1

Do

es b

acc

ala

ure

ate

ed

ucatio

n

ma

ke a

diffe

ren

ce in

nu

rsin

g

pra

ctic

e?

Angel C

K L

EE

RN

BN

MB

A M

MedS

cP

hD

2

Backgro

und

•186

0: fo

rmal n

urs

ing e

ducatio

n b

y

Flo

rence N

ightin

ga

le (1

50 y

ears

)

•B

acca

laure

ate

pre

para

tion fo

r nurs

es

–1

96

0: in

the

U.S

.

–1

99

0: in

U.K

.

–2

00

0: in

H.K

.

•2010: re

sum

e h

ospita

l-based tra

inin

g, E

N/R

N

pro

gra

ms

•T

he s

tance o

f nurs

ing in

the 2

1st

centu

ry re

main

s a

su

bje

ct o

f dis

cours

e.

3

Ou

tline o

f dis

cu

ssio

n

1.

Ho

w d

id th

e v

alu

e a

nd

be

liefs

in n

urs

ing

in

he

rited

from

Flo

ren

ce

Nig

htin

ga

le s

ha

do

w

cu

rren

t pra

ctic

e?

2.

Are

the

re a

ny s

ign

ifica

nt m

ove

s in

nu

rsin

g

ed

uca

tion

to b

ridg

e th

e k

no

wle

dg

e-p

ractic

e g

ap?

3.

Do

the

ne

w m

od

els

in n

urs

ing

ed

uca

tion

brin

g

po

sitiv

e h

ea

lthca

re o

utc

om

es c

om

pa

red

to th

e

Ca

tho

lic m

od

el?

4

Th

e o

ne q

uestio

n q

uestio

n

Afte

r educatio

nal re

form

s fo

r nurs

es,

5

Ag

en

da

1.

How

did

the v

alu

e a

nd b

elie

fs in

nurs

ing

inherite

d fro

m F

lore

nce N

ightin

gale

shadow

curre

nt p

ractic

e?

6

Valu

e a

nd

Belie

fs in

Nu

rsin

g

•B

rought fo

rth b

y F

lore

nce N

ightin

gale

•In

term

s o

f nurs

ing e

ducatio

n a

nd n

urs

ing

pra

ctic

e

78

9

Valu

e a

nd

Belie

fs o

f Nu

rsin

g

•N

urs

ing is

a p

rofe

ssio

n

•E

nte

ring n

urs

ing is

like re

spondin

g to

a

call th

us a

sole

mn d

ecis

ion to

make

•Life

-long c

om

mitm

ent

10

Imp

licatio

ns

to n

urs

ing

ed

uca

tion

an

d p

ractic

e

•N

urs

ing

is a

pro

fessio

n

–A

bsta

in fro

m m

isbeha

vio

r

–M

ain

tain

and in

cre

ase th

e s

tand

ard

–P

reserv

e c

onfid

entia

lity

•S

ole

mn

de

cis

ion

to a

ca

ll –

pra

ctic

e fa

ithfu

lly

•L

ife-lo

ng

co

mm

itme

nt

–Loya

lty to

aid

the p

hysic

ian

–D

evote

to w

elfa

re o

f …

11

12

Qu

ality

ass

ura

nc

e a

s a

first s

tep

to

pro

fes

sio

naliz

atio

n

She a

ddre

ssed d

iffere

nt d

om

ain

s o

f quality

assura

nce:

•S

tructu

re

•P

rocess

•O

utc

om

es

13

Qu

ality

ass

ura

nc

e a

s a

first s

tep

to

pro

fes

sio

naliz

atio

n

•S

he

esta

blis

hed s

tandard

s o

f care

in

pra

ctic

e.

•U

nknow

n in

the 1

9th

centu

ry, N

ightin

gale

had to

cre

ate

not o

nly

a s

tructu

re, b

ut a

lso

a c

ultu

reto

support th

at s

tructu

re.

14

Stru

ctu

re d

om

ain

•(Dosse

y, 2

00

0, p

p.1

40)

Sh

e s

ou

gh

t wa

ys to

imp

rove :

•S

taff tra

inin

g &

de

ve

lop

me

nt -

e.g

. fo

rmal tra

inin

g fo

r nurs

es; im

pro

ve th

eir w

ork

ing

cond

itions

•In

frastru

ctu

ree.g

. monito

r hospita

l die

t; impro

ve p

hysic

al d

esig

n o

f the

hosp

ital k

itchen

15

Pro

cess d

om

ain

•(Dosse

y, 2

00

0, p

p.1

40)

Sh

e s

ou

gh

t wa

ys to

imp

rove :

•W

ork

syste

m

e.g

. medic

atio

n p

urc

hasin

g s

yste

m; a

ll hospita

l supp

lies

•M

on

itorin

g s

yste

me.g

. intro

ducin

g n

urs

e s

uperin

ten

dent, to

follo

w a

ll the ru

les

and p

roced

ure

s s

et fo

rth b

y th

e M

ed

ica

l De

partm

ent

•A

pp

oin

ting

syste

me.g

. reje

ct a

pp

oin

ting h

osp

ital p

ers

onne

l ba

sin

g o

n

conn

ectio

ns, th

us s

he w

as n

ever re

lucta

nt to

hire

and fire

16

Ou

tco

me d

om

ain

(Dosse

y, 2

00

0, p

p.1

40)

Sh

e d

eve

lop

co

ns

iste

nt m

ea

su

rab

le

pa

tien

t ou

tco

me

s.

Sh

e p

rep

are

d q

ua

rterly

rep

orts

to th

e

go

ve

rnin

g c

om

mitte

e o

n

(1) th

e p

urp

ose

of d

eliv

erin

g im

pro

ve

d

pa

tien

t ca

re

(2) h

er p

assio

n o

f be

sid

e c

are

giv

ing

.

17

Th

e im

po

rtan

ce o

f nu

rsin

g

ed

uca

tion

•(Dosse

y, 2

00

0, p

p.1

40)

Nig

htin

ga

le m

ain

tain

ed

an

d u

ph

eld

nu

rsin

g s

tan

dard

thro

ug

h

•recru

iting q

uality

stu

dents

•impartin

g g

ood e

ducatio

nal in

put

•pro

vid

ing s

tringent tra

inin

g w

ith a

sound

know

ledge b

ase.

18

Nu

rsin

g e

tiqu

ette

•H

avin

g th

e m

issio

n to

serv

e,

•B

ein

g a

sw

ift and a

ccura

te o

bserv

er,

•B

ein

g a

pt to

care

,

•R

egard

ing n

urs

ing a

s a

callin

g ra

ther

than a

care

er a

lone

Ch

an

g, 1

999, p

p. 1

60

19

if nurs

ing e

ducatio

n d

oes N

OT

•base o

n s

tring

en

t scie

ntific

g

rou

nd

•re

quire

a c

hara

cte

r for th

e jo

b

•re

spond n

urs

ing a

s a

callin

g

Nig

htin

ga

le N

ote

s, 1

860.

20

Sele

ctio

n o

f a n

urs

ing

stu

den

t

•C

alle

d fo

r hig

hly

qualifie

d c

andid

ate

s a

t th

e b

egin

nin

g

•w

ho w

as d

ete

rmin

ed to

devote

her life

to

am

elio

rate

hum

an s

uffe

ring

•w

as s

tringent

–1

6 o

ut o

f 20

00

[< 1

% ]

ap

plic

an

ts fo

r first

recru

itme

nt a

t Nu

rsin

g s

ch

oo

l, St. T

ho

ma

s

Ho

sp

ital, U

K in

18

60

Ch

an

g, 1

999, p

p. 1

60

21

Nig

htin

gale

’s v

isio

n o

n N

urs

ing

•S

he

refe

rred

sic

kn

ess, h

ea

lth a

nd

he

alin

g to

as

Dossey, 2

000, p

p.8

822

Nig

htin

gale

’s m

issio

n o

n h

ealth

care

•S

he

was th

e m

oth

er o

f pu

blic

he

alth

•S

he

pra

ctic

e e

vid

ence

-ba

se

d n

urs

ing

•S

he

was c

on

scie

ntio

us o

f the

ory

-p

ractic

e g

ap

•S

he

was v

igila

nt o

f pre

se

rvin

g th

e

ba

sic

prin

cip

les o

f co

mm

un

ica

ble

d

ise

ase

s

Dosse

y, 2

00

0, p

p.8

8

23

Were

Nig

htin

gale

’s

actu

aliz

ed

?

24

Nu

rsin

g e

du

catio

n in

the la

st

cen

tury

In te

rms o

f

•P

ed

ag

og

ica

l ratio

na

les

•L

ea

rnin

g o

bje

ctiv

es

•P

atie

nt o

utc

om

es

25

Ped

ag

og

ical ra

tion

ale

s o

f h

ealth

care

TO

:

Ho

listic

mo

de

l:

Pe

rso

n-o

rien

ted

; aim

s a

t

pro

vis

ion

of s

afe

an

d

qu

ality

he

alth

ca

re to

me

et p

hysic

al, p

sych

o-

so

cia

l an

d s

piritu

al

ne

ed

s

FR

OM

:

Me

dic

al m

od

el:

Dis

ea

se

-orie

nte

d; a

ims

at id

en

tifyin

g th

e

‘righ

t’tre

atm

en

t

1; 2

, pp. 5

26

Re

gard

sp

iritual c

are

as im

porta

nt h

ealin

g

sourc

e

Infre

quently

addre

ss

such a

spect

Sp

iritua

l

Be re

ady to

liste

nLeave it to

fam

ily

Psycho-

socia

l

Incre

ase in

de

x o

f

susp

icio

n a

nd a

ssess

Refe

r to p

sychia

trist o

r

socia

l work

er

Menta

l

Enh

ance p

atie

nts

’sense o

f wellb

ein

gR

elie

ve s

ym

pto

ms a

nd

reduce d

isab

ility; fo

ste

r

physic

al re

hab

ilitatio

n

Physic

al

Ho

listic

mo

del

Med

ical m

od

el

Asp

ects In

health

care

, nu

rses w

ill

27

By re

ceiv

ing

health

care

, p

atie

nts

will

Ob

tain

form

al s

upp

ort fro

m

ho

sp

ital o

r oth

er N

GO

vo

lun

teers

Do

it by s

elf

Sp

iritua

l

Re

ce

ive

info

rma

l or fo

rma

l su

pp

ort fro

m d

iffere

nt

so

urc

es

Ta

ke

it as p

ers

ona

l or fa

mily

is

su

eP

sycho-

socia

l

Incre

ase a

ware

ne

ss a

nd

se

ek h

elp

Hid

e u

p s

uch

ne

eds o

r be

re

ferre

d to

psych

iatris

t if serio

us s

ym

pto

ms o

ccu

r

Menta

l

Le

arn

to liv

e w

ith th

e

dis

ease

Be

dis

ease

free

or re

du

ce

d

isa

bility

Physic

al

Ho

listic

mo

del

Med

ical m

od

el

Asp

ects

28

Co

mp

arin

g th

e c

od

es o

f pra

ctic

e

Upho

ld th

e im

age o

f nurs

es

Com

ply

with

law

s o

f Ho

ng

Kong

Be fa

ithfu

l to th

e p

rofe

ssio

n

Devotio

n; C

om

mitm

ent to

patie

nt c

are

Attitu

de

Accounta

ble

and p

rofe

ssio

na

l

decis

ion-m

aker in

care

pro

vis

ion

Do n

o h

arm

De

cis

ion

-

ma

kin

g

Pro

vid

e s

afe

and c

om

pete

nt

nurs

ing

Main

tain

the a

gre

ed s

tan

dard

of p

ractic

e

Lo

yally

aid

the p

hysic

ians

Ele

vate

sta

nd

ard

of

pro

fessio

n

Pra

ctic

e

Pro

fessio

na

l co

de

of p

ractic

e

Nig

htin

ga

le’s

Ple

dg

e

29

Ro

les o

f nu

rses in

tran

sitio

n

Now–A

care

manager

–A

n a

dvocate

–A

n e

ducato

r–

A re

searc

her2

Nig

htin

gale

’s tim

e–

A c

are

r–

Ate

chnic

ian

–C

olle

ct h

ospita

l sta

tistic

s (lim

it to

senio

r sta

ff–

An a

dm

inis

trato

r1

1 C

ha

ng, 1

999, p

p. 1

60; 2

Hong K

on

g N

urs

ing C

ouncil, 2

002, p

p. 5

30

31

Ag

en

da

2.

Are

there

any s

ignific

ant m

oves in

nurs

ing e

ducatio

n to

brid

ge th

e

know

ledge-p

ractic

e g

ap?

32

Sig

nific

an

t mo

ve

s in

nu

rsin

g

ed

uca

tion

Befo

re 2

000: A

ppre

ntic

eship

in h

ospita

l tra

inin

g, ie

. Paid

sta

ff

•�

2000 o

nw

ard

s: T

ertia

ry e

ducatio

n, s

elf-

financed le

arn

ers

•�

In fu

ture

: Specia

lty n

urs

ing; A

cadem

y o

f nurs

ing

33

Hie

rarc

hy o

f nu

rsin

g c

are

er

Re

se

arc

he

rs

OR

Te

ac

he

rs

Clin

icia

ns

Stu

de

nts

34

Imp

licatio

ns

of s

uch

a h

iera

rch

y

C

T/R

S

35

Pro

ble

ms in

su

ch

hie

rarc

hy

•L

imit in

div

idu

al a

nd

pro

fessio

na

l gro

wth

�lo

we

r jo

b s

atis

factio

n �

hig

h w

asta

ge

, bu

rno

ut,

diffic

ulty

in re

tain

hig

h-c

alib

rep

ers

on

ne

l…

•D

iscre

te w

ork

role

s �

ina

de

qu

ate

co

mm

un

ica

tion

s b

etw

ee

n s

ecto

rs �

the

ory

-p

ractic

e g

ap

•D

ifficu

lt to e

xe

rcis

e E

BP

�In

flexib

le to

me

et

ne

w h

ea

lthca

re c

ha

llen

ge

s

36

Imp

licatio

ns

of s

uch

a h

iera

rch

y

•O

nly

a s

mall n

um

ber o

f pra

ctis

ing

nurs

es

are

serv

ing th

e ro

les o

f researc

hers

and

teachers

37

Th

eo

ry-p

ractic

e g

ap

s

1.B

acca

lau

rea

te g

rad

ua

tes o

f the

last d

eca

de

is

a m

ino

rity g

rou

p in

clin

ica

l pra

ctic

e.

2.M

ajo

rity n

urs

es a

re s

en

ior p

ractitio

ne

rs w

ho

are

eith

er b

eg

inn

ers

or re

ad

ers

of c

linic

al

rese

arc

h1.

3.C

om

pe

ting

clin

ica

l de

ma

nd

s d

ete

r the

ap

plic

atio

n o

f EB

P2

.

4.T

he

co

nce

pt o

f life-lo

ng

lea

rnin

g is

ne

w a

nd

role

co

nflic

t exis

ts b

etw

ee

n w

ork

, fam

ily a

nd

stu

dy.

1 L

ee e

t al, 2

005; 2

Lee e

t al. 2

007

38

Ro

les o

f nu

rses in

tran

sitio

n

Only

the to

p a

dm

inis

trato

r

Part o

f the c

linic

ian’s

role

Majo

r care

-giv

er

Appre

ntic

e

Nig

htin

ga

le’s

time

an

d

afte

r

Nu

rse

Re

se

arc

he

r (R)

Nu

rse

Te

ach

er (T

)

Nu

rse

Clin

icia

n (C

)

Nu

rse

Stu

de

nt (S

)

Ro

le

39

Ro

les o

f nu

rses in

tran

sitio

n

Inquire

r an

d b

uild

er o

f nurs

ing

kno

wle

dge b

ase to

guid

e E

BP

an

d

qua

lity c

are

A R

ese

arc

he

r (R)

Kno

wle

dg

eab

le in

both

clin

ica

l and

acad

em

ic a

rena to

brid

ge T

PG

A T

ea

ch

er (T

)

Indepe

nd

ent a

nd a

ccounta

ble

decis

ion-

maker a

nd e

xerc

ises E

BP

A C

linic

ian

(C)

Critic

al le

arn

ers

via

PB

L m

ode, k

now

ing

its trip

le ro

les in

futu

reA

Stu

de

nt (S

)

De

sira

ble

AS

K

[A=

Attitu

de, S

=S

kill, K

=K

no

wle

dg

e]

Ro

le

40

Th

e n

ew

lea

rners

in th

e

Mille

nn

ium

Re

se

arc

h

Ed

uc

atio

nP

rac

tice

N.S

NS

=N

urs

ing s

tudents

41

New

bra

nd

of n

urs

es re

qu

ired

Fa

st e

pid

em

iolo

gic

al tra

nsitio

n

in h

ea

lth a

nd

he

alth

ca

re

issu

es �

ne

ed

up

da

ted

an

d

rob

ust re

se

arc

h e

vid

en

ce

to

gu

ide

ou

r pra

ctic

e

Evid

en

ce

-ba

se

d

pra

ctic

e, E

BP

Eve

r-em

erg

ing

dis

ea

se

s a

nd

ch

an

ge

of d

ise

ase

pa

ttern

acro

ss th

e re

gio

ns a

nd

the

glo

be

Pro

ble

m-b

ase

d

lea

rnin

g, P

BL

Ju

stific

atio

ns

Ch

ara

cte

ristic

s o

f

cu

rren

t nu

rse

s

42

43

Ep

idem

iolo

gic

al tra

nsitio

n

•In

cre

asin

g c

hro

nic

illne

ss in

yo

un

ge

r ag

e g

rou

ps

•G

lob

al e

me

rge

nce

of d

isa

bility

du

e to

so

cia

l

ine

qu

alitie

s a

nd

hig

h p

reva

len

ce

in m

en

tal

he

alth

•P

an

de

mic

of c

om

mu

nic

ab

le d

ise

ase

s a

nd

dru

g

resis

tan

t vira

l stra

ins

44

Ep

idem

iolo

gic

al tra

nsitio

n

•C

hanges in

socio

dem

ogra

phy

show

n b

y

the p

opula

tion p

yra

mid

s:

–A

gin

g in

pla

ce

–L

ow

fertility

rate

–R

isin

g d

ep

en

de

ncy ra

tio

–G

en

de

r imb

ala

nce

45

Ep

idem

iolo

gic

al tra

nsitio

n

•T

he

so

cia

l ca

usa

tion

of h

ea

lth a

nd

illne

ss

•A

div

ers

ity o

f he

alth

co

nce

rns a

t scho

ol, w

ork

pla

ce

, fam

ily

•H

ea

lth c

are

utiliz

atio

n a

nd

ba

rriers

to h

ea

lth c

are

•S

ocio

eco

no

mic

ine

qu

alitie

s in

he

alth

: Inte

gra

ting

ind

ivid

ua

l, co

mm

un

ity a

nd

so

cie

tal le

ve

l

46

Em

erg

ing

health

care

co

ncern

s

•A

ccountin

g fo

r dis

ease a

nd d

istre

ss

•G

ender a

nd h

ealth

•C

ultu

ral v

aria

tion in

the e

xperie

nce o

f health

and illn

ess

47

Em

erg

ing

eth

ical is

su

es in

h

ealth

care

•A

ssis

ted re

pro

ductiv

e te

chnolo

gie

s

•A

dvanced d

irectiv

es

•S

tem

cell re

searc

h

•R

outin

ized

vaccin

atio

n a

gain

st g

enita

l dis

eases

48

Th

e d

ilem

ma

•A

ssis

ted re

pro

ductiv

e te

chno

log

ies: H

elp

ing

couple

s v

s.

killin

g liv

es

•A

dva

nce

d d

irectiv

es: w

e k

no

w v

s. G

od k

now

s; m

eanin

g

in s

uffe

ring

vs. g

ettin

g rid

of s

uffe

ring b

y a

ll means

•S

tem

cell re

searc

h: T

echn

olo

gy fo

r life v

s. life

for

techno

logy

•R

outin

ize

dvaccin

atio

n a

gain

st g

enita

l dis

eases:

pers

on

al c

ontro

l to re

frain

from

pro

mis

cu

ity v

s.

techno

log

ical p

reve

ntio

n

49

Nu

rse

s g

et c

au

gh

t up

in

health

care

dile

mm

a

•H

ealth

care

issues:

–D

ive

rse

, eve

r-gro

win

g, ra

pid

ly c

ha

ng

ing

, in

vo

lve

eth

ica

l leg

al c

on

trove

rsy

•N

urs

es m

ake a

cla

im fo

r an in

dependent,

pro

fessio

nal a

nd a

ccounta

ble

decis

ion in

health

care

–W

he

re’s

the

evid

en

ce

?

–W

hic

h p

ers

pe

ctiv

e to

take

?

•T

heory

-pra

ctic

e g

ap!

50

Th

eo

ry-p

ractic

e g

ap

s

TH

EO

RY

PR

AC

TIC

E

•Theory

develo

pm

ent

takes tim

e

•Dis

sem

inatio

n o

f new

kno

wle

dge

•Critic

al a

pp

rais

al o

f pap

ers

•Tim

e

•Cu

lture

51

Sig

nific

an

ce o

f dis

cu

ssio

n

•T

he

pe

ren

nia

l de

ba

te c

on

ce

rnin

g th

e s

o-c

alle

d

'the

ory

-pra

ctic

e g

ap

' pe

rva

de

s h

ea

lth

pro

fessio

na

l ed

uca

tion

. (Ne

wto

n e

t al., 2

00

9)

•A

co

nce

rn a

mo

ng

pre

-a

nd

po

st-re

gis

tratio

n

un

de

rgra

du

ate

nu

rsin

g s

tude

nts

an

d n

urs

es.

(Fin

n e

t al., 2

01

0)

•F

orm

s th

e b

arrie

rs to

imp

lem

en

ting

evid

en

ce

-b

ase

d p

ractic

e. (P

eck e

t al., 2

00

9)

52

Th

eo

ry-P

ractic

e G

ap

(TP

G)

•S

tudent s

kills

and a

ttribute

s w

ere

a

concern

•A

bla

me c

ultu

re b

etw

een s

om

e

univ

ers

ities a

nd m

enta

l health

trusts

(Evans, 2

009)

53

•T

he c

oncern

over p

roductio

n o

f gra

duate

s

who a

re fit fo

r pra

ctic

e a

nd p

urp

ose

(Tic

kle

et a

l., 2010)

•N

urs

ing s

tudents

' train

ing is

suffe

ring

•P

atie

nts

and fa

mily

suffe

r

•H

ospita

l suffe

rs

(Evans, 2

009)

Th

eo

ry-P

ractic

e G

ap

(TP

G)

54

Th

eo

ry-P

ractic

e G

ap

•4

pa

rticip

an

ts re

flectin

g o

n th

eir p

erio

pe

rativ

ee

xp

erie

nce

s d

urin

g p

lace

me

nt

•fiv

e th

em

es:

–dis

covery

of s

elf-le

arn

ing;

–skill a

cq

uire

ment in

clin

ical p

lace

ment;

–assim

ilatio

n o

f know

ledge (m

indin

g th

e th

eory

-pra

ctic

e g

ap);

–clin

ica

l sca

ffold

ing (th

e im

porta

nce o

f clin

ical s

up

port)

and

–pro

fessio

nal e

motio

nal e

mancip

atio

n (re

flectin

g th

e

phe

nom

en

a o

f learn

ing in

the p

ractic

e s

ettin

g a

nd s

kill

acqu

isitio

n).

(Ne

acsu

, 20

06

)

55

Th

eo

ry-P

ractic

e G

ap

•S

ign

ifica

nt d

iffere

nce

s b

etw

ee

n a

ctu

al

ob

se

rva

tion

s a

nd

ide

al p

erc

ep

tion

s o

f mid

wife

ry

pra

ctic

e w

ere

fou

nd

in tw

o o

f the

four c

linic

al

se

tting

s (b

irth c

en

ters

an

d h

om

eb

irth) a

nd

•O

ne

typ

e o

f ed

uca

tion

pro

gra

m (B

A to

BS

N to

C

NM

). No

diffe

ren

ce

wa

s fo

un

d b

etw

ee

n

trad

ition

al v

ers

us d

ista

nce

lea

rnin

g p

rog

ram

s.

(La

ng

e a

nd

Ke

nn

ed

y, 2

00

6)

56

Typ

es o

f TP

G

Tra

nsfe

r kn

ow

led

ge

an

d s

kill fro

m

•Labora

tory

learn

ing �

clin

ical s

ettin

g

•R

esearc

h fin

din

gs �

clin

ical p

ractic

e

57

Ap

plie

d la

bo

rato

ry le

arn

ing

to

clin

ical s

ettin

g

Exam

ple

s:

•T

he u

se o

f sim

ula

tion, w

ithin

mid

wife

ry

educatio

n (D

avis

et a

l., 2009);

•In

troducin

g a

pre

cepto

rship

clin

ical

pla

cem

ent m

odel a

t one h

ealth

care

org

anis

atio

n(N

ew

ton e

t al., 2

009)

58

Ap

plie

d la

bo

rato

ry le

arn

ing

to

clin

ical s

ettin

gA

im o

f the s

tudy :

•H

ow

nurs

ing s

tudents

' kno

wle

dge a

nd s

kills

gain

ed

with

in u

niv

ers

ity c

linic

al la

bora

torie

s tra

nsfe

r into

the

reality

of th

e c

linic

al e

nviro

nm

ent.

Meth

od:

•In

terv

iew

s +

focus g

roup

•S

eco

nd a

nd th

ird y

ear u

nderg

rad

uate

nurs

ing s

tudents

(n

=28)

•D

ata

were

transcrib

ed a

nd im

porte

d in

to N

Viv

o8 fo

r th

em

atic

ana

lysis

.

(New

ton

et a

l., 2009)

59

Fin

din

gs: F

ou

r ke

y th

em

es

•S

tud

en

ts' p

erc

ep

tion

s o

f the

ir lea

rnin

g

pre

fere

nce

s

•P

erc

eiv

ed

lack o

f au

the

ntic

ity o

f clin

ica

l la

bo

rato

ries

•L

ea

rnin

g o

pp

ortu

nitie

s a

va

ilab

le in

the

clin

ica

l se

tting

•In

flue

nce

of in

div

idu

al te

ach

ers

on

stu

de

nt

lea

rnin

g

Ap

plie

d la

bo

rato

ry le

arn

ing

to

clin

ical s

ettin

g

60

•U

se a

fresh a

ppro

ach th

at c

oncentra

tes

on d

iffere

nt fo

rms o

f know

ledge

•A

im to

inte

gra

te s

ubje

ct-b

ased a

nd w

ork

-based k

now

ledge, a

nd

•Id

entify

the w

ays in

whic

h th

ese a

re

conte

xtu

alis

ed

and 're

-conte

xtu

alis

ed' in

m

ovem

ents

betw

een d

iffere

nt s

ites o

f le

arn

ing in

colle

ges a

nd w

ork

pla

ces.

(Evans e

t al., 2

010)

Ap

plie

d la

bo

rato

ry le

arn

ing

to

clin

ical s

ettin

g

61

Ap

plie

d re

searc

h fin

din

gs to

clin

ical p

ractic

e•

Stu

dy re

sults

show

that n

urs

es w

ere

genera

lly in

tere

ste

d to

use re

searc

h

findin

gs

•H

indra

nces to

do s

o d

ue to

: –

lack o

f time

,

–la

ck o

f pee

r an

d m

an

ag

er s

up

po

rt

–lim

ited

kn

ow

led

ge

an

d s

kills

of th

e re

se

arc

h

pro

ce

ss

(Anth

ony e

t al., 2

008)

62

•T

here

is a

lag tim

e in

researc

h

public

atio

ns th

at ta

ke y

ears

to b

e fo

und

in te

xtb

ook (A

nth

ony e

t al., 2

008)

Ap

plie

d re

searc

h fin

din

gs to

clin

ical p

ractic

e

63

Ap

plie

d re

searc

h fin

din

gs to

clin

ical p

ractic

e

ME

TH

OD

:

•A

syste

ma

tic re

vie

w o

f pa

pe

rs id

en

tifyin

g th

e

pro

ble

m (p

ha

rma

co

kin

etic

s in

EC

MO

pa

tien

ts)

an

d th

e d

isse

min

atio

n o

f this

to c

linic

ian

s w

as

un

de

rtake

n.

(An

tho

ny e

t al., 2

00

8)

•E

CM

O-e

xtra

co

rpo

rea

l me

mb

ran

e o

xyg

en

atio

n

64

Ap

plie

d re

se

arc

h fin

din

gs to

clin

ical p

ractic

e

Fin

din

gs:

•3

pa

pe

rs lik

ely

to b

e a

cce

sse

d b

y c

linic

ian

s

•2

textb

ooks a

dd

resse

d th

ese

issu

es

•It to

ok e

igh

t ye

ars

from

the

issu

e b

ein

g firs

t ra

ise

d to

an

y m

ed

ica

l or n

urs

ing

text

dis

cu

ssin

g it.

•P

ub

lica

tion

s c

an

be

fou

nd

in M

ed

line

, an

d

tho

se

dis

se

min

atin

g to

nu

rse

s in

CIN

AH

L.

•L

ag

time

of jo

urn

al fin

din

gs to

textb

ook

(An

tho

ny e

t al., 2

00

8)

65

TP

G m

ay b

e a

pp

are

nt

•T

he n

otio

n th

at k

now

ledge g

ain

ed in

univ

ers

ity d

oes n

ot tra

nsla

te w

ell in

to th

e

work

pla

ce is

unavoid

able

if it is a

m

anife

sta

tion o

f the le

arn

ing a

ppro

aches

used a

nd th

e c

ultu

res o

pera

tive in

the tw

o

locatio

ns. (N

ew

ton, 2

009)

66

Facto

rs a

ffectin

g T

PG

1.

Pers

onal (E

vans, 2

009)

•A

ca

de

mia

•M

en

tor/p

rece

pto

r

•S

tud

en

ts

2.

Org

aniz

atio

nal

•C

urric

ulu

m

•C

linic

al s

ettin

g

67

Pers

on

al fa

cto

rs -

Acad

em

ia

•C

linic

al u

pdatin

g fo

r academ

ic s

taff m

ay

help

TP

G (T

ickle

et a

l., 2010)

•Lectu

rer-p

ractitio

ner is

expecte

d to

brid

ge

the g

ap b

etw

een e

ducatio

n a

nd p

ractic

e

(Barre

tt, 2007)

•E

ducato

rs a

re e

xpecte

d to

help

stu

dents

to

reduce th

e d

iffere

nce b

etw

een w

hat is

consid

ere

d id

eal a

nd w

hat is

real (S

chere

r and S

chere

r, 2007)

68

Pers

on

al fa

cto

rs -

Men

tor/p

rec

ep

tor

•A

ttitude o

f clin

ical s

taff –

impro

ve th

e

rela

tionship

betw

een p

ractic

e a

nd

academ

ia (H

appell,2

006)

•P

recepto

r behavio

rs in

fluence s

tudent

confid

ence s

elf-e

fficacy (J

ord

an a

nd

Farle

y, 2

008)

69

•T

he d

iverg

ent re

quire

ments

and

expecta

tions b

etw

een th

e u

niv

ers

ity a

nd

the re

gis

tere

d n

urs

es (m

ento

rs) p

rovid

ing

superv

isio

n

•S

ituatio

n is

wors

e w

hen b

oth

pla

y a

role

in

stu

dent a

ssessm

ent

(Reid

-Searl, 2

009)

Pers

on

al fa

cto

rs -

Men

tor/p

rec

ep

tor

70

Pers

on

al fa

cto

rs -

Stu

de

nts

1.

Stu

dents

learn

ing p

refe

rences a

nd

oth

ers

(New

ton e

t al., 2

009)

2.

Stu

dents

are

aw

are

of it (P

utte

n2008)

71

Org

an

izatio

nal fa

cto

rs

1.

Nu

rsin

g c

urric

ulu

m–

Educatio

na

l tool fo

r analy

tic/ra

tion

al c

linic

al

decis

ion-m

akin

g fro

m in

tuitiv

e/e

xperie

ntia

l not

ava

ilab

le.

–S

ug

gest n

ine m

odes o

f pra

ctic

e in

a re

vis

ed

cogn

itive c

ontin

uum

to c

linic

al ju

dgem

ent

and

decis

ion-m

akin

g in

nu

rsin

g.

–C

ogn

itive c

ontin

uum

theory

synth

esiz

es riv

al a

nd

com

ple

me

nta

ry a

ppro

aches to

decis

ion th

eory

in a

n

accessib

le fo

rmat, a

nd v

ario

us n

urs

ing s

cho

lars

have a

dvo

cate

d its

use to

enhan

ce th

e

effe

ctiv

ene

ss o

f nurs

es’clin

ica

l judgem

ent

and

decis

ion-m

akin

g.

(Sta

nd

ing, 2

008)

72

Org

an

izatio

nal fa

cto

rs

2. C

linic

al s

ettin

g:

–T

ime

–C

om

pe

ting

de

ma

nd

s

–N

orm

s a

nd

reg

ula

tion

s

–A

cce

ss to

reso

urc

es: In

no

va

tion

s to

clo

se

the

the

ory

-pra

ctic

e g

ap

73

Four s

tages o

f the c

urric

ulu

m d

evelo

pm

ent

pro

cess w

ere

identifie

d:

•E

xplo

ratio

n

•D

esig

n

•Im

ple

menta

tion

•E

valu

atio

n

(Fin

n e

t al., 2

010)

Inn

ovatio

ns to

brid

ge T

PG

74

•D

evelo

pm

ent a

nd im

ple

menta

tion o

f a

new

part-tim

e p

ost-re

gis

tratio

n d

egre

e

did

not h

ave m

uch im

pact o

n T

PG

.

•T

hus a

n e

nquiry

and p

ractic

e b

ased

learn

ing p

hilo

sophy w

as in

troduced to

narro

w T

PG

.

•(F

inn e

t al., 2

010)

Inn

ovatio

ns to

brid

ge T

PG

75

•A

im o

f stu

dy

–T

o e

xp

lore

nu

rsin

g u

nd

erg

rad

ua

tes'

inte

rpe

rso

na

l skills

an

d th

e e

ffects

of u

sin

g

em

piric

al d

ata

as a

tea

ch

ing

an

d le

arn

ing

reso

urc

e.

Inn

ovatio

ns to

brid

ge T

PG

76

•M

ET

HO

DS

:

–2

-Ph

ase

stu

dy

–P

ha

se

1 s

aw

10

stu

de

nt n

urs

e-p

atie

nt

inte

ractio

ns a

ud

io re

co

rde

d a

nd

tran

scrib

ed

an

d th

e d

ata

su

bje

cte

d to

con

ve

rsa

tion

an

aly

sis

.

–P

ha

se

2 s

aw

tap

es a

nd

tran

scrip

ts o

f sim

ilar

inte

ractio

ns u

se

d a

s a

tea

ch

ing

reso

urc

e w

ith

the

sa

me

co

ho

rt of s

tud

en

ts (n

= 4

8)

Inn

ovatio

ns to

brid

ge T

PG

77

•R

esults

–S

tud

en

ts w

ere

ab

le to

ackn

ow

led

ge

the

ir

limita

tion

in n

urs

e-p

atie

nt in

tera

ctio

ns w

hic

h

we

re ta

sk-c

en

tred

an

d b

ure

au

cra

tica

lly

org

an

ize

d.

–S

tud

en

ts re

ga

rds s

uch

tea

ch

ing

ap

pro

ach

po

sitiv

e a

nd

imp

rove

the

ir effe

ctiv

en

ess o

f

brin

gin

g th

e re

alitie

s o

f clin

ica

l pra

ctic

e in

to

the

cla

ssro

om

.

Inn

ovatio

ns to

brid

ge T

PG

78

•R

esults

–

Stu

de

nts

rep

orte

d d

ifficu

lty in

tran

sfe

rring

the

p

rincip

les o

f 'go

od

' co

mm

un

ica

tion

from

the

cla

ssro

om

into

the

ir ow

n in

tera

ctio

ns w

ith

pa

tien

ts.

–S

tud

en

ts' re

flectio

n o

f writte

n a

nd

sp

oke

n

eva

lua

tion

s in

the

pra

ctic

e o

f IPS

tea

ch

ing

is

reco

mm

en

de

d a

s a

me

an

s o

f clo

sin

g th

e

the

ory

-pra

ctic

e g

ap

.

(Ale

d, 2

00

9)

Inn

ovatio

ns to

brid

ge T

PG

79

•T

raditio

nal jo

int c

linic

al a

nd a

cadem

ic

positio

ns d

oes n

ot w

ork

well to

addre

ss

TP

G.

(Kris

tiansen, 2

006)

•P

ilot o

n N

urs

ing C

linic

al D

evelo

pm

ent

Units

(Happell, 2

006)

Inn

ovatio

ns to

brid

ge T

PG

80

•N

urs

ing

Clin

ica

l De

ve

lop

me

nt U

nits

(NC

DU

s)

we

re in

trod

uce

d in

the

Un

ited

Kin

gd

om

•P

relim

ary

resu

lt of a

qu

alita

tive

eva

lua

tion

co

nd

ucte

d w

ith p

artic

ipa

nts

(n=

14

) in V

icto

ria,

Au

stra

lia.

•T

he

find

ing

s s

ug

ge

st th

at th

is in

itiativ

e c

an

sig

nific

an

tly e

nh

an

ce

rela

tion

sh

ips w

ith, a

nd

attitu

de

s to

wa

rds, a

ca

de

mia

.

(Ha

pp

ell, 2

00

6)

Inn

ovatio

ns to

brid

ge T

PG

81

•D

octo

ral s

tudent (u

nder s

uperv

isio

n)

superv

ised te

achin

g p

ractic

um

sat th

e

hospita

l.

•S

/he a

ssis

ts th

e h

ospita

l to im

ple

ment

evid

ence-b

ased p

ractic

e w

ith th

e u

ltimate

goal o

f apply

ing fo

r Magnet s

tatu

s.

•(P

eck e

t al., 2

009)

Inn

ovatio

ns to

brid

ge T

PG

82

Outc

om

e:

•T

he h

ospita

l appre

cia

ted re

searc

h

expertis

e a

nd m

ento

ring fo

r the s

taff

mem

bers

.

•T

he d

octo

ral s

tudents

benefite

d fro

m th

e

opportu

nitie

s to

teach a

nd to

share

know

ledge w

ith th

ese c

linic

al e

xperts

.

•T

his

pro

gra

m h

as b

een s

uccessfu

l in

meetin

g th

e n

eeds o

f both

partie

s.

Inn

ovatio

ns to

brid

ge T

PG

83

In v

iew

of n

atio

nal a

nd in

tern

atio

nal d

ebate

on s

tandard

s, g

uid

elin

es a

nd e

xpert

sta

ndard

s in

care

is in

cre

asin

g.

The d

evelo

pm

ent a

nd in

troductio

n o

f expert

sta

ndard

s c

ould

be a

help

ful s

upport to

overc

om

e th

e th

eory

-pra

ctic

e g

ap

(Wie

teck, 2

009)

Oth

er s

ug

ge

stio

ns

to b

ridg

e T

PG

84

Ho

w d

o w

e p

ositio

n o

urs

elv

es

in 2

1s

t Cen

tury

?

Any n

ew

way o

ut?

85

Po

rtrait n

urs

ing

ed

ucatio

n

in n

eed

S

C/T

T/R

C/R

C/T

/R

86

Ho

w a

bo

ut th

e C

ath

olic

Nu

rse

s?

Any h

ealth

care

model to

follo

w?

87

Ou

r role

mo

del in

health

care

A

A

A

A

MASTER

MASTER

MASTER

MASTER

A

A

A

A

TEACHER

TEACHER

TEACHER

TEACHER

He w

ent aro

und all o

f Galilee,

teachin

g in

their sy

nag

ogues…

Mt, 4

, 23

Teach

ing ab

out an

ger / lo

ve /

pray

er / heav

en / ju

dgin

g o

thers:

Mt, 5

-7

JESUS

JESUS

JESUS

JESUS

A

A

A

A

CARE

CARE

CARE

CARE--- -

GIV

ER

GIV

ER

GIV

ER

GIV

ER

Work

very

late: Luke 4

, 40

When

it was ev

enin

g, th

ey

bro

ught h

im m

any w

ho w

ere possessed

by d

emons…

Mt 8

, 16

A H

EALER

A H

EALER

A H

EALER

A H

EALER

He cu

res of ev

ery d

isease and

illnesses M

t, 4, 2

3

88

Sym

bo

lic to

ols

used

by J

esu

s in

h

ealin

g

VOIC

EVOIC

EVOIC

EVOIC

E

MASTER

MASTER

MASTER

MASTER

SPIR

ITSPIR

ITSPIR

ITSPIR

IT

TEACHER

TEACHER

TEACHER

TEACHER

JESUS

JESUS

JESUS

JESUS

CARE

CARE

CARE

CARE--- -

GIV

ER

GIV

ER

GIV

ER

GIV

ER

HAND

HAND

HAND

HAND

(LUKE, 4

: 40)

(LUKE, 4

: 40)

(LUKE, 4

: 40)

(LUKE, 4

: 40)

HEALER

HEALER

HEALER

HEALER

HEART

HEART

HEART

HEART

89

Jesu

s is

90

Qu

ality

of a

heale

r dem

on

stra

ted

b

y J

esu

s

•B

e fu

lly p

resent

–A

pa

ir of lis

ten

ing

ea

rs;

•C

entu

rion

’s s

erv

ant. W

hen J

esus h

eard

this

, he

was a

maze

d…

Mt 8

, 10

–T

ow

ard

tho

se

in p

ain

an

d s

uffe

ring

–R

esp

ect th

e p

atie

nts

; pro

po

sin

g a

n in

vita

tion

to h

ea

l

91

Qu

ality

of a

heale

r dem

on

stra

ted

b

y J

esu

s

•B

e a

vaila

ble

•B

e a

cceptin

g -

patie

nts

’pre

fere

nce o

f time,

pla

ce a

nd w

ays

•B

e e

nth

usia

stic

•B

e p

rom

pt/tim

ely

to o

ffer h

elp

Luke 5

:

•B

e re

ady

–T

o s

ofte

n s

uffe

ring

92

To

ols

used

by J

esu

s in

healin

g

an

d c

arin

g

•G

oo

d u

se

s o

f hu

ma

n s

en

se

s

–G

ifted, fre

e; a

ll entitle

d to

use

–W

e a

re b

orn

surv

ivors

, heale

rs to

ours

elv

es a

nd

oth

ers

•E

ye c

onta

ct

•T

ouch

–L

uke

5: 1

3, L

epers

sa

id to

Jesus, ‘L

ord

, if yo

u w

ish, y

ou c

an m

ake

me c

lean.’

Jesus s

tretc

hed o

ut h

is h

and, to

uched h

im…

93

To

ols

used

by J

esu

s in

healin

g

an

d c

arin

g

•P

rayer

–F

aith

(Luke 5

,20

; ‘wh

en

J s

aw

the

ir faith

’,love

, �w

e

rem

ain

me

rcifu

l Sa

ma

ritan

s

–B

e h

um

bly

un

ited

with

Ho

ly T

rinity

Fa

the

r/Je

su

s/S

pirit, o

ur B

ES

T ro

le m

od

el, o

ur

true

he

ale

r, ou

r so

urc

e o

f life to

kn

ow

HIS

WA

Y / H

IS W

ILL

to h

ea

l

94

Ab

ove a

ll,

The b

est h

ealin

g to

ol is

•Jesus H

imself O

R o

urs

elv

es a

s a

nurs

e

–A

na

tura

l, dyn

am

ic, re

sp

on

siv

e th

era

pe

utic

ag

en

t

–W

e n

ee

d to

rech

arg

e o

urs

elv

es v

ia p

raye

rs

an

d c

on

tinu

ing

ed

uca

tion

s

95

In s

um

mary

•T

he s

uccess o

f Flo

rence N

ightin

gale

fell

into

:

(1) H

er m

issio

n o

f nu

rsin

g w

as c

lea

r in th

at s

he

wo

uld

pro

mo

te th

e re

co

ve

ry o

f the

sic

k a

s a

resu

lt of w

ar a

nd

dis

ea

se

s in

the

com

mu

nity

in m

id 1

85

0’s

(2) S

he

wa

s in

stru

me

nta

l an

d s

yste

ma

tic in

pu

tting

ide

as in

to p

ractic

e

96

In s

um

mary

To

actu

aliz

e o

ur m

issio

n o

f nu

rsin

g, w

e m

ay:

•F

ind

he

lp p

artly

from

wis

do

m a

nd

he

ritag

e fro

m

Flo

ren

ce

Nig

htin

ga

le w

ho

resp

on

de

d to

Go

d’s

ca

lling

to b

e a

nu

rse

•D

eve

lop

de

ep

ly a

nd

firmly

with

ou

r Fa

ith in

Go

d

be

ca

use

:

–It p

roves to

be th

e b

est m

odel

–It fits

in w

ell w

ith h

olis

tic m

ode

l

–N

urs

ing th

e p

oor, w

eak, s

ick, a

band

on

ed, d

yin

g is

a

callin

g

97

In c

onclu

sio

n‘Does baccalaureate education m

ake a difference in

nursing practice?’

98

In c

onclu

sio

n

Ba

cca

lau

rea

te n

urs

ing

ed

uca

tion

will

imp

rove

pa

tien

t ou

tco

me

s

pro

vid

ed

the h

olis

tic m

odel in

pedagogy

and c

om

pre

hensiv

e ro

les o

f nurs

es a

re

actu

aliz

ed.

99

•B

acca

lau

rea

te e

du

ca

tion

is a

me

an

s

an

d n

ot a

n e

nds fo

r the

nu

rses

100

In c

onclu

sio

n

•T

he m

issio

n o

f nurs

ing a

nd th

e g

oal o

f nurs

ing e

ducatio

n a

re a

chie

ved if a

nurs

e

can a

ppre

cia

te th

e c

om

bin

ed a

nd in

here

nt

role

s o

f bein

g a

life-lo

ng le

arn

er, te

acher,

clin

icia

n a

nd re

searc

her

•B

y s

eein

g th

ese ro

les a

s c

om

ple

menta

ry

and n

ot c

om

petin

g w

ith e

ach o

ther

101

In c

onclu

sio

n

Th

e n

ext q

ue

stio

n w

ho

is th

e u

ltima

te

be

ne

ficia

ryo

f su

ch

a d

iffere

nce

?

Ho

pe

fully

no

t just th

e n

urs

e, b

ut

pa

tien

ts, fa

milie

s, s

ocie

ty a

s a

wh

ole

102

In c

onclu

sio

n

•W

e la

ck d

ata

thu

s n

ee

d to

revis

it our

pro

gra

m a

nd

co

nd

uct o

n-g

oin

g

rese

arc

h to

iden

tify th

e re

latio

nsh

ip

nu

rse

s’in

pu

t an

d p

atie

nt o

utc

om

es in

Ho

ng

Ko

ng

.

103

In c

onclu

sio

n

•A

s a

ca

tho

lic n

urs

e, w

e re

sp

on

d

nu

rsin

g a

s a

ca

lling

, thu

s w

e c

om

mit

ou

r ca

re to

all d

isre

gard

races,

eth

nic

s, b

ou

nda

ries, g

en

de

r, ag

es

an

d le

ve

l of d

isa

bilitie

s b

ecau

se

we

resp

ect G

od

’s c

rea

tion

an

d H

IS

na

tura

l law

s a

nd

be

au

ty in

eve

ry life

.

104

In c

onclu

sio

n

1.

Va

lue

an

d b

elie

fsin

nu

rsin

g in

he

rited

from

F

lore

nce

Nig

htin

ga

le.

2.

Th

e s

ign

ifica

nt m

ove

s in

nu

rsin

g e

du

ca

tion

to

brid

ge

the

kn

ow

led

ge

-pra

ctic

e g

ap

.

3.

JE

SU

Sis

on

e o

f ou

r be

st ro

le m

od

el in

dis

ea

se

a

nd

he

alth

wh

o d

em

on

stra

tes h

olis

tic c

are

and

h

ow

to u

se

ou

rse

lve

s a

s a

he

alin

g to

olfo

r p

atie

nts

, fam

ilies a

nd

po

pu

latio

ns to

brin

g

po

sitiv

e e

nd

urin

g h

ea

lthca

re o

utc

om

es.

105

106

Refe

rences

•A

led

. J. (2

007

). Pu

tting

pra

ctic

e in

to te

ach

ing: a

n e

xp

lora

tory

stu

dy

of n

urs

ing

und

erg

rad

ua

tes' in

terp

ers

on

al s

kills

an

d th

e e

ffects

of

usin

g e

mp

irica

l da

ta a

s a

tea

ch

ing

and

lea

rnin

g re

so

urc

e. J

ourn

al o

f C

linic

al N

urs

ing

, 16

(12): 2

29

7-2

30

7•

An

tho

ny, D

, La

wson

, G. a

nd

Cra

wfo

rd., D

. (20

08). T

he

theo

ry-

pra

ctic

e g

ap

: EC

MO

resea

rch

exam

ple

. Pa

ed

iatric

Nurs

ing

, 20(1

): 4

1-4

5.

•B

arre

tt, D. (2

00

7). T

he

clin

ica

l role

of n

urs

e le

ctu

rers

: pa

st, p

rese

nt,

an

d fu

ture

. Nu

rse

Ed

uca

tion

To

da

y, 2

7(5

): 36

7-3

74

.•

Bo

rlase, J

. and

Ab

els

on

-Mitc

he

ll, N. (2

00

8). U

ser p

erc

ep

tion

s o

f the

K

no

wle

dg

e U

nd

erp

inn

ing

Pra

ctic

e O

rien

tatio

n D

ial (K

UP

OD

) as a

to

ol to

en

hance

learn

ing. N

urs

e E

du

catio

n in

Pra

ctic

e, 8

(1): 9

-19

.•

Do

sse

y, B

. M. 2

000

. Flo

ren

ce

Nig

htin

gale

: mystic

, vis

ion

ary

, h

ea

ler.

PA

: Sp

ring

hou

se

Co

rp.

107

Refe

rences

•E

vans, K

., Guile

, D., H

arris

, J. a

nd A

llan, H

. (2010). P

uttin

g k

no

wle

dg

e to

w

ork

: a n

ew

ap

pro

ach. N

urs

e E

ducatio

n T

oda

y, 3

0(3

): 245-2

51.

•E

vans, M

. (2009). T

acklin

g th

e th

eory

-pra

ctic

e g

ap in

me

nta

l hea

lth n

urs

e

train

ing

•Journ

al, 1

3(2

): 21-2

4

•F

inn, F

. L., F

ensom

, S. A

. and C

hesser-S

myth

, P. (2

010). P

rom

otin

g

learn

ing tra

nsfe

r in p

ost re

gis

tratio

n e

ducatio

n: a

colla

bora

tive a

ppro

ach.

Nurs

e E

ducatio

n in

Pra

ctic

e, 1

0(1

): 32-3

7

•H

app

ell. B

. (20

06). N

urs

ing c

linic

al d

evelo

pm

ents

units

--a s

trate

gy to

pro

mote

the re

latio

nsh

ip b

etw

een p

ractic

e a

nd a

cad

em

ia. In

tern

atio

nal

Journ

al o

f Psychia

tric N

urs

ing R

esearc

h, 1

1(3

): 1322-1

330

.ngK

ong N

urs

ing

Council 2

002

•H

ong K

ong N

urs

ing C

ouncil. (2

002). C

ode o

f Pro

fessio

na

l Conduct a

nd

Code o

f Eth

ics fo

r Nurs

es in

Hong K

on

g. R

etrie

ved a

t http

://ww

w.n

ch

k.o

rg.h

k/file

ma

nager/e

n/p

df/c

onduct_

eng.p

df

on 1

0 A

ugust

2010.

108

Refe

rences

•Jord

an, R

. and F

arle

y, C

. L. (2

008). T

he c

onfid

ence to

pra

ctic

e m

idw

ifery

: pre

cepto

r influ

ence o

n s

tudent s

elf-

effic

acy. J

ourn

al o

f Mid

wife

ry &

Wom

en's

He

alth

, 53(5

): 413-4

20.

•K

ristia

nse

n, E

. (2006). J

oin

t app

oin

tments

-a

Norw

egia

n e

xperie

nce

[Norw

eg

ian] N

ors

kT

idsskrift

For

Sykep

leie

fors

knin

g, 8

(2): 2

2-3

3.

•Lan

ge, G

. and K

enn

edy, H

. P. 2

006. S

tude

nt

perc

eptio

ns o

f idea

l and a

ctu

al m

idw

ifery

pra

ctic

e.

Journ

al o

f Mid

wife

ry &

Wom

en's

Hea

lth, 5

1(2

): 71-7

7.

•N

eacsu, A

. (2006). E

xplo

ring s

tudent n

urs

es'

experie

nce

s o

f learn

ing a

nd s

kill a

cqu

isitio

n in

perio

pera

tive

care

. Journ

al o

f Advance

d P

erio

pera

tive

Care

, 2(4

): 167-1

75.

109

Refe

rences

•N

ew

ton, J

. M., B

illett, S

., Jolly

, B. a

nd

Ockerb

y, C

. M. (2

00

9). L

ost in

tra

nsla

tion

: ba

rriers

to le

arn

ing

in h

ea

lth p

rofe

ssio

na

l clin

ica

l e

duca

tion

. Lea

rnin

g in

He

alth

& S

ocia

l Ca

re, 8

(4): 3

15-3

27

.•

Pe

ck, S

., Leste

r, J., H

insha

w, G

., Stile

s, A

. an

d D

ingm

an

, S. K

. (2

00

9). E

BP

pa

rtners

: do

cto

ral s

tude

nts

an

d p

ractic

ing

clin

icia

ns

brid

gin

g th

e th

eory

-pra

ctic

e g

ap. C

ritica

l Ca

re N

urs

ing

Qu

arte

rly,

32

(2): 9

9-1

05

•P

utte

nD

. (200

8). T

he

live

d e

xp

erie

nce

of n

ew

ly q

ua

lified

mid

wiv

es:

a q

ua

litativ

e s

tud

y. J

ourn

al: B

ritish

Jo

urn

al o

f Mid

wife

ry, 1

6(6

): 348

.•

Re

id-S

earl, K

., Mo

xha

m, L

., Wa

lker S

. an

d H

ap

pe

ll, B. (2

00

9).

Inte

rna

l co

nflic

t: un

derg

radu

ate

nurs

ing s

tude

nts

' resp

onse

to

ina

de

qua

te s

up

erv

isio

n d

urin

g th

e a

dm

inis

tratio

n o

f me

dic

atio

n.

Co

lleg

ian

, 16(2

): 71-7

7.

110

Refe

rences

•S

als

ali

M. a

nd

Meh

rda

d, N

. (20

09). Ira

nia

n n

urs

es' c

on

stra

int fo

r re

se

arc

h u

tiliza

tion

. BM

C N

urs

ing

, 8, P

ag

es: 1

1p

.•

Sch

ere

r, Z. A

. P. a

nd

Sch

ere

r, E. A

. (200

7). R

efle

ctio

ns o

n n

urs

ing

tea

ch

ing

in th

e p

ost-m

od

ern

ity e

ra a

nd

the

me

taph

or o

f a th

eory

-p

ractic

e g

ap

. Re

vis

taLa

tino

-Am

eric

an

a d

e E

nfe

rma

ge

m(R

LA

E),

15

(3): 4

98

-501

.•

Sta

nd

ing

, M. (2

00

8).C

linic

al ju

dg

me

nt a

nd

decis

ion-m

akin

g in

n

urs

ing

–n

ine

mod

es o

f pra

ctic

e in

a re

vis

ed

co

gn

itive

con

tinu

um

. Jo

urn

al o

f Adva

nced

Nurs

ing

, 62

(1): 1

24

-13

4•

Tic

kle

, E., D

avys, D

. and

McK

en

na, J

. (20

10). Is

clin

ica

l up

da

ting a

va

lua

ble

mech

an

ism

for e

nh

ancin

g th

e s

tud

ent e

xp

erie

nce

? J

ourn

al:

Britis

h J

ourn

al o

f Occu

patio

na

l Th

era

py, 7

3(5

): 237

-239

•W

iete

ck, P

. (20

09).T

ransfe

r of n

atio

na

l exp

ert s

tan

dard

s in

to n

urs

ing

p

ractic

e [G

erm

an

]. Pfle

gew

issen

scha

ft, 11(4

): 22

7-2

39

.