Implementation and evaluation of a virtual learning center for distributed education. (1/194)

A number of tools are required to support a distributed education program. This paper will relate experiences in the development and implementation of a web-based Virtual Learning Center. Initial evaluation offers direction for further development, necessary university support, and faculty and student preparation.  (+info)

The role of physical and psychological factors in occupational low back pain: a prospective cohort study. (2/194)

OBJECTIVE: To examine risk factors for onset of low back pain (LBP) in healthcare workers. METHODS: Nursing students, during their 3 year training period, and 1 year after training were studied in a prospective cohort study, with repeated self reported measurements of determinants of LBP at 6 monthly intervals for 3 years during training, and after a 12 month interval there was an additional final follow up. RESULTS: During training, increased risk of new episodes of LBP was associated with having had LBP at baseline, with part time work, and with a high score on the general health questionnaire (GHQ). A high GHQ score preceded the onset of LBP, in such a way that a high score at the immediately previous follow up increased risk of LBP at the next follow up. 12 Months after training, a history of recurring LBP during training increased the risk of a new episode as did having obtained work as a nurse. A high GHQ score at this follow up was also associated with a concurrently increased risk. Pre-existing GHQ score, either at the end of training or at baseline, had no effect on risk of LBP 12 months after training. CONCLUSIONS: Other than a history of LBP, pre-existing psychological distress was the only factor found to have a pre-existing influence on new episodes of LBP. Increased levels of psychological distress (as measured by the GHQ) preceded the occurrence of new episodes of pain by only short intervening periods, implying a role for acute distress in the onset of the disorder. This finding suggests that management of the onset of occupational LBP may be improved by management of psychological distress.  (+info)

Factors associated with successful answering of clinical questions using an information retrieval system. (3/194)

OBJECTIVES: Despite the growing use of online databases by clinicians, there has been very little research documenting how effectively they are used. This study assessed the ability of medical and nurse-practitioner students to answer clinical questions using an information retrieval system. It also attempted to identify the demographic, experience, cognitive, personality, search mechanics, and user-satisfaction factors associated with successful use of a retrieval system. METHODS: Twenty-nine students completed questionnaires of clinical and computer experience as well as tests of cognitive abilities and personality type. They were then administered three clinical questions to answer in a medical library setting using the MEDLINE database and electronic and print full-text resources. RESULTS: Medical students were able to answer more questions correctly than nurse-practitioner students before and after searching, but both had comparable improvements in the number of correct questions before and after searching. Successful ability to answer questions was also associated with having experience in literature searching and higher standardized test-score percentiles. CONCLUSIONS: Medical and nurse-practitioner students obtained comparable benefits in the ability to answer clinical questions from use of the information retrieval system. Future research must examine strategies that improve successful search and retrieval of clinical questions posed by clinicians in practice.  (+info)

Tuberculin reactivity and subsequent development of tuberculosis in a cohort of student nurses. (4/194)

This retrospective study documents a strong correlation between tuberculin reactivity and the subsequent development of active tuberculosis in student nurses. 12% of the 25 student nurses with tuberculin reactions above 20 mm developed tuberculosis over a period of 2 years, compared to only 0.3% of the 341 student nurses with reactions of 20 mm or less. The implications of these findings for preventive therapy are discussed.  (+info)

Investigating student nurses' constructions of health promotion in nursing education. (5/194)

This article describes student nurses' constructions of health promotion and the change of these constructions during their nursing education in two Finnish polytechnics. The data consisted of essays written by the 19 student nurses before they began their nursing education in 1997 and of stimulated recall interviews with the same students during the second year of their education in 1998. The data were analyzed by using thematic analysis. During the first study year, 13 students' constructions of health promotion changed. Six students had initially broad constructions of health promotion and their constructions remained unchanged. Four basic changes were found in the students' constructions: (1) the emphasis shifted from physical to multidimensional health promotion, (2) health promotion became more concrete and contextual, (3) the conception of perfect health became more permissive and relative, and (4) the interpretation of health promotion shifted from performing towards being there for the patient. These results may indicate that student nurses in Finnish polytechnics were attempting to adopt the empowerment approach to health promotion for their constructions. Moreover, the results represent a major challenge concerning nursing education and health promotion learning from the constructivistic approach to knowledge building.  (+info)

Caring for the older person: an exploration of perceptions using personal construct theory. (6/194)

BACKGROUND: There is a reluctance among nurses to enter elderly care. OBJECTIVE: To discover nurses' perceptions of the elderly patients in their care. METHOD: After a period of participant observation, we selected 26 nurses from among those working in two elderly-care rehabilitation hospitals. Interpersonal perceptions were investigated using personal construct theory. We elicited personal constructs, produced repertory grids and rated patients according to popularity. RESULTS AND CONCLUSIONS: The most common way of perceiving patients was in terms of mental or physical dependence. Health-care assistants were more likely than staff nurses to perceive patients in terms of their personality. Nurses tended to have simplified ways of perceiving their patients. Popular patients were always mentally intact.  (+info)

Introducing quality improvement to pre-qualification nursing students: evaluation of an experiential programme. (7/194)

OBJECTIVE: To evaluate a programme introducing quality improvement (QI) in nursing education. SETTINGS: Betanien College of Nursing and clinical practices at hospitals in Bergen. SUBJECTS: 52 nursing students from a second year class working in 16 groups undertaking hospital based practical studies. INTERVENTION: Second year nursing students were assigned to follow a patient during a day's work and to record the processes of care from the patient's perspective. Data collected included waiting times, patient information, people in contact with the patient, investigations, and procedures performed. Students also identified aspects of practice that could be improved. They then attended a 2 day theoretical introductory course in QI and each group produced flow charts, cause/effect diagrams, and outlines of quality goals using structure, process, and results criteria to describe potential improvements. Each group produced a report of their findings. Main measures-A two-part questionnaire completed by the students before and after the intervention was used to assess the development of their understanding of QI. Evidence that students could apply a range of QI tools and techniques in the specific setting of a hospital ward was assessed from the final reports of their clinical attachments. RESULTS: The students had a significantly better knowledge of QI after the introductory course and group work than before it, and most students indicated that they considered the topic highly relevant for their later career. They reported that it was quite useful to observe one patient throughout one shift and, to some extent, they learned something new. Students found the introductory course and working in groups useful, and most thought the programme should be included in the curriculum for other nursing students. They considered it important for nurses in general to have knowledge about QI, indicating a high perceived relevance of the course. All 16 groups delivered reports of their group work which were approved by the tutors. Through the reports, all the groups demonstrated knowledge and ability to apply tools and techniques in their practical studies in a hospital setting. CONCLUSIONS: The introduction of a short experience-based programme into the practical studies of second year nursing students enabled them to learn about the concepts, tools, and techniques of continuous QI in a way that should provide them with the skills to undertake it as part of routine practice.  (+info)

Factors associated with success in searching MEDLINE and applying evidence to answer clinical questions. (8/194)

OBJECTIVES: This study sought to assess the ability of medical and nurse practitioner students to use MEDLINE to obtain evidence for answering clinical questions and to identify factors associated with the successful answering of questions. METHODS: A convenience sample of medical and nurse practitioner students was recruited. After completing instruments measuring demographic variables, computer and searching attitudes and experience, and cognitive traits, the subjects were given a brief orientation to MEDLINE searching and the techniques of evidence-based medicine. The subjects were then given 5 questions (from a pool of 20) to answer in two sessions using the Ovid MEDLINE system and the Oregon Health & Science University library collection. Each question was answered using three possible responses that reflected the quality of the evidence. All actions capable of being logged by the Ovid system were captured. Statistical analysis was performed using a model based on generalized estimating equations. The relevance-based measures of recall and precision were measured by defining end queries and having relevance judgments made by physicians who were not associated with the study. RESULTS: Forty-five medical and 21 nurse practitioner students provided usable answers to 324 questions. The rate of correctness increased from 32.3 to 51.6 percent for medical students and from 31.7 to 34.7 percent for nurse practitioner students. Ability to answer questions correctly was most strongly associated with correctness of the answer before searching, user experience with MEDLINE features, the evidence-based medicine question type, and the spatial visualization score. The spatial visualization score showed multi-colinearity with student type (medical vs. nurse practitioner). Medical and nurse practitioner students obtained comparable recall and precision, neither of which was associated with correctness of the answer. CONCLUSIONS: Medical and nurse practitioner students in this study were at best moderately successful at answering clinical questions correctly with the assistance of literature searching. The results confirm the importance of evaluating both search ability and the ability to use the resulting information to accomplish a clinical task.  (+info)