Using message framing to achieve long-term behavioral changes in persons with diabetes.

This study examines how the framing of educational information affects changes in health-related knowledge, attitudes, and behavior. Patients with diabetes viewed either a gain- or a loss-framed informational video about proper foot care and its importance for the prevention of health-threatening problems. The gain-framed messages sustained long-term positive behavioral change. Regression analyses showed that changes in attitudes were predicted by changes in knowledge and that both framing and attitudes were predictors of long-term behavior. This study is important for nurses and certified diabetes educators in that it demonstrates that gain-framed messages are effective in sustaining health-promoting behavior.

Learning nursing procedures: the influence of simulator fidelity and student gender on teaching effectiveness.

Simulation technologies are gaining widespread acceptance across a variety of educational domains and applications. The current research examines whether basic nursing procedure training with high-fidelity versus low-fidelity mannequins results in differential skill acquisition and perceptions of simulator utility. Fifty-two first-year students were taught nasogastric tube and indwelling urinary catheter insertion in one of two ways. The first group learned nasogastric tube and urinary catheter insertion using high-fidelity and low-fidelity mannequins, respectively, and the second group learned nasogastric tube and urinary catheter insertion using low-fidelity and high-fidelity mannequins, respectively. The dependent measures included student performance on nasogastric tube and urinary catheter insertion testing, as measured by observer-based instruments, and self-report questionnaires probing student attitudes about the use of simulation in nursing education. Results demonstrated higher performance with high-fidelity than with low-fidelity mannequin training. In response to a self-report posttraining questionnaire, participants expressed a more positive attitude toward the high-fidelity mannequin, especially regarding its responsiveness and realism.

Evaluation of a simulation-based program for medic cognitive skills training.

Simulation-based training is a promising instructional approach for training military and civilian first responders. In addition to training in relevant taskwork skills, there is increasing need for first responder training in cognitively-based skills such as situation assessment and decision making. The First Responder Simulation Training (FIRST) program trains cognitive skills using complex and degraded situations. The program is comprised of five detailed scenarios, evaluation instruments, debriefing guidelines for each scenario, a multimedia tutorial that explains how to use the evaluation and debriefing instruments, and a detailed scenario guide for administering the scenarios. We conducted an evaluation of the FIRST program to assess its training utility and usability. The program was well-received by both instructors and participants. Instructors noted the importance of training cognitive skills and found the instructor materials valuable for teaching them how to administer a simulation-based training program. Participants found the scenarios realistic and challenging, and noted that such simulation-based training would be a valuable supplement to medic curricula.

Training teams for the perioperative environment: a research agenda.

A research agenda for investigating the impact of team-work training on patient safety in the perioperative environment is presented. The current status of teamwork training is reviewed briefly, and conclusions based on existing research are presented. We present a roadmap for future research on how teamwork training should be structured, delivered, and evaluated to optimize patient safety in the operating room. For teamwork skills to be assessed and have credibility, team performance measures must be grounded in team theory, account for individual and team-level performance, capture team process and outcomes, adhere to standards for reliability and validity, and address real or perceived barriers to measurement. The interdisciplinary nature of work in the perioperative environment and the necessity of cooperation among team members play an important role in enabling patient safety and avoiding errors. Teams make fewer mistakes than do individuals, especially when each team member knows his or her responsibilities, as well as those of other team members. However, simply installing a team structure without addressing the organizational context of care--the culture--does not automatically ensure it will operate effectively. Factors associated with the design of teamwork training, measures of training effectiveness, and the assessment process that should be explored in near-term work (1 to 2 years) are addressed. We also address the impact of the organizational environment, including the role of institutional support and culture, that need to be explored in longer term research (3 to 5 years).