An evaluation of paper-and-pencil and computer-assisted simulations.

Two formats of delivering clinical simulations for nurse practitioners were evaluated in this study. The two formats included paper-and-pencil, latent-image format, and computer-assisted instruction. Twelve students in a graduate family nurse practitioner curriculum were the subjects. They reported no preference for type of format nor were any differences observed in student performance when comparing the two formats. The cost for the latent-image format was estimated at approximately $8500 and the cost for computer simulation at approximately $10,500. The implications of these findings for nursing curriculums are discussed.

Attitudes of emergency nurses toward organ and tissue donation.

OBJECTIVE: Organ and tissue transplantation has gained increased acceptance as a medical procedure. Costs for most transplantations are reimbursed by insurance companies, and the list of transplantable tissues and organs has doubled during the past 10 years. To meet this resulting increased demand, more organs and tissues need to be recovered from potential donors. The purpose of this study was to examine the relationship between emergency nurses' attitudes and their intention to ask potential donor families if they will donate their family member's organs and tissues. METHODS: Thirty hospitals were sent a letter inviting them to participate in this descriptive survey research design. Survey packets were sent to the 17 hospitals that responded positively to the request. Surveys contained a cover letter to the participants with directions and assurance that anonymity would be maintained. Completed surveys were returned directly to the researcher. RESULTS: We found a relationship between the nurses' attitudes and the frequency with which they approached families regarding donation. Further analysis revealed that nurses' attitudes about organ and tissue donation were related to their confidence in asking families about donation. The study also demonstrated that emergency nurses want educational programs that offer information on how to approach donor families. DISCUSSION: These results can be used to develop educational programs for emergency nurses to provide them information that can increase their confidence in asking families about donation and subsequently increase the number of families they approach regarding donation.

Determinants of positive health behavior in middle childhood.

The purpose of this study was to determine the contributions of sociodemographic variables, health experiences, family functioning, self-esteem, intrinsic motivation, and health perception to the health behaviors of preadolescent children. A convenience sample of 9- and 10-year-old children (N = 260) and their mothers responded to self-report questionnaires. Health behaviors were found to be gender specific and formed partially through a set of background variables that are largely fixed and nonmodifiable; these variables then interface with explanatory, modifiable factors that include the child's self-esteem, intrinsic motivation, and perceptions of health. Two models are described; 53% of the variance in girls' behavior and 63% of the variance in boys' behavior are explained.

A study of construct validity: simultaneous as a measure of nurse practitioners' problem-solving skills.

A national sample of 46 nurse practitioners (NPs) and a Midwestern sample of 31 nurses completed five instruments designed to provide evidence of the construct validity of patient management problems (PMPs). The subjects completed three simulations, a multiple-choice cognitive examination in the content are of the simulations, and a demographic questionnaire. The first hypothesis stated that a claim for the construct validity of simulations would be warranted if significant differences were found between performance of NPs and nurses on simulations designed for NPs. A second hypothesis stated that no significant differences would be found across the three different simulations. The cognitive examination was hypothesized to be a meaningful covariate, as performance on a simulation depends in part on knowledge of the content area of the simulations. The examination was not found to be a significant covariate in this analysis. Meaningful differences were found between NPs and nurses, supporting the claim for the construct validity of the simulations. Meaningful differences were also found across the three simulations for both groups of subjects, suggesting that the second hypothesis of consistency of performance may have been inappropriately formulated. One measurement characteristic of the simulations may be difficulty level.

A validation study: simulations as a measure of nurse practitioners' problem-solving skills.

A national sample of 79 masters- and certificate-prepared family and adult nurse practitioners completed six instruments designed to validate one type of clinical simulation, patient management problems (PMPs). The instruments were: a self-chart audit, self-evaluation rating scale, colleague evaluation rating scale, multiple-choice examination. PMP simulation, and demographic questionnaire. Use of a multitrait-multimethod correlation matrix, a multivariate analysis of covariance, and a stepwise multiple regression analysis provided modest evidence to support the claim that the PMP simulation is a valid measure of the construct clinical problem solving. In fact, a multiple-choice examination appeared to be an equal, if not superior, instrument.