The Privately Financed Public University: A Case Study of the University of Michigan-Ann Arbor

Policy Report by Vicki Murrayhttp://deepblue.lib.umich.edu/bitstream/2027.42/88326/1/2005_Goldwater_UM_Report.pd

Institutional and Student Transitions Into Enhanced Blended Learning

This presentation provides an overview of the ‘Transitions into blended learning’ project, which has focused on three areas: developing an institutional transition framework, researching student experiences, and identifying interventions to support effective transitions. The framework identified external drivers for blended learning, a set of considerations for institutions, and a set of processes to facilitate change involving three stakeholder groups at the heart of the model. The work included learner experience research with students newly engaged in blended learning. This work identified support needs around access (to technology and learning materials), attitudes (towards learning online) and attributes (skills) needed to engage autonomously in blended learning. The institution-wide Enhancement themes team identified a set of interventions or ‘anchor points’ to prevent the institution ‘drifting back’ into purely traditional approaches to learning and teaching. These included the recognition and promotion of good practice through case studies, development of an institutional e-learning framework, and an event to encourage staff and students to share good practice in blended learning. This three-year project was largely led by a PhD student (JA), working with the principal investigator (VHD) and the institutional representative (KG)

hivstigma.com, an innovative web-supported stigma-reduction intervention for gay and bisexual men

An intervention to address stigma directed toward HIV-positive men and to enhance the sexual health of gay and bisexual men was developed through a community-based process involving HIV prevention workers, public health, government, and researchers. The intervention aimed to diminish stigma, create greater support for HIV-positive men, make disclosure safer and easier, discourage reliance on disclosure to prevent transmission, and encourage testing. The question, “If you were rejected every time you disclosed, would you?” was widely disseminated in the gay community and supported by the website, hivstigma.com, to encourage participation in blog-based discussions. Eight bloggers moderated lively discussions over 5 months. There were 20,844 unique visitors to the site averaging more than 5 minutes each; 4,384 visitors returned more than 10 times. 1,942 men answered a pre-test survey on a popular gay dating site and 1,791, a post-test evaluation. Results show a statistically significant shift among those aware of the intervention toward reduced stigma-related attitudes and behaviors, and toward recognition that HIV positive gay men face stigma in the gay community and that stigma reduces the likelihood of HIV disclosure

Seizure burden and neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy.

Aim: To examine the relationship between electrographic seizures and long-term outcome in neonates with hypoxic-ischemic encephalopathy (HIE). Method: Full-term neonates with HIE born in Cork University Maternity Hospital from 2003 to 2006 (pre-hypothermia era) and 2009 to 2012 (hypothermia era) were included in this observational study. All had early continuous electroencephalography monitoring. All electrographic seizures were annotated. The total seizure burden and hourly seizure burden were calculated. Outcome (normal/abnormal) was assessed at 24 to 48 months in surviving neonates using either the Bayley Scales of Infant and Toddler Development, Third Edition or the Griffiths Mental Development Scales; a diagnosis of cerebral palsy or epilepsy was also considered an abnormal outcome. Results: Continuous electroencephalography was recorded for a median of 57.1 hours (interquartile range 33.5-80.5h) in 47 neonates (31 males, 16 females); 29 out of 47 (62%) had electrographic seizures and 25 out of 47 (53%) had an abnormal outcome. The presence of seizures per se was not associated with abnormal outcome (p=0.126); however, the odds of an abnormal outcome increased over ninefold (odds ratio [OR] 9.56; 95% confidence interval [95% CI] 2.43-37.67) if a neonate had a total seizure burden of more than 40 minutes (p=0.001), and eightfold (OR: 8.00; 95% CI: 2.06-31.07) if a neonate had a maximum hourly seizure burden of more than 13 minutes per hour (p=0.003). Controlling for electrographic HIE grade or treatment with hypothermia did not change the direction of the relationship between seizure burden and outcome. Interpretation: In HIE, a high electrographic seizure burden is significantly associated with abnormal outcome, independent of HIE severity or treatment with hypothermia

Benner\u27s model and Duchscher\u27s theory: Providing the framework for understanding new graduate nurses\u27 transition to practice

The transition to quality and safety in the new graduate registered nurses\u27 practice remains problematic directly impacting patient outcomes. Effective mentoring during transition serves to enhance experiential learning, allowing the development and establishment of safe, quality nursing practice. Comprehensive understanding of the transition process, including the barriers and effective enablers to transition is the key to effective mentoring. A theoretical framework guided by Duchscher\u27s Stages of Transition Theory and Transition Shock Model and Benner\u27s From novice to expert model can facilitate such understanding. Nurse Theorists play an important part in shaping nurse education and practice and have provided nurse educators and leaders an understanding to shape skill acquisition and the transition process for new graduate registered nurses. The res ultantresearchmodels and theory of these influencial nurses are pertinent to transition of new graduate registered nurses. This paper outlines the theories of Duchscher and Benner and how their research formed the theoretical framework to facilitate the measurement, understanding and improvement of the safety and quality of nursing care and impact the future nursing workforce

New graduate nurses\u27 clinical safety knowledge by the numbers

AIM: To explore new graduate registered nurses\u27 knowledge and attitudes concerning medical error and patient safety, during their first 6 months of professional practice. BACKGROUND: New graduate registered nurses demonstrate basic skills and levels of performance due to limited exposure and experience in actual situations. There is a concern held for their clinical reasoning skills required to recognize patient deterioration, posing a threat to patient safety. METHODS: An online questionnaire was used to survey new graduate registered nurses at three time points during graduate nurse programmes between August 2016 and February 2018. RESULTS: A decrease in self-reported knowledge and attitudes regarding medical errors was noted over the three time points. These results indicate initial confidence in theoretical knowledge and attitudes upon completion of undergraduate education, and prior to commencing professional practice. CONCLUSION: Results suggest that a theory practice gap persists with respect to medical error for transitioning new nurses. IMPACT FOR NURSING MANAGEMENT: New nurses lack confidence around compromised patient safety situations and a knowledge gap around actions related to medical error. Nurse managers and educators should be made aware of this gap to implement strategies to decrease risk during novice nurse transition

New graduate nurses\u27 understanding and attitudes about patient safety upon transition to practice

AIMS: To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. BACKGROUND: New graduate registered nurses\u27 transition is accompanied by a degree of shock which may be in tune with the described theory-practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. DESIGN: Qualitative descriptive approach using semi-structured interviews. METHODS: Data were collected during 2017-18 from 11 participants consenting to face-to-face or telephone semi-structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). RESULTS: Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses\u27 clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. CONCLUSION: Transition shock leaves new graduate registered nurses\u27 focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. RELEVANCE TO PRACTICE: Having an understanding of the new graduate registered nurses\u27 experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time

New graduate registered nurses’ knowledge of patient safety and practice: A literature review

Aims and objectives To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Background Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. Design A focused review of research literature. Methods The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. Results This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Conclusions Issues raised in the 1970s remain a concern for today\u27s new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Relevance to clinical practice Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition

Hoki ki tōu maunga kia purea ai koe ki ngā hau o Tāwhirimātea. A tangata whenua model of supervision

This thesis explores a cultural practice, specifically a Tangata Whenua (people of the land) model for supervision through the experiences of research participants using a phenomenological approach. The model for supervision is called, ‘Hoki ki tōu maunga kia purea ai koe ki ngā hau o Tāwhirimātea’ (Return to your mountain to be cleansed by the winds of Tāwhirimātea). Māori (Indigenous people of Aotearoa, New Zealand) epistemology and tangata whenua frames of reference are woven throughout this qualitative study as bracketed by the researcher’s Māori centric orientation to Phenomenology and Kaupapa Māori Theory, the research methodologies. The fusion of ever changing horizons are highlighted as the hermeneutics of traditional cultural practices performed on ancestral locations interact in positive ways for Māori social workers today. Karakia (incantation), mihi (identification through kinship relationship to people and land), waiata, (song), whakataukī (proverbial sayings), pūkōrero (narratives) and te reo me ōna tikanga (Māori language and processes) are a few of these practices which reconnect the participants to their own iwi (tribal) and hapū (sub-tribal) ways of knowing, seeing and being. Thus 'grounded' they are better able to integrate tangata whenua epistemologies within the workplace and in their practice. In effect the benefits extend to the whānau they work with and can be transferred in kind to advance hapū and iwi wellbeing. The phenomenological inquiry acknowledges the research participants claim to select, recollect and reflect on expressions within their own traditional knowing beyond those modelled by the researcher. The study found the efficacy of Hoki ki tōu maunga is as a cohesive and holistic model of supervision of wellbeing for kaimahi Māori implementing Māori models of practice and working with whānau Māori. The findings of the study highlight the need for tangata whenua epistemologies and methodologies to be integrated into social work and supervision practice policies for Māori social workers as a cultural standard