Cognitive Preference and Clinical Experience: The Relationship Between Student Nurse Anesthetists' and Certified Registered Nurse Anesthetists' Thinking Styles.

This study examined the relationship between cognitive preference and clinical experience in student registered nurse anesthetists (SRNAs) and certified registered nurse anesthetists (CRNAs). Survey data was collected from enrolled SRNAs and practicing CRNAs via an email link distributive through a network sampling technique. Participants completed the Rational Experiential Inventory (REI-40), which assesses individuals' preference, ability, and engagement with rational and experiential cognitive styles. Data analysis revealed that SRNAs and CRNAs have the ability and engagement preference for rational decision-making. Furthermore, there was no statistical significance in years of clinical experience to cognitive preference, nor was there a statistically significant difference between SRNA and CRNA REI-40 Inventory results. Based on these findings, the dominant cognitive preference is rational cognition and experiential thinking preference remains constant with increased experience. This knowledge contributes to our understanding of CRNAs' decision-making related to cognitive processes and provides insight into SRNA clinical education and CRNA continuing development.

Improved management of pediatric obesity in the primary care setting through implementation of the healthy care for healthy kids obesity toolkit.

Pediatric obesity has become a major health care concern over the last several decades. This condition can lead to detrimental life-long physical and mental comorbidities. Pediatric primary care providers have a unique opportunity to both prevent and treat pediatric obesity in their clinics. However, discussing this topic with families can be uncomfortable and time consuming. Time efficient resources to educate and increase confidence are needed to improve the management of pediatric obesity. This quality improvement project integrated the Healthy Care for Healthy Kids by the National Institute for Children's Healthcare Quality (2014) into the electronic medical record at a pediatric primary care office in rural East Tennessee. This toolkit included handouts, management algorithms, and provider education for pediatric obesity. After an 8-week implementation period, improvements in lab draws and evaluation of a family''s readiness to change were noted. Overall, providers reported the toolkit was helpful and improved patient interaction. Currently, the clinic is still utilizing the integrated resources and handouts.

Identifying adolescents with hoarding disorder.

Hoarding disorder is a relatively new diagnosis in the DSM-5, only just included in the most recent edition. The disorder has piqued the interest of many in the community, in part because of the hit TV show called "Hoarders." Although there is interest, there continues to be relatively few research studies into the causes, treatment, and management of this disorder specifically in adolescences. Yet, in the research that has been published, it often sites the disorder first appearing in adolescents. This paper will discuss the following elements of adolescent hoarding disorder: The potential etiology and risk factors noted in the literature, the DSM-5 criteria for the diagnosis of hoarding disorder, and the characteristic signs and symptoms found in the adolescent presentation, as well as treatment. Finally, it will also include recommendations for healthcare professionals for early screening and treatment.

"The Good Ole' Girls' Nursing Club": The Male Student Perspective.

BACKGROUND: Diversity in nursing remains limited with little progress made in the recruitment of males. The purpose of this research was to garner the male nursing students' perspectives of their lived experiences while enrolled in their undergraduate program. METHOD: A phenomenological group focus approach was utilized with male nursing students regarding their lived experiences of what factors support or negate their being successful in completing a nursing program. RESULTS: Four themes were interpreted: exclusion, gender bias, career expectations, and acceptance. Exclusion and gender bias were seen as negative impact factors, while career expectations was both a motivating factor and a negating factor. Acceptance was interpreted as an important positive factor. CONCLUSION: A call for change to the profession of nursing from a culture of the "good ole' girls' nursing club" to one of "great nurses from both genders and all ethnicities" is critical for the future growth of the profession.

Universal adolescent depression prevention programs: a review.

Although the subject of adolescent depression has gained significant attention, little is being done in the way of primary prevention. The purpose of this article is to conduct a review of the literature through the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. This review was conducted utilizing several online databases, as well as web and hand searches. Eleven studies were identified through a process of elimination and critically appraised by a two-tiered method. Results indicated cognitive-behavioral universal prevention interventions can be effective on decreasing depressive symptomalogy in adolescents. All reviewed studies were conducted in the school environment by professionals and/or school staff; however, only three of the programs implemented demonstrated adoption and sustainability. School nurses can be instrumental in bridging the gap between the planning and developing of prevention programs and translation into the real-world school environment.

An integrative review of adolescent depression screening instruments: applicability for use by school nurses.

BACKGROUND: Major depression is a significant yet underdiagnosed problem of adolescence. The consequences of undiagnosed and untreated depression in this vulnerable population can have detrimental effects. School nurses are in a prime position to perform early screening and referral. However, the school environment requires special consideration as the setting for screening of adolescent depression. OBJECTIVE: The purpose of this paper is to identify instruments that can be utilized by the school nurse to perform easily administered, rapid adolescent depression screenings that are valid, reliable, and economical. METHODS: An integrative review of current depression instruments used in adolescents was conducted. RESULTS: Of the seven most commonly used instruments, only four of those fit the criteria listed for conducting screening in the school setting by the school nurse. The four instruments include the Beck Depression Inventory-Youth (BDI-Y), the Children's Depression Inventory, the Center for Epidemiological Studies-Depression Scale for Children, and the Reynolds Adolescent Depression Scale. CONCLUSION: Although all four of the identified instruments provide reliability and validity in the school setting, it is the other criteria: affordability, ease of administration, and the ability of the instrument to be rapidly scored, that placed the Center for Epidemiological Studies-Depression Scale for Children and the BDI-Y as the reasonable choice of instruments for use by the school nurse.

Implementation and testing of the OPT Model as a teaching strategy in an undergraduate psychiatric nursing course.

Teaching undergraduate nursing students to think critically and reason clinically is a challenge for nurse educators, yet these skills are essential for the professional nurse. The Outcome-Present State-Test (OPT) Model of Reflective Clinical Reasoning (Pesut & Herman, 1999) provides a framework for teaching clinical reasoning skills to nursing students. This article describes how the model can be used in clinical teaching of undergraduate students in psychiatric and mental health settings and presents some findings from an evaluation of the model. Strategies employed in the model implementation are described, along with the benefits and limitations of this teaching method in a psychiatric clinical setting.

Evaluation of the Outcome-Present State Test Model as a way to teach clinical reasoning.

The Outcome-Present State Test (OPT) Model of Clinical Reasoning is a nursing process model designed to help students develop clinical reasoning skills. Although many nurse educators are using the OPT model as a teaching strategy, few are formally evaluating its use as a method. We used the OPT model as a teaching tool in an undergraduate psychiatric and mental health clinical nursing course and evaluated how quickly students became adept at using it. Most students mastered the use of the model; 29 of 43 students achieved the criterion score (a score greater than 65 on 3 or more models completed over 4 weeks). Not only did the students gain clinical reasoning skills, but they also used and learned more about the North American Nursing Diagnosis Association, Nursing Interventions Classification, and Nursing Outcomes Classification languages. Recommendations for future use of the model include adding client strengths and increasing focus on the quality of students' responses.