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The clinical role of nurse lecturers: Past, present, and future.

The clinical role of nurse lecturers has been the subject of much debate since the transfer of nurse education into Higher Education Institutions within the United Kingdom. This article provides a critical evaluation of the clinical role of nurse lecturers in terms of policy drivers and strategies for implementing national guidelines. Policies from the initiation of Project 2000, through to recent consultation documents on the support of students in practice, are evaluated. Formal aspects of the nurse lecturer remit, such as link tutor and personal supervisor roles, are discussed in terms of their impact on clinical practice. There is also a brief review of the development of the lecturer practitioner role as a bridge between education and practice. The fundamental arguments in support of nurse lecturers maintaining a clinical role in practice are analysed. This analysis includes consideration of the concept of 'clinical credibility' in terms of the impact on teaching and the closure of the theory-practice gap. The article concludes with suggestions for strategies to resolve the ongoing debate surrounding the clinical role of nurse lecturers. These recommendations include a review of staff:student ratios in nurse education, re-evaluation of the need for a clinical role, and the use of innovative recruitment and development strategies by higher education institutions.

Faculty, Nursing↗

Listening comprehension and recall abilities in adolescents with language-learning disabilities and without disabilities for social studies lectures.

Listening comprehension and recall abilities for social studies lectures were examined and compared in 20 adolescent males with language-learning disabilities (LLD) and 29 without disabilities (WD). Subjects viewed two social studies lectures with comparison and causation expository discourse structures and verbally responded to literal and inferential comprehension questions. Regardless of lecture type or question type, the group with LLD performed significantly more poorly than did the group WD. Both groups responded accurately to significantly more inferential questions for the causation lecture over the comparison lecture. Neither group demonstrated a significant difference with respect to their response accuracy for the literal questions across lecture types.

Adolescent↗

A randomised controlled trial comparing two methods of teaching medical students trauma and orthopaedics: traditional lectures versus the "donut round".

OBJECTIVE: To assess whether a new form of teaching, the 'donut round', is as good at imparting factual knowledge as interactive lectures in both the short-term and the long-term. DESIGN: Randomised controlled trial. SETTING: University of Oxford Medical School. PARTICIPANTS: 106 fifth year clinical medical students taught half of their A&E/trauma course by donut round and half by lecture. MAIN OUTCOME MEASURES: The results of multiple choice questions (MCQs) divided according to how the material was taught. Three MCQ papers were set: one at the end of a four-week course, one approximately 10 weeks later and a final exam approximately 17 months after the first. RESULTS: At the first MCQ, the average result for questions taught by donut round was 41.0 (out of 50) and for those taught by conventional lecture was 40.1. At 10 weeks these averages fell to 36.3 and 37.3 and at 17 months they were 38.7 and 38.1, respectively. None of these pairs were significantly different. Ratios were calculated for each candidate by dividing their donut round score by their lecture score. The average ratios for the first, second and third MCQ papers were: 1.029, 1.007 and 1.027, respectively, and were not significantly different. The individual ratios of all candidates in all three MCQs were plotted against their equivalent total mark. The calculated linear regression showed a statistically significant advantage of donut rounds over lectures in those candidates who scored a total mark less than 89 (n=260, p=0.02). CONCLUSIONS: Donut rounds are at least as good as lectures in imparting factual knowledge and may provide a selective advantage to weaker students.

Clinical Competence↗

Does the perception of downloading speed influence the evaluation of web-based lectures?

Medical schools put little emphasis upon education on public health, even though public health has played an important role in this century. One way to harness its benefit in order to improve global health in the 21st century is to globally share lectures on public health through the Internet. We have developed the Supercourse comprising of web-based learning modules on epidemiology in a standardized format with the size of each web page less than 10 kilobytes. A cross-sectional observational study was conducted to investigate the association of the perception of the access speed to Web-based lectures by teachers with their perception of lecture quality. There were 223 teachers who rated the lectures: 72% were from North America or Western Europe, 40% had taught epidemiology, and 14% reported that the speed of access was slow. Odds ratio of above-average rating among those who reported that the speed of access was fast relative to those who reported that the speed of access was slow was 4.25 (2.03-8.91; P = 0.001). The odds ratios were similar and significant after taking into account several other factors, including the variation of rating across lectures, region, and experiences in teaching epidemiology. The results indicate that the perception of the quality of Web-based lectures is related to the speed of access to a web page. The speed of access may be as important, if not more important, as the content itself. This suggests that, to share educational materials on the Web globally for teachers, one must consider not only the content, but also how people at local sites gain access to the Internet.

Cross-Sectional Studies↗

Comparison of Internet versus lecture instructional methods for teaching nursing research.

Although many higher education programs are using the Internet to teach classes, there are few published reports on the effectiveness of this method on test scores or student satisfaction. The purpose of this study was to compare test and student satisfaction scores of graduate nursing students who take a nursing research course via the Internet with those of students who take the same course via traditional lecture instruction. In addition, student technical support use and Internet student lecture attendance also were examined. A total of 97 students (Internet, 44; lectures, 53) participated. There were no significant differences in test scores and overall course student satisfaction (P > .05). However, the Internet students reported significantly higher (P = .04) stimulation of learning compared with the traditional lecture students. Technical support use by the Internet students was high initially and was related to software problems. Of interest were the large proportion of Internet students (73 percent) who attended at least 3 of the 10 lectures. Use of the Internet to teach graduate-level nursing research can provide comparable learning and student satisfaction to traditional lecture instructional methods.

Computer-Assisted Instruction↗

Application of the RealAudio package to computerized medical lectures.

We created a multimedia system to computerize past lectures using RealAudio software. Physicians, medical researchers and students can browse the contents of lecture slides and handouts with synchronous audio using the Internet. The audience can easily review the most interesting parts of lectures and medical students can listen to complete medical lectures from remote sites with narration and slide depiction, whenever convenient. We have created three multimedia programs; the memorial lecture of a professor's retirement, a new method of hand washing for surgical procedures and a lecture on medical informatics. The cost of this system and the results of the evaluation by medical students are described. The ease of using this application makes it a potentially valuable tool for clinicians and researchers.

Computer-Assisted Instruction↗

Effects of three types of lecture notes on medical student achievement.

Two parallel studies were conducted with junior medical students to determine what influence the forms of lecture notes would have on learning. The three types of notes given to the students were: a comprehensive manuscript of the lecture containing text, tables, and figures; a partial handout which included some illustrations but required substantial annotation by the students; and a skeleton outline containing no data from the lecture. The students' knowledge about the subject was measured before the lecture, immediately after the lecture, two to four weeks later, and approximately three months later. The students' responses to questionnaires indicated a strong preference for very detained handouts as essential to preparation for examinations. By contract, the students' performances on tests generally were better for those who had received the partial or skeleton handout formats. This was particularly true for information presented during the last quarter of each lecture, when learning efficiency of the skeleton handout group increased while the other two handout groups exhibited learning fatigue. It was concluded that learning by medical students was improved when they recorded notes in class.

Achievement↗

An evaluation of critical care lecturer practitioners.

The aim of this study was to evaluate the educational value and impact upon staff of critical care lecturer practitioners. Data were collected through three staff focus groups (n=21) and a questionnaire completed by 70 members of trust or university staff. A majority of respondents felt that the lecturer practitioner roles had considerable effect upon adult critical care services. Six main categories of findings were derived from analysis and integration of both focus group and questionnaire data--development of knowledge; staff support; being a teacher; developing and maintaining the workforce; role improvement plus removal of the lecturer practitioner role. Many of these findings concur with the limited quantity of evaluative literature on the lecturer practitioner role. The authors produced a report recommending continued funding for existing lecturer practitioner posts; introduction of more lecturer practitioner posts should be considered, and further role evaluation should be conducted at both a local and national level.

Attitude of Health Personnel↗

Learning human anatomy: does learning occur during a lecture?

Information uptake during a formal lecture was evaluated using a sample of 43 second-year medical students to whom a topic on human developmental anatomy was presented. The sample was divided into two groups: Blue (group B) (21 students) and Red (group R) (22 students). Prior to the lecture, a pre-test of 20 multiple choice questions was administered to each group. The lecture was then delivered over 50 minutes. Both in its preparation and presentation, the lecture conformed to the principles of programmed instruction. After a 10-minute students' question-and-answer session, a post-test was served. For group B, this was group R's pretest while group R, in turn, received group B's pretest. No question in the pre-test was repeated in the post-test. Intergroup comparisons of pre-test scores and of post-test scores revealed non-significant differences (P greater than 0.05), thus confirming that the pre- and the post-tests were of comparable difficulty. In each group, the mean post-test score was significantly higher than the pre-test score (P less than 0.001). The pooled scores indicated that the percentage mastery of material presented during the lecture increased from -1.8% to 58.4%. These results demonstrate that significant learning can occur during a lecture prepared and delivered in accordance with sound pedagogical principles.

Anatomy↗

An innovative method to enhance interaction during lecture sessions.

The B. P. Koirala Institute of Health Sciences, Dharan, is following an innovative hybrid curriculum. Conventional lectures are replaced by "structured interactive sessions" (SIS). SIS involves increased interchange between teachers, students, and lecture contents by proper planning and organized efforts. It can promote active learning and heighten attention and motivation. The present study was conducted to enhance active interactions during such sessions. The students were divided into two groups and asked to come prepared for the lectures. Students were encouraged to ask questions and interact informally during lectures. A scoreboard was maintained, and student feedback was taken at the end of the lecture block. The entire student response was reduced to a student acceptability index (SAI). Our results show a statistically significant increase in interactions per student per day. A majority of the responses in the questionnaire and SAI were favorable. Specific comments and suggestions of students were also positive. These results show that simple innovative techniques enhance the interactions during a lecture session.

Cardiology↗

Three approaches to use of questioning by clinical lecturers: a pilot study.

In the current health care climate nurses require very good problem solving and critical thinking skills. Questioning as a teaching strategy is viewed as one way to promote such student learning. Using a comparative descriptive quantitative and a qualitative approach, this pilot study investigated the types of questions asked of students by lecturers working within the preceptorship model in the clinical setting. A convenience sample of five volunteer nursing lecturers were tape recorded during their interactions with undergraduate students (n = 8). Initially two auditing approaches were used to analyse the interview data: relevant parts of Mogan and Warbinek's (1994) Observation of Nursing Teachers in Clinical Settings instrument (ONTICS Tool) and Craig and Page's (1981) conceptual framework as adapted by Sellappah, Hussey, Blackmore and McMurray (1998). The data were further analysed by qualitative content analysis. This study supported the findings of the ONTICS tool and Sellappah et al's framework that teachers asked predominantly directive style and low level questions. What the two approaches did not adequately capture was the complexity of the lecturers' questioning behaviours or the effects of contextual factors. The content analysis process however, identified three broad categories forming a model that effectively integrated aspects of the context of the lecturer/student interaction. It also represented lecturer questioning behaviours more comprehensively. The preliminary model offered has the potential to highlight the importance of lecturers asking questions that lead students to extend their thinking about practice. It could also contribute to student learning by assisting lecturers to understand the value and critical nature of their questioning and serve as a framework for staff development.

Education, Nursing, Baccalaureate↗

Student performance and perceptions of a lecture-based course compared with the same course utilizing group discussion.

BACKGROUND AND PURPOSE: Self-directed learning is believed to be an important aspect of the reflective clinical practitioner. This study was a comparison of student learning and student perceptions of course and instructor effectiveness, course difficulty, and amount learned between the active learning and lecture sections of a course. SUBJECTS: Participants in this study were 170 physical therapist students in 3 sections of a physiology course in the first year of their professional program. METHODS: Course grades and the results of teacher-course evaluations were compared between a lecture section and an active learning section. The students in the original active learning section were reassessed 1 year later to determine their perceptions of the course. The differences were analyzed using Kruskal-Wallis and Mann-Whitney U tests. RESULTS: Course grades were higher in both active learning sections than in the lecture section. However, the students in both active learning sections perceived that they had learned less than students in the lecture section. Students' perceptions of course and instructor effectiveness were lower in the active learning sections than in the lecture section. There were no differences between the lecture and active learning sections on the students' perceptions of course difficulty. CONCLUSION AND DISCUSSION: Although they did better in the active learning environment, physical therapist students in a basic sciences course (physiology) in the first year of their professional program perceived that they had learned less in active learning courses. They also had lower perceptions of course and instructor quality.

Educational Measurement↗

The lecture: increasing student learning.

This study involved a single lecture given to second-year medical students. Its purpose was to detemine whether significant learning of the lecture content could occur during the lecture. The author's criteria for "significant" learning was mastery of 75 percent of what he predetermined to be the important of "required" content plus T-test analysis of pretest-posttest learning. The class divided into Groups A and B. At the commencement of the lecture Group A took Test 1 as its pretest and Group B took Test 2. Immediately following the lecture Group A took Test 2 as its posttest and Group B took Test 1. Comparing Test 1 with Test 2 as pretests and again as posttest, they were not significantly different at the .05 level. However, Group A's posttest scores were significantly higher than its pretest scores (p less than .005). The same was found for Group B, with both groups' averaging over 90 percent mastery of the required content and demonstrating that significant learning occurred during the lecture.

Education, Medical, Undergraduate↗

Relationship between small group problem-solving activity and lectures in health science curricula.

Components of problem-based education, such as small group teaching, are being implemented in diverse health curricula. Implementation, however, is often motivated by the intuitive appeal of many problem-based learning components, when what is needed is the detailed examination of how these components support students' integration of knowledge as well as continuity of their learning experiences. This study presents an investigation of the relationship between lecture and small group teaching (SGT) in a medical curriculum. Four problem-oriented SGT sessions representing diverse topics in the first-year curriculum and their corresponding lectures were videotaped and analyzed using techniques of concept mapping, where the broad concepts from the lectures were identified and matched to the case-specific concepts in the small group sessions. The results show that lectures function as an anchor for the students' discussion of issues relevant to clinical problem-solving and interventions in small group sessions. These discussions extended to contextual aspects of clinical practice that were not dealt with in the lectures, such as ethical/cultural issues around the treatment of patients. Furthermore, small group environments were found to promote discussions that allowed the integration of information from different sources and encompassed concepts across a number of disciplines. These results suggest that carefully designed small group sessions serve the purposes of 1) illustrating broader concepts in lectures to case-specific, clinically relevant problem-solving and 2) promoting knowledge integration from diverse sources of information. The implications of these results for learning and reasoning in health science curricula are discussed.

Cardiology↗

Job dissatisfaction in lecturers in School of Medical Sciences Universiti Sains Malaysia and Faculty of Medicine Universiti Kebangsaan Malaysia.

Job dissatisfaction in doctors and teachers is known to have direct consequences on the quality of service and teaching for patients and students respectively. A cross-sectional study to assess dissatisfaction in lecturers of School of Medical Sciences, Universiti Sains Malaysia (USM) and Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (CQ) version 1.7 (revised 1997) by Robert Karasek was self-administered to 73 (response rate 58.4%) and 80 (response rate 41.7%) lecturers in the medical faculties of USM and UKM, respectively. The prevalence of job dissatisfaction in USM and UKM lecturers were 42.6% and 42.9%, respectively; the difference was not significant (p>0.05). Risk factors of job dissatisfaction in USM lecturers were decision authority (p<0.001) and psychological job demand (p<0.001). Significant risk factors of job dissatisfaction in UKM lecturers were skill discretion (p<0.01) and psychological job demand (p<0.001). We conclude that psychological job demand was a risk factor of job dissatisfaction in both USM and UKM lecturers; in USM, decision authority was protective, while in UKM, skill discretion was protective against job dissatisfaction.

Adult↗

Nobel Lecture. Aquaporin water channels.

Thank you very much. I am humbled, I am delighted; I am honored. This is every scientist's dream: to give the Nobel Lecture in Stockholm. But I would not be honest if I did not tell you that I am having a little anxiety being on this platform. I have lectured a number of times in Sweden, and I thought I would share with you some events preceding a special lecture that I gave here a few years ago. Arriving at Arlanda Airport, I waited in line at the Pass Control behind a group of businessmen in suits with briefcases. I heard the first in line asked by the control officer to state the purpose of his visit to Sweden. When the man replied "business," the officer approved and stamped his passport. One at a time, each stepped forward and was asked the same thing; each answered "business" and was approved. Eventually it was my turn, and I was dressed in rumpled clothes after spending the night in the Economy Minus section of an SAS jetliner. The officer asked me the purpose of my visit, and I said "I am here to give the von Euler Lecture at Karolinska Institute." The officer immediately looked up, stared at me, and asked, "Are you nervous?" At that point I became intensely nervous and said "Yes, I am a little nervous." The officer looked up again and stated "Well, you should be!" So if the lecturers look a little nervous, the problem is at Arlanda.

Animals↗

Individual differences in reactivity to and coping with the stress of lecturing.

The aim of this study was to evaluate the moderating effect of several psychologically and biologically defined characteristics for both psychological and physiological indices of reactivity to and coping with lecturing stress. Student teachers were measured in two standardized lecturing situations: once at the start of a three-month practice period and once at the end of this period. Reactivity was operationalized as an increase in heart rate, cortisol excretion and subjective anxiety responses in anticipation of and at the start of the lecture. Coping was operationalized as the attunement of these responses during, or recovery after lecturing (short term coping), and as the adaptation of these responses across the three-month practice period (long term coping). It was found that reactivity to and (particularly long term) coping with the lecturing stressor could well be predicted by moderators such as physical fitness, extraversion, neuroticism, social anxiety and several coping styles. Specificity of predictor sets for sex and response parameters is discussed.

Adaptation, Psychological↗

The educational preparation of undergraduate nursing students in pharmacology: perceptions and experiences of lecturers and students.

This paper explores the perceptions and experiences of lecturers and undergraduate nursing students relating to teaching and learning issues in pharmacology. A total of 14 focus group interviews were conducted at 10 university settings, which involved seven academic staff and seven student interviews. The focus group interviewing method was used because it enabled all participants to have 'a say', facilitated the expression of diverse views, and allowed participants to express themselves without fear that their views would be openly criticised. Student participants comprised second and third year undergraduate nurses while lecturer participants involved course coordinators, subject coordinators, and bioscience and nursing lecturers. The 'framework' method was used for data analysis, which involved the following stages: familiarisation, identifying a thematic framework, indexing, charting, and finally, mapping and interpretation. Four major themes emerged from discussions with lecturers and students: teaching considerations, learning considerations, the relationship between pharmacology knowledge and clinical practice, and the features of an 'ideal' programme in pharmacology. The findings highlighted that potential conflicts existed among academic staff relating to the balance of pharmacology and nursing content in curricula, which often led to over-laden curricula. Potential conflicts also existed between lecturers and students about the value placed on a separate pharmacology subject as opposed to an integrated pharmacology programme. In summary, there is still much scope for educational initiatives to improve students' knowledge of pharmacology and medication management.

Adult↗