• Becoming a stranger: The experience of African students' transformation in a baccalaureate school of nursing

      Omotosho, Samson Akinloye; Neal, Maggie T. (1998)
      This phenomenological study sought to understand the experience of African nursing students as they transition into nursing within the American culture. The central question was, what is it like to be an African nursing student in the United States? Students told stories about their experience that held significant meaning for them. Analysis of themes generated from the conversations revealed that the students' experience meant a personal transition and transformation, both as students and as strangers. The students' experience began with their detachment from home, a place that meant familiarity, security and comfort, indeed, was part of their very being. The detachment, experienced as a loss, was grieved by the students through frequent reference to home as they made comparisons of home's texture to that of their present life in America. The experience opened possibilities for realizing life's dreams. It also led to being a stranger. Being a stranger, the student was confronted with the challenges of making language effective, confronting issues about difference, learning new technology, facing unfamiliar methods of testing, and learning unfamiliar cultural practices. The students' transitioning encompassed adaptation, determination to succeed, reconciliation of new and old experiences, and the realization that some experiences were not reconcilable. Students were transformed by becoming more independent and developing new perspectives on life. Personally, the study initiated an inward journey that awakened a more holistic vision of the phenomenon of transition and transformation. It provided a new knowing that kindled a second chance at the meaning of being an African student. Finally, educators are urged to seek understanding of students through the art of unknowing; a call for open-mindedness, a posture for cherishing of diversity, a capacity for sensitivity to students' attachment to home places, and a consciousness for the historical nature of being. Administrators are urged to design orientation programs to address African students' difficulties related to technology, diversity and communication. African students need to reflect on memories of home and past, nourish those that make life flourish and unbound from those that are limiting. What might curriculum be like if these insights become praxis?
    • Debriefing Practices in Nursing Education Programs in the United States

      Fey, Mary K.; Jenkins, Louise Sherman (2014)
      Debriefing is essential to learning in simulation based education. However, little is known about current debriefing practices. While there is no single theory of debriefing, consistent themes about the characteristics of debriefing emerge from the simulation literature. The purpose of this study was to describe debriefing practices in prelicensure nursing programs. Logistic regression analysis identified the characteristics of the nursing program and the simulation administrator that are associated with the use of theory based debriefing. A descriptive cross-sectional design was used. Data was collected via the internet. The study questionnaire consisted of three parts: demographic questions about the nursing program, questions about the simulation administrator, and questions about debriefing practices. The study sample comprised prelicensure nursing programs from across the United States representing all entry level degree programs (n = 502). Descriptive analyses showed that most programs have integrated simulation into their curriculum. Most schools designate a faculty member to have responsibility for simulation activities. The majority of debriefing facilitators have no training in debriefing. Less than 20% of all debriefers have their competence assessed. Debriefing is not usually guided by a theory or model. The majority of respondents (82%) reported debriefing practices that incorporated the concepts of Kolb's experiential learning theory. Further data analysis explored the relationships that significantly affected the use of theory based debriefing practices. The presence of a designated simulation administrator was significantly associated with the use of theory based debriefing. Simulation administrators who had formal training in simulation and who were in the 46-55 year old age group were significantly more likely to practice theory based debriefing. Training and competency assessment, along with structuring debriefing discussions were significantly associated with the use of theory based debriefing. Findings suggest that nursing programs should allocated resources to several aspects of the simulation program. Programs should have a designated simulation administrator. This person should have training in simulation based education. All faculty who facilitate debriefings should have training and should have their competence assessed regularly. This study provides information about debriefing practices; the study should be repeated with other types of learners (e.g. medical students, licensed practitioners).
    • Psychological and physical health of Chinese immigrants in the Howard County, Maryland: A community survey

      Lee, Mei Ching; Thomas, Sue Ann, 1947- (2011)
      Background: Immigrants are the fastest growing fraction of the United States (USA) population. One in every ten people in USA is foreign born. Migration is a stressful event. Immigrants are vulnerable to psychological distress symptoms which increase their risk of heart disease, stroke and diabetes. Chinese are the third largest immigrant group in USA. From 1980 to 2006, the numbers of Chinese immigrants has increased by five-fold. However, little is known about their psychological health. Study of Chinese immigrants increases our understanding of their psychological health condition and the relationship to physical health and can inform the development of culturally sensitive community programs to improve psychological health in Chinese immigrants. Purpose: The purpose of this study was to identify risk factors for psychological distress of Chinese immigrants using a biopsychosocial model. The intention was to identify modifiable factors for psychological distress in Chinese immigrants. Methods: A cross-sectional design was used to conduct a descriptive-correlation survey study. A total of 247 Chinese speaking immigrants in Howard County were recruited. All instruments used in the study were written in Chinese including the Chinese Cultural Orientation Scale, Chinese Bicultural Identity Integration Scale, Chinese Riverside Acculturation Stress Inventory and Chinese Kessler Psychological Distress Scale. Data were analyzed using descriptive statistics, Chi squares, t-tests, Pearson's correlations and hierarchical linear multiple regressions. Results: The psychological distress rate among Chinese immigrants in the study was 22.3%. Biological and social factors explained 17.8% of the variability in psychological distress scores, adjusted R2 = .155 (p<.001). Adding acculturation factors into the regression model increased R2 by .104 (p<.001). The interaction effect of acculturation stress and English proficiency was the strongest predictor of psychological distress scores in Chinese immigrants. Other predictors in the model included age, self-reported health status and financial strain. The final model explained 26.1% of the variability in psychological distress scores. Conclusion: Howard County is the third richest county by per capita income in the nation. Yet, financial uncertainty remains a strong predictor of psychological distress for Chinese immigrants. Interventions of social services could be developed to meet Chinese immigrants' needs. English proficiency is important for psychological health in Chinese immigrants, especially when facing acculturation stress. Participants with low Englishproficiency are more susceptible to acculturation stress to develop psychological distress symptoms. Culturally sensitive strategies are recommended to improve English proficiency in Chinese immigrants. In this sample, there was a fairly low rate of chronic disease. However self-reported health remained a significant risk factor in the model. Further study is needed to examine what factors contribute to an individuals' perception of health and how that perception of health influences psychological health.
    • Using Mobile Devices to Access Evidence-Based Information in a Rural Health Clinic

      Carter-Templeton, Heather; Wu, Lin, M.L.I.S., A.H.I.P. (2014)
      The specific aim of this study was to describe the feasibility and usability of a mobile device and selected electronic evidence-based information programs (EEBIP) for supporting clinical decision making in a rural health clinic. This qualitative, descriptive study focused on the nurses' descriptions of their experience with the selected mobile device and EEBIP. The investigators recruited a purposive sample of seven nurses providing direct patient care at a rural healthcare clinic in the southern region of the United States .