Cancer care in Nepal: variables that affect diagnosis, treatment, and prognosis: a case study.

This manuscript presents a case study of a Nepalese woman experiencing breast cancer. Six themes were identified to have an impact on the diagnosis, treatment, and prognosis. They include: cultural impact on women's roles, socioeconomic status and education, surgical oncologist-patient relationship, surgical oncologist-nurse relationship, nurses' lack of oncology knowledge, and lack of a cancer screening and prevention program in Nepal. Cancer care is on the rise in Nepal. However, many of the variables identified above are not considered in the cancer care provided. Nepal has just opened its first national cancer center with the intent to improve cancer care throughout the country.

The impact of the use of inquiry-based learning as a teaching methodology on the development of critical thinking.

Problem-based learning (PBL) uses patients' problems to develop students' problem-solving and clinical skills. Inquiry-based learning (IBL) was developed as a similar methodology that was more holistic and flexible. This study sought to determine if inquiry-based learning (IBL) enhances critical-thinking ability as measured by the Watson Glaser Critical Thinking Appraisal (WGCTA). The WGCTA was administered to 228 nursing students in the first semester and 257 students in the final semester of their program. When the scores were stratified into groups, the students in the low group showed a significant increase in mean score, no change in the medium group, and a significant drop for the high group.

Impact of a student interdisciplinary oncology team project.

Team approaches to health care have been developing steadily over the past 30 years in response to increasing concerns about accessibility, efficiency, and comprehensiveness of health care services. Implementation of team approaches has been accompanied by development of curricula and educational experiences that educate health professionals both in effective teamwork skills and in understanding the contributions each profession makes to comprehensive health care. Such a project was implemented in 1975 at the University of Hawaii involving the Schools of Nursing, Social Work, and Medicine. This paper describes an evaluation of the impact of an interdisciplinary team approach to the care of oncology patients by students in medicine, nursing, and social work. Evaluation is based upon project objectives using a series of pre- and posttest measures and weekly logs by participating students between 1979 and 1985. The paper addresses the following questions: What was the impact of the team experience on participating students as reflected in evaluation data? How effective was the Student Interdisciplinary Oncology Team Project in helping students achieve each of the seven stated objectives? What are the differences in professional socialization processes among the three professions represented in the project?

Learning needs of Oncology Nursing Society members.

The ONS mission is to promote excellence in oncology nursing. In its effort to carry out this mission, ONS has a responsibility to provide high-quality continuing education (CE) for cancer nurses. An important first step in the provision of quality CE is determining learners' needs. The ONS Continuing Education Provider Committee (CEPC) conducted a comprehensive educational needs assessment of the ONS membership during 1988. Preferred content (98 topics were included), level of content needed (basic versus advanced), preferred teaching-learning methods, and items related to the logistics of CE programs (i.e., preferred length, days of week, employer reimbursement) were assessed. Half of the 1988 ONS membership (6,500) was randomly surveyed, with a 30.8% (2,002) return rate. Analysis revealed the five topics of most interest to be oncologic emergencies, pain, critical care of the patient with cancer, legal issues, and advanced nursing practice roles.

A comparison of the clinical judgment process in experienced registered nurses and student nurses.

The purpose of this study was to analyze the clinical judgment process used by registered nurses identified as highly-skilled judgment-makers (HSJMs) and student nurses. Two areas of the clinical judgment process were explored: the type and number of cues elicited, and the judgment process. Thirteen students within a month of graduation, and 13 HSJMs participated in this study. For each participant, the judgment task was the initial assessment of a hospitalized patient. Each nurse reviewed the patient's Kardex, listened to the end-of-shift report and then assessed the patient as if this was the beginning of a workshift. This nurse-patient interview was tape recorded. Each nurse was then asked to review her thoughts as short segments of the nurse-patient interview were replayed. This was also tape recorded. These tapes were transcribed, and three nurse educators rated each transcript using a judgment process rating scale. Results of this study indicated the following: the registered nurses collected significantly more cues than the students, use of each cue type was not the same, students and HSJMs collected cues in the same proportion, and total scores on the rating scale could discriminate between the student and HSJM groups.

A comparison of role conceptions and role deprivation of baccalaureate students in nursing participating in a preceptorship or a traditional clinical program.

In this study, the professional and bureaucratic role conceptions and role deprivation of students participating in a preceptorship program were compared to those in a traditional faculty-supervised clinical group. The role conceptions and role deprivation of nursing faculty and preceptors were also examined. One hundred eighteen students in a two-year upper division baccalaureate program participated in this study. The Corwin Nursing Role Conception tool was administered. Results indicated no differences in role conceptions or role deprivation in students participating in the preceptorship program and those who did not. There were no differences in the developmental pattern of role conception and role deprivation during two years of nursing education. Also, nursing faculty had a significantly higher professional role conception and a significantly lower bureaucratic role conception than preceptors but there were no differences in role deprivation between the two groups.