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The Science of Learning https://deansforimpact.org/wp-content/uploads/2016/12/The_Science_of_Learning.pdf

4 Elements of Adult Learning https://www.shiftelearning.com/blog/effective-adult-learning-neuroscience

Incorporating the Experiential Learning Cycle in Online Classes http://jolt.merlot.org/vol9no4/baasanjav_1213.pdf

Learning & Memory    http://www.bioedonline.org/videos/lecture-series/your-brain-is-you/learning-and-memory/

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11 Active Learning Strategies to Engage Active Learning

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The Neighborhood a Web-based platform to support conceptual teaching and learning

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List of Computer Games for Teaching Students

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List of Computer Games for Teaching Students

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7 Online Tools to Make Custom Learning Games (No Coding Required!)

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By Elizabeth Kahn It is a fact that even in the 21st century, students need to study and review information they’ve been taught in class. In fact, many scientific studies have asserted that learning doesn’t take place without repetition. Study guides created by the teacher or student in the form of…

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Kahoot! | Learning games | Make learning awesome!

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Kahoot! is a game-based learning platform that brings engagement and fun to 1+ billion players every year at school, at work, and at home.

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For Remote or In-Person Classrooms

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Classroom Jeopardy Review Game | Buzzer Mode | Factile

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Create your own Jeopardy template online without PowerPoint, or browse the pre-made templates to play Jeopardy-style classroom games or quizzes in minutes.

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Here are 156 free nursing games with some 6,000 questions designed to make your nurse learning / education more interesting, engaging and fun! In this section we have developed, and are experimenting with, different kinds of educational nursing games. Online games are very popular, so why not apply them to your nursing education?

The Super Nurse and Word Guess games have been developed in HTML5. Therefore, the latest browser versions of Internet Explorer (IE10/11), Firefox, Chrome or Safari need to be used. These games can also be played on most mobile devices.

We have enhanced the games software to produce a Report that you can print out and keep for your records, or to hand in for assignments. For statistical and research purposes, the game results are now being tracked and recorded.

Click on a Title below to open up a specific nursing educational game in a new window. If you find the audio annoying or distracting, click the Mute button on your computer. Enjoy!

1. Nursing Games - Super Nurse Series

1.27 Drug Dosage Calculations I - This game tests your knowledge of the metric system and how to accurately make conversions between the various units. ( 15 items selected from 50 questions).

1.28 Drug Dosage Calculations II - Test and refresh you knowledge and skills about how to calculate the correct tablet medication dosages. ( 15 items selected from 50 questions).

1.29 Drug Dosage Calculations III- This game is designed to assess and review your knowledge and skills in calculating the correct fluid medication dosages. ( 15 items selected from 50 questions).

1.30 Drug Dosage Calculations IV - Test and refresh your knowledge and skills in calculating the correct dosages for medication administration by injection. ( 15 items selected from 50 questions).

1.31 Drug Dosage Calculations V - This game assesses your knowledge and skills in calculating the correct intravenous (IV) dosages, flow rates and administration times. ( 15 items selected from 50 questions).

2. Nursing Games - Word Guess Series

2.45 Pediatric Disorders I - Test your knowledge of the names of disorders related to child development, vision, hearing, blood, respiratory system and nervous system in pediatric patients. (1 5 items drawn from a pool of 45 questions).

These Drag and Drop games were developed using Articulate's StoryLine 3 software. For best viewing of these SL3 games on Apple's iPhone and iPad, download and install the FREE Articulate from the iTunes Store. If you are using an Android tablet or phone, download and install the FREE Articulate Android Player App from Google Play.

3.2 Blood Tests I - See how well you know the indications / applications of 60 blood tests used to diagnose and monitor various body disorders and diseases. ( 15 questions selected from 60).

3.3 Blood Tests II - Test and refresh your knowledge of the indications / applications of another 60 blood tests used to diagnose and monitor various body disorders and diseases. ( 15 questions selected from 60).

3.4 Cancer Symptoms - Try this funky nursing game to see how well you know the signs and symptoms of 12 different types of common cancers. ( 24 questions).

3.5 Diagnostic Tests I - Try this game to see how well you know the indications / applications of 45 electrodiagnostic, endoscopic and nuclear diagnostic technologies, tools and procedures used to identify, monitor and evaluate body disorders and diseases. ( 15 questions from 45).

3.6 Diagnostic Tests II - Another game to see how well you know the indications / applications of 45 manometric, ultrasound and x-ray diagnostic technologies, tools and procedures used to identify, monitor and evaluate body disorders and diseases. ( 15 questions from 45).

3.10 Infectious Diseases - See how well you know the causes (bacteria, virus, fungi, parasites or protozoa) of these infectious diseases. ( 48 questions).

3.18 Oral Dosages - Another game about calculating the correct dosages for medications administered orally using solutions, suspensions, mixtures and syrups. ( 15 questions randomly selected from 35 items).

3.21 Pressure Ulcer Terms II - Another game to review the terminology used in the assessment, prevention and treatment of pressure ulcers / bedsores. ( 20 questions chosen from 70 items).

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Here are 156 free nursing games with some 6,000 questions designed to make your nurse learning / education more interesting, engaging and fun! In this section we have developed, and are experimenting with, different kinds of educational nursing games. Online games are very popular, so why not apply them to your nursing education?

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Easily create beautiful interactive video lessons for your students you can integrate right into your LMS. Track students' progress with hassle-free analytics as you flip your classroom!

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Infographic Tool

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How Presentation Zen Fixed My Bad PowerPoints

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Writing Good Multiple Choice Test Questions

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Writing Good Multiple Choice Test Questions

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Cite this guide: Brame, C. (2013) Writing good multiple choice test questions. Retrieved [todaysdate] from https://cft.vanderbilt.edu/guides-sub-pages/writing-good-multiple-choice-test-questions/.

Multiple choice test questions, also known as items, can be an effective and efficient way to assess learning outcomes. Multiple choice test items have several potential advantages:

Versatility: Multiple choice test items can be written to assess various levels of learning outcomes, from basic recall to application, analysis, and evaluation. Because students are choosing from a set of potential answers, however, there are obvious limits on what can be tested with multiple choice items. For example, they are not an effective way to test students' ability to organize thoughts or articulate explanations or creative ideas.

Reliability: Reliability is defined as the degree to which a test consistently measures a learning outcome. Multiple choice test items are less susceptible to guessing than true/false questions, making them a more reliable means of assessment. The reliability is enhanced when the number of MC items focused on a single learning objective is increased. In addition, the objective scoring associated with multiple choice test items frees them from problems with scorer inconsistency that can plague scoring of essay questions.

Validity: Validity is the degree to which a test measures the learning outcomes it purports to measure. Because students can typically answer a multiple choice item much more quickly than an essay question, tests based on multiple choice items can typically focus on a relatively broad representation of course material, thus increasing the validity of the assessment.

The key to taking advantage of these strengths, however, is construction of good multiple choice items.

A multiple choice item consists of a problem, known as the stem, and a list of suggested solutions, known as alternatives. The alternatives consist of one correct or best alternative, which is the answer, and incorrect or inferior alternatives, known as distractors.

Constructing an Effective Stem

1. The stem should be meaningful by itself and should present a definite problem. A stem that presents a definite problem allows a focus on the learning outcome. A stem that does not present a clear problem, however, may test students' ability to draw inferences from vague descriptions rather serving as a more direct test of students' achievement of the learning outcome.

2. The stem should not contain irrelevant material, which can decrease the reliability and the validity of the test scores (Haldyna and Downing 1989).

3. The stem should be negatively stated only when significant learning outcomes require it. Students often have difficulty understanding items with negative phrasing (Rodriguez 1997). If a significant learning outcome requires negative phrasing, such as identification of dangerous laboratory or clinical practices, the negative element should be emphasized with italics or capitalization.

4. The stem should be a question or a partial sentence. A question stem is preferable because it allows the student to focus on answering the question rather than holding the partial sentence in working memory and sequentially completing it with each alternative (Statman 1988). The cognitive load is increased when the stem is constructed with an initial or interior blank, so this construction should be avoided.

Constructing Effective Alternatives

1. All alternatives should be plausible. The function of the incorrect alternatives is to serve as distractors,which should be selected by students who did not achieve the learning outcome but ignored by students who did achieve the learning outcome. Alternatives that are implausible don't serve as functional distractors and thus should not be used. Common student errors provide the best source of distractors.

2. Alternatives should be stated clearly and concisely. Items that are excessively wordy assess students' reading ability rather than their attainment of the learning objective

3. Alternatives should be mutually exclusive. Alternatives with overlapping content may be considered "trick" items by test-takers, excessive use of which can erode trust and respect for the testing process.

4. Alternatives should be homogenous in content. Alternatives that are heterogeneous in content can provide cues to student about the correct answer.

5. Alternatives should be free from clues about which response is correct. Sophisticated test-takers are alert to inadvertent clues to the correct answer, such differences in grammar, length, formatting, and language choice in the alternatives. It's therefore important that alternatives

have grammar consistent with the stem.

are parallel in form.

are similar in length.

use similar language (e.g., all unlike textbook language or all like textbook language).

6. The alternatives "all of the above" and "none of the above" should not be used. When "all of the above" is used as an answer, test-takers who can identify more than one alternative as correct can select the correct answer even if unsure about other alternative(s). When "none of the above" is used as an alternative, test-takers who can eliminate a single option can thereby eliminate a second option. In either case, students can use partial knowledge to arrive at a correct answer.

7. The alternatives should be presented in a logical order (e.g., alphabetical or numerical) to avoid a bias toward certain positions.

8. The number of alternatives can vary among items as long as all alternatives are plausible. Plausible alternatives serve as functional distractors, which are those chosen by students that have not achieved the objective but ignored by students that have achieved the objective. There is little difference in difficulty, discrimination, and test score reliability among items containing two, three, and four distractors.

Additional Guidelines

1. Avoid complex multiple choice items , in which some or all of the alternatives consist of different combinations of options. As with "all of the above" answers, a sophisticated test-taker can use partial knowledge to achieve a correct answer.

2. Keep the specific content of items independent of one another. Savvy test-takers can use information in one question to answer another question, reducing the validity of the test.

Considerations for Writing Multiple Choice Items that Test Higher-order Thinking

When writing multiple choice items to test higher-order thinking, design questions that focus on higher levels of cognition as defined by Bloom's taxonomy. A stem that presents a problem that requires application of course principles, analysis of a problem, or evaluation of alternatives is focused on higher-order thinking and thus tests students' ability to do such thinking. In constructing multiple choice items to test higher order thinking, it can also be helpful to design problems that require multilogical thinking, where multilogical thinking is defined as "thinking that requires knowledge of more than one fact to logically and systematically apply concepts to a ...problem" (Morrison and Free, 2001, page 20). Finally, designing alternatives that require a high level of discrimination can also contribute to multiple choice items that test higher-order thinking.

Additional Resources

Burton, Steven J., Sudweeks, Richard R., Merrill, Paul F., and Wood, Bud. How to Prepare Better Multiple Choice Test Items: Guidelines for University Faculty, 1991.

Cheung, Derek and Bucat, Robert. How can we construct good multiple-choice items? Presented at the Science and Technology Education Conference, Hong Kong, June 20-21, 2002.

Haladyna, Thomas M. Developing and validating multiple-choice test items, 2nd edition. Lawrence Erlbaum Associates, 1999.

Haladyna, Thomas M. and Downing, S. M.. Validity of a taxonomy of multiple-choice item-writing rules. Applied Measurement in Education, 2(1), 51-78, 1989.

Morrison, Susan and Free, Kathleen. Writing multiple-choice test items that promote and measure critical thinking. Journal of Nursing Education 40: 17-24, 2001.

This teaching guide is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Writing Good Multiple Choice Test Questions

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by Cynthia J. Brame Print Version Cite this guide: Brame, C. (2013) Writing good multiple choice test questions. Retrieved [todaysdate] from https://cft.vanderbilt.edu/guides-sub-pages/writing-good-multiple-choice-test-questions/. Constructing an Effective Stem Constructing Effective Alternatives Additional Guidelines for Multiple Choice Questions Considerations for Writing Multiple Choice Items that Test Higher-order Thinking Additional Resources Multiple choice test questions, also known as items,...

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The Quality and Safety Education for Nurses (QSEN) project addresses the challenge of preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work.

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The National Database of Nursing Quality IndicatorsTM (NDNQI®) is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level. Linkages between nurse staffing levels and patient outcomes have already been demonstrated through the use of this database. Currently over 1100 facilities in the United States contribute to this growing database which can now be used to show the economic implications of various levels of nurse staffing. The purpose of this article is to describe the work and accomplishments related to the NDNQI as researchers utilize its nursing-sensitive outcomes measures to demonstrate the value of nurses in promoting quality patient care. After reviewing the history of evaluating nursing care quality, this article will explain the purpose of the NDNQI and describe how the database has been operationalized. Accomplishments and future plans of the NDNQI will also be discussed.

Citation: Montalvo, I., (September 30, 2007) "The National Database of Nursing Quality Indicators TM (NDNQI ®)" OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3, Manuscript 2.

DOI: 10.3912/OJIN.Vol12No03Man02

Key Words: nursing-sensitive indicators, quality, nurse staffing, patient outcomes, nursing outcomes, performance measurement

Quality is a broad term that encompasses various aspects of nursing care. Various health care measures have been identified over the years as indicators of health care quality ( American Nurses Association, 1995; Institute of Medicine, 1999, 2001, 2005; Joint Commission, 2007). In 2004, the National Quality Forum (NQF), via its voluntary consensus standards process, endorsed 15 national standards to be used in evaluating nursing-sensitive care. These standards are now known as the NQF 15 ( Kurtzman & Corrigan, 2007). The purpose of this article is to describe the work and accomplishments related to the National Database of Nursing Quality Indicators TM (NDNQI ®) as researchers utilize its nursing-sensitive outcomes measures to demonstrate the value of nurses in promoting quality patient care. After reviewing the history of evaluating nursing care quality, this article will explain the purpose of the NDNQI and describe how the database has been operationalized. Accomplishments and future plans of the NDNQI will also be discussed.
History of Evaluating Nursing Care Quality
Evaluating the quality of nursing practice began when Florence Nightingale identified nursing's role in health care quality and began to measure patient outcomes. She used statistical methods to generate reports correlating patient outcomes to environmental conditions ( Dossey, 2005; Nightingale, 1859/1946). Over the years, quality measurement in health care has evolved. The work done in the 1970s by the American Nurses Association (ANA), the wide dissemination of the Quality Assurance (QA) model ( Rantz, 1995), and the introduction of Donabedian's structure, process, and outcomes model ( Donabedian, 1988, 1992) have offered a comprehensive method for evaluating health care quality.

The workforce restructuring and redesign prevalent in the early 1990s demonstrated the need for the ANA to evaluate nurse staffing and identify linkages between nurse staffing and patient outcomes. The workforce restructuring and redesign prevalent in the early 1990s demonstrated the need for the ANA to evaluate nurse staffing and identify linkages between nurse staffing and patient outcomes. In 1994 the ANA Board of Directors asked ANA staff to investigate the impact of these changes on the safety and quality of patient care. In 1994, ANA launched the Patient Safety and Quality Initiative ( ANA, 1995). A series of pilot studies across the United States were funded by ANA to evaluate linkages between nurse staffing and quality of care ( ANA, 1996a, 1997, 2000a, 2000b, 2000c). Multiple quality indicators were identified initially. Evidence of the effectiveness of these indicators was used to adopt a final set of 10 nursing-sensitive indicators to use in evaluating patient care quality ( Gallagher & Rowell, 2003). Implementation guidelines were subsequently published ( ANA, 1996b, 1999).

Nursing-sensitive indicators identify structures of care and care processes, both of which in turn influence care outcomes. Nursing-sensitive indicators are distinct and specific to nursing, and differ from medical indicators of care quality. For example, one structural nursing indicator is nursing care hours provided per patient day. Nursing outcome indicators are those outcomes most influenced by nursing care.
Purpose of the NDNQI®
In 1998, the National Database of Nursing Quality Indicators was established by ANA so that ANA could continue to collect and build on data obtained from earlier studies and further develop nursing's body of knowledge related to factors which influence the quality of nursing care. Linkages between nurse staffing and patient outcomes had already been identified, but continued data collection and reporting was necessary to evaluate nursing care quality at the unit level and thus fulfill nursing's commitment to evaluating and improving patient care.

Nursing's foundational principles and guidelines identify that as a profession, nursing has a responsibility to measure, evaluate, and improve practice. This is stated in two of nursing's guiding documents:

The Code of Ethics for Nurses with Interpretative Statements states: The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient (ANA, 2001, p.12).

Nursing: Scope & Standards of Practice, Standard 7 states: The registered nurse systematically enhances the quality and effectiveness of nursing practice (ANA, 2004. p. 33).

The Utilization Guide for the ANA Principles for Nurse Staffing recognizes that in order to measure sufficiency of staffing on an ongoing basis, at a minimum, unit level nursing-sensitive structure, process, and outcome indicators need to be collected ( ANA, 2005). NDNQI's mission is to aid the nurse in patient safety and quality improvement efforts... NDNQI's mission is to aid the nurse in patient safety and quality improvement efforts by providing research-based, national, comparative data on nursing care and the relationship of this care to patient outcomes.
Operationalization of the National Database
The NDNQI ® database is managed at the University of Kansas Medical Center (KUMC) School of Nursing under contract to ANA with fiscal and legal support provided by KUMC Research Institute (KUMCRI). A health care facility that is interested in joining the NDNQI submits a signed contract and fee, based on hospital size, to KUMCRI, along with information on the person who will be the facility's NDNQI ® primary point of contact. This person is then identified as the NDNQI Site Coordinator. The NDNQI Site Coordinator serves as the interface between the participating facility and the NDNQI liaisons working at the University of Kansas. The NDNQI ® liaisons provide ongoing assistance and support to health care facilities at multiple levels. For example they provide help in identifying nursing units appropriately for data entry; offer web-based, data-entry tutorials; conduct pilot testing; and answer questions about definitions and the reading of reports. NDNQI ® researchers are also available to answer questions related to the database or the nursing measures.

Education on NDNQI and nursing-sensitive indicators has been ongoing for participating facilities since 1999. Facilities have quarterly conference calls with NDNQI ® staff to review any changes or updates to the indicators or database. They also have the opportunity to participate in pilot studies performed when an indicator is being evaluated for implementation.

Once access to the database has been provided, the facility NDNQI ® Site Coordinator will work with NDNQI staff from the University of Kansas to correctly classify the nursing units. This is an important step to ensure nursing units are classified appropriately prior to data entry. The facility NDNQI Site Coordinator and other authorized hospital staff also complete web-based tutorials to learn about each indicator prior to initial data submission. The facility NDNQI Site Coordinator has continuous access to the indicator definitions and is responsible for aligning the hospital data collected to NDNQI definitions. The facility NDNQI Site Coordinator has continuous access to the indicator definitions and is responsible for aligning the hospital data collected to NDNQI definitions. On average, it takes three months to join the database and start data submission. The NDNQI is then dependent on hospitals correctly submitting the data on a quarterly basis. All data is submitted electronically via the intranet in a secure website or by XML submission. Data checks and error reports are conducted on an ongoing basis by participating facilities and by NDNQI staff to ensure data integrity.

As of the writing of this article, the NDNQI has implemented six of the ten original ANA-endorsed NDNQI indicators (See Table 1). The initial set of indicators used in establishing the database was selected based on feasibility testing. These indicators included: Falls, Falls with Injury, Nursing Care Hours per Patient Day, Skill Mix, Pressure Ulcer Prevalence, and Hospital-Acquired Pressure Ulcer Prevalence. The RN job satisfaction indicator was pilot tested in 2001 and subsequently implemented in 2002. The RN satisfaction survey is an important indicator to assist nursing leaders and staff in evaluating the work environment so as to facilitate nursing retention and recruiting efforts.

Pediatric and psychiatric indicators have been added more recently because participating hospitals requested indicators for these areas. Additional NQF endorsed measures ( Table 1) were then added to the database because these represented additional nursing measures available that had already gone through a consensus measure approval process. ANA supported the addition of these measures to the database because they were of interest nationally to the nursing profession and were in concert withANA's seminal work and ongoing support of nursing measures.

Implementing an indicator is a multi-step process ( Table 2) that includes evaluating the evidence that a specified indicator is nurse sensitive and then pilot testing ( Table 3) of the indicator by participating facilities. In addition, ...there is ongoing monitoring and testing for validity and reliability per NDNQI standard operating procedure. there is ongoing monitoring and testing for validity and reliability per NDNQI standard operating procedure. An outcome indicator is deemed to be nursing sensitive if there is a correlation or multivariate association between some aspect of the nursing workforce or a nursing process and the outcome. The NDNQI utilizes state-of-the-science methods, such as the hierarchical mixed model, to assess the strength of correlation between nursing workforce characteristics and outcomes ( Gajewski et al., 2007; Hart, et al., 2006).

Table 2. Indicator Development Process

1. Review scientific literature for: (a) evidence that some aspect of nursing case has an effect on a patient outcome; (b) specific definitions of the indicators; and (c) evidence that the indicators can be validly and reliably measured

2. Collect information from researchers in the field on threats to reliability and validity

3. Conduct expert review of draft indicator definitions, data collection guidelines, and data collection forms

4. Distribute revised definitions, guidelines, and forms to clinical experts for comments on face validity and feasibility of reliable data collection

5. Incorporate clinical expert feedback and develop revised versions of definitions, guidelines, and forms

6. Conduct a pilot study (Table 3) using the draft data collection materials and review data; also interview hospital study coordinators to identify additional threats to reliability and validity

7. Finalize definitions, data collection guidelines, and forms

8. Train database participants in standardized data collection practices

1. Develop the indicator with draft guidelines and data collection instruments

2. Recruit pilot testers via e-mail and phone

3. Select pilot sites from those interested. Sites are selected for hospital/unit diversity

4. Guide pilot sites in collecting data according to the draft guidelines

5. Analyze data submitted by pilot sites

6. Collect written and telephone evaluations to assess for clarity, feasibility, and assessment of threats to validity and reliability

7. Analyze pilot data for indicator refinement

8. Finalize guidelines and instruments for dissemination

Quarterly Reports are downloaded electronically from the web by participating facilities. Reports can be downloaded in Adobe PDF, or Microsoft Excel format to facilitate data sharing and dissemination within a given institution. Figure 1 provides a sample of two tables from the report. The reports range from 25-200+ pages based on the number of nursing units and indicators for which hospitals submit data. The reports provide the most current eight quarters worth of data and a rolling average of those eight quarters with national comparisons at the unit level based on patient type, unit type, hospital bed size, and statistical significance of unit performance. For example, patient falls with injury could be reported for each adult medical unit of a 100-199 bed facility. The means for all medical units in a given-size facility can be compared with national standards for a given, nursing-sensitive indicator. The process measures associated with falls are collected and reported as well as the outcome measure of a patient fall.

Figure 1 - Sample Tables from NDNQI Reports

The significance of offering the reports at the unit level is that such reports provide data regarding the specific site where the care occurs and provides a better comparison among like units. The significance of offering the reports at the unit level is that such reports provide data regarding the specific site where the care occurs and provides a better comparison among like units. Nursing leaders at participating facilities have used the information to advocate for more staff or a different mix of staff based on their comparisons of units in comparable facilities nation wide. Staff are also able to identify whether their performance improved after they intervened in an area needing improvement, e.g., a decrease in the fall rate due to implementation of a new protocol.

Some facilities join NDNQI as part of their Magnet TM Journey to report nursing-sensitive indicators. The Magnet facilities represent about 20% of the database. The remaining 80% of NDNQI-participating facilities join because they believe in the value of evaluating the quality of nursing care and improving outcomes, activities which are both basic responsibilities of the profession. NDNQI is also used to aid in the recruitment and retention of nurses by hospitals that use the annual RN Survey data and quarterly data to improve work environments, to staff based on patient outcomes, and to meet regulatory or state reporting requirements.
Broad Accomplishments
NDNQI accomplishments include development of nationally accepted measures to assess the quality of nursing care, improvements in training procedures for data submission, identification of nursing workforce structures and processes that influence outcomes, and sharing best practices for improving outcomes. Each will be discussed in turn. Nursing leaders at participating facilities have used the information to advocate for more staff...

To date the NDNQI has already developed a number of standards. Four of the 15 standard nursing measures endorsed by the NQF have been NDNQI measures. Thirteen indicators already have been implemented in NDNQI, and at the time of this writing three additional measures, which are also NQF-endorsed measures, are scheduled for implementation. Of the 13 implemented indicators, eight are NQF consensus measures. NQF uses a consensus process to endorse measures. This process includes (a) consensus standard development, (b) widespread review, (c) member voting and member council approval, (d) board of directors action, and (e) evaluation. The importance of the NQF-endorsed indicators is that they provide a standard measure for evaluating nursing care and are the only nursing measures that have been endorsed for public reporting.

Data training procedures and submissions have advanced from a telephone call for 1:1 training and submission using a CD, to use of comprehensive, web-based tutorials training participants to submit data using electronic means. Data submission now involves specification of unit types and various patient types, such as adult, pediatric, neonatal, psychiatric, and rehabilitation patient populations.

Research on the database has yielded meaningful information on both workforce characteristics which influence quality outcomes and the importance of evaluating the data based on unit type. Identification of important correlations between structures and processes and observed nursing outcomes can help facilities improve their nursing care outcomes.Dunton et al. ( 2004) evaluated nurse staffing and patient falls and noted important correlations. They observed that lower fall rates were associated with higher staffing on certain types of units, and noted a strong relationship between fall rates, nursing hours, and skill mix. Hart, et al.( 2006) studied the incidence of pressure ulcers among NDNQI hospitals, and reported a difference in quality outcomes based on the nursing workforce element of certification. As a result of the Hart et al. study an additional, web-based tutorial on pressure ulcers was created by NDNQIto educate the staff nurse on wound assessment. It is available publicly on the NDNQI web-site for any nurse to complete. Both of these studies demonstrated the value of reporting nursing-sensitive indicator data at the unit level, recognizing that variability of outcomes occurs at the unit level based on patient type, nurse staffing, and the nursing workforce characteristics. The NDNQI database enables researchers to identify various nursing workforce elements that can impact patient outcome, such as nurse staffing, skill mix, and specific nursing processes. It also enables researchers to identify process elements that can influence patient outcomes. Identification of important correlations between structures and processes and observed nursing outcomes can help facilities improve their nursing care outcomes. The database provides the end user with a powerful tool to aid in decision making related to improving the nursing work environment and patient outcomes.

...80% of NDNQI-participating facilities join because they believe in the value of evaluating the quality of nursing care and improving outcomes, activities which are both basic responsibilities of the profession. NDNQIstaff have also helped facilities improve patient care by sharing best practices. In 2006 NDNQIstaff identified facilities that had sustained an improvement in a given nursing-sensitive indicator. These facilities were asked to share what they had done to bring about this improvement. Fourteen facilities were profiled in a monograph identifying their experience with the database, their use of the data, and improvement strategies they had implemented to improve nursing performance in a given measure ( Montalvo & Dunton, 2007). For example, in one facility the hospital-acquired pressure ulcer (HAPU) rate dropped from 6.31 to 3.04 after implementing a quality improvement process that included assigning wound/ostomy/ continence specialists to specific nursing units to help all staff improve their surveillance for HAPUs and adopt a zero tolerance for HAPU. The opportunity for varying-size facilities to share these best practices adds to nursing's knowledge base and helps nurses nation wide to improve nursing practice and patient outcome. The First Annual NDNQI Data Use Conference was held in January 2007 and was highly successful with 900 attendees being able to walk away with practical tools and tips in utilizing NDNQI data and to improve nursing-sensitive indicator outcomes. The monograph by Montalvo and Dunton, along with the annual national conference, have aided in disseminating such helpful information to all interested parties.

The current consumer-driven health care environment requires accountability for the health care decisions made and the impact of these decisions on patients. Although direct financial cost/benefits have not been fully calculated with NDNQI globally, the staff nurses and nurse leaders now have a valuable nursing tool to aid them in decision making about staffing, skill mix, patient care processes, and workforce characteristics that affect patient outcomes, thus influencing directly and indirectly the cost of patient care. The facility now has the data necessary to calculate their cost/benefit ratio based on their improvements and outcomes.
Future Plans and Goals for NDNQI®
The NDNQI database continues to grow in the number of facilities participating and in methodological sophistication. The database has grown from the original 30 facilities to over 1100 facilities in 2007, and ongoing investment and database enhancements continue. Two key developments are slated to begin in 2007. One is to develop methods for measuring unit-level acuity. This will provide mixed acuity units (units having more than 10% of patients representing a different patient population, such as rehabilitation patients on medical units [NDNQIoperational definition, 2007]) and universal bed units (those having patient rooms equipped to care for any patient regardless of acuity [ Brown, 2007]) with the ability to receive comparisons from NDNQI.

The second enhancement is to improve reporting features of NDNQI, so that more finite or granular comparisons of a very specific type of unit can be made. An example of a more finite comparison for particular facilities would be comparing coronary critical care units in the 100-bed to 199-bed hospitals. More enhanced reporting will provide more specific comparisons, the ability to download and post different sections of the report, new color graphics, single report cards, and hospital-level summaries. These value-added enhancements will provide the end user with a more powerful tool to evaluate nursing care, improve quality, and influence outcomes for both the patient and the nursing staff alike.

New indicators are added to the database on an annual basis. Additionally, over the next 18 months, existing indicators in the database will become available for all appropriate nursing units. For example, the current psychiatric assault indicator could be pertinent in the Emergency Department (ED) because the ED is a point of entry for these patients. As the demand for data increases, expanding existing indicators to relevant areas will facilitate the ability of facilities to respond to patient and staff needs.
Conclusion
Researchers will also continue to benefit from these enhancements. These developments will enable researchers to fine-tune their research questions and identify additional associations between nursing workforce characteristics and processes and the observed patient outcomes.

The NDNQI has made considerable progress since the ANA Board of Directors asked ANA staff to investigate the impact of workforce restructuring and redesign on patient care and to quantify the relationship between nurse staffing and patient outcomes. Today's national spotlights on patient safety and public reporting have increased the need for nursing to collect and monitor data related to patient outcomes. It is also critical to continue these efforts to ensure nursing has the appropriate workforce to render the care necessary to optimize patient outcomes at the unit level. NDNQI studies have demonstrated the value of nursing care and the significance of nursing's contribution to positive patient outcomes. NDNQI data now has the validity and reliability to be used to evaluate nursing care, improve patient outcomes, and identify the linkages between nurse staffing and patient outcomes at the unit level. NDNQI has indeed become the seminal nursing database that is used to influence nursing policy and improve nursing care.

Isis Montalvo, MS, MBA, RN
E-mail: Isis.Montalvo@ana.org

Isis Montalvo is Manager, Nursing Practice & Policy at the American Nurses Association (ANA). She is primarily responsible for providing oversight to the National Database of Nursing Quality Indicators™ (NDNQI®) in which over 1100 hospitals currently participate ( www.nursingquality.org). Ms. Montalvo has over 20 years experience in multiple areas of clinical and administrative practice with a focus in critical care and performance improvement. As a former NDNQI Site Coordinator, Quality Specialist, and Nursing Research Chair at a large urban facility she brings expertise in data analysis, performance improvement, and nursing care evaluation. In 1996, she received her Master's in Business Administration from the University of Baltimore in Maryland and her Master's of Science in Nursing Administration from the University of Maryland . She is a Critical Care Registered Nurse (CCRN) Alumnus and a member of the American Association of Critical Care Nurses, the American Society of Association Executives/The Center for Association Leadership, the National Association for Healthcare Quality, and Phi Kappa Phi and Sigma Theta Tau honor societies.

American Nurses Association. (1995). Nursings report card for acute care. Washington, DC: American Nurses Publishing.

American Nurses Association. (1996a). Nursing quality indicators: Definitions and implications Washington, DC: American Nurses Publishing. Available: www.nursingworld.org/books/pdescr.cfm?cnum=11#NP-108

American Nurses Association. (1997). Implementing nursings report card: A study of RN staffing, length of stay and patient outcomes. Washington, DC: American Nurses Publishing.

Brown, K.K. (2007, March/April) The universal bed care delivery model. Patient Safety and Quality Health Care. Retrieved, August 19, 2007 from www.psqh.com/marapr07/caredelivery.html

Donabedian A. (1988). The quality of care: How can it be assessed? JAMA, 260,1743-1748.

Donabedian, A. (1992). The role of outcomes in quality assessment and assurance. Quality Review Bulletin, 11, 356-60.

Dunton, N., Gajewski, B., Taunton, R.L., & Moore, J. (2004). Nurse staffing and patient falls on acute care hospital units. Nurse Outlook, 52, 53-9.

Gajewski, B., Hart, S., Bergquist-Beringer, S., & Dunton, N. (2007). Inter-rater reliability of pressure ulcer staging: Ordinal probit Bayesian hierarchical model that allows for uncertain rater response. Statistics in Medicine (in press).

Gallagher, R.M. & Rowell, P.A. (2003). Claiming the future of nursing through nursing-sensitive quality indicators. Nursing Administration Quarterly 24(4), 273-284.

Hart, S., Berquist, S., Gajewski, B., & Dunton, N. (2006). Reliability testing of the National Database of Nursing Quality Indicators pressure ulcer indicator. Journal of Nursing Care Quality 21(3), 256-265.

Institute of Medicine. (1999). To err is human: Building a safer health system. Washington, DC: National Academies Press.

Institute of Medicine. (2001). Crossing the quality chasm. Washington, DC: National Academies Press.

Institute of Medicine. (2005). Performance measurement: Accelerating improvement. Washington, DC: National Academies Press.

Kurtzman, E.T., & Corrigan, J.M. (2007). Measuring the contribution of nursing to quality, patient safety, and health care outcomes. Policy, Politics & Nursing Practice, 8(1), 20-36.

Nightingale, F. (1859; reprinted 1946). Notes on nursing: What it is, and what it is not. Philadelphia: Edward Stern & Company.

© 2007 OJIN: The Online Journal of Issues in Nursing
Article published September 30, 2007

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the value of rns: how can we communicate our economic worth?

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The National Database of Nursing Quality Indicators

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The National Database of Nursing Quality IndicatorsTM (NDNQI®) is the only national nursing database that provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate nursing care at the unit level. Linkages between nurse staffing levels and patient outcomes have already been demonstrated through the use of this database.

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QSEN - Peer-reviewed teaching strategies

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QSEN - Peer-reviewed teaching strategies

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Over 100 teaching strategies

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Below is a listing of the peer-reviewed teaching strategies published on our website. Each strategy submitted undergoes a blind peer-review by a volunteer QSEN Teaching Strategy reviewer. You will receive feedback on revisions from the reviewer and then submit your revisions. You can scroll through the listing or search the strategies by author, title, and keywords.

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The materials on the QSEN Web site are freely available for educational use, but original content such as the teaching strategies must be cited. Please read our Terms and Conditions before using this material.

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Below is a listing of the peer-reviewed teaching strategies published on our website. Each strategy submitted undergoes a blind peer-review by a volunteer QSEN Teaching Strategy reviewer. You will receive feedback on revisions from the reviewer and then submit your revisions. You can scroll through the listing or search the strategies by author, title, and keywords.

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The following search form can be used to search the QSEN teaching and practice strategies using the specific categories assigned to them.

Please note that this uses an AND search query, meaning that it will look for documents that include all of the terms you choose. The more terms you select, the fewer results you will get back.

To view the complete list of strategies, see Teaching and Practice Strategies.

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The following search form can be used to search the QSEN teaching and practice strategies using the specific categories assigned to them. Please note that this uses an AND search query, meaning that it will look for documents that include all of the terms you choose.

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Creating a Rubric: Online Tutorial for Faculty

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Creating a Rubric: Online Tutorial for Faculty

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Creating a Rubric

Rubrics are a tool to help you evaluate student performance. Knowing how to create and use rubrics gives you a better understanding of assessment and another option for assessing student performance. Rubrics are a great way to improve communication, learning, and grading fairness. In this course we will cover:

what rubrics are and how they can benefit you and your students

assessment concepts that relate to rubrics

how to create a rubric

how to judge the quality of the rubrics you create

The tutorial also provides several examples of rubrics and a list of resources where you can learn more.

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Rubrics are a tool to help you evaluate student performance. Knowing how to create and use rubrics gives you a better understanding of assessment and another option for assessing student performance. Rubrics are a great way to improve communication, learning, and grading fairness. Course authored and designed by Lisa O'Reilly, Instructional Designer."

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https://www.michigancenterfornursing.org/system/files/G-CFA%20Manual%20Tab%208%20Conducting%20Pre%20Post%20Conferences-R6.pdf

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Teaching Critical Thinking Using Case Studies

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Teaching Critical Thinking Using Case Studies

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Summary

This paper examines the use of case studies as teaching strategies to promote critical thinking. Critical thinking and case studies are defined as teaching method. The benefits and limitations of case studies are also discussed. The literature review investigates research studies that have indicated how case studies facilitate and promote active learning, help clinical problem solving, and encourage the development of critical thinking skills. Using case studies in teaching will assist nurse educators in promoting active learning; furthermore, it will help in developing critical thinking skills, which are extremely important for nurses and other health care professionals.

View full text

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Promotion of critical thinking by using case studies as teaching method

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This paper examines the use of case studies as teaching strategies to promote critical thinking. Critical thinking and case studies are defined as teaching method. The benefits and limitations of case studies are also discussed. The literature review investigates research studies that have indicated how case studies facilitate and promote active learning, help clinical problem solving, and encourage the development of critical thinking skills.

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Writing Your Teaching Philosophy | Center for Educational Innovation

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Your teaching philosophy is a self-reflective statement of your beliefs about teaching and learning. It’s a one to two page narrative that conveys your core ideas about being an effective teacher in the context of your discipline. It develops these ideas with specific, concrete examples of what the…

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https://www.chronicle.com/article/8-Tips-to-Improve-Your-CV/246720

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Your CV - as its full name, "curriculum vitae," suggests - is the record of your academic life. But it's also a passport through that life, and one you'll have to show to gatekeepers over and over. If you want to get past those gates, your CV had better do its job.

I talk a lot in The Graduate Adviser column about the career prospects of Ph.D.s outside of academe, but this month I turn to the central document of academic life: the CV. Of course a strong CV is built on strong achievements. But you also have to present your record in an interesting and impressive way. And that's where many aspiring academics fall short.

What follows are eight tips to improve your CV.

But first, understand the difference between a CV and a résumé. There's plenty of overlap between the two - it's fair to describe a CV as an academic résumé. But the differences are salient. A résumé tends to be directly purpose-driven. It might start out with an explicit career objective ("a public-relations position that combines analysis and customer relations"), while a CV rarely features that kind of rhetoric.

CVs have specific purposes, too - they're more implicit, that's all. You have to design a CV for the audience it will reach - and you have to attend to the particular readings habits of that audience.

Résumés are typically more compact than CVs. Just about everyone who's written a résumé has encountered the injunction to keep it short. But if a CV is usually more comprehensive, that doesn't mean it should be swollen with watery excess. Keep in mind that every unnecessary item on your vita threatens, by its very presence, to distract your reader from the necessary stuff.

What makes a CV entry necessary? That depends on who's reading, and why.

Always remember: Your CV combines autobiography and salesmanship. It needs to persuade readers to hire you for the job, give you the grant, or award you the fellowship. You have to select the aspects of yourself that will sell you to your specific audience.

Other people read your CV because they have something you want. When you prepare the document for their eyes, keep your specific goal in mind and customize accordingly. If you're sending your CV as part of an application for a grant, you probably don't need to include your campus service work - because unnecessary extras distract the reader. If you're applying for a teaching job at a research university, you'll present your teaching record differently than if you're applying for an opening at a private high school.

In other words, a CV is not just a written record of your credentials. It's an argument in favor of you. Write with that in mind.

Generally speaking, put your educational credentials first. As you make that argument for yourself, follow the prevailing rules. Education is the business most CV-readers are in. Readers of résumés might not care much about where you went to school and what degrees you got, but CV readers almost always look for that information right away. Don't annoy them by burying it.

When you lay out your CV, follow the conventions of your discipline. A CV is not the place to challenge your reader's assumptions. If scientists expect your publications to be presented in chronological order and in a specific bibliographic format, then meet their expectations. If you don't, you'll distract your readers from their most important task, which is to assess your credentials.

Draft your vita knowing it will be skimmed. I keep returning to distraction because it ought to be your greatest concern. Consider that most people going through a stack of applications will spend only a couple of minutes reading each CV - if that. You have to make the most of that brief time.

Worse, most readers don't read a CV carefully. They skim it. You can't change that fact, so accommodate to it instead: Write to be skimmed. Which brings me to my next two points.

Most important, write visually. That's an umbrella term. It means you should attend to the visual balance between text and white space on your CV, use formatting thoughtfully to create emphasis, and, above all, consider the movement of a skimming reader's fast-moving eye.

You may wonder how you can tell where readers are going to look. It takes some practice. You can get it by reading other people's CVs (which are abundant online), and watching where your own eyes travel. Where do you home in? What do you skip? Do your eyes move sequentially from section marker to section marker, or do they jump around?

A good CV uses formatting to catch and direct the reader's attention. Boldface, for example, will attract the reader - as it does you when you read this essay. Underlining does the same.

On the other hand, big bricks of text - i.e., chunky paragraphs - will repel readers. When the skimming reader's eye encounters a long paragraph, it usually just bounces off it and drops downward to the next resting point. Resting points are important because even skimming readers need a place to stop. Indentation and other formatting choices provide visual variety and contrasts, and they also provide section markers to give readers a momentary rest before you redirect them.

Use boldface, underlining, and other attention-getting hooks judiciously. Overuse renders them ineffective, or worse. If a CV assaults the eye with a blizzard of words and a farrago of underlining, bolding, italics, text boxes, and so on, you'll turn off many readers and get less of their precious time.

Front-load your most important entries. This, too, is about keeping in mind your readers' limited amount of time for looking at CVs. If your most impressive credential is the prize you won for your dissertation, then figure out a way to put it before your reader as soon as you can - and flag it so it won't be missed.

You have to do that because reading lengthy CVs gets tiring very fast. Make sure your readers see what you want them to see before they run out of attention, shift into "it's time to finish" mode, and start hitting "page down."

Avoid inside baseball. That's a journalistic term for insider talk. You'll conserve your reader's patience if you present the important stuff intelligibly. Unless you're applying for an opening in a department you're already teaching in, your reference to "Sociology 342" will be lost. Worse, it will be interpreted as a sign that you don't really understand who your audience is - and your readers will take note of that failure.

Use your CV to guide the interview you hope to land. Your CV should include only those things that you want to talk about in the job interview. Remember that an interview is a conversation about you - and your application provides the ingredients for that discussion. Imagine how you'd like the conversation to go, and organize your CV to make that outcome more, not less, likely.

The inverse also holds true: If you don't want to talk about a particular controversy in your field (say, a high-profile sexual-harassment case in your discipline), then avoid names and references on your CV that might lead a reader to ask you about it.

Of course your application comprises more than your CV. If you're applying for a job, your cover letter is at least as important. That'll be the subject of my next column.

Leonard Cassuto, a professor of English at Fordham University, writes regularly about graduate education in this space. His latest book is The Graduate School Mess: What Caused It and How We Can Fix It, published by Harvard University Press. He welcomes comments, suggestions, and stories at lcassuto@erols.com. His Twitter handle is @LCassuto.

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Your CV - as its full name, "curriculum vitae," suggests - is the record of your academic life. But it's also a passport through that life, and one you'll have to show to gatekeepers over and over. If you want to get past those gates, your CV had better do its job.

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http://www.anpd.org/page/ipce-resources

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https://youtu.be/AGQyaGtrTUc

Theory
https://learn.dcollege.net/bbcswebdav/pid-8386047-dt-content-rid-87268540_1/xid-87268540_1
Kilpatricks Learning Evaluation Theory
http://www.youtube.com/watch?v=oBpI0B5PtaA
Theory Based Evaluation
http://www.youtube.com/watch?v=eZRiemmQ6wQ

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https://learn.dcollege.net/bbcswebdav/pid-8626159-dt-content-rid-93729646_1/xid-93729646_1
Gap Assessment
https://learn.dcollege.net/bbcswebdav/pid-8626165-dt-content-rid-93730206_1/xid-93730206_1
https://learn.dcollege.net/bbcswebdav/pid-8626164-dt-content-rid-93729098_1/xid-93729098_1
https://learn.dcollege.net/bbcswebdav/pid-8672001-dt-content-rid-94048080_1/xid-94048080_1

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Presenter Media - PowerPoint Templates, 3D Animations and Clipart

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Institute of Medicine & Robert Wood Johnson Foundation. (2011). The future of nursing: Leading change, advancing health. Retrieved from: http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

Benner, P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402-407.
Benner's from Novice to Expert.pdf

Ironside, P. M., McNelis, A. M., & Ebright, P. (2014). Clinical education in nursing: Rethinking learning in practice settings. Nursing Outlook, 62(3), 185-191. doi: 10.1016/joutlook.2013.12.004

Karuhije, H. F. (1997). Classroom and clinical teaching in nursing: delineating differences. Nursing Forum, 32(2), 5-12.

Future of Nursing Focus on Education Brief 2010(1).pdf     Classroom and Clinical Teaching Dilineating the Difference_1__1_(1).pdf

Clinical education in nursing rethinking learning in practice settings(1).pdf

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The National Post-Baccalaureate Graduate Nurse Residency Program A Model for Excellence in Transition to Practice

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Perceptions of Professional Practice and Work Environment of New Graduates in a Nurse Residency Program

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Nurse Residency Programs An Essential Requirement for Nursing

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Nurse Residency Programs An Integrative Review of the Literature

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https://socrative.com/

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http://www.apastyle.org/

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Association for Nursing Professional Development

https://www.anpd.org/

Professional Nurse Educator Group

https://pneg.org/

National League for Nursing

http://www.nln.org/

American Assoc of Colleges of Nursing

https://www.aacnnursing.org/

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Promoting Active Learning
https://teachingcommons.stanford.edu/resources/learning-resources/promoting-active-learning

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11 Active Learning Strategies to Engage Active Learning

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Resource Articles