Sylvia T. Brown

A Review of Narrative Pedagogy Strategies to Transform Traditional Nursing Education

Traditional nursing pedagogies using teacher-centered learning approaches have produced efficient, knowledgeable nursing graduates for many years. However, 21st century learners will require and demand new educational approaches. The information age of computers has challenged all facets of education to keep pace. Nursing education must evolve with ever-changing forms of communication and technology and recognize generational differences in learning. The creation of partnerships in learning, rather than the traditional hierarchy of education, is projected to meet the needs of todays learners more effectively. The National League for Nursing, in its position statements, has challenged nurse educators to develop new research-based pedagogies responsive to the changing health care environment and reflective of new partnerships between and among students, teachers, and clinicians. This article will explore examples of one approach, narrative pedagogy, and its usefulness in nursing education as a way to expand the pedagogical literacy of nurse educators.

Factors that influence patient satisfaction in the emergency department.

This descriptive correlation study examined the satisfaction levels of urgent and nonurgent patients in relation to nursing care, the emergency department (ED) environment, ancillary services, and information received. The sample consisted of 28 subjects, with the majority of patients being very satisfied with nursing care. The primary area of concern was information about the length of waiting time. The satisfaction levels of ED patients with the care they receive has become increasingly important in todays health care environment. ED nurses play an important role in ensuring that patients are satisfied and receive quality care.

Faculty and student perceptions of effective clinical teachers.

The following study has been conducted to discover the characteristics of an effective clinical teacher as described by faculty and students in a selected baccalaureate school of nursing. Through determination of these characteristics, clinical teachers can improve their teaching methodology and provide a more effective learning environment for the learner. The identification of these characteristics also has implications for graduate nursing education, as clinical teachers are being prepared in this arena to enter the teaching environment. Administrators should consider utilization of these characteristics for teacher evaluation purposes. Nursing educators must attempt to bridge the gap between what educators and students perceive as characteristics of the effective clinical teacher. The ultimate goal to be achieved from identification of effective clinical teacher characteristics, as determined in this study, is improvement in clinical teaching.

Pain experience of the elderly.

Too often, the elderly suffer silently and needlessly with chronic pain. To investigate the pain experience of the elderly living in the community, a descriptive research design was used. The aims of the study were to determine the prevalence of pain in an older population living in the community, to obtain a description of the older adults pain experience, and to determine strategies used to manage their pain. The results of the study indicated that >90% of the elderly living in the community experienced pain within the past month, with 41% reporting discomforting, distressing, horrible, or excruciating pain. Musculoskeletal pain was found to be the most predominant pain, and inactivity was the most effective strategy used to lessen pain. Pain in the elderly continues to be a challenge which needs to be addressed more effectively by health care providers. Based on the high prevalence of pain experienced by the elderly and the expected demographic shifts in the next two decades, it is imperative to continue research in this area to assure the highest quality of life, as well as maximum functional ability, for the elderly. Health care providers need to understand the multidimensional pain experience that occurs in the daily life of the community-dwelling older adult and the most effective management strategies that can be used to provide pain relief.

Women's Evaluation of Intrapartum Nonpharmacological Pain Relief Methods Used during Labor

A wide variety of pain relief measures are available to women in labor. This retrospective, descriptive survey design study examined which nonpharmacologic pain-relief techniques laboring women use most often and the effectiveness of the chosen techniques. Of the 10 nonpharmacological strategies rated by the sample (N=46), breathing techniques, relaxation, acupressure, and massage were found to be the most effective. However, no specific technique or techniques were helpful for all participants. The results provide directions for childbirth educators in designing and implementing an effective childbirth education curriculum that assists women to have empowered birth experiences.

PERCEPTIONS of the Use of Reflective Learning Journals in Online Graduate Nursing Education

ABSTRACT The purpose of this study was to examine the perceptions of graduate nursing students and a small sample of faculty regarding learning outcomes associated with reflective learning journals (RLJ) in online education. Reflective journaling is used extensively in nursing curricula, yet few studies have explored perceptions of learning outcomes with online students, specifically those preparing to become nurse educators. An electronic survey was developed utilizing items associated with four learning outcomes of reflective journaling: professional development, personal growth, empowerment, and facilitation of the learning process. Positive outcomes such as the connection between theory and practice, recognition of strengths and weaknesses, and integration of new ideas and concepts were identified. Obstacles included the amount of time needed for reflection and grading, and the development of trust between students and faculty. The results of this study indicate that graduate students and faculty perceive positive learning outcomes with the use of reflective journals in online education.

Characteristics of labor pain at two stages of cervical dilation

&NA; This study characterized the pain reported in a selected group of obstetrical patients in labor and compared the pain experienced at 2 stages of dilation, dilation of 2–5 cm and of 6–10 cm. Pain was defined as the perception of an unpleasant sensory and emotional experience with multidimensional factors that evoke behavioral responses. The characteristics of pain were operationalized as responses of 78 laboring women to 3 self‐report measures, the Visual Analogue Scale (VAS), Present Pain Intensity (PPI), and the McGill Pain Questionnaire (PRI‐R), and 1 observational measure, the nurse‐rated Behavioral Index of Pain (BIP). As cervical dilation increased, there were significant increases in self‐reported pain and observed pain on all the cited measures. Pain was characterized as ‘discomforting’ during early dilation and as ‘distressing, horrible, excruciating’ as dilation progressed. Significant increases in pain with increased dilation occurred on all measures for multigravidas but only on the VAS for primigravidas.

A Self-Management Program for Chronic Obstructive Pulmonary Disease: Relationship to Dyspnea and Self-Efficacy

&NA; The purpose of this quasi‐experimental study was to determine the effects of a nurse‐directed self‐management program on dyspnea and self‐efficacy levels in patients with chronic obstructive pulmonary disease (COPD). The Health Belief Model and the Theory of Self‐Efficacy provided the theoretical framework for the study. The sample included 10 COPD patients from rural North Carolina who attended a 6‐week nurse‐directed self‐management program. Dyspnea and self‐efficacy were measured before and after the program by using a vertical visual analogue scale for dyspnea and the COPD Self‐Efficacy Scale. A single‐group quasi‐experimental design that incorporated a pretest and a posttest was used. Paired t tests were used to compare the pretest and the posttest levels of dyspnea and self‐efficacy. The findings revealed no significant change in levels of dyspnea after the program. Levels of self‐efficacy, however, were found to have increased at a statistically significant level (p < .001) following the program. This study indicates that using a group teaching method to teach self‐management skills improved self‐efficacy levels.

THE USE of Innovative Pedagogies in Nursing Education: An International Perspective

ABSTRACT The purpose of this global study was to explore the types of innovative pedagogies used in nursing education worldwide; transformative learning theory served as the theoretical basis for the study. A descriptive, mixed‐method design with a researcher‐developed instrument was used to conduct the electronic survey. Respondents were 946 nurse educator members of Sigma Theta Tau International; more than 93 percent were Caucasian women. Respondents indicated that the conventional teacher‐centered approach remains the most prevalent pedagogical style (56 percent); fewer than 20 percent of respondents used feminist or postmodern approaches. Ninety percent of respondents reported using instruments to evaluate the effectiveness of their teaching. The majority viewed their faculty role as facilitator (88 percent) or information provider (65 percent). Greater efforts are needed to create an evidence base for nursing education through research that focuses on the effectiveness of innovative pedagogical strategies. This study, by describing the current patterns of teaching/learning strategies and approaches used by nurse educators, provides a beginning research base for improving nursing education.

Learner-centered characteristics of nurse educators.

The purpose of this study was to describe the learner-centered teaching characteristics of nurse faculty who report using contemporary pedagogy. A secondary analysis of data collected by an international survey of nurse educators regarding pedagogical teaching approaches and strategies was used to answer the research questions.The study sought to: 1) describe characteristics emerging from faculty response, 2) make inferences from faculty responses regarding meaning, and 3) make inferences regarding the importance of the meaning to nursing.A qualitative research design was used to address the research question. Themes that emerged were placed under the concepts of power, role of teacher, responsibility of learner, and philosophy of evaluation guided by Weimers (2002) conceptual framework of a learner-centered philosophy of teaching. Themes and meaning units derived from the study helped to generate textual and structure statements that represent the characterizations of learner-centered nurse educators.