Transition to postnatal renal function.

In-utero the placenta is the primary organ responsible for neonatal homeostasis of fluid and electrolyte balance. With birth, this responsibility now transitions to the neonatal kidney. For successful transition to extrauterine renal physiology to occur maturation of neonatal glomerular filtration must occur, which is dependent on the development of renal blood flow. While these functions are decreased at birth, the term infant's kidneys are still able to manage homeostasis and are sufficient for growth and development. However, stressors can limit the adaptive properties of the neonatal kidney. This is especially important for those infants born before 34 weeks' gestation, when nephrogenesis is not yet complete. Knowledge of the changes in renal physiology is essential in caring for the neonate during transition. This article describes those changes.

Identifying strengths and weaknesses in the utilization of Objective Structured Clinical Examination (OSCE) in a nursing program.

Objective Structured Clinical Examination (OSCE) is used in nursing to assess students' transfer of classroom and laboratory learning experiences into simulated clinical practice. OSCE is a performance-based exam in which students are observed demonstrating a multitude of clinical behaviors. The purpose of this study was to identify strengths and weaknesses in the utilization of OSCE in this nursing program with 60 full-time students ages 21 to 23. An evaluation methodology was used for this study. Interviews were conducted with two groups: faculty facilitators of OSCE and standardized patients (SPs). Areas of focus were: data collection of students' performance, SP selection and training, and modification of the Nursing Interview Interaction Scale (NIIS). It was found that with appropriate SP selection and training, utilization of appropriate tools, and good data collection, OSCE can offer a valid and reliable means of testing nursing students' clinical competencies.