Comparison of student learning among three teaching methodologies in the pediatric clinical setting.

Facilitating effective clinical learning for pediatric nursing students is becoming increasingly challenging and limited in opportunities. Hospital leaders are concerned about the critical thinking and prioritization skills of new graduates and believe that inpatient clinical experiences are the only way to develop these skills. This study sought to compare the effectiveness of three different clinical teaching schedules in preparing nursing students to care for children and their families. Teaching methodology was randomly assigned to various amount of times in acute care inpatient settings. Student knowledge, clinical decision making, and student satisfaction and perception of learning were measured. No statistically significant differences among groups for either knowledge scores or clinical reasoning scores were noted. Student satisfaction results did not reveal differences among groups. Study findings will help educators to better plan clinical experiences and more effectively utilize an array of settings to optimize the clinical learning of pediatric nursing content.

Establishing a tutoring and academic support center: Collaborating with nurse educator students.

Academic demands challenge many nursing students as they embark on their professional journey to become competent nurses or further their education. Challenges with incorporating successful retention strategies were problematic during the worldwide COVID-19 public health emergency. Academic student support services were urgently needed. This article describes the successful development of a funded college campus's academic support service center using virtual nurse educator tutoring services for undergraduate and graduate nursing students. The mission of the center is to assist nursing students to become independent, self-confident, and efficient learners who successfully fulfill all academic nursing program requirements. Evidence-based education was provided to train tutors and refine their technology competencies. Tutoring was provided for graduate students to fulfill the need for similar types of academic support services. Metrics were collected to evaluate the relationship between tutoring and academic success indicators. Initial evaluations of tutoring sessions by tutees suggest that peer tutoring as an adjunctive teaching and learning strategy can positively impact academic performance. Findings included improved student quantitative measures including higher exam scores and GPAs along with qualitative outcomes suggesting increased critical thinking skills, self-direction, and self-confidence. Nurse educator student tutors gained valuable teaching experience that promoted their overall academic role development.

Speed cameras for the prevention of road traffic injuries and deaths.

BACKGROUND: It is estimated that by 2020, road traffic crashes will have moved from ninth to third in the world ranking of burden of disease, as measured in disability adjusted life years. The prevention of road traffic injuries is of global public health importance. Measures aimed at reducing traffic speed are considered essential to preventing road injuries; the use of speed cameras is one such measure. OBJECTIVES: To assess whether the use of speed cameras reduces the incidence of speeding, road traffic crashes, injuries and deaths. SEARCH STRATEGY: We searched the following electronic databases covering all available years up to March 2010; the Cochrane Library, MEDLINE (WebSPIRS), EMBASE (WebSPIRS), TRANSPORT, IRRD (International Road Research Documentation), TRANSDOC (European Conference of Ministers of Transport databases), Web of Science (Science and Social Science Citation Index), PsycINFO, CINAHL, EconLit, WHO database, Sociological Abstracts, Dissertation Abstracts, Index to Theses. SELECTION CRITERIA: Randomised controlled trials, interrupted time series and controlled before-after studies that assessed the impact of speed cameras on speeding, road crashes, crashes causing injury and fatalities were eligible for inclusion. DATA COLLECTION AND ANALYSIS: We independently screened studies for inclusion, extracted data, assessed methodological quality, reported study authors' outcomes and where possible, calculated standardised results based on the information available in each study. Due to considerable heterogeneity between and within included studies, a meta-analysis was not appropriate. MAIN RESULTS: Thirty five studies met the inclusion criteria. Compared with controls, the relative reduction in average speed ranged from 1% to 15% and the reduction in proportion of vehicles speeding ranged from 14% to 65%. In the vicinity of camera sites, the pre/post reductions ranged from 8% to 49% for all crashes and 11% to 44% for fatal and serious injury crashes. Compared with controls, the relative improvement in pre/post injury crash proportions ranged from 8% to 50%. AUTHORS' CONCLUSIONS: Despite the methodological limitations and the variability in degree of signal to noise effect, the consistency of reported reductions in speed and crash outcomes across all studies show that speed cameras are a worthwhile intervention for reducing the number of road traffic injuries and deaths. However, whilst the the evidence base clearly demonstrates a positive direction in the effect, an overall magnitude of this effect is currently not deducible due to heterogeneity and lack of methodological rigour. More studies of a scientifically rigorous and homogenous nature are necessary, to provide the answer to the magnitude of effect.

Speed cameras for the prevention of road traffic injuries and deaths.

BACKGROUND: It is estimated that by 2020, road traffic crashes will have moved from ninth to third in the world ranking of burden of disease, as measured in disability adjusted life years. The prevention of road traffic injuries is of global public health importance. Measures aimed at reducing traffic speed are considered essential to preventing road injuries; the use of speed cameras is one such measure. OBJECTIVES: To assess whether the use of speed cameras reduces the incidence of speeding, road traffic crashes, injuries and deaths. SEARCH STRATEGY: We searched the following electronic databases covering all available years up to March 2010; the Cochrane Library, MEDLINE (WebSPIRS), EMBASE (WebSPIRS), TRANSPORT, IRRD (International Road Research Documentation), TRANSDOC (European Conference of Ministers of Transport databases), Web of Science (Science and Social Science Citation Index), PsycINFO, CINAHL, EconLit, WHO database, Sociological Abstracts, Dissertation Abstracts, Index to Theses. SELECTION CRITERIA: Randomised controlled trials, interrupted time series and controlled before-after studies that assessed the impact of speed cameras on speeding, road crashes, crashes causing injury and fatalities were eligible for inclusion. DATA COLLECTION AND ANALYSIS: We independently screened studies for inclusion, extracted data, assessed methodological quality, reported study authors' outcomes and where possible, calculated standardised results based on the information available in each study. Due to considerable heterogeneity between and within included studies, a meta-analysis was not appropriate. MAIN RESULTS: Thirty five studies met the inclusion criteria. Compared with controls, the relative reduction in average speed ranged from 1% to 15% and the reduction in proportion of vehicles speeding ranged from 14% to 65%. In the vicinity of camera sites, the pre/post reductions ranged from 8% to 49% for all crashes and 11% to 44% for fatal and serious injury crashes. Compared with controls, the relative improvement in pre/post injury crash proportions ranged from 8% to 50%. AUTHORS' CONCLUSIONS: Despite the methodological limitations and the variability in degree of signal to noise effect, the consistency of reported reductions in speed and crash outcomes across all studies show that speed cameras are a worthwhile intervention for reducing the number of road traffic injuries and deaths. However, whilst the the evidence base clearly demonstrates a positive direction in the effect, an overall magnitude of this effect is currently not deducible due to heterogeneity and lack of methodological rigour. More studies of a scientifically rigorous and homogenous nature are necessary, to provide the answer to the magnitude of effect.

Transitioning from direct care to virtual clinical experiences during the COVID-19 pandemic.

When the COVID-19 pandemic forced university campuses and healthcare agencies to temporarily suspend both undergraduate and graduate direct care educational experiences, nursing programs had to formulate alternative plans to facilitate clinical learning. Texas Woman's University used this opportunity to assemble a faculty group tasked with creating a set of college-wide guidelines for virtual simulation use as a substitution for traditional face-to-face clinical. The process included completing a needs assessment of both undergraduate and graduate level programs across three campuses and identifying regulatory requirements and limitations for clinical experiences. The task force utilized the information gathered to develop evidence-based recommendations for simulation hour equivalence ratios and compiled a list of virtual activities and products faculty could use to complete clinical experiences. Undergraduate and graduate student surveys were conducted to determine the effectiveness of the transition to virtual clinical experiences. Overall, the majority of survey results were positive regarding virtual simulation experiences providing students with valuable opportunities to enhance their learning. Negative comments regarding the impact of COVID-19 on a personal level included issues involving internet access and web conferencing logistics, lack of motivation to study, family difficulties, and faculty inexperience teaching in an online environment. Undergraduate pre-licensure students were provided with opportunities to successfully complete all remaining required clinical hours virtually, while graduate students were allowed to complete non-direct care hours as applicable using virtual clinical experiences.

Population-based normative values for the Australian/Canadian (AUSCAN) Hand Osteoarthritis Index: part 2.

OBJECTIVES: To develop population-based age- and gender-specific normative values for the pain, stiffness, and physical function subscales of the AUSCAN Index for benchmarking applications. METHODS: A scannable survey questionnaire capable of capturing AUSCAN Index data and demographic information was developed, pretested, and distributed to a stratified random sample of 36,000 members of the Australian general public generated by the Australian Electoral Commission. RESULTS: Age- and gender-specific AUSCAN normative values were estimated based on approximately 7300 subjects. Age-related differences were noted in all 3 AUSCAN subscales. In general, pain, stiffness, and difficulty with physical function percentiles increased with age. CONCLUSIONS: AUSCAN normative values provide opportunity for benchmarking the health status of individuals with hand osteoarthritis against their age- and gender-matched peers in the general population. These normative values provide unique opportunities for using the AUSCAN Index in benchmarking applications, in both clinical practice and research.

Population-based normative values for the Western Ontario and McMaster (WOMAC) Osteoarthritis Index: part I.

OBJECTIVES: To develop population-based age- and gender-specific normative values for the pain, stiffness, and physical function subscales of the WOMAC Index for benchmarking applications. METHODS: A scannable survey questionnaire capable of capturing WOMAC Index data and demographic information was developed, pretested, and distributed to a stratified random sample of 36,000 members of the Australian general public generated by the Australian Electoral Commission. RESULTS: Age- and gender-specific WOMAC normative values were estimated based on approximately 7300 subjects. Age-related differences were noted in all 3 WOMAC subscales. In general, pain, stiffness, and difficulty with physical function percentiles increased with age. CONCLUSIONS: WOMAC normative values provide opportunity for benchmarking the health status of individuals with hip and knee osteoarthritis against their age- and gender-matched peers in the general population. These normative values provide unique opportunities for using the WOMAC Index in benchmarking applications in both clinical practice and research.

Osteoarthritis Index delivered by mobile phone (m-WOMAC) is valid, reliable, and responsive.

OBJECTIVES: To evaluate the validity, reliability, responsiveness, and mode preference of electronic data capture (EDC) using the Western Ontario and McMaster (WOMAC) numerical rating scale (NRS) 3.1 Osteoarthritis (OA) Index on Motorola V3 mobile phones. STUDY DESIGN AND SETTING: Patients with OA undergoing hip or knee joint replacement were assessed preoperatively and 3-4 months postoperatively, completing the WOMAC Index in paper (p-WOMAC) and electronic (m-WOMAC) format in random order. RESULTS: Data were successfully and securely transmitted from patients in Australia to a server in the United States. Pearson correlations between the summated total index scores (TISs) for the p-WOMAC and m-WOMAC pre- and postsurgery were 0.98 and 0.99 (P<0.0001). There were no clinically important or statistically significant between-method differences in the adjusted total summated scores, pre- and postsurgery (adjusted mean differences=4.44, P=0.474 and 1.73, P=0.781, respectively). Internal consistency estimates of m-WOMAC reliability were 0.87-0.98. The m-WOMAC detected clinically important, statistically significant (P<0.0001) improvements in pain, stiffness, function, and TIS. No statistically significant differences in mode preference were detected. CONCLUSIONS: There was close agreement and no significant differences between m-WOMAC and p-WOMAC scores. This study confirms the validity, reliability, and responsiveness of the Exco InTouch-engineered, Java-based m-WOMAC Index application. EDC with the m-WOMAC Index provides unique opportunities for using quantitative measurement in clinical research and practice.

Osteoarthritis Measurement in Routine Rheumatology Outpatient Practice (OMIRROP) in Australia: a survey of practice style, instrument use, responder criteria, and state-attainment criteria.

OBJECTIVE: The purpose of the 2007 Osteoarthritis Measurement in Routine Rheumatology Outpatient Practice survey was to describe practice styles, instrument usage, and perceptions of responder criteria and state-attainment criteria in osteoarthritis (OA) management in routine clinical rheumatology practice. METHODS: A 16-item questionnaire (65 subcomponents) was developed, pretested, revised, formatted, and mailed to rheumatologists residing in Australia. Responses were obtained from 136 rheumatologists (response rate 58%). RESULTS: Approximately half the Australian respondents did not follow up their patients with hip and knee OA and two-thirds did not follow up their patients with hand OA. Health status measures (HSM) were infrequently used, even by those respondents who followed their patients with OA longitudinally, and the scores from those HSM that were used, were rarely if ever formally recorded. Respondents rated the following 6 requirements of a measure for use in clinical practice as very important: validity, reliability, responsiveness, simplicity, quick completion, and easy scoring. One-fifth to one-quarter of respondents indicated they did not know quantitatively what constituted a clinically important improvement, or a health state acceptable to patients with OA. The majority of the remainder selected values not closely aligned with published values in the peer review literature. CONCLUSION: While simply describing the health status of the patient is interesting, the more strategic applications are in benchmarking, and using the data to inform shared decision-making and therapeutic goal-setting. The OMIRROP survey suggests that further investigation of interpretation issues are essential, before evaluating the role of quantitative measurement in routine OA clinical practice.