Baccalaureate Level Research Articles

Teaching Note—Beyond Bricoleur: A Guiding Portrait of the Advanced Generalist

Graduate programs of social work have been challenged to define how the advanced generalist concentration differs from the generalist training at the baccalaureate level. This teaching note likens the generalist to a bricoleur, or skilled handyman. A role-based portrait of the advanced generalist is offered, which describes how skills of the bricoleur are transcended. Examples suggest how these definitive skills can be realized in a graduate program. The portrait is then found to be compatible with a set of advanced generalist practice behaviors and an advanced generalist exam required for licensure by several states.

Reeling in RNs with a residency program.

Reeling in RNs with a residency program.

Preparing for patient-centered care: assessing nursing student knowledge, comfort, and cultural competence toward the Latino population.

As the Latino population continues to grow throughout the United States, cultural competence training of nursing students at the baccalaureate level has become a priority. This study aimed to explore undergraduate nursing students' attitudes and beliefs toward Latino patients and their perceived readiness to provide care to Latino patients. A cross-sectional survey was conducted at four major nursing schools in the southeastern United States, which is the region that has seen the highest percentage of growth in the Latino population. Results from multivariable regression suggest that social interaction with Latino individuals and cultural immersion in a Spanish-speaking country predict student knowledge, cultural competence, and comfort with Latino patients. Direct influence by nursing programs, such as clinical experience, coursework, and language proficiency, are positively associated with the designed outcomes, but these relationships are not statistically significant. Our findings suggest that dosage of training matters. Implications for student recruitment, selection, and training are discussed.

Using Classicc Articles in the Teaching of Undergraduate Economics

A standard approach to economics education at the undergraduate level is simplification and summarisation. The idea is that economics is a complicated subject which must be boiled down for university students to allow them a grasp of fundamentals that can then serve as a basis for more advanced study of the field’s various complexities, controversies and nuances. However there is a different pedagogy that emphasizes the use of source materials at an early stage. The argument is that even in technical fields, ‘consensus’ summaries of knowledge give a false appearance of certainty and settled debate while early exposure to original expositions by key thinkers provides students with a greater sense of the fundamental nature of intellectual discourse, develops critical thinking and sharpens communication and analytical skills. In effect it is rather like the benefits of ‘raw’ versus ‘processed’ foods: the latter is harder to digest but more nutritious than the former.This paper describes how classic articles have been used to teach undergraduate economics in a first year introductory Macroeconomics class and a third year topics in Microeconomics class. The paper reviews the ‘standard’ approach to undergraduate economics education focusing on the use (or lack thereof) of ‘primary’ or ‘source’ materials; the philosophy of ‘classics’ based pedagogy (mainly focused on ‘liberal arts’ education) and its applicability to the teaching of economics; describes how source materials have been used by the author in university economics classes; and provides conclusions and recommendations for potentially greater use of assignment of source texts in economics at the baccalaureate level.

Rural‐Urban Disparities in School Nursing: Implications for Continuing Education and Rural School Health

Little is known about the professional and educational challenges experienced by rural school nurses. We conducted this study to describe disparities between the urban and rural professional school nurse workforce in New Mexico and to identify how best to meet the continuing education needs of New Mexico's rural school nurse workforce. We analyzed state data from a 2009 New Mexico Department of Health school nurse workforce survey (71.7% response rate). We included all survey respondents who indicated working as a school nurse in a public school setting in any grade K-12 and who identified their county of employment (N = 311). Rural school nurses were twice as likely as metropolitan nurses to provide clinical services to multiple school campuses (67.3% compared to 30.1%, P < .0001). They were less likely to hold a nursing degree at the baccalaureate level or higher (62.7% compared to 82.3%, P = .0002). Rural school nurses were less likely than metropolitan nurses to have received recent continuing education on anaphylaxis (P < .0001), asthma (P = .027), body mass index (BMI)/healthy weight (P = .0002), diabetes (P < .0001), lesbian, gay, bisexual and transgender (LGBT) health (P = .0004), and suicide risk identification and prevention (P = .015). Online courses and telehealth were identified by rural school nurses as among the preferred means for receiving continuing education. Our findings support the provision of online courses and telehealth content to address urban-rural disparities in school nursing education and support rural school health.

Impact of a rural interprofessional health professions summer preceptorship educational experience on participants' attitudes and knowledge.

A six-week rural interprofessional health professions summer preceptorship provided an interprofessional training experience (IPE) for upper level baccalaureate and post-baccalaureate/graduate level health professions students in Dixon, Illinois, USA. There are three distinct yet complementary components of this forty hours per week summer preceptorship: Numerous interprofessional clinical shadowing experiences, a community service-learning project carried out as a team and weekly classroom sessions. This study assesses knowledge and attitude changes about IPE among students who participated in this Rural Interprofessional Health Professions Summer Preceptorship between 2006 and 2011. Fifty-two students over the six program years were asked to complete an identical pre-/post-questionnaire. The questionnaire included scales on seven topics, two of which addressed knowledge and attitudes about IPE: (i) Understanding of their own and other professions' work roles and (ii) Perceived ability to work effectively in interprofessional teams and make use of skills of other professions. Fifty of the fifty two (96.1%) students completed both the pre- and post-tests. Positive changes from the pre- to the post-tests were observed for the scales that related to interaction with other professions and assessment of their professional skills and students' understanding of the roles of other professions. Pre- versus post-preceptorship students also reported greater experience working as a member of an interprofessional team and an increase in their support for interprofessional education within a rural setting being required for all health professions students. A rural interprofessional health professions summer preceptorship that includes preceptor shadowing, a community service-learning project and classroom work proved to be an effective approach to developing interprofessional health care teams, increasing the knowledge and skills of participating students and creating positive attitudes toward interactions with other professions.

The effects of a hardiness educational intervention on hardiness and perceived stress of junior baccalaureate nursing students

Baccalaureate nursing education is stressful. The stress encompasses a range of academic, personal, clinical, and social reasons. A hardiness educational program, a tool for stress management, based on theory, research, and practice, exists to enhance the attitudes and coping strategies of hardiness (Maddi, 2007; Maddi et al., 2002). Research has shown that students who completed the hardiness educational program, subsequently improved in grade point average (GPA), college retention rates, and health (Maddi et al., 2002). Little research has been done to explore the effects of hardiness education with junior baccalaureate nursing students. Early identification of hardiness, the need for hardiness education, or stress management in this population may influence persistence in and completion of a nursing program (Hensel and Stoelting-Gettelfinger, 2011). Therefore, the aims were to determine if an increase in hardiness and a decrease in perceived stress in junior baccalaureate nursing students occurred in those who participated in a hardiness intervention. The application of the Hardiness Model and the Roy Adaptation Model established connections and conceptual collaboration among stress, stimuli, adaptation, and hardi-coping. A quasi-experimental non-equivalent control group with pre-test and post-test was used with a convenience sample of full-time junior level baccalaureate nursing students. Data were collected from August 2011 to December 2011. Results of statistical analyses by paired t-tests revealed that the hardiness intervention did not have a statistically significant effect on increasing hardiness scores. The hardiness intervention did have a statistically significant effect on decreasing perceived stress scores. The significant decrease in perceived stress was congruent with the Hardiness Model and the Roy Adaptation Model. Further hardiness research among junior baccalaureate nursing students, utilizing the entire hardiness intervention, was recommended.

Students’ Lived Experience in an Associate’s Degree to Baccalaureate Degree Continuation Program: Opening Doors, Opening Eyes, Opening Minds

Major nursing organizations, federal agencies, and researchers are recommending that all nurses be educated to at least the baccalaureate level. This article reports the results of a qualitative study of the experiences of students enrolled in a direct associate's degree to baccalaureate degree nursing program. Based on multiple small group interviews conducted during an 18-month period, a multistep interpretive analytic process was used that ultimately described themes within a holistic view of the phenomenon. The results showed an overarching theme of transformative change over time, centered within the "place" of the university. The study suggested that there are differences beyond additional coursework that describe a transformative process in associate's degree to baccalaureate degree education. An atmosphere, or "space created," for reflection on learning is significant to consider in the development of education programs.

Mechanical Ventilation Competencies of the Respiratory Therapist in 2015 and BeyondDiscussion

The evolution of critical care and mechanical ventilation has been dramatic and rapid over the last 10 years and can be expected to continue at this pace into the future. As a result, the competencies of the respiratory therapist regarding mechanical ventilation in 2015 and beyond are expected to also markedly increase. Respiratory therapists are expected to be the experts on the mechanical ventilator and all aspects of the application of mechanical ventilation. They will be considered consultants on all aspect of ventilatory support. This requires an expanded education in a number of areas. To achieve these levels of competency, as recommended by the third "2015 and Beyond" conference, the entry level education of the respiratory therapist of the future must be at the baccalaureate level.

Roles and Strategies of Diabetes Support Group Facilitators

The purpose of the study was to explore the roles and strategies implemented by diabetes support group facilitators. A descriptive exploratory design that included 2 in-depth interviews and 1 group interview of 6 diabetes support group facilitators was implemented over a 2-month period. The participants described the role of facilitator as involving 4 major aspects: (1) a philosophy of shared authority and group ownership; (2) a conception of diabetes as a highly complex disease interconnected with all aspects of one's life; (3) a focus on quality of life; and (4) recognition of perfectionism as neither possible nor desirable in self-management. These role aspects formed the context for facilitator strategies in working with support groups. Four strategies were identified based on the individual and group interviews: (1) connecting, (2) exchanging information, (3) managing group dynamics, and (4) promoting problem solving. A facilitator support group model was developed from the study results. A clear need exists to develop and teach best practices for support group facilitation. Education in this area should occur systematically at the baccalaureate and master's levels as the role of health providers increasingly expands to include populations living with chronic diseases. Health care providers who are functioning in this role need continuing education to provide proficient care in this area of practice.

Designing the Information Literacy Competency Standards for Nursing

This column documents the rationale for creating information literacy competency standards for nursing based on the Association of College and Research Libraries (ACRL) “Information Literacy Competency Standards for Higher Education” and the three documents from the American Association of Colleges of Nursing (AACN) on essential skills for nurses in baccalaureate, masters, and doctoral level education and practice. It chronicles the process of the task force which is designing the discipline specific skills and predicts the value of their use, once they are published.

Snapshot of the AAOHN Membership

The American Association of Occupational Health Nurses, Inc. (AAOHN) conducted a web-based membership survey of 2123 members (41% response rate) in May and June 2012. This column presents educational, certification, and selected industry data for registered nurse and advanced practice nurse AAOHN members. Members are highly experienced, with 57% reporting more than 16 years of experience. Sixty-eight percent of AAOHN members are educated at or above the baccalaureate level. An additional 8.4% are currently enrolled in an educational program. Seventy-six percent are nationally certified as occupational health nurses or occupational health nurse specialists (COHN/COHN-S), case managers, safety professionals, ergonomists, or nurse practitioners. The majority (89%) work full-time as employees of their facility (85%), with manufacturing (34%), hospital/health care (26%), and government/military (10%) being the top three industry sectors. Ten percent work for small employers (fewer than 500 employees), whereas 12% work with more than 50,000 employees. Thirteen percent of AAOHN members work globally. Future columns will present additional 2012 AAOHN member survey data.

The History, Implications, and Development of the Baccalaureate Transition Resource Manual

Life is full of transitions, changes, and adaptations. In this article, we will describe the developmental process and transition steps of a baccalaureate degree program in nuclear medicine technology (NMT). We will introduce a living document that was created by the leadership of the Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMI-TS). This article suggests that the SNMMI-TS Baccalaureate Transition Resource Manual should be considered in programmatic degree criteria related to practitioner preparedness. We believe other institutions may benefit from this experience in the development of their own baccalaureate program. Our experiences may allow other institutions to have insights that will facilitate their own process for new program development. The resource manual delivers an innovative curriculum emphasizing interdisciplinary collaboration on degree content among science courses, general education courses, and additional NMT didactic completion courses. The Joint Review Committee on Educational Programs in Nuclear Medicine Technology did incorporate many of the recommendations from the Curriculum Guide for Educational Programs in Nuclear Medicine Technology, fourth edition, from the SNMMI-TS. The resource manual in conjunction with data on the transitioning of the first 3 pilot schools is the first step the SNMMI-TS has made in helping schools transition to the baccalaureate level. The manual is intended to be a living document and will be changed as additional programs make the transition and new models are created.

Glitch in the gradient: Additional education does not uniformly equal better health

While the relationship between education and general health has been firmly established in the literature, surprisingly little research has analyzed individual components of the global health judgments, such as chronic conditions or pain. We present a systematic account of the health gradient for multiple health outcomes by detailed educational categories among U.S. working-age adults. Using the 1997–2010 National Health Interview Surveys (N = 204,764), we analyze individual health outcomes ranging from cardiovascular disease to vision problems with a series of logistic regression models. The results at the presecondary and baccalaureate levels are consistent with the health gradient. An unexpected finding occurs among adults with some college but no degree, and those with technical/vocational associate degrees: these groups report more pain and a higher prevalence of a broad range of conditions than high school graduates who never attended college. We discuss several explanations for the observed patterns. The findings challenge the broadly accepted educational gradient in health; additionally, the lower postsecondary groups comprise a quarter of American adults. Jointly, there is a clear research and policy impetus to understand the source of this ‘glitch’ in the health gradient.

Oncology Nurse Internships: A Foundation and Future for Oncology Nursing Practice?

To meet the demands of hospitalized patients, new graduates must have the knowledge and skills to care for acutely ill patients with complex needs. Schools of nursing must emphasize the foundation of a broad knowledge base to help graduates prepare to work in a variety of clinical settings. Specialized training in areas such as oncology, critical care, pediatrics, and obstetrics is not emphasized at the baccalaureate level.

Gap Analysis Survey: An Aid in Transitioning to Standardized Curricula for Nuclear Medicine Technology

This article discusses the process by which the Society of Nuclear Medicine Technology Section (SNMTS) is assisting educators as they transition to comply with the fourth edition of the Curriculum Guide for Educational Programs in Nuclear Medicine Technology. An electronic survey was sent to a list of nuclear medicine technology programs compiled by the educational division of the SNMTS. The collected data included committee member demographics, goals and objectives, conference call minutes, consultation discussions, transition examples, 4- and 2-y program curricula, and certificate program curricula. There were 56 responses to the survey. All respondents were program directors, with 3 respondents having more than one type of program, for a total of 59 programs. Of these, 19 (33.93%) were baccalaureate, 19 (28.57%) associate, and 21 (37.5%) certificate. Forty-eight respondents (85.71%) had accreditation through the Joint Review Commission on Educational Programs in Nuclear Medicine Technology, 6 (10.71%) had regional accreditation, and 2 (3.57%) were accredited through other entities. Thirteen categories of required general education courses were identified, and the existing program curricula of 9 (69.2%) courses were more than 50% compliant with the fourth edition Curriculum Guide. The fact that no measurable gap could be found within the didactic professional content across programs was due to the lack of a degree requirement and content standardization within the profession. The data indicated that the participating programs offer a minimum of 1-15 contact hours in emerging technology modalities. The required clinical hours ranged from 765 to 1,920 for degree or certificate completion. The average number of clinical hours required for all programs was 1,331.69. Standardization of the number and types of courses is needed both for current baccalaureate programs and for clinical education. This standardization will guide programs in transitioning from a certificate or associate level to the baccalaureate level. The greatest obstacle is in expanding curricula to meet the recommendations of the fourth edition Curriculum Guide. Such expansion to entry-level competency may be met by incorporating hybrid imaging courses, secondary-level courses, and equivalency courses on the basic sciences and emerging technologies.

Nursing Care Plans versus Concept Maps in the Enhancement of Critical Thinking Skills in Nursing Students Enrolled in a Baccalaureate Nursing Program

Appropriate and effective critical thinking and problem solving is necessary for all nurses in order to make complex decisions that improve patient outcomes, safety, and quality of nursing care. With the current emphasis on quality improvement, critical thinking ability is a noteworthy concern within the nursing profession. An in-depth review of literature related to critical thinking was performed. The use of nursing care plans and concept mapping to improve critical thinking skills was among the recommendations identified. This study compares the use of nursing care plans and concept mapping as a teaching strategy for the enhancement of critical thinking skills in baccalaureate level nursing students. The California Critical Thinking Skills Test was used as a method of comparison and evaluation. Results indicate that concept mapping enhances critical thinking skills in baccalaureate nursing students.

Effects of an Interprofessional Rural Rotation on Nursing Student Interest, Perceptions, and Intent

Purpose Rural areas are in critical need of nurses to meet the health needs of their residents. The problem under investigation in this study was whether a semester-long interdisciplinary rural rotation changed nursing students’ interest in rural health, perceptions of their performance of selected nursing skills, and their intention to practice in a rural community. Sample Two hundred forty eight (248) senior level baccalaureate students completed pre- and post-rotation surveys. 53.6% of students reported an increased interest in rural health. Findings Significant differences were found in students’ confidence in aspects of their performance including recognizing cultural differences, community assessment, community participation, meeting the unique needs of rural patients, identifying barriers to care, and identifying the impact of socioeconomic status on health. Students who attended high school in a rural community, expressed increased interest in rural health, and evaluated the rotation favorably were more likely to practice in a rural state after graduation (p < .05). Conclusions The findings have implications for changes in nursing education. A more comprehensive approach to rural health may be needed to attract students to nursing practice in rural communities. Key Words : Rural, Nursing education, Nursing practice, Intention

Survey of Directors of Respiratory Therapy Departments Regarding the Future Education and Credentialing of Respiratory Care Students and Staff

Information and opinions were sought on the need for graduating and practicing respiratory therapists to obtain 66 competencies necessary for practice in 2015 and beyond, the required length of respiratory care programs, the educational needs of practicing therapists, current and future workforce positions, and the appropriate credential needed by graduating therapists. Survey responses from respiratory therapy department directors or managers are the basis of this report. After pilot testing and refining the questions, a self-administered, Internet based, American Association for Respiratory Care (AARC) endorsed survey was used to gather information from 2,368 individuals designated as respiratory therapy department directors or managers in the AARC membership list as of May 2010. A total of 663 valid survey responses (28.0%) were received. On average, the vacancy rate of surveyed hospitals was only 0.81 full-time equivalents (FTEs). Responses by directors on 66 competencies described in the second 2015 conference as needed by graduate and practicing respiratory therapists indicated 90% agreement on 37, between 50% and 90% agreement on 25, and < 50% agreement on 4 competencies. There was no consensus among directors on the academic preparation of new graduates, with 245 (36.8%) indicating a preference for a baccalaureate or master's degree, 243 (36.7%) indicating a preference for an associate degree, and 176 (26.5%) indicating no preference. There were 270 (41.8%) respondents who indicated that a baccalaureate or master's degree in respiratory therapy should be required to qualify for a license to deliver respiratory care. The survey indicated that 523 (81.2%) of directors are in favor of the RRT credential being required to practice in 2015 and beyond. There was good agreement that graduate and practicing therapists should obtain the vast majority of the 66 competencies surveyed and that the entry level credential should be the RRT. Similar numbers of managers favored an entry level baccalaureate degree as favored an associate degree.

Implementation of an Intraoperative Clinical Experience for Senior Level Baccalaureate Nursing Students

Perioperative nursing is a specialty that has been eliminated from many nursing education programs. With the loss of perioperative clinical experiences, the number of students pursuing a career in perioperative nursing after graduation has declined. A faculty member at one Midwestern school of nursing developed and implemented a perioperative clinical experience for senior-level baccalaureate nursing students in a critical care nursing course. This program, developed with the assistance of four local hospitals and the college of nursing, included an eight-hour OR orientation and 56 clinical hours. Students were placed in the OR under preceptor guidance and supervision. Feedback from evaluations was positive and provided recommendations for improving the program, in particular, to allow more clinical hours and more hands-on experience for the students.