Margaret M. Ross

A Comparison of Problem-Based and Conventional Curricula in Nursing Education

AbstractThe purpose of this study was to compare graduating baccalaureate students in a problem-based curriculum with those in a conventional nursing program with regard to perceived preparation for clinical practice, clinical functioning, knowledge and satisfaction with their education. Prior tograduation, students completed a self-report questionnaire that consisted of five sections and took about 45 minutes to complete. Following graduation, their pass rates on the National Nursing Registration Examination (RN Exam) were also compared.The findings indicated no significant differences in their perceived preparation for nursing practice, although the conventional students scored higher in all areas. There were also no significant differences between the two groups in their perceived clinical functioning, although there was a trend toward higher function in the areas of communication and self-directed learning in the PBL group. There were no statistically significant differences in RN scores. The PBL students scored significantly higher on perceptions of their nursing knowledge, particularly in the areas of individual, family and community health assessment, communication, teaching/learning, and the health care system. The students undertaking the PBL program were more satisfied with their educational experience than their counterparts in the conventional program, indicating higher satisfaction with tutors, level of independence, assessment and program outcomes, but no difference in relation to workload orclarity of expectationsThis study contributes to our understanding of the relationship between different educational approaches and student outcomes. It suggests that PBL is an effective approach for educating nurses. Furthermore, it indicates that nursing students in the PBL program, like their counterparts in PBL medical programs, report higher levels of satisfaction. Future studies that are longitudinal in design and rely less on self-report measures would contribute further to our understanding of the benefits and limitations of PBL in nursing education.

The Use of the Diary as a Data Collection Technique

The initiation of a research project requires many decisions, not the least of which is the selection of a method for data collection. This decision is, in large measure, guided by the nature of the research question which generally prescribes the selection of a strategy for data collection from among an array of possible alternatives. This article addresses the use of a diary for data collection. Although diaries have traditionally been used in social science and health research, their use in nursing research is more recent. The article begins with a brief discussion of the rationale for using the diary to gather data in a study of personal and professional care giving. A brief review of the use of diaries in previous studies follows, along with a description of the use of a diary in the caregiving study and a discussion of the possible threats to high quality data as well as measures used to ensure the collection of high quality data The article concludes with a discussion of the strengths and weaknesses of the diary andmakes recommendations regarding its use in nursing research.

End of Life Care: The Experience of Seniors and Informal Caregivers

As Canadas elderly population grows, an increasing number of seniors will require care as they face the end of life. Relatively little research attention, however, has been given to end-of-life issues, including those related to treatment and care for persons who are both old and dying. Families and health care providers have little direction and guidance to ensure an optimum quality of life for seniors prior to death and during the period of bereavement. This article presents an abbreviated summary of the literature regarding end-of-life issues and challenges for seniors who face a life threatening illness and are at, or near, the end of their lives. The article is also informed by a series of focus groups with elderly and other informal caregivers regarding the giving of help and getting support while caring for persons who are dying. It concludes with a response to this evidence by making a series of recommendations aimed at ensuring optimal end-of-life care for seniors who are dying and their families.

Nursing Curricula and Violence Issues

This article presents the findings of a survey of Canadian schools of nursing (N = 155) that determined the extent to which violence-related content is addressed in nursing curricula. The study yielded a response rate of 88%. Theoretical content regarding violence against children and women of all ages, and suicide as a response to abuse formed part of the curriculum of all schools of nursing, if only in readings. Child abuse and suicide received the greatest number of hours of instruction, followed by woman abuse, sexual assault, and elder abuse. University schools of nursing provided the greatest number of hours of instruction when compared with other types of schools. Schools in Western and Atlantic Canada provided the greatest number of hours of instruction on woman abuse when compared with other regions of the country. The majority of university schools provided experiential instruction in the area of violence, with the other types of schools providing very little such instruction. Findings revealed a sensitivity to the importance of including content on violence in nursing curricula; however, the approach to this content is largely incidental and heavily dependent on individual faculty interests. Implications of this study point to the need for the systematic inclusion of violence-related content and the sharing of resources among schools of nursing.

Continuing Education for Staff in Long-Term Care Facilities: Corporate Philosophies and Approaches.

The purpose of this study was to determine corporate philosophies of continuing education and approaches to meeting the learning needs of staff who strive to provide for the increasingly challenging care requirements of seniors who reside in long-term care facilities. In-depth interviews lasting approximately 1 hour were conducted with key informants at the administrative level from nine long-term care facilities. Content analysis revealed a commitment to continuing education for staff. While recognizing the importance of organizational responsibility for continuing education, administrators placed emphasis on the individual responsibility of staff. Learning needs were identified as affective, managerial, and physical in nature. Challenges to providing continuing education programs were derived from a general lack of fiscal and human resources. A variety of measures was suggested as important to supporting the continuing learning of staff. Implications of this study point to the need for long-term care facilities to incorporate into their strategic plans measures of ensuring continuing education as a basis for the ongoing competence and development of staff. In addition, there is a need for collaboration between long-term care facilities and other institutions of a long-term care, acute care, and educational nature in the development of strategies to operationalize a philosophy of continuing learning as a basis for the provision of optimal care to residents.

END-OF-LIFE CARE FOR SENIORS: PUBLIC AND PROFESSIONAL AWARENESS

Seniors living with disease or dying should be able to receive competent, comprehensive, and compassionate end-of-life care that offers dignity, self-determination, and relief from pain and suffering. Such care is predicated on an informed public and health and social service providers who are in end-of-life issues and appropriate approaches. There is, however, little evidence that seniors and their families are about end-of-life issues or about their treatment and care options. Furthermore, health and social service providers do not predictably receive the education and training necessary to ensure a high quality of end-of-life care for seniors. This paper discusses public and professional awareness and offers strategies aimed at increasing awareness of end-of-life issues. These strategies also support the development of an approach to end-of-life care for seniors that is caring, compassionate, and ethically, spiritually, and culturally appropriate. The article contributes to an emerging agenda directed at ensuring that all seniors receive end-of-life care that allows a positive conclusion to their lives.