of pregnancies are unplanned, fetal development may be affected before a woman receives prenatal care. Young women are especially vulnerable to poor outcomes due to risky behaviors. Education about preconception health is not common practice. This article describes a peer education preconception health program for college women that provided a basis for an expanded program with larger, more diverse populations. Nursing students as peer educators presented the program to over 100 young women using the mnemonic REFRAMED PLUS to address eight preconception risk areas and reproductive life planning. Materials to augment the program, developed by peer educators, included a brochure on preconception health, a risk assessment tool, a DVD with stories of young women who experienced unplanned pregnancies, and a Reproductive Life Plan book. Peer educators administered a pretest, showed the DVD, guided discussions, assessed each womans health risks and administered a posttest. The risk assessment revealed that young women have several preconception health risks. Following the preconception program, posttest scores indicated increased knowledge of preconception health. For preconception healthcare to be successful, preconception risk assessments, education and counseling must be addressed by nurses every time a young woman receives care. When possible, peer educators should be used to disseminate the message to all women of childbearing age.

Using the Case Method to Develop Critical Thinking Skills for the Care of High-Risk Families

The complexity of the high-risk family coupled with the intricacies of the changing health care system force educators to examine how nursing students are prepared to care for these families. The Nursing and the High Risk Family course employs the case method teaching and learning strategy to help nursing students develop the critical thinking skills needed to assist high-risk childbearing and child-rearing families to meet their needs. Using the case method teaching and learning strategy, groups of students experience real-life situations in a nonthreatening classroom environment. The case method approach supports flexibility, creativity, change, risk taking, and consequently, encourages critical thinking. The Critical Thinking Model for Nursing Judgment, which defines the basic, complex, and commitment level of critical thinking, provides a framework for integrating increasingly more complex case studies into the course. Different case formats and levels of questioning promote students’ progression toward the commitment level of critical thinking.

Student-centered outcomes evaluation of the Clinical Immersion Program: five years later.

Curricular innovation is an ever-present element of nursing education. It is incumbent for nurse educators to evaluate their curricula and its outcomes to ensure quality nursing education. This article describes a comprehensive student-centered outcome evaluation of the Clinical Immersion Model. This model and the foundational components unique to the curricular design and the senior clinical immersion are described. Several methods of evaluation, including National Council Licensure Examination for Registered Nurses pass rates, exit surveys, alumni surveys, and a senior nursing student focus group, are presented. Implications of this evaluation and future directions are explored to inform potential implementation and adaptation of this effective curriculum by other schools of nursing.

Preparedness for Clinical: Evaluation of the Core Elements of the Clinical Immersion Curriculum Model

The Clinical Immersion Model is an innovative baccalaureate nursing curriculum that has demonstrated successful outcomes over the past 10 years. For those intending to adopt the model, individual components in isolation may prove ineffective. This article describes three core components of the curriculum that form the foundation of preparation for the senior-year clinical immersion. Detailed student-centered outcomes evaluation of these critical components is shared. Results of a mixed-methods evaluation, including surveys and focus groups, are presented. Implications of this curricular evaluation and future directions are explored.