Using gaming simulation to evaluate bioterrorism and emergency readiness education.

OBJECTIVE: We performed an outcome evaluation of the impact of public health preparedness training as a group comparison posttest design to determine the differences in the way individuals who had participated in training performed in a simulated emergency. METHODS: The Experimental Group 1 included students who had graduated from or were currently enrolled in the bioterrorism and emergency readiness (BT/ER) curriculum at the University of Minnesota School of Public Health. The comparison groups included individuals who had access to the Internet and were aware of the 2006 online simulation Disaster in Franklin County: A Public Health Simulation. The evaluation process employed surveys and the gaming simulation as sources for primary data. RESULTS: Participants in the BT/ER curriculum (p=0.0001) and other participants completing at least 45 hours of training in the past year (p=0.0001) demonstrated higher effectiveness scores (accuracy of chosen responses within the simulation) than participants who did not report significant amounts of training. CONCLUSIONS: This evaluation research demonstrated that training is significantly associated with better performance in a simulated emergency using gaming technology.

Doctor of philosophy and doctor of nursing practice as complementary degrees.

The introduction of the doctor of nursing practice (DNP) has raised serious concerns about the discipline's continuing ability to build its body of knowledge at an appropriate rate. After noting the various concerns that have been raised that the DNP siphons off prospective doctor of philosophy (PhD) students and compromises the standing of schools of nursing in universities, the distinct but complementary roles of nurses with the two preparations are described. Rather than worry about the DNP distracting from the PhD, the argument is made that these two degrees support one another and together can help to advance the creation and translation of knowledge into the practice of the discipline. Similar discussions about the distinction between practice and research in the field of education are noted.

Conceptual frameworks used in funded nursing health services research projects.

Theories not only suggest ideas for research, but they provide order and logic to an investigation and limit the number and type of variables to be considered to a reasonable few. Although relatively little health services research is done within nursing, there is a growing appreciation of the need for knowledge related to the use, costs, quality, delivery, organization, financing, and outcomes of health care and how nursing practice influences these variables. Conceptual frameworks used by investigators in funded grants from the Agency for Healthcare Research and Quality show that workforce-related health services research of nursing phenomena is based on a wide variety of conceptual models, many of the investigator's own invention. Ultimately, there may emerge new theories or conceptual frameworks that combine clinical, organizational, financial, and outcome variables from the unique perspective of nursing. Such conceptualizations will guide future researchers and add coherence to the body of health services research into nursing issues.

Patient education in heart failure.

The preparation of chronically ill patients for self-care has traditionally rested on the assumption that patients require certain knowledge and skills. A review of the literature on the subject of patient education in heart failure suggests that although teaching patients about the care of a chronic condition is necessary, it may be more effective if supplemented by continuing reinforcement, symptom monitoring, and behavioral reinforcement by an interdisciplinary team. Nurses have an opportunity and a responsibility to dissect and test the teaching-learning process in heart failure. Evidence that builds on what is already known about patient education will allow nurses to construct protocols that can be adopted as standards of practice and included in electronic health records.

Nursing faculty satisfaction with individual, institutional, and leadership factors.

A survey of full-time nursing faculty in Minnesota examined perceptions about individual, institutional, and leadership characteristics. Of 548 surveys sent, 298 responses were analyzed (54 percent). Faculty were, on average, 50.5 years old, female (96 percent), and white (97 percent). Approximately 82 percent would choose nursing again, 63 percent would choose to work in their current institutions, and only 9 percent would not choose a faculty career again. Ninety-eight percent were committed to their careers and 97 percent to the profession. Only 44 percent had confidence in nursing's direction. Similarities among faculty included having input into their roles and time; clarity about their work and goals fitting with the schools' vision and goals; the role of the dean and senior faculty in maintaining the vision; the sense that their opinions are routinely solicited and incorporated; and compensation is not fair for the work that is done. Most (80 percent) felt that there were effective communication systems, constructive feedback from colleagues (71 percent), and a supportive network in their departments (55 percent). Differences related mostly to role functions; for example, baccalaureate and graduate faculty were more involved and had greater skills, rewards, and resources in research, and faculty in associate's degree and licensed practical nurse programs perceived greater support for providing patient care. Recommendations are given for creating supportive work environments for faculty.

Matching standards and needs in doctoral education in nursing.

The debate about the number and type of doctoral degrees required in nursing has recurred with regularity throughout the history of nursing. National discussions about the shortcomings and relevance of the PhD within general higher education circles are described. Applicability of these concerns to nursing education is discussed. In the midst of this national debate, new nursing doctoral degrees are being proposed and implemented. Emergence of these new degrees has caused many to worry about replicating at the highest degree level the current confusion about nursing preparation at the entry level. A classification of doctoral degrees in nursing is proposed along with a call for standardization of degrees.