Awareness and implementation of the 2000 United States public health service tobacco dependence treatment guideline in a public hospital system.

The 2000 United States Public Health Service (USPHS) clinical practice guideline, "Treating Tobacco Use and Dependence," recommends systems interventions to integrate the treatment of tobacco into routine health care. The Tobacco Control Initiative employed a systems approach to integrate evidence-based treatment for tobacco use into patient care practices in Louisiana's safety net health care system. The purpose of this study was to assess changes in awareness and implementation of the USPHS clinical practice guideline. Surveys were administered to a purposive sample of hospital personnel from key departments in the Louisiana State University system of public hospitals in 2003 (n = 24) and 2007 (n = 44). Perceptions of implementation success improved for 50 of 59 distinct survey items. Rasch scaling was used to assess overall (scaled) change and showed substantial improvement from 2003 to 2007 (P < 0.001). Survey items also were grouped into 6 logical key concept sets. Improvement occurred in perceptions for all 6 key concepts; however, not uniformly. Results of the 2003 and 2007 surveys illustrate the potential effectiveness of using a systems approach to integrate the assessment and treatment of tobacco use into routine care practices in a public health care delivery system that serves medically vulnerable populations.

The effect of type of learning environment on perceived learning among graduate nursing students.

A quasi-experimental study was conducted to examine the effect of type of learning environment (Internet only, compressed video remote-site, and compressed video host-site) on perceived learning among graduate nursing students. A convenience sample of 49 students enrolled in a graduate nursing research course was selected for the study. The findings showed no differences in perceived learning and final course grades among students enrolled in the three sections of the research course. While the effects of type of learning environment, feelings of connectedness, learner-learner, and learner-system interactions on perceived learning were not statistically significant, learner-instructor interactions had a significant effect on perceived learning. The study findings are encouraging in that students felt that they learned the course content and these perceptions were the same regardless of type of learning environment. The findings also suggest that the quality of instruction is more of an influence on learning than type of teaching modality.