Mary M. Hoke

The impact of active learning on nursing students' clinical success.

Active, cooperative learning is a method to teach the critical thinking skills necessary for the transfer and use of classroom-acquired knowledge in the clinical setting. Yet many nursing educators continue to use teacher-centered educational approaches while identifying an array of barriers for the voiced preference for student-centered education. Using holistic, active cooperative learning strategies (faculty role modeling, student interactive and group learning, and group testing) within a didactic class, the authors found differences in the average clinical grade (87.03) when compared to the average clinical grade for students who had been taught using a lecture approach (84.19).

Risk factors for excessive or inadequate gestational weight gain among Hispanic women in a U.S.-Mexico border state.

OBJECTIVE To identify risk factors for excessive or inadequate gestational weight gain and associated morbidities among Hispanic women in a U.S.-Mexico border state. DESIGN Case-control design. SETTING New Mexico. PARTICIPANTS Hispanic women responding to the New Mexico Pregnancy Risk Assessment Monitoring System 2000 to 2003; 1,597 women in final excessive versus adequate gestational weight gain analyses and 1,351 in final inadequate versus adequate gestational weight gain analyses. METHODS Information from birth certificates and Pregnancy Risk Assessment Monitoring System questionnaires were use in logistic regression analyses to identify risk factors and associated events. RESULTS Prevalence of excessive gestational weight gain was 35.7%, while inadequate gestational weight gain was 30.4%. Among factors associated with increased risk of excessive gestational weight gain were overweight (odds ratio [OR]=2.87, 95% confidence interval [CI]=2.11, 3.90) or obese status (OR=1.82, 95% CI=1.38, 2.39), whereas residing in a U.S.-Mexico border county reduced such risk (OR=0.75, 95% CI=0.59, 0.97). Among risk factors for inadequate gestational weight gain were gestational diabetes (OR=1.58, 95% CI=1.05, 2.37) and inadequate prenatal care (OR=2.17, 95% CI=1.56, 3.02). After adjusting for confounders, inadequate gestational weight gain increased risk of low birth weight (OR=l.92, 95% CI=1.11, 3.29), while excessive gestational weight gain reduced this risk (OR=0.29, 95% CI=0.12, 0.68) but increased risk of macrosomia (OR=2.07, 95% CI=1.32, 3.25). CONCLUSION Prepregnant overweight and obese status were among factors associated with excessive gestational weight gain among Hispanic women, whereas inadequate prenatal care was among factors associated with increased risk of inadequate gestational weight gain.

Using Objective Structured Clinical Examinations to Meet Clinical Competence Evaluation Challenges With Distance Education Students

PURPOSE This study aims to describe the use of modified objective structured clinical examinations (OSCEs) developed to address the identified educational need for formative advanced practice psychiatric mental health (PMH) student assessments and focused learning experiences within a modified nursing distance education program that serves advanced practice nurse PMH students from rural/underserved areas. CONCLUSION OSCEs represent a practical solution to the challenges of clinical competency evaluation in psychiatric nursing distance education programs. PRACTICE IMPLICATIONS OSCEs add a supportive evaluation layer to the precepted experience. This increases the availability of PMH nurse practitioner/clinical nurse specialist distance education programs focused on improving advanced PMH nursing services in rural and underserved areas.

Outcomes of ADN-BSN Partnerships to Increase Baccalaureate Prepared Nurses

The limited supply of BSN nurses hinders efforts to increase patient care quality and address health disparities. In largely rural and economically disadvantaged areas, associate degree prepared nurses provide the majority of nursing services. To address a statewide need, a BSN Program and 3 ADN Programs formed a partnership to take BSN education to rural and medically underserved areas. This article describes the program planning, implementation, and evaluation using an adapted assessment framework with partnership principles as its foundation. Interactive television, internet education components, local clinical experiences, and distant nursing faculty liaisons were used. The nursing course sequence was completed by 101 of 102 students. Halls Professionalism Scale, the California Critical Thinking Disposition Inventory, and the California Critical Thinking Skills Test measured the increases found in professional socialization and critical thinking. Use of the adapted theoretical framework represented a strategic approach to developing a distance delivered nursing education program.

Promotores and The Chronic Care Model: An Organizational Assessment

Although promising research is developing related to promotores and the Chronic Care Model (CCM), studies of the effectiveness of the integration of these two system innovations in addressing health disparities are limited. This article reports on an organizational assessment and analysis of promotores working in a system of federally-sponsored community health clinics along the United States–Mexico border where the CCM has been operationalized. The work of promotores was found to be largely invisible within the CCM. This highlights the need for further investigation if the potential of these combined system innovations to address health disparities among Hispanics is to be realized.

Correlations Between Spirituality and Health-Promoting Behaviors Among Sheltered Homeless Women

This study examined the relationship between spirituality and health-promoting behaviors in a convenience sample of 90 sheltered homeless women using the Health Promotion Lifestyle Profile II, the Spiritual Well-Being Scale, and a demographic questionnaire. A moderate positive correlation was found between spiritual well-being and overall health promoting lifestyle (r = .426). Moderate to strong positive correlations were found between the Spiritual Well-Being Scale and the Health Promotion Lifestyle Profile II dimension subscales (physical activity, nutrition, spiritual growth, interpersonal relations, and stress management). The results support the importance of spirituality in relation to health-promoting behaviors among sheltered homeless women.

Academic Faculty Qualifications for Community/Public Health Nursing: An Association of Community Health Nursing Educators Position Paper

The Association of Community Health Nursing Educators (ACHNE) has developed a number of documents designed to delineate the scope and function of community/public health nursing (C/PHN) educators, researchers, and practitioners. Consistent with the mission of ACHNE, this position paper entitled Academic Faculty Qualifications for Community/Public Health Nursing has been developed by the Faculty Qualifications Task Force. The shortage of qualified nursing faculty has been well documented. In particular, this shortage has increased the difficulty in having sufficient numbers of faculty who are educationally and experientially qualified to teach in the C/PHN specialty. ACHNE is addressing this concern by setting forth preferred qualifications for faculty to teach C/PHN at both the graduate and undergraduate level. While we recognize that the current faculty shortage may require schools to use faculty to teach in areas in which they do not have appropriate formal preparation, the paper outlines best practices for teaching C/PHN, a goal we urge all schools of nursing to work toward. Task Force members developed an earlier draft of the document in fall 2008, and input was solicited and received from ACHNE members and considered in the final document, which was approved by the ACHNE Executive Board in July 2009.

The Clinic HELP Initiative: Promoting Health Education in Primary Care Clinics

Funding from a local conversion foundation was used to develop an initiative to extend health education services to medically indigent residents along the U.S.-Mexican border. The initiative included the direct funding of 10 clinic sites, the development of a technical assistance team, and the establishment of a health education network. Strengths, weaknesses, and lessons learned are discussed. Recommendations for collaboration between private funding agencies, universities, and practice sites include: developing a support system for health educators, providing ongoing training, and helping health educators develop measurable goals and objectives.

Guidance Counselors’ Ratings of Important Attributes for Registered Nurses and Prospective Nursing Students: A Comparison of Hispanic and Non-Hispanic Career Counselors

Perceptions of counselors from Hispanic serving high schools regarding professional nursing as a career have received limited study. A cross-sectional descriptive study of a convenience sample of 55 guidance counselors from Hispanic serving institutions identified the number of requests/referrals to nursing programs and perceptions of prospective nursing student and registered nurse attributes. Hispanic counselors rated caring and professional leadership skills higher than did White non-Hispanic counselors. Recommendations for academic nursing and counselor partnerships are provided. Las percepciones de consejeros en preparatorias de servicio a hispanos en cuanto a la profesión de enfermería como carrera han recibido estudio limitado. Un estudio descriptivo seccional cruzado de una muestra de conveniencia de 55 consejeros vocacionales en instituciones de servicio a hispanos identificaron el número de referencias a programas de enfermería y las percepciones de estudiantes prospecto de enfermería con los atributos de enfermeros registrados. Los consejeros hispanos calificaron más alto que los consejeros blancos no-hispanos en habilidades de liderazgo profesional y compasión. Recomendaciones para equipos o relaciones entre enfermería académica y consejería se proveen.

Development of a dynamic model to guide health disparities research.

Various populations experience health disparities related to risk factors such as gender, race or ethnicity, educational level, income level, and geographic location. These populations often experience barriers to access and utilization of services, which can lead to adverse health outcomes. Health promotion interventions developed within the context of communities represent resources that may offer protection to these populations. The purpose of this article is to describe the evolution of a conceptual model for the study of health disparities. The model, based on a review of literature, was developed to guide 19 pilot studies funded by the Texas-New Mexico P20 Southwest Partnership Center for Nursing Research on Health Disparities. Reflection on these studies, their respective methodologies, and findings resulted in a revised model to guide further studies of communities experiencing health disparities.