Ethical issues and critical thinking: students' stories

Through the stories told by these students it is evident that beginning students do think critically and act ethically during their first clinical nursing course. Ethical dilemmas involving students and staff, patients, faculty, and peers depict beginning students' development of values as they evolve into professionals. The conscientiousness and caring displayed by beginning students is apparent from students' shared perspectives. It is particularly encouraging that they seemed to focus more on values and cognitive aspects of patient care than on primarily technical psychomotor skills such as taking blood pressures and giving injections. Teaching beginning students is a challenge because the educator's role is twofold: Help students build a foundation for developing ongoing critical thinking abilities and help students develop an ethical view of patient care. Further exploration of critical thinking and ethical decision making should emphasize the mutual student-educator roles in facilitating self-awareness, through conscious awareness of their beliefs, values, feelings, and multiple perspectives. Because nursing emphasizes the human element and student nurses deal with human lives, educators play a vital role in facilitating the development of beginning students as critical thinkers and as ethical nurses. The most knowledgeable and most psychologically mature faculty are needed to teach beginning nursing students. Through ongoing reflection and critical thinking, nurse educators can help beginning students to identify and develop multiple perspectives on the ethics of nursing practice.     

A model for ethical management of faculty—Student dual relationships.

The article discusses the nature of faculty-student dual relationships and provides guidelines for their ethical management. Three general guidelines for faculty in maintaining ethical relationships with students are (a) acknowledging the power and responsibility of the faculty role, (b) developing a frame for evaluating faculty-student relationships, and (c) fostering and maintaining a climate that supports ethical relationships with students. As a profession, psychologists should be discussing this issue more openly, and research on problematic faculty-student relationships and their management is warranted. Awareness of dilemmas concerning dual-role relationships and experience in addressing these dilemmas may provide valuable lessons for the student's future professional interactions with clients, students, and other professionals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of a new P450 subfamily, CYP4F1, expressed in rat hepatic tumors

This study focused on the belief of some nurse educators that caring cannot be taught directly and is learned by students from faculty role-modeling and faculty student interactions in clinical, classroom, and other situations. The purpose was to further explore these beliefs to determine if nursing students perceived that they learn caring behaviors through observing role-modeling by faculty, as well as to explore students' perceptions of other means by which they learn about caring. Since opportunities for faculty to model nurse caring behaviors in the clinical setting are varied and serendipitous, a videotaped scenario simulating a patient care situation, using professional actors, was created and shown to nursing students. The videotape was seen by 137 BSN and ADN students who then recorded their perceptions on a two-page open-ended questionnaire developed by the researchers. Results from this study indicated that students do learn about caring from faculty role-modeling, as well as from health care staff they encounter, often in a very paradoxical way. Many interesting and unintended results also occurred through the use of this research approach.     

Psychologist as teacher and mentor: Affirming ethical values throughout the curriculum.

Argues that those involved in mentoring and teaching graduate students in professional psychology training programs must be concerned with 2 extracurricular issues when they consider how to influence students' ethical behavior. First, they must be ethical in their own interactions with students. Second, they must deal responsibly with students when students engage in unethical or unprofessional conduct. It is argued that the implicit attitudes and explicit behavior of faculty communicate as much as course content about being ethical. Last, strategies are identified for handling these special responsibilities on the basis of the Ethical Principles of Psychologists (American Psychological Association, 1990) and the broader ethical principles underlying those standards. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bridge to the future: nontraditional clinical settings, concepts and issues

Healthcare restructuring in the wake of healthcare reform places greater emphasis on primary healthcare. Clinical education in acute care settings and existing community health agencies are not compatible with teaching basic concepts, principles and skills fundamental to nursing. Problems of clients in acute care settings are too complex and clients in the community are often too dispersed for necessary faculty support and supervision of beginning nursing students. Nontraditional learning settings offer the baccalaureate student the opportunity to practice fundamental skills of care and address professional skills of negotiation, assertiveness, organization, collaboration and leadership. An overview of faculty designed clinical learning experiences in nontraditional sites such as McDonald's restaurants, inner city churches, YWCA's, the campus community and homes are presented. The legal, ethical and academic issues associated with nontraditional learning settings are discussed in relation to individual empowerment, decision making and evaluation. Implications for the future address the role of the students and faculty as they interact with the community in which they live and practice.     

Clinical knowledge and skill priorities in substance abuse education: a nursing faculty longitudinal survey

The aims of this study were to: 1) determine which of 16 substance abuse content areas nursing faculty fellows considered important for their professional growth; 2) determine content areas in which faculty fellows planned to obtain knowledge and skill development during the coming year; and 3) to identify content areas faculty fellows thought undergraduate and/or graduate students should be taught. Questionnaires were mailed to the 43 nursing faculty fellows who were recipients of substance abuse federal training during the 1989-1994 academic years. The response rate was 81%. One and a half years later, 66% responded to the same items on a follow-up survey. The results showed that faculty ratings of knowledge and skill development needs for themselves and their students in nursing were stable over time. Findings can be used to guide faculty and curriculum development in alcohol and other substance abuse.     

Nursing students' responses to ethical dilemmas in nursing practice

In literature as well as in nursing practice a growing concern about nurses' ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students' ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg's definition of morality was refined by adding a care perspective. The results show that the majority of students can be located in the fourth moral stage according to Kohlberg's theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions.     

Identification, accommodation, and success of students with learning disabilities in nursing education programs

Few studies have addressed the issue of nursing students with learning disabilities, although students with both identified and undiagnosed learning disabilities are pursuing nursing education. Legal mandates concerning these students impact nursing programs and faculty. To reduce the risk of discrimination litigation, nursing education programs need to establish educational strategies to promote these students' success. The purpose of this research was to discover the extent to which Bachelor of Science in Nursing and Associate Degree of Nursing programs in one southeastern state admit, identify, and graduate nursing students with learning disabilities, and to identify accommodations provided by these programs to promote success among this student population. Of the 54 programs surveyed, 45 responded. Almost 50% indicated that their program had admitted nursing students with learning disabilities and one-third reported graduating students with learning disabilities. Enrolled students with undiagnosed learning disabilities were identified during their course of studies by both faculty members and by students themselves. The most frequently reported accommodations for students were counselors, tutors, tape-recorded lectures, and computer access. As the number of students with learning disabilities seeking post-secondary education increases, nursing programs and nurse educators will be involved with greater numbers of students needing educational accommodations.     

Concealed lung abscess in critically ill, mechanically ventilated patients

This article reports on phenomenological research designed to discover how caring was taught in a nursing education program. The basic questions were: 1) What is the meaning of caring to the faculty and students; 2) How do the faculty communicate this meaning to the students; and 3) How does this meaning shape the experience of the students? Data were collected from a small associate degree nursing program using: a) semi-structured interviews with all faculty and a selected group of students, b) classroom observations, and c) review of documents. Data were analyzed for and found to have content explaining the meaning of caring, how caring was being taught, and what students were learning about caring as the essence of nursing. Implications derived speak to the need for faculty and administrators to have caring as a way of being if they wish to communicate caring as the essence of nursing to students.     

Codependency in nursing students: recognition and modification of behavioral characteristics

Recent literature estimates that there are approximately 2 1/2 million nurses; of these a significant number may exhibit signs of codependency, a behavior pattern that impedes an individual's ability to relate to others on mature level. Codependency develops in dysfunctional family systems and manifests itself in compulsive behaviors that make life painful and work emotionally difficult. Often, constructive communication is difficult as codependent persons tend to feel low self-esteem and low self-worth. Nursing students may exhibit characteristic codependency traits among fellow students in the classroom, in the clinical setting, and in interactions with faculty. Nurse educators, through their own self-awareness, introspection, and knowledge of the behaviors and characteristics of codependency, can facilitate more effective communication with all nursing students to promote healthier interactions and relationships. Techniques to modify one's method of interacting with others have clear potential for improving professional as well as personal relationships.     

Reflections on determining authorship credit and authorship order on faculty-student collaborations.

Explores the process of determining authorship credit and authorship order on collaborative publications with students. The article presents hypothetical cases that describe relevant ethical issues, highlights ethical principles that could provide assistance in addressing these dilemmas, and makes recommendations to faculty who collaborate with students on scholarly projects. It is proposed that authorship credit and order decisions should be based on the relative scholarly abilities and professional contributions of the collaborators. Furthermore, it is recommended that both faculty and students participate in the authorship decision-making process early in the collaborative endeavor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cooperative learning: a model for teaching

Cooperative learning provides a socially and intellectually stimulating model for the instruction of nursing students. It is one method of encouraging students to take responsibility for their own learning. Students are often able to explain a concept to another student in a unique way not used by faculty. This model harnesses and directs that student input in a constructive manner to increase achievement and accountability for all involved. Faculty must continue to examine how nursing is taught. The world is changing far too rapidly to do "business as usual." Cooperative learning is one strategy that can be used to motivate students to take active and responsible roles in their learning.     

Sex and gender in the college classroom: A quantitative analysis of faculty–student interactions and perceptions.

Students and instructors from 24 classrooms across 8 departments at a major university were observed in this study to (a) assess for sex differences in faculty–student interactions and in students' perceptions of their college classroom environment, (b) compare student perceptions of their college classroom interaction patterns with observed faculty–student interactions, and (c) assess a variety of demographic characteristics together to determine their singular and/or interactive effects on faculty–student interaction patterns and student perceptions. Male and female students did not differ in their classroom participation or perceptions, and instructors did not interact differently with the male and female students. Student perceptions strongly correlated with their own behaviors and with instructor behaviors. Classroom interactions and student perceptions varied on the basis of different demographic characteristics including instructor sex, class size, instructor monitoring of gender–race equity in the classroom, gender relevance of the course, and the sex ratio of the class. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EFSUMB tutorial: thermal and mechanical indices

According to the most recently available data presented in the Statistical Abstract of the United States 1994 (United States Bureau of the Census, 1994), 17,100 young Americans (15 to 44 years old) died in 1991 due to suicide. At no other time during the life span were suicide rates so high. Suicide among college and university students is estimated by some to be 50% higher than for other Americans of comparable age (Westefeld & Pattilo, 1987). Not only is suicide considered by many authors to be the number one health problem on the nation's campuses (Mathiasen, 1988), but the suicide rate for this population has tripled over the past 25 years (Hardin & Weast, 1989). Professional nursing students could perhaps be at an even higher risk for suicide than other college students. Manicini, Lavecchia, and Clegg point out that "[n]ursing students are more doubtful than other college students about their academic performance. They encounter stress in adjusting to a rigorous program of theory and practice. The reality is often far different from a prospective student's image of it" (cited in Lampkin, Cannon, & Fairchild, 1985, p. 148). Because of the longevity of contact hours spent with nursing students in both lecture and clinical milieus, nursing faculty are in a uniquely favorable position to identify and assess those students who appear to be at risk for suicide. In addition, as most nurse educators provide supportive relationships, rich with caring and trust for their students, distressed students are usually open to talking to a faculty member. If a suicidal risk is found during the assessment interview, the faculty member should then provide an immediate referral for further psychiatric evaluation and intervention. To assist faculty in the quick recall of the essential components of this helping process the acronym S.A.V.E. is used: 1. S: Suicidal behaviors. 2. A: Assessment interview. 3. V: Value student. 4. E: Evaluation-Referral.     

Update--noise induced hearing loss and the military environment

Quality clinical experiences are a critical component of advanced practice nursing (APN) curricula. Historically, nursing instructors coordinated both the didactic and clinical components of a course. Increasingly, course coordinators organize the didactic component, and external preceptors working in the clinical setting function as practicum teachers. Both scenarios involve labor-intensive processes, and neither facilitate the scheduling of clinical experiences that build on progressive learning across the student's curriculum. A centralized, computerized, relational data base for efficient management of APN preceptors and students across the curriculum was designed. One master's-prepared clinical coordinator maintains the data base and performs all related functions. This system offers numerous benefits to students, preceptors, ] faculty, and nursing school, including balanced and progressively complex clinical learning experiences for students from competent preceptors: consistent interface with students and preceptors; faculty relief from time-consuming tasks; rapid generation of a variety of tables, rosters, and reports; consistent tracking of preceptor evaluations; timely acknowledgment of preceptor assistance; and efficient communication among students, preceptors, faculty, and school administration.     

Role model behaviors in the clinical setting

The purpose of this study was to identify the role modeling behaviors of clinical nursing faculty that junior and senior baccalaureate students consider important. Bandura's Social Learning Theory provided the theoretical framework for the three research questions. A questionnaire, composed of 28 role model behaviors, was constructed to correspond to the three research questions. The overall alpha coefficient for the questionnaire was .95. The findings of this study indicate that clinical faculty are considered role models by their students. Students perceived themselves as practicing the role model behaviors, but they also perceived that the clinical faculty were inconsistent in rewarding them for their attempts to emulate those behaviors considered important. Areas for future research are discussed.     

Interview with: Donna Vidam, CPM. Interview by Ina May Gaskin

The application of Leininger's Theory of Culture Care Diversity and Universality to the dialogue between students and faculty regarding nursing education and practice provides the theoretical framework for evaluating a transcultural nursing curriculum in a transcultural, transnational setting on the Texas-Mexico border. In evaluating the first semester of this cultural encounter between the nurse-patient-community system and baccalaureate nursing education, faculty and students at Texas A&M International University School of Nursing in Laredo identified some particular challenges and assessed the effectiveness of approaches to meeting these challenges within the context of Leininger's Culture Care Theory and its three modes of action: culture care preservation, accommodation, and repatterning.     

Baccalaureate curriculum. Gerontological nursing objectives

1. Gerontological preparation for nursing practice is no longer a curricular luxury; it is a necessity. Baccalaureate nursing education must include broad content and guided practice in gerontological nursing. 2. Incorporating gerontology into a baccalaureate nursing curriculum often is a challenge. Reasons include gerontology not being a "traditional" specialty area; health care professionals in the United States, including nurses, not viewing older adults differently from younger adults; students not being expected to apply knowledge or concepts specifically related to gerontology; and efforts to incorporate gerontological content into a curriculum being resisted due to ageism--a "natural" avoidance of aging from which nursing faculty are not exempt. 3. Because of the limited numbers of nurses with an advanced education in gerontology, the recruitment of experienced, knowledgeable faculty is difficult. Most gerontology faculty are still largely self-taught and enter nursing education via the fields of medical/surgical, psychiatric, or community nursing. It is largely these faculty who must plan and "pioneer" gerontology in the curriculum.     

Health education via interactive television

Providing health education in rural areas is a challenge because of the time and cost involved in travel to serve small groups of clients in their own towns. Baccalaureate nursing students provided health education to faculty and staff members in five rural high schools simultaneously through the use of interactive television.