Integration of study material in the problem-based learning method.

Throughout the world educators are starting to realise that integrated curricula reflect the "real world". Students learn how to integrate theory appropriately with practice and it stimulates higher order thinking skills. Problem-based learning (PBL) was used as a learning strategy in an integrated undergraduate programme. A quantitative non-experimental design, a survey, was used to determine how problem-based learning influences integration of learning by the students. Using a purposive sampling method all the first-year nursing students (43) at the University of the Free State participating in the programme were included in the study. Data was collected by means of a student perception questionnaire (SPQ). PBL does contribute to an integration of learning. All the students agreed that community problems were brought to the classroom and that theory and practice were complementary. Students also indicated that PBL enhanced gathering of information from various sources and a holistic view of a situation. Problem-based learning also increased the ability to consider problems from various viewpoints and taught students clinical reasoning. Certain aspects of integration still seem to be a problem as 42% of the students indicated that subjects were not related, 21% that subjects were not integrated and 37% that scenarios were not realistic. This might be attributed to the fact that only the nursing subjects were taught by means of PBL. It is recommended that scenarios be revised to make them more realistic and that traditional subjects such as Anatomy, Microbiology and Chemical Science be integrated with nursing subjects by means of problem-solving themes, to form a meaningful core curriculum.

A community partnership programme addresses the needs of three partners in a unique way.

The process for the establishment of a community development programme between three partners, namely the community of Mangaung, the University of the Orange Free State and the Health Department of the Free State is discussed from the beginning. The phases of the process, the related stumbling blocks, the reasons for success, the scope of the programme, as well as the extent to which the three partners benefited from it, are discussed.

[Axillary temperature compared to tympanic membrane temperature in children]. / Aksillêre temperatuur vergelyk met timpaniese membraan temperatuur in kinders.

The purpose of the study was to measure the axillary temperature at three, six and nine minutes in a hundred children between the ages of one and twelve years who were selected in a non-random deliberate way, and to compare the measurements with the tympanic membrane temperature (golden standard) which was measured in the test persons at the same time. The results were described by sensitivity, specificity, limits of agreement, and predictive values. From some of the findings of the research it is apparent that the axillary temperature reading increased after measurement of three, six and nine minutes. A maximum temperature reading was reached after three minutes in only 9% of the test persons, in 25% after six minutes and in 66% after nine minutes. From the findings it is clear that the ranges that were used influenced the sensitivity of the measurements, and it would appear that the range 35.5 degrees C to 37.2 degrees C was the best range to measure pyrexia in the age group one to 12 years. The 9-minute measurement then had the highest sensitivity. However, the specificity of measurement in this range was lower. The conclusion was drawn that axillary temperature measurement is an acceptable method, with certain reservations, to use as screening method for pyrexia in emergency divisions or clinics.

Adapting to and implementing a problem- and community-based approach to nursing education.

The process of change, implemented by the School of Nursing at the University of the Orange Free State so that a paradigm shift in approaches to nursing education at undergraduate level could be achieved, is outlined. The necessity to change, the identification of external and internal variables that impact on change, the founding of a support system, the process of overcoming resistance to change, the evaluation of the process of change and options for the future, are discussed. The rationale for the implementation of a problem-based teaching strategy and the phasing in of a community-based approach to teaching as the heart of the process of change are discussed.

Assessment of learning needs and the development of an educational programme for registered nurses in advanced midwifery and neonatology.

A key step in the development of any educational programme is learning needs assessment. This is however often neglected. The purpose of this research was to identify learning needs of potential students in order to develop a relevant educational programme for registered nurses in advanced midwifery and neonatology. A survey design was used, and the population of the study was the registered nurses in the Free State. Two thousand questionnaires were mailed to respondents, selected by means of simple random sampling. Advanced educational programmes emphasize the teaching of advanced knowledge and skills and accept that the students entering these programmes already have specific knowledge and skills included in the curricula for basic programmes. This is contrary to the findings of this study. The results underline the importance of learning needs assessment in the development of relevant educational programmes.

A development and support programme for black first year nursing students.

The changed student culture in the School of Nursing from a traditional white, Afrikaans-speaking to a multicultural student community, led to a variety of problems. Many of these were experienced by students (mainly those in their first year) from historically disadvantaged educational backgrounds. The aim of this study was to establish a developmental and support programme for black first year nursing students. An action and developmental approach was followed and the research was carried out over a period of four years. The programme was developed and evaluated by means of several actions in Phase I (1992-1995) and re-planning took place throughout. The programme was implemented in Phase II and the level of student development was determined. The students experienced a number of problems and their performance as regards development was below average in terms of cultural participation and interpersonal relationships. In spite of the fact that the majority had commenced their studies with an average E matriculation symbol, 84.8% of them passed five or more semester courses at the end of 1996.

[Standards for making a community diagnosis]. / Standaarde vir die maak van 'n gemeenskapsdiagnose.

Standards for the making of a community diagnosis were formulated and validated on a national basis. These standards can be utilised by the community health nurse to improve the quality of community diagnoses. The quality of community diagnosis by community health nurses, was analysed by means of a retrospective audit. Incomplete diagnosis were observed in the compilation of a community profile and data resources were inadequately utilised. Important health indicators were not taken into account during the interpretation of data and planning strategies were incomplete. It appears as if the community health nurse tends to pay more attention to data that is readily available or can be utilised for quick results in his/her community planning.

[Standards of patient education for nursing practice in general hospitals]. / Pasiëntonderrigstandaarde vir verpleegpraktyk in algemene hospitale.

A lack of patient education standards was identified and the researchers attempted in this study to develop standards for patient education. An instrument for the evaluation of patient knowledge was also developed.

The early biochemical and hormonal profile of patients with long bone fractures at risk of fat embolism syndrome.

Free fatty acids (FFA) are believed to play a role in the genesis of the fat embolism syndrome (FES). Levels of plasma FFA, glucose, insulin, and the stress hormones cortisol, growth hormone, prolactin, glucagon, and catecholamines were measured on admission to hospital in: a) 14 patients with long bone fractures at risk of developing FES, b) 14 patients with soft-tissue injuries of comparable severity, and c) 20 healthy fasting subjects. The findings were similar in both groups of injured patients and in keeping with the hormonal and substrate responses to the stress of trauma; plasma FFA levels were raised but in neither group was the rise pronounced. Plasma FFA levels of the fracture patients were only moderately higher than the values of the healthy fasting subjects. These findings suggest that mobilized FFA from peripheral adipose tissue are not important in the genesis of the FES, but do not exclude a role for FFA derived mainly from hydrolysis of triglyceride emboli in the lung.