Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty.

OBJECTIVE: To explore how older patients self-manage their coronary heart disease (CHD) after undergoing elective percutaneous transluminal coronary angioplasty (PTCA). METHODS: This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients (n = 93) approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings informed the purposive sampling for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualitative data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants (n = 47) classified as 65 years of age or older. RESULTS: 78.7% (n = 37) of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% (n = 16) thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% (n = 19) would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less (P = 0.02) and smoked less (P = 0.01) than their younger counterparts in the study. Age did not seem to affect PTCA patients' likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption (P = 0.237). CONCLUSIONS: The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants' likelihood to alter lifestyle factors.

Exploring the opinions of registered nurses working in a clinical transfusion environment on the contribution of e-learning to personal learning and clinical practice: results of a small scale educational research study.

AIM: To explore the opinions of registered nurses on the Learnbloodtransfusion Module 1: Safe Transfusion Practice e-learning programme to meeting personal learning styles and learning needs. METHOD: A qualitative research methodology was applied based on the principles of phenomenology. Adopting a convenience sampling plan supported the recruitment of participants who had successfully completed the e-learning course. ANALYSIS: Thematic analysis from the semi-structured interviews identified common emerging themes through application of Colaizzis framework. RESULTS: Seven participants of total sample population (89) volunteered to participate in the study. Five themes emerged which included learning preferences, interactive learning, course design, patient safety and future learning needs. Findings positively show the e-learning programme captures the learning styles and needs of learners. In particular, learning styles of a reflector, theorist and activist as well as a visual learner can actively engage in the online learning experience. In an attempt to bridge the knowledge practice gap, further opinions are offered on the course design and the application of knowledge to practice following completion of the course. CONCLUSION: The findings of the small scale research study have shown that the e-learning course does meet the diverse learning styles and needs of nurses working in a clinical transfusion environment. However, technology alone is not sufficient and a blended approach to learning must be adopted to meet bridging the theory practice gap supporting the integration of knowledge to clinical practice.

Systematic review of grading practice: is there evidence of grade inflation?

This paper describes the outcomes of a systematic review of literature pertaining to the grading of practice within nursing, midwifery, medicine and allied health professions. From a total of 215 papers, 147 were included and data were extracted using a systematic data extraction tool. The focus of this paper relates to one of the emerging themes: the issue of grade inflation. The paper examines the grade inflation phenomenon: it discusses the reasons for grade inflation from a variety of perspectives. The paper reports on the suggestions made within the literature on how to control grade inflation, but these, the authors conclude, are not fully evaluated and should be adopted only where rigorous evaluation can carried out. It is imperative that evaluations include the usefulness, reliability and validity testing of rubrics or any other solutions to grade inflation that are adopted by clinicians and educators.

Can we predict successful completion of the common foundation programme at interview?

AIM: To gain an understanding of patterns of retention and attrition for student nurses on the diploma of higher education (DipHE)/bachelor of science (B.Sc.) (adult) on completion of the common foundation programme (CFP=year 1 of the programme). METHOD: A questionnaire called the "interview score sheet" (ISS) collected data on six cohorts from a Higher Education Institution in Scotland. At the initial recruitment interview each candidate was scored independently by two interviewers on the ISS. Successful/unsuccessful attempts of theory-based and practice-based modules, and any reasons for attrition were recorded throughout the CFP. For the purposes of this study success was defined as achieving a pass grade in all modules associated with year 1 of the programme. MAIN OUTCOME MEASURES: The study investigated the potential of the ISS in providing a reliable guide for student selection onto the DipHE/B.Sc. in nursing (adult) and providing information about the characteristics of a typical successful/unsuccessful student from the CFP. ANALYSIS: Statistical analysis was conducted to examine the correlation between the total score on the ISS, any characteristics on the ISS and the students' successful completion of the CFP. RESULTS: Six-hundred and thirty-eight students entered the CFP: 118 (18%) were unsuccessful and 520 (82%) were successful completers of the CFP. From the characteristics noted at interview on the ISS, the most reliable predictor of success was age. The total score achieved on the ISS was shown not to be a reliable predictor of success. Although not statistically significant, testing of numeracy and standard and content of written work may be of some value in predicting success and may warrant further study.

Can an interview score sheet assist with student selection onto the bachelor of science/diploma of higher education (adult) nursing programme? Findings from a pilot study.

AIM: To develop an interview score sheet (ISS) to assist with the selection of student nurses on the Bachelor of Science (B.Sc.)/Diploma of Higher Education (DipHE) (Adult). METHOD: A pilot study was undertaken over a 6-month period to design and used a questionnaire to collect information on the candidate at interview. This questionnaire was called the "interview score sheet" (ISS). Using the ISS, each candidate was scored independently by two interviewers. MAIN OUTCOME MEASURES: The study was used to evaluate the usefulness of a score sheet at interview in aiding with the selection of candidates. Also the study was used to identify the demographics of the candidates and to assess the consistency of the scoring system. RESULTS: One hundred and twenty six candidates, ageing from 16 to 51 years were interviewed over 6 months. Ninety of the candidates were accepted onto the course. The highest score achievable on the ISS was 40, and the lowest was 2. Of those candidates accepted (n=90) the average score was 28, and for those candidates rejected (n=36) the average score was 20.6. CONCLUSION: The ISS proved to be a useful tool to decide on candidate suitability. Those candidates accepted onto the course were more likely to be scored higher than those rejected. FUTURE STUDY: Correlation of scores with firstly the characteristics of the successful candidates, and secondly with the characteristics of those who did not complete the 3-year programme.

The value of role modelling: Perceptions of undergraduate and diploma nursing (adult) students.

Using a grounded theory methodology, this paper demonstrates the value of role modelling in teaching and learning within the clinical area. Views of undergraduate (n=20) and diploma (n=22) nursing (adult) students were sought using individual and focus group interviews. Although the importance of role modelling is acknowledged within the literature, there appears to be little written about the value of providing role modelling within the clinical learning environment to facilitate learning for student nurses. Both groups of students stated the importance of having access to a good role model in order that they could observe and practice skills and/or behaviour. 'Good' role models were seen to have a tremendous influence on the clinical learning environment and on the development of students' competence and confidence. Recommendations were made to include discussions on the value of role modelling on enhancing the clinical learning environment within mentor preparation courses. These discussions should emphasise the value of observational learning, the necessity of providing constructive feedback and the need for role models to enable the student to convert observed behaviour/skills into their own behaviour and skills set.