Marilyn H. Oermann

New Graduates' Perceptions of Clinical Practice

This study describes the stresses and challenges experienced by graduate nurses in clinical practice during their initial orientation period and examines the relationship of social support to these stresses. Thirty-five graduate nurses completed a modified Pagana Clinical Stress Questionnaire and social support measure during their orientation period. The graduates experienced a moderate degree of stress in their orientation. Stresses identified most frequently were: lack of experience as a nurse, interactions with physicians, lack of organizational skills and new situations and procedures. Although orientation was stressful, when describing emotions experienced during this period, graduates reported positive emotions most frequently. Pearson correlation revealed no significant relationship between social support and stress. Significant correlations were found, however, between social support and stimulation in clinical practice (r = 57, p = .001) and development of self-confidence (r = 39, p = .029). Findings highlighted the important role of the preceptor during orientation.

The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students

This study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students.

Reflections on undergraduate nursing education: a look to the future.

The nursing shortage combined with a shortage of faculty have created new challenges for schools of nursing particularly at the undergraduate level. At a time when schools are attempting to increase student enrollment, there are fewer faculty available for teaching those students. Faculty are increasingly faced with more responsibilities and demands placed on them to prepare students with essential knowledge and skills for beginning practice. The purposes of this paper are to examine current challenges in undergraduate nursing education and some strategies for addressing them.

Comparison of two instructional modalities for nursing student CPR skill acquisition

AIMS The purpose of the study was to compare performance based measures of CPR skills (compressions, ventilations with bag-valve-mask (BVM), and single rescuer CPR) from two types of CPR courses: a computer-based course (HeartCode BLS) with voice advisory manikin (VAM) feedback and instructor-led (IL) training with traditional manikins. METHODS 604 nursing students from 10 schools of nursing throughout the United States were randomized by school to course type. After successful course completion, students performed 3min each of compressions; ventilations with BVM; and single rescuer CPR on a Laerdal Resusci Anne SkillReporter manikin. The primary outcome measures were: (1) compression rate, (2) percentage of compressions performed with adequate depth, (3) percentage of compressions performed with correct hand placement, (4) number of ventilations/min, and (5) percentage of ventilations with adequate volume. RESULTS There were no differences in compression rates between the two courses. However, students with HeartCode BLS with VAM training performed more compressions with adequate depth and correct hand placement and had more ventilations with adequate volume than students who had IL courses particularly when learning on hard molded manikins. During single rescuer CPR, students who had HeartCode BLS with VAM training had more compressions with adequate depth and ventilations with adequate volume than students with IL training. CONCLUSION Students who trained using HeartCode BLS and practiced with VAMs performed more compressions with adequate depth and ventilations with adequate volume than students who had IL courses. Results of this study provide evidence to support use of HeartCode BLS with VAM for training nursing students in CPR.

Effects of educational intervention in waiting room on patient satisfaction.

This study examines the effects of a low-cost educational intervention designed to occupy the waiting time in the clinic on patient satisfaction with the clinic visit. Patients waiting for appointments were randomly assigned to two groups: (1) educational intervention in the clinic waiting room (n = 160) and (2) usual clinic care (no structured education during the waiting time in the clinic; n = 160). There were significant negative correlations between satisfaction with the visit overall and the time patients waited in the clinic waiting room (r = -.17, p = .003) and their total wait time (r = -.16, p = .005). Patients who were taught while they waited in the clinics were more satisfied with their education than the control group (t = 4.26, df = 318, p < 0.001).

Strategy to assess, develop, and evaluate critical thinking.

BACKGROUND To care for patients with complex health problems, nurses need a strong knowledge base and critical thinking skills. Critical thinking enables the nurse to process and analyze information, solve clinical problems, and decide on actions to take. Teaching and evaluation, however, often focus on memorizing facts and details about clinical care rather than on critical thinking. METHOD Context-dependent test items are designed to evaluate critical thinking and may be used in orientation, in competency testing, and by preceptors and others who work with beginning nurses for formative evaluation and discussions with them. A context-dependent item presents introductory material to analyze and determine a course of action. The introductory material may be a clinical scenario, an issue nurses might face in their practice, patient data, graphs or flow sheets, and other types of material for analysis. Carefully planned questions for assessing critical thinking are then asked. CONCLUSION The article describes how to develop and use context-dependent items in nursing continuing education.

Evaluation of asthma websites for patient and parent education

The purpose of this study was to evaluate the quality of websites on asthma for patient and parent education. Seventy websites were evaluated based on the Health Information Technology Institute (HITI) criteria; eight core content criteria from the National Heart, Lung, and Blood Institute guidelines; and readability. The ten best websites for asthma education were identified for patient teaching and educating parents about asthma.

DELIBERATE PRACTICE of MOTOR SKILLS in Nursing Education: CPR AS EXEMPLAR

ABSTRACT Our study explored the effects of deliberate practice on the retention of cardiopulmonary resuscitation (CPR) psychomotor skills among nursing students. The practice sessions were short, six minutes a session one time a month. Differences in performance between students who had deliberate practice and a control group, with no practice beyond the initial training, were compared every three months for one year. The intervention group performed better than the control over the 12 months. There is a need in nursing education for deliberate practice of relevant and high‐use skills for students to improve their performance and gradually develop their expertise.

Evaluation of web sites on management of pain in children

Increasingly, consumers access the Internet for information about their health problems and treatments and to learn more about their health care. Although Web sites can be valuable resources, the information may not be accurate or current. The purpose of this project was to evaluate the quality of Web sites for parents on the management of childrens pain. The Health Information Technology Institute criteria were used to evaluate 40 Web sites identified from two search engines: MSN and Google. After the evaluation process was completed, the readability of the sites was determined. Of the 40 sites, 29 (72.5%) provided useful information for parents searching to educate themselves about pain management. Other sites advertised the pain management services of their facility or were not relevant for patient education. The reading levels of the Web sites ranged from grade 7.7 to 12; the mean reading grade level of the 40 sites was 10.8, too high for many consumers. This article discusses the role of the nurse in evaluating health Web sites and teaching patients how best to use the Web for their health information.

Reforming Nursing Education for Future Practice

Health care reform, regardless of the specific proposal ultimately accepted, calls for changes in baccalaureate nursing education to prepare students for community-based practice. These changes include a shift toward the community as the primary setting for clinical practice; greater emphasis in the curriculum and more extensive clinical experiences in health promotion and prevention of illness; integration of primary health care within different levels of the curriculum; more interdisciplinary experiences in the delivery of care; expanded knowledge and skills for care of mothers, children, the aged, and critically ill patients in varied settings; and the reexamination of teaching strategies for preparing students with these expanded competencies. As nursing faculty consider the impact of health care reform, they are called upon to reexamine the curriculum and clinical experiences provided within their programs to prepare students for practice in community-based systems.