One Stop: Examining the Reasons Patients Use the Emergency Department for Nonurgent Care and the Barriers They Face.

INTRODUCTION: Despite the plethora of research on the use of emergency department services for nonurgent primary health care, the vast majority of this research is quantitative in nature. To date, there is little research that reports on the problem from the patients' perspective and/or lived experience, which compromises health care providers' understanding of the essence of the problem as described by the patients. Thus, this study will provide a qualitative description of nonurgent ED visits from the patients' perspective. Specifically, this study answers the following research questions: 1) What are the reasons for patients and/or caregivers visiting the emergency department for nonurgent health conditions? and 2) What are the barriers experienced by patients and/or caregivers when seeking access to health care? METHODS: A qualitative descriptive design with face-to-face interviews of 33 consenting participants was conducted at 4 emergency departments. All interviewed participants were triaged as nonurgent patients by the ED personnel. RESULTS: Three themes surfaced from the data regarding reasons for using the emergency department: 1) Practitioner referral; 2) Efficacy of care; and 3) Time saver. When describing barriers that participants experienced when seeking care outside of the emergency department for their nonurgent conditions, 3 themes that emerged are lack of primary care provider, financial difficulties, and lack of comprehensive care outside the emergency department. DISCUSSION: The results of the study can help inform patient-centered care and future policy initiatives that will address the practices and barriers contributing to nonurgent ED visits.

Evaluating undergraduate nursing students' learning using standardized patients.

BACKGROUND: The use of standardized patients is an established training technique in medical education. However, this problem-based learning approach is relatively new to the field of nursing education. Its benefits to undergraduate nursing education continue to be underinvestigated in the nursing literature. PURPOSE: The purpose of this study was to examine the effectiveness of using standardized patients in improving health assessment skills among first-year nursing students. METHODS: A comparative design was conducted on a convenience sample of 108 first-year undergraduate nursing students. Study participants were recruited from a university and community college collaborative nursing program in southwestern Ontario. RESULTS: Analysis of covariance results showed that after adjusting for baseline differences, the intervention group had higher objective structured clinical examination mean scores than the control group (M = 78.57 and 69.28, F = 24.13, P ≤ .001). However, the two groups were not different in their theory scores (M = 77.23 and 77.29, F = .002, P = .963). CONCLUSION: The findings suggest that the use of standardized patients is an effective educational technique in undergraduate nursing education.