Judith W. Herrman

CLINICAL IMMERSION: A Residency Model for Nursing Education

The education of future generations of nurses is in need of philosophic and programmatic transformation in keeping with the rapidly changing health care delivery system. The Nurse Residency Model is one baccalaureate nursing programs response to calls for reform. Rooted in a spirit of collegiality and lifelong learning, the three facets of its philosophy include enhanced socialization, improved transition to practice, and increased student accountability. Students gain increased competency and demonstrate increased accountability with each progressive semester in the program, which culminates in clinical immersion in the senior year. Unique programmatic features of this model include field experiences, the simulation lab, and a work requirement. Additional benefits include resource efficiency and patient safety. Implementation remains an ongoing process. Outcome indicators are expected to yield valuable data on which to develop an evidence base in support of the model.

Using film clips to enhance nursing education.

Film clips in nursing education provide a unique way to promote active learning. Several methods for using film clips and combining them with other teaching strategies are discussed. Suggestions for the use of popular clips, logistical aspects of showing clips in class, and legal issues associated with copyright are addressed. Faculty are encouraged to use this strategy to evoke emotional responses, generate discussion, enhance clinical decision making, and provide vicarious learning.

What Do Adolescents Think About Teen Parenting

Unexpected increases in the teen birth rates have stimulated a renewed focus on the prevention of teen pregnancy. Although many adults believe there are certain costs associated with teen parenting, the attitudes of teens toward the parenting experience are not known. The purpose of this descriptive study was to determine teens’ thoughts on how their lives would change if they experienced a teen birth in the areas of relationships, vocation, and life impacts. The Thoughts on Teen Parenting Survey (TTPS), designed to measure demographic variables and perspectives on the costs and rewards of teen parenting, was administered to 695 high school students. The survey yielded a composite score, subscale scores, and aggregate data measuring teen thoughts on the consequences of the teen parenting experience. Findings may be used to identify teens at risk for pregnancy, develop interventions, and evaluate prevention strategies based on the insights of teens.

Systemic Barriers to Diabetes Management in Primary Care: A Qualitative Analysis of Delaware Physicians

Primary care providers deliver the majority of care for patients with diabetes. This article presents a qualitative analysis of systemic barriers to primary care diabetes management in the small office setting in Delaware. Grounded theory was used to identify key themes of focus group discussions with 25 Delaware physicians. A total of 6 systemic barriers were identified: (1) a persistent orientation toward acute care; (2) an inability to provide proactive, population-based patient management; (3) an inability to provide adequate self-management education; (4) poor integration of payer-driven disease management activities; (5) lack of universally available clinical information; and (6) lack of public health support. The results suggest that significant systemic barriers limit the ability of primary care providers, particularly those in small practices, to effectively manage diabetes in current practice. Future primary care reform should consider how to support providers, particularly those in small practices, to overcome these barriers.

Development of a Survey to Assess Adolescent Perceptions of Teen Parenting

Initiatives designed to prevent teen pregnancy are often based on adult perceptions of the negative aspects of a teen birth. Qualitative research has revealed that teens may perceive positive rewards associated with teen parenting. These perceptions have not yet been examined through survey research. The theory of reasoned action proposes that individuals assess the costs and rewards prior to engaging in a behavior and provides a framework for the development of a survey instrument designed to measure adolescent thoughts about the costs and rewards of the teen parenting experience. This manuscript describes the development and testing of a quantitative survey instrument designed to measure adolescents’ perceptions. Pretesting, piloting, exploratory factor analysis, and a variety of reliability and validity measures were used to determine the value of the measure. The Thoughts on Teen Parenting Survey (TTPS) demonstrates an alpha level of .90. The TTPS yields a cumulative score of teen perceptions about the impact of a teen birth during the adolescent years that may be used to assess youth beliefs, correlated with demographic data, used to identify teens at risk for pregnancy/parenting, or provide a pretest/posttest to assess the effectiveness of interventions designed to foster realistic attitudes toward teen parenting.

Comprehensive Sexuality Education: A Historical and Comparative Analysis of Public Opinion

This research clarifies the public support of comprehensive sexuality education (CSE) in terms of acceptance, content, timing, and effectiveness as it may inform practice in the United States. The historical context of public opinion, as well as a summary of the efficacy of abstinence only education (AOE) versus CSE in the scientific literature, provides the foundation for this investigation. Several studies of public opinion, including a new survey, continue this exploration with the intent to further what is known about the public opinion about CSE. Findings of a state-wide survey study of adult views of sexuality education are compared with the results of public opinion research from various states and regions in the US. Support for CSE as well as related variables are explored. There is support for CSE among adults from around the US related to its incorporation into education, effectiveness, appropriate timing, potential content, and access to information and contraception. These findings indicate that general practices of CSE are consistent with public opinion and current research. These conclusions may be useful in garnering or expanding local support for CSE to ensure optimal education that is based on sound evidence and public opinion.

A pilot program to address healthy sexual behaviors among girls in juvenile detention.

PURPOSE This pilot study was designed to determine the effectiveness of an intervention on sexual behavior among girls in juvenile detention. METHODS The pre/posttest model assessed for changes in knowledge, attitudes, and reported behaviors. This program merged three curricula to create the unique Young Women Get Real Program with nursing student program facilitators. FINDINGS Despite high levels of satisfaction with the program, the data related to the final sample (n = 35) failed to reveal significant changes in measured variables. CONCLUSIONS The results may inform nurses as they pursue interventions to promote responsible sexual behavior in selected populations.

Siblings' Perceptions of the Costs and Rewards of Diabetes and its Treatment

This qualitative descriptive study explored the perceptions of siblings about the costs and rewards of diabetes and its management for the child with Type 1 diabetes, the sibling, and the family. Twenty children were interviewed using a semistructured interview guide. Children attending a day camp for children with diabetes and their siblings made up the sample. Iterative and thematic analysis yielded three cost themes and two reward themes. The perspectives of siblings about diabetes may aid in the development of family-focused teaching programs with the goal to assist family adaptation to Type 1 diabetes.

FROM BETA-BLOCKERS TO BOOT CAMP: Preparing Students for the NCLEX-RN

&NA; Although it is thought that reviewing essential materials and learning how to answer computer‐generated questions are optimal preparations for NCLEX‐RN®, strategies that build knowledge, self‐confidence, and professionalism of the nurse taking the exam are equally important. A senior seminar course that guides formal NCLEX‐RN preparation is presented in this article with specific course strategies and a blueprint of seminar content that can be adapted to the nursing curriculum.

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.