Best practices for learning physiology: combining classroom and online methods.

Physiology is a requisite course for many professional allied health programs and is a foundational science for learning pathophysiology, health assessment, and pharmacology. Given the demand for online learning in the health sciences, it is important to evaluate the efficacy of online and in-class teaching methods, especially as they are combined to form hybrid courses. The purpose of this study was to compare two hybrid physiology sections in which one section was offered mostly in-class (85% in-class), and the other section was offered mostly online (85% online). The two sections in 2 yr (year 1 and year 2) were compared in terms of knowledge of physiology measured in exam scores and pretest-posttest improvement, and in measures of student satisfaction with teaching. In year 1, there were some differences on individual exam scores between the two sections, but no significant differences in mean exam scores or in pretest-posttest improvements. However, in terms of student satisfaction, the mostly in-class students in year 1 rated the instructor significantly higher than did the mostly online students. Comparisons between in-class and online students in the year 2 cohort yielded data that showed that mean exam scores were not statistically different, but pre-post changes were significantly greater in the mostly online section; student satisfaction among mostly online students also improved significantly. Education researchers must investigate effective combinations of in-class and online methods for student learning outcomes, while maintaining the flexibility and convenience that online methods provide.

Designing a measure of Complexity Compression in registered nurses.

Researchers in Minnesota have described and validated the phenomenon of Complexity Compression in qualitative studies of registered nurses. Analysis of themes from this research led to the design of a survey to assess nurses' agreement with variables that contribute to their experience of Complexity Compression. The survey was administered to a random sample of 199 registered nurses in Minnesota. Exploratory factor analysis was used to evaluate the attributes of Complexity Compression and its underlying structure. Three factors emerged that explained 51.4% of the variance in responses: work of nursing, systems, and personal factors. Internal consistency of the factors ranged from .79 to .89. Validity of the survey for assessment of Complexity Compression in hospital-based nurses was supported. The construct of Complexity Compression and its contributing factors will be tested in future studies with nurses in a variety of health care settings.

Development and validation of a screen for specialized discharge planning services.

BACKGROUND: There is no rigorously developed and empirically validated screening tool to identify, early in the hospital stay, those adults who will use specialized hospital discharge planning services. OBJECTIVES: To develop and validate a screen using hospital admission clinical data that discriminates between adults who use and do not use specialized discharge planning services. METHODS: Subjects consisted of prospectively sampled adult patients admitted to two hospitals located in a Midwestern United States city in 1998 (tool development sample, n = 991) and 2002 (validation sample, n = 303). Variables suggestive of being predictive of use of specialized hospital discharge planning services were identified from the literature and were obtained from direct participant interviews, record review, and administrative databases. The outcome was a documented referral for involvement of specialized discharge planning personnel with the patient's plan of care and was identified from review of hospital records. RESULTS: Of 24 variables examined, only age, disability, living alone, and self-rated walking limitation were jointly predictive of use of specialized discharge planning services in the development sample. Standardized coefficients from the joint model were used to estimate a screening score. A cut-point was derived and had a sensitivity of 75% and specificity of 78% in the development sample. The screen performed equally well in the validation sample and the development sample. CONCLUSION: A screening tool consisting of a limited number of characteristics readily available early in the hospital stay that were shown to be highly predictive of the use of specialized discharge planning services was developed. The application of such a tool will hopefully assist providers to deploy services appropriately and in a timely fashion.