ABSTRACT
Errors in thinking contribute to harm, delays in diagnosis, incorrect treatments, or failures to recognize clinical changes. Models of cognition are useful in understanding error occurrence and avoidance. Intra-team conflict can represent failures in joint cognitive processing. The authors developed training focused on recognizing and managing cognitive bias and resolving conflicts. The program provides context and introduces models of cognition, concepts of bias, team cognition, conflict resolution, and 2 tools. "IDEA" incorporates 4 de-biasing strategies: Identify assumptions; Don't assume correctness; Explore expectations; Assess alternatives. "TLA" presents strategies for resolving conflicts: Tell your thoughts; Listen actively, and Ask questions. A total of 4941 care providers participated in training using didactic presentations, group discussion, and simulation. Learners rated training effectiveness at 4.68 on a scale of 1 to 5 (5 as optimum) and perceived improvement in recognizing or managing errors. Nonphysician caregivers reported greatest improvement. Training to improve critical thinking is feasible, well received, and effective.
Subject(s)
Inservice Training/methods , Patient Care Team , Patient Safety , Quality Improvement , Thinking , Communication , Humans , Medical Errors/prevention & controlABSTRACT
This is the third and final part of a series of articles that report the findings of a study that investigated the effects of a summer externship program on the transition into a professional role among nurses who participated in a summer nurse externship program at an acute care pediatric hospital. Specifically, this article reports the retention and recruitment benefits of a summer nurse externship program for the institution from 1998 through 2003. A total of 153 externs out of the 193 (79.0%) assumed a registered nurse position at the institution, and 77% remained in that role for 12 months. Overall, the nurse extern program for this institution appeared to be an effective recruitment and retention strategy that is on par with the institution and national data for retention and turnover data.
Subject(s)
Education, Nursing , Internship, Nonmedical , Personnel Selection , Female , Humans , Male , Personnel Administration, Hospital , Personnel Turnover/statistics & numerical data , Program Evaluation , United StatesABSTRACT
This article reports the qualitative findings from a focus group interview conducted with six currently registered nurses who participated in a summer nurse externship program. It is Part II of a three-part study that examined the influence of nurse externship programs on the transition process from graduate to professional nurse. The focus group explored the perceptions of former nurses about the impact of the externship program on their transition into the professional nurse role. In the role of nurse externs, individuals were able to view, experience, and, consequently, come to understand the culture of nursing in an acute healthcare system without being full-fledged members of it. Three themes induced from the analysis of the findings were as follows: (1) being a part of the real scene; (2) figuring out the environment; and (3) gaining awareness and becoming frightened.
Subject(s)
Attitude of Health Personnel , Education, Nursing, Continuing/organization & administration , Inservice Training/organization & administration , Internship, Nonmedical/organization & administration , Nursing Staff, Hospital/education , Clinical Competence/standards , Focus Groups , Hospitals, Pediatric , Humans , Interprofessional Relations , Leadership , Nurse's Role/psychology , Nursing Education Research , Nursing Methodology Research , Nursing Staff, Hospital/organization & administration , Nursing Staff, Hospital/psychology , Organ Culture Techniques , Pediatric Nursing/education , Pediatric Nursing/organization & administration , Program Evaluation , Psychomotor Performance , Qualitative Research , Self Efficacy , Socialization , ThinkingABSTRACT
This article is Part I of a three-part series that reports the quantitative findings that investigated if an externship program had a long-term effect on new graduates' role socialization to the healthcare environment. Two groups were compared: a group of 26 registered nurses who had participated in the externship program and a matched cohort group of 26 nurses who had not participated in an externship program at this institution or any other clinical agency. No statistically significant differences were found between the groups on the variables of job satisfaction and sense of belonging. In contrast, the analysis did demonstrate significant differences in the mean scores for professionalism and role socialization between the two groups; however, the average score on each scale for those nurses in the cohort group was higher as compared to the average scale score of the nurses who had been nurse externs.
