A concept analysis of abductive reasoning.

AIM: To describe an analysis of the concept of abductive reasoning. BACKGROUND: In the discipline of nursing, abductive reasoning has received only philosophical attention and remains a vague concept. In addition to deductive and inductive reasoning, abductive reasoning is not recognized even in prominent nursing knowledge development literature. Therefore, what abductive reasoning is and how it can inform nursing practice and education was explored. DESIGN: Concept analysis. DATA SOURCES: Combinations of specific keywords were searched in Web of Science, CINAHL, PsychINFO, PubMed, Medline and EMBASE. The analysis was conducted in June 2012 and only literature before this period was included. No time limits were set. METHODS: Rodger's evolutionary method for conducting concept analysis was used. RESULTS: Twelve records were included in the analysis. The most common surrogate term was retroduction, whereas related terms included intuition and pattern and similarity recognition. Antecedents consisted of a complex, puzzling situation and a clinician with creativity, experience and knowledge. Consequences included the formation of broad hypotheses that enhance understanding of care situations. Overall, abductive reasoning was described as the process of hypothesis or theory generation and evaluation. It was also viewed as inference to the best explanation. CONCLUSION: As a new approach, abductive reasoning could enhance reasoning abilities of novice clinicians. It can not only incorporate various ways of knowing but also its holistic approach to learning appears to be promising in problem-based learning. As nursing literature on abductive reasoning is predominantly philosophical, practical consequences of abductive reasoning warrant further research.

Comparative Analysis of External Validity Reporting in Non-randomized Intervention Studies.

This article describes a comparative analysis of external validity reporting in non-randomized behavioural and public health intervention studies that used and did not use the TREND (Transparent Reporting of Evaluations with Non-randomized Designs) statement. The search resulted in 14 non-randomized intervention studies that were rated based on Green and Glasgow's criteria for external validity reporting. Studies that used the TREND statement demonstrated improved external validity reporting when compared with studies that did not use the TREND statement. The implication is that the TREND statement and Green and Glasgow's criteria can improve external validity reporting of non-randomized behavioural and public health interventions.

Cet article présente une analyse comparative d'établissements de rapports de validité externe dans le cadre d'études d'interventions non aléatoires en matière de comportements et de santé publique faisant usage et ne faisant pas usage de l'énoncé TREND (Transparent Reporting of Evaluations with Non-randomized Designs). La recherche a relevé 14 études d'interventions non aléatoires, lesquelles ont été évaluées selon les critères de Green et Glasgow quant à l'établissement de rapports de validité externe. Les études ayant utilisé l'énoncé TREND ont démontré la présence de rapports de validité externe améliorés, en comparaison avec les études n'ayant pas fait usage de l'énoncé TREND. En conclusion, l'énoncé TREND et les critères de Green et Glasgow peuvent améliorer les rapports de validité externe d'interventions non aléatoires en matière de comportements et de santé publique.

Usefulness of Abductive Reasoning in Nursing Education: A Pilot Study.

BACKGROUND: Hypothetico-deductive reasoning used by novice nurses could limit their ability to explain a presenting care situation in its entirety. Hence, scholars recommend the use of abductive reasoning as an alternative approach. PURPOSE: This study explored the effects of abductive reasoning training on baccalaureate nursing students' hypothesis generation abilities. METHOD: Through a pretest-posttest study, we delivered educational training on abductive reasoning and examined hypothesis accuracy, expertise, and breadth. Participants generated scenario-specific hypotheses before and after the training. Academic content experts validated the scenarios, and 2 independent raters scored participants' hypotheses. RESULTS: Twenty first- and second-year nursing students participated in this pilot study. Posttest scores showed a significant improvement in participants' hypothesis generation abilities: accuracy (P < .001), expertise (P < .001), and breadth (P = .006). CONCLUSION: Abductive reasoning training in nursing education may improve students' hypothesis generation abilities.

Evolving as nurse educators in problem-based learning through a community of faculty development.

Effective faculty development programs are of paramount importance in this era of profound change in nursing education driven by baccalaureate-degree entry to practice and the concurrent implementation of college/university collaborative partnerships in Ontario, Canada. The overall purpose of this study was to design, disseminate, and evaluate a faculty development program involving nursing faculty from the McMaster University, Mohawk College, and Conestoga College. In keeping with selected conceptual models and responses to a needs assessment, faculty participated in a collaborative faculty development program that included a planned workshop, a mentorship program, and regular faculty development activities. This article presents the qualitative program evaluation component that included focus group discussions and subsequent content analysis to gain an understanding of the experiences and meaning of the faculty who participated in the faculty development program. The overarching theme was that the faculty experienced a sense of evolving as nurse educators in problem-based learning (PBL) through a community of faculty development. The following themes emerged: becoming certain in the midst of uncertainty; developing collegial trust and community; embracing PBL; valuing faculty development; and evolving as a nurse educator in PBL through faculty development. The results attest to the benefits of a collaborative faculty development program, guide future faculty development, and promote mastery in PBL.

Considerations for adolescent integrative health care in Canada.

The increased use of complementary/alternative medicine (CAM) has stimulated practitioners, policy makers, and researchers to examine its integration into mainstream medicine. For adolescents, there is evidence that they are using CAM as an option for health care. However, there is limited information on how adolescent integrative care should be developed in Canada. Practice, practice environments, and education are the three areas identified in which modifications should be made to current adolescent-focused practice in Canada to make it more of an integrative system.

The impact of curricular changes on BSCN students' clinical learning outcomes.

Ongoing curricular renewal is a necessary phenomenon in nursing education to align learning with ever-changing professional practice demands. The McMaster Mohawk Conestoga BScN Program in Hamilton, Ontario, Canada recently engaged in a comprehensive curriculum renewal. The purpose of this study was to evaluate the impact of curricular changes on students' deep learning. Faculty perceptions about student learning outcomes during final year clinical placements were gathered through a combination of individual interviews and focus groups using Interpretive Descriptive qualitative research methodology. Twenty five faculty members who supervised BScN students in clinical placements before and after curriculum renewal shared perceptions of changes in students' overall performance. The chosen clinical learning outcomes were: changes in students' performance related to person-centred care, clinical reasoning and judgment, pathophysiology, and evidence-informed decision-making. Faculty described three major themes in students' performance 1) pulling it all together, 2) seeing the whole person, and 3) finding their nursing voices. This reflected a shift to person-centred care, increasing professional confidence, and improved clinical reasoning and judgment and no changes to integrating pathophysiology or evidence-informed decision-making. In this study curriculum renewal provided an excellent starting point for the scholarship of teaching and learning within nursing education.

Comparison of Self- and Faculty-Directed Learning of Psychomotor Skills.

This randomized controlled trial compared the effectiveness of self-directed learning (SDL) and faculty directed, demonstration-return-demonstration learning (DRD) for psychomotor clinical nursing skills and level of knowledge of second year baccalaureate nursing students. The self-directed learning approach of a university was compared to a community college's approach of tutor demonstration-student return demonstration for students from the University. Data were collected using questionnaires measuring academic outcomes after the students were exposed to the different learning approaches. The data were compared for differences in grades in an objective structured clinical examination (OSCE). Findings indicated that students perceived there were differences in the learning process, however there were no differences of interest in most of the academic outcomes. While students did not differ on the total OSCE grade, students using the SDL method received higher grades in only one of the marker stations and students using the DRD method received higher grades in only one marker and one observer station. The group of students receiving the DRD method indicated that they were given enough help from faculty, were allowed sufficient practice time and expected that the SDL method would be more stressful. 30.8% of the students in the SDL group recommended their learning method to future second year students, while 100% of the DRD group recommended the DRD method. Although the outcome appeared not to differ, more students indicated satisfaction with the faculty-directed (DRD) approach.

Editorial: Ser reflexivo, ser profesional, transformarse más allá del hoy / Editorial: Being reflective, being professional, becoming beyond today

La práctica de enfermería hoy en día es compleja y cambiante. Como Frenk et al. (1) notan, la educación en ciencias de salud ha experimentado cambios fundamentales durante el siglo pasado; de un enfoque basado en ciencia, a currículos basados en problemas, hasta currículos basados en sistemas y competencias. Sin embargo, el eje constante en la práctica de enfermería ha sido, y continúa siendo la reflexión en la práctica y la reflexión sobre la práctica (2).

A comprehensive faculty development model for nursing education.

Professional nursing education has undergone profound legislative changes requiring a university baccalaureate in nursing as entry to practice as a registered nurse (RN) in Ontario, Canada. Subsequent partnerships between colleges and universities were mandated by the ministry of post secondary education in order to maximize existing resources, such as faculty, and capitalize on the strenghts of both sectors. Faculty, in partnered collaborative undergraduate nursing programs, are challenged by the ever-evolving transition in conceptualization, development, and delivery of nursing education; consequently, the design, dissemination, and evaluation of effective faculty development programs is of paramount importance (Steinert, 2000). This paper focuses on the creation of the Comprehensive Faculty Development Model implemented by a collaborative BScN program partnership in south-western Ontario. It describes the model's contextual underpinnings, illustrates the component parts, explains their relationship, and provides an in-depth discussion of foundational concepts. The model was developed under the auspices of a collaborative faculty development committee with representation from all partners. Summaries of four research studies designed and implemented by members of the partnership provide a useful assessment of how faculty members experienced the inaugural BScN program; however, more study is needed in order to understand what approaches to faculty development are most effective and sustainable.

Exploring adolescent complementary/alternative medicine (CAM) use in Canada.

A qualitative study using a grounded theory approach investigated adolescents' perceptions about complementary/alternative medicine (CAM) use. Adolescents, attending a clinic at the Canadian College of Naturopathic Medicine, were interviewed after receiving ethics approval. Data were collected using semi-structured interviews. The decision of adolescents to use CAM was based within the context of their world and how it shaped influencing factors. Factors that influenced adolescents' decision to use CAM were identified as certain personality traits, culture, media, social contacts and the ability of CAM providers to develop therapeutic relationships. The barriers and benefits of CAM use influenced evaluation of choices. The importance of barriers in limiting freedom of choice in health care decisions should be investigated by practitioners as they provide care to adolescents. Health care planning for integrative models of care requires determining the "right" blend of expertise by knowing interprofessional boundaries, determining mixed skill sets to provide the essential services and ensuring appropriate regulation that allows practitioners to use their full scope of practice.

Development of professional confidence by post diploma baccalaureate nursing students.

Professional confidence should be nurtured in a caring nursing curriculum, however there is a lack of clarity as to what confidence means, how it is perceived by students, and what educators can do to instill professional confidence in nursing students. A qualitative study using focus groups was conducted to explore the components of professional confidence as perceived by diploma-prepared registered nurses enrolled in a two-year student-centered, problem-based baccalaureate degree program. Students identified professional confidence as developing through a two-phase process. During the first phase, Becoming Informed, students reported acquiring knowledge, theory and critical thinking in the supportive environment of small tutorial groups, which in turn enabled them to examine nursing practice and defend decisions with clarity and confidence. In Finding a Voice of My Own they clearly articulated an evidence-based nursing position in both academic and clinical environments with a sense of ownership and congruence with their own values. Each phase was further composed of four processes: feeling, knowing, doing and reflecting. When supported through these phases, students felt prepared (i.e. confident) to assume broader roles in health care. Post diploma programs should acknowledge and build on the skills and abilities nurses bring to the educational setting, yet challenge learners to develop critical self appraisal.

Professional confidence in baccalaureate nursing students.

"You need to develop more confidence" is a common refrain noted by students and faculty alike. As nurse educators, we believe that encouraging students to develop their professional confidence is an important role. Moreover, the nursing profession demands that nursing care be delivered with confidence. Although the importance of professional confidence is acknowledged in the literature, there is surprisingly little written about its development or strategies that promote professional confidence in nursing education. A qualitative study was conducted to explore the meaning and influences on professional confidence as perceived by nursing students enrolled in a four year generic baccalaureate nursing program. Focus groups were audiotaped, transcribed verbatim and analyzed using thematic content analysis method. The meaning of professional confidence involved: feeling, knowing, believing, accepting, doing, looking, becoming, and evolving. Positive and negative influences in developing professional confidence centered around two time periods, prior to entering nursing, and within the nursing program. Students identified strategies to assist themselves in developing professional confidence. Faculty development is one recommendation for faculty.