Jean W. Lange

Integrating Spirituality into Undergraduate Nursing Curricula

Nursing programs have done a commendable job keeping pace with the rapid advances in disease management. Yet, spirituality has received far less attention in nursing curricula (Keefe, 2005) and nursing students often do not have a strong foundation in this area. The purpose of this project was to integrate spirituality into the undergraduate nursing curricula and measure student outcomes related to spiritual knowledge and attitudes. Nursing faculty participated in a spirituality education program and followed this with sessions focused on integration of spiritual content into individual nursing courses. Student pre and post-tests were administered using a standard instrument to evaluate the effectiveness of the program. Significant differences in spirituality knowledge and attitudes among senior-level nursing students (t = -3.059, p = .004) were revealed. As the healthcare system becomes increasingly complex, providing students with tools to identify and strengthen inner resources is essential to patient care.

Integration of End-of-Life Care Content in Undergraduate Nursing Curricula: Student Knowledge and Perceptions

Studies indicate that nurses spend more time with patients at the end of life than any other health care discipline (K. M. Foley & H. Gelband, 2003). So it is imperative that nurses be educated so they can provide this high-quality end-of-life care. The purpose of this project was to provide a current state of end-of-life nursing education in the literature and to report on end-of-life knowledge and experiences of two groups of nursing students in one small, liberal arts university. A total of 111 undergraduate students (61 sophomores and 50 seniors) were administered a 50-item, multiple-choice test to determine their baseline knowledge about end-of-life care. Sophomore scores ranged from 20% to 86% with a mean of 60.98 (SD = 11.83). Senior pretest scores ranged from 70% to 96% with a mean of 83.26 (SD = 6.6). An independent samples t test was conducted to determine if there was a difference in group mean knowledge between sophomore and senior students. Levenes test for equality of variance was significant (F = 4.22, P < .05); thus, a t test with equal variance assumed revealed a significant difference between sophomore and senior group means (t = -10.44, P < .001). The review of literature and student knowledge and experience assessment resulted in the development of a model of end-of-life curriculum integration implemented at the university and sets the stage for future program evaluation studies.

Validation of the End-of-Life Nursing Education Consortium Knowledge Assessment Test: An Abbreviated Version

The need for improved nursing knowledge about end-of-life care is well documented; however, efficient measures to evaluate knowledge attainment from end-of-life training programs are lacking. The authors tested a 50-item version of an original 109-item knowledge assessment tool developed by the End-of-Life Nursing Education Consortium. Items with highest item-to-total correlations were selected to represent each of the nine domains in the original instrument. One hundred forty-one graduate and undergraduate nursing students pretested the shorter version. Thirty graduate students also completed the original version. Item analysis, equivalence, and internal consistency estimates were conducted to evaluate the validity of the 50-item version. Scores on the 109-item and 50-item versions were highly correlated (r = 0.92), and the total scale internal consistency estimate for the 50-item version surpassed the 0.80 standard (Kudar Richardson [KR] 20 = 0.84). Item difficulty and discrimination indices suggest that the revised version should discern knowledge attainment across varied achievement levels. Pretest scores were well below the 80% target for mastery among graduate students in practice and support the ongoing need for end-of-life education. The results support the utility of the shorter version to assess baseline end-of-life knowledge. Further testing is needed to demonstrate its usefulness in end-of-life program evaluation.

Puerto Rican Women’s Perceptions of Heart Disease Risk:

Women frequently fail to recognize that coronary heart disease (CHD), not breast cancer, is the primary cause of female mortality. CHD mortality among U.S. mainland Puerto Rican (PR) women is second only to African American women. It is unknown what PR women understand about their risk, what factors they believe contribute to CHD, or whether they know the atypical symptoms often experienced by women. Most CHD studies exclude Hispanic women. Those that do often aggregate their results, making subgroup variations invisible. This study explored awareness of CHD symptoms, risks, and help-seeking behaviors among 12 PR women. Focus group methodology revealed that participants were unaware of their risk and had misconceptions about CHD symptoms and contributing factors. Barriers to early recognition and treatment included lack of knowledge, gender role conflict (caregiver vs. care recipient), and fears of falsely alarming family members or the embarrassment of feeling “dismissed” by health care providers.

Transforming the organizational culture of a school of nursing through innovative program development.

This article illustrates how a grant designed to promote new program development provided a vehicle for organizational transformation. The collaboration surrounding this initiative created a common focus within the school that more effectively channeled its resources and resulted in an unprecedented level of scholarly achievement and recognition. Faculty leveraged the success of this initial grant to procure additional funding for related projects. The importance of partnerships and teamwork were two valuable lessons learned. We believe that our experience is replicable in other schools of nursing interested in organizational transformation. Gibson and Barsades model of managed change guided the projects implementation and evaluation processes. Recommendations for engaging faculty, gaining support, and developing a collaborative network are discussed in the article, with findings from a stakeholder-focused evaluation demonstrating new program goal achievement as well as the transformative changes that occurred in the organizational culture. A focused, theory-derived program plan, with comprehensive process and outcome evaluation components resulted in a major transformation of one school of nursing. Unanticipated outcomes included renewed synergy among faculty; the development of a preferred vision for the future; scholarly collaboration around a central theme that effectively channeled limited resources and dramatically increased productivity; increased regional and national recognition; and the creation of regional, national, and international partnerships.

Using Simulation Pedagogy to Enhance Teamwork and Communication in the Care of Older Adults: The ELDER Project

The Expanded Learning and Dedication to Elders in the Region (ELDER) project addressed the needs of under-served older adults by educating health care providers in home health and long-term care facilities. Four agencies in a health professional shortage/medically underserved area participated. Focus groups were held to determine agency-specific educational needs. Curricula from the John A. Hartford Foundation were adapted to design unique curricula for each agency and level of personnel during the first 2 years. The focus of this report is the case-based simulation learning approach used in year 3 to validate application of knowledge and facilitate teamwork and interprofessional communication. Three simulation sessions on varying topics were conducted at each site. Postsimulation surveys and qualitative interviews with hired evaluators showed that participants found simulations helpful to their practice. Tailored on-site education incorporating mid-fidelity simulation was an effective model for translating gerontological knowledge into practice and encouraging communication and teamwork in these settings.