What You Cannot See Can Still Kill You: On the Use of Latent Constructs.

Nursing research relies heavily on the use of latent constructs to describe and understand phenomena that cannot be measured through direct observation. In statistical models, variables representing these constructs, often operationalized and represented as scores on self-report measures, stand in as symbolic representations of real forces having an impact on patients' experiences of living and dying. In this sense, latent constructs represent real phenomena that cannot always be seen directly.

Measuring grade inflation: a clinical grade discrepancy score.

Grade inflation presents pedagogical and safety concerns for nursing educators and is defined as a "greater percentage of excellent scores than student performances warrant" (Speer et al., 2000, p. 112). This descriptive correlational study evaluated the relationship of licensure exam-style final written exams and faculty assigned clinical grades from undergraduate students (N = 281) for evidence of grade inflation at a private undergraduate nursing program in the Northeast of the United States and developed a new measurement of grade inflation, the clinical grade discrepancy score. This measurement can be used in programs where clinical competency is graded on a numeric scale. Evidence suggested grade inflation was present and the clinical grade discrepancy score was an indicator of the severity of grade inflation. The correlation between licensure-style final written exams and faculty assigned clinical grades was moderate to low at 0.357. The clinical grade discrepancy scores were 98% positive indicating likely grade inflation. Some 70% of clinical grade discrepancy scores indicated a difference of student licensure-style final written exams and faculty assigned clinical grades of at least one full letter grade (10 points out of 100). Use of this new measure as a tool in exploring the prevalence of grade inflation and implications for patient safety are discussed.

Sex differences in college student adherence to NIAAA drinking guidelines.

BACKGROUND: Exceeding nationally recommended drinking limits puts individuals at increased risk of experiencing harmful effects due to alcohol consumption. Both weekly and daily limits exist to prevent harm due to toxicity and intoxication, respectively. It remains unclear how well college students adhere to recommended limits, and whether their drinking is sensitive to the wider sex difference in weekly versus daily drinking limits. METHODS: This study used a daily-level, academic-year-long, multisite sample to describe adherence to NIAAA daily (no more than 4 drinks per day for men, 3 drinks per day for women) and weekly (no more than 14 drinks per week for men, 7 drinks per week for women) drinking guidelines, and to test for sex differences and time effects. College students (n = 992; 58% female) reported daily drinking on a biweekly basis using web-based surveys throughout their first year of college. RESULTS: Women exceeded weekly limits more frequently (15% of weeks [14 to 17%]) than men (12% [10 to 14%]). Women and men exceeded daily drinking limits similarly often (25 and 27%, respectively). In a generalized estimating equations analysis across all 18 biweekly assessments, adjusted for covariates and a linear trend over time, women were more likely to exceed weekly guidelines compared to men. Sex differences in exceeding daily limits were not significant. Over time, rates of exceeding limits declined for daily limits but only for men for weekly limits. CONCLUSIONS: Female college students are more likely to exceed weekly alcohol intake limits than men. Furthermore, trends over time suggest that college students may be maturing out of heavy episodic drinking, but women may not mature out of harmful levels of weekly drinking. The observed disparity in risk for long-term health consequences may represent a missed opportunity for education and intervention.

Simulation stimulates learning in a childbearing clinical course.

Preparing nursing students to become integral members of today's health care team presents educators with unique challenges in both classroom and clinical settings. This study examined the effectiveness of adding high-fidelity simulation to a childbearing clinical course. Our systematic research addressed the importance of evaluating the outcomes of using simulation on both knowledge acquisition and clinical competency. We found simulation to have a positive effect on not only student clinical performance, but also knowledge development in the undergraduate child-bearing clinical course. These outcome data will inform the curriculum changes needed as we strive to facilitate student proficiency in clinical concepts and skills and prepare the next generation of nurses entering our increasingly complex health care system.