Kathie Lasater

Assessing the Reliability, Validity, and Use of the Lasater Clinical Judgment Rubric: Three Approaches

The purpose of this article is to summarize the methods and findings from three different approaches examining the reliability and validity of data from the Lasater Clinical Judgment Rubric (LCJR) using human patient simulation. The first study, by Adamson, assessed the interrater reliability of data produced using the LCJR using intraclass correlation (2,1). Interrater reliability was calculated to be 0.889. The second study, by Gubrud-Howe, used the percent agreement strategy for assessing interrater reliability. Results ranged from 92% to 96%. The third study, by Sideras, used level of agreement for reliability analyses. Results ranged from 57% to 100%. Findings from each of these studies provided evidence supporting the validity of the LCJR for assessing clinical judgment during simulated patient care scenarios. This article provides extensive information about psychometrics and appropriate use of the LCJR and concludes with recommendations for further psychometric assessment and use of the LCJR.

Best Practices in Academic Mentoring: A Model for Excellence

Mentoring is important for the recruitment and retention of qualified nurse faculty, their ongoing career development, and leadership development. However, what are current best practices of mentoring? The purpose of this paper is to provide an overview of a model for excellence in establishing a formal mentoring program for academic nurse educators. Six themes for establishing a formal mentoring program are presented, highlighting best practices in mentoring as culled from experience and the literature. Themes reflect aims to achieve appropriately matched dyads, establish clear mentorship purpose and goals, solidify the dyad relationship, advocate for and guide the protégé, integrate the protégé into the academic culture, and mobilize institutional resources for mentoring support. Attending to the six themes will help mentors achieve important protégé outcomes, such as orientation to the educator role, integration into the academic community, development of teaching, scholarship, and service skills, as well as leadership development. The model is intended to be generalizable for faculty teaching in a variety of academic nursing institution types and sizes. Mentoring that integrates the six themes assists faculty members to better navigate the academic environment and more easily transition to new roles and responsibilities.

Connecting in distance mentoring: communication practices that work.

BACKGROUND As nursing and healthcare become more global, supported by technology, the opportunities for distance mentoring increase. Mentorship is critical to nurse educator recruitment and retention. STUDY OBJECTIVE The purpose of this study was to identify communication practices of nurse educators involved in mentoring at a distance. DESIGN/SETTINGS A qualitative design, utilizing in-person or telephone interviews was used. Participants were twenty-three protégés or mentors who were part of a yearlong distance mentoring program. ANALYSIS METHOD An iterative process of hermeneutic analysis identified three themes; this paper focuses on the theme of connectedness. RESULTS Participant narratives illuminate practices of connecting at a distance: meeting face-to-face, sharing personal information, experiencing reciprocity, journaling, being vulnerable, establishing ones presence, and appreciating different perspectives. CONCLUSION Distance does not appear to limit the connecting potential leading to a meaningful mentoring relationship; rather, it offers possibilities that local mentoring relationships may not. Nurse educators in under-resourced countries, those in small programs without a cadre of senior faculty, and students in distance programs are among those who stand to benefit from distance mentoring relationships.

Research Scholars Program: A Faculty Development Initiative at the Oregon College of Oriental Medicine

BACKGROUND The Research Scholars Program (RSP) was created at the Oregon College of Oriental Medicine (OCOM) to provide faculty development in research literacy, research-informed clinical practice, and research participation skills. The RSP is part of a broad effort, funded by a National Institutes of Health/National Center for Complementary and Alternative Medicine R25 education grant, to infuse an evidence-based perspective into the curriculum at schools of complementary and alternative medicine. The RSP arose from the realization that this curriculum reform would first necessitate faculty training in both research appreciation and pedagogy. OCOMs grant, Acupuncture Practitioner Research Education Enhancement, is a partnership with the Oregon Health & Science University School of Nursing (OHSU SON). DESIGN The RSP was developed initially as a collaborative effort among the OCOM Dean of Research (R.H.), OCOM Director of Research Education (S.F.), and an OHSU SON education specialist (K.L.). The 9-month, 8 hours per month seminar-style RSP provides the opportunity for a cohort of OCOM faculty and staff to explore research-related concepts and content as well as pedagogical practices that emphasize interactive, learner-centered teaching. The RSP adheres to a competency-based approach as developed by the Education Committee of the grant. As a tangible outcome, each Research Scholar designs a sustainable learning activity that infuses a research perspective into their courses, clinic supervision, or other sphere of influence at the college. In this paper, we describe the creative process and the lessons learned during the planning and initial implementation of the RSP. CONCLUSIONS We view the early successes of the RSP as encouraging signs that research literacy and an evidence-based perspective are becoming increasingly accepted as needed skill sets for present-day practitioners of acupuncture and Oriental medicine.

Interprofessional Education: Finding a Place to Start.

The Institute of Medicine has recommended interprofessional education (IPE) to improve patient safety and quality outcomes. However, getting started in IPE can be overwhelming and fraught with barriers. One health science university began by offering a 2-week intensive course that was integrated into existing courses. The evaluation validated the need for more understanding about professional roles and preparation as well as for faculty to learn from each other.

Falls prevention education: Interprofessional training to enhance collaborative practice

ABSTRACT The gap between the complex health care needs of older adults and the availability of geriatrics-trained health care professionals is widening. Interprofessional education offers an opportunity to engage multiple professions in interactive learning and clinically relevant problem solving to achieve high-quality patient-centered care. This article describes a project that engaged an interprofessional teaching team to support interprofessional practice teams to reduce falls in older adults via implementation of evidence-based practice guidelines. Ninety-five participants from 25 teams were trained on multiple strategies to decrease the risk of falls in older adults. The intervention facilitated increases in knowledge, confidence in skill performance, and team commitment to change practice patterns to support the health and safety of older adults. Findings suggest that community-based practices can successfully support the training of interprofessional teams and that training may lead to improved care processes and outcomes for older adults.

WHEN IT WORKS: Learning Community Health Nursing Concepts from Clinical Experience

Clinical faculty often struggle to design competency demonstrations that promote quality learning experiences. A nursing program in Oregon combined mental health and community health nursing practica and required well-planned, integrated competency demonstrations. This requirement became the impetus for students to promote the health of clients and learn clinical concepts that are difficult to experience in a typical term. Faculty coached students to make a significant contribution that would last beyond their clinical practica. A case study in competency demonstration design is described, and implications for curriculum development are presented.

Mannequin-based simulation to reinforce pharmacology concepts.

Simulation education provides many new learning opportunities to healthcare training. This article delineates a method that utilizes a variety of teaching methods that include structured lecture-based education, active simulation-based education, and reflective inquiry. A course in pharmacology is used as an example to show how these different methods can be employed to offer students an immersive experience that reinforces traditional lecture-based learning. The paper is presented in such a way that it is easily applied to multiple situations and includes schematics, evaluation data, and equipment lists. Evaluation data strongly supported the continued use of this methodology.

A Digital Toolkit to Implement and Manage a Multisite Study

Calls for multisite studies are increasing in nursing education. However, the challenge of implementing consistent protocols and maintaining rigorous standards across sites can be daunting. One purpose of a recent multisite, collaborative, simulation study was to evaluate a digital toolkits effectiveness for managing a multisite study. We describe the digital toolkit composed of Web-based technologies used to manage a study involving five sites including one United Kingdom site. The digital toolkit included a wiki, a project Web site to coordinate the protocols and study materials, software to organize study materials, and a secure location for sharing data. Most of these are familiar tools; however, combined as a toolkit, they became a useful management system. Web-based communication strategies and coordinated technical support served as key adjuncts to foster collaboration. This article also offers practical implications and recommendations for using a digital toolkit in other multisite studies.

An Interprofessional Approach to Reducing the Risk of Falls Through Enhanced Collaborative Practice

Falls are the leading cause of accidental deaths in older adults and are a growing public health concern. The American Geriatrics Society (AGS) and British Geriatrics Society (BGS) published guidelines for falls screening and risk reduction, yet few primary care providers report following any guidelines for falls prevention. This article describes a project that engaged an interprofessional teaching team to support interprofessional clinical teams to reduce fall risk in older adults by implementing the AGS/BGS guidelines. Twenty‐five interprofessional clinical teams with representatives from medicine, nursing, pharmacy, and social work were recruited from ambulatory, long‐term care, hospital, and home health settings for a structured intervention: a 4‐hour training workshop plus coaching for implementation for 1 year. The workshop focused on evidence‐based strategies to decrease the risk of falls, including screening for falls; assessing gait, balance, orthostatic blood pressure, and other medical conditions; exercise including tai chi; vitamin D supplementation; medication review and reduction; and environmental assessment. Quantitative and qualitative data were collected using chart reviews, coaching plans and field notes, and postintervention structured interviews of participants. Site visits and coaching field notes confirmed uptake of the strategies. Chart reviews showed significant improvement in adoption of all falls prevention strategies except vitamin D supplementation. Long‐term care facilities were more likely to address environmental concerns and add tai chi classes, and ambulatory settings were more likely to initiate falls screening. The intervention demonstrated that interprofessional practice change to target falls prevention can be incorporated into primary care and long‐term care settings.