Graduate nurses' learning trajectories and experiences of problem based learning: a focused ethnography study.

BACKGROUND: Problem-based learning seeks to foster active, collaborative and self directed learning. It is increasingly utilized in health professional education; however, it is difficult to ascertain effectiveness. Empirically, student satisfaction does not match academic achievement but the reasons for this are unclear. OBJECTIVE: To explore the experience trajectories and satisfaction of graduates who had completed an undergraduate problem-based learning nursing program. DESIGN AND METHODS: Qualitative focused ethnography using individual and group semi-structured interviews. Categories and themes were identified using inductive constant comparison. A comparative matrix analysis of differing levels of the two core processes illuminated specific experience profiles. PARTICIPANTS AND SETTING: Forty five program graduates who had graduated between one and nine years previously from a Western Canadian program offered at four academic sites. The sample was mostly female (n=37), aged 26-30 years (n=23) and graduated 5-8 years previously (n=20). RESULTS: Levels of satisfaction with the program varied markedly. Two core processes contributed to this: "understanding" and "valuing" problem-based learning. Specific experience profiles included: "Happy as fish in water" which represents those who understood and valued the approach, and flourished; "I'll do it but I won't like it" reflects those who understood and could adjust to the academic context but did not particularly value it; "I just want to be a nurse" characterized those who consistently disliked and resisted the process but endured in order to graduate. Each profile was characterized by attitudes, intentions, learning preferences and program satisfaction. CONCLUSIONS: We theorize an underlying mechanism explaining these diverse levels of satisfaction are differing orientations to studying. This approach to understanding how students typically approach learning is strongly linked to perceptions of academic quality and program satisfaction in higher education research, although it has been neglected in nursing problem-based learning research. Orientations to studying include reproductive surface learning, deep learning for understanding and meaning, and strategic approaches to maximize desired objectives. These orientations are congruent with the descriptive typologies developed in this research. This provides an effective explanation as to why some students adapt easily and flourish in problem-based learning contexts, while others continually struggle to adapt. Further research is needed to determine the relationship between deep, surface, and strategic orientations to study and student satisfaction in nursing programs.

Effects of the trematode Microphallus turgidus on locomotion and prey capture in the grass shrimp Palaemonetes pugio.

The grass shrimp, Palaemonetes pugio, is common in estuaries and marshes along the east coast of the USA and is frequently infected with metacercariae of the trematode, Microphallus turgidus. To test whether or not M. turgidus has an effect on intermediate host behaviour, the length of time spent swimming and walking over 1 min and 3 min intervals and prey (Artemia) capture rates of uninfected grass shrimp and those infected with 1-10, 11-20 or 21-30 metacercarial cysts were compared. Uninfected shrimps spent significantly more time swimming than infected shrimps during the first minute of observation. There were no differences between the control and infected groups in terms of swimming at 3 min, walking at 1 and 3 min, or in numbers of prey captured. These results indicate that M. turgidus may induce little or no change in grass shrimp locomotion nor in prey capture behaviour. This is in contrast to other parasites that modify intermediate host behaviour to enhance their transmission to definitive hosts. Furthermore, these data support earlier studies indicating that M. turgidus does not affect the growth and survival of P. pugio.

Video technology. Use in nursing research.

Video technology is becoming more popular as a research tool because it has unique features that capture accurately and comprehensively the nature of nursing phenomena. Video technology is used extensively in nursing as an educational tool or intervention, a means of monitoring quality assurance standards, and as tool to collect research data. Videotaping is useful because is provides continuous multi-media, multisensory information about the subject and its context. Credibility for video data is based on the question of to what extent do the data or results adequately represent true behavior. The three main issues in video research that impact the credibility of data are observer bias, participant reactivity to knowledge of being videotaped, and maintenance of consistent data quality. Not all threats to credibility can be overcome. The key is to acknowledge insurmountable problems, to consider their limitations in data analysis, and to evaluate and report their effects.

Evaluation of blood donors with elevated serum alanine aminotransferase levels.

We evaluated 100 asymptomatic blood donors with serum alanine aminotransferase (ALT) levels exceeding 0.83 mu kat/L, for evidence of liver disease or risk factors for non-A, non-B hepatitis and followed serum ALT levels for another 6 months. In 92 donors completing the study, ALT elevations occurred once in 33%, intermittently in 36%, persistently in 28%. Twenty-two donors were obese, 5 had clinical and biochemical evidence of alcoholic liver disease, and 45 drank alcohol regularly; 1 had hemochromatosis, and another, myopathy. In 22 no cause for elevated serum ALT levels was found. The presence or absence of risk of acquiring hepatitis did not correlate with the pattern of ALT elevations or the identification of another cause for the elevated ALT levels. In 92 blood donors with an initially elevated ALT level, two-thirds have intermittent or persistent elevations; most approximately 20% have no apparent cause for the elevations other than possible non-A, non-B hepatitis. These findings may be helpful in counseling and following blood donors with elevated ALT levels.