• Title/Summary/Keyword: self-evidence

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A Systematic Review of Evidence for Education and Training Interventions in Microsurgery

  • Ghanem, Ali M.;Hachach-Haram, Nadine;Leung, Clement Chi Ming;Myers, Simon Richard
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.312-319
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    • 2013
  • Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

The Effects of an Evidence-based Nursing Course Using Action Learning on Undergraduate Nursing Students (액션러닝을 활용한 근거기반간호 수업운영의 효과)

  • Jang, Keum-Sung.;Kim, Eun A;Park, Hyunyoung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.21 no.1
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    • pp.119-128
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    • 2015
  • Purpose: This study was conducted to evaluate the effectiveness of an evidence-based nursing (EBN) course using action learning-based team learning in undergraduate nursing students. Methods: A quasi-experimental pretest-posttest control group design was employed. The participants who consented were 45 second-year nursing students (22 in the experimental, 23 in the control group) from a university in G-city, Korea. The intervention included lectures, practicals, team activities and reflection on overviewing EBN, formulating clinical questions, searching the evidence, and criticizing the research articles. At the beginning and the end of the 7-week EBN course, the participants completed self-reported questionnaires. Frequencies, $x^2$-test, t-test, and ANCOVA with the SPSS program 18.0, were used to analyze the data. Results: The experimental group showed significantly higher scores on EBN competency (F=25.80, p<001), information literacy (F=13.75, p=.001), and proactivity in problem solving (F=5.32, p=.026) than the control group. Conclusion: This study provides evidence that an EBN course improves undergraduate nursing students' EBN competencies, information literacy, and proactivity in problem solving. Team learning in EBN education can be an effective teaching strategy.

Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting (근거기반의 수술 후 오심·구토 관리 프로토콜의 개발 및 임상적 평가)

  • Oh, In Ohg;Yoo, Jae Yong;Oh, Eui Geum
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.86-97
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    • 2017
  • Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

A meta-analysis of intervention studies on the effects of self-management in knee osteoarthritis (무릎 골관절염 대상자에게 적용한 자가관리 중재의 효과 메타분석)

  • Kim, Young-Il;Park, Jeong Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.1946-1956
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    • 2015
  • The purpose of the this study was to provide objective evidence through a systematic review and meta-analysis regarding the effects of self-management in knee osteoarthritis. Articles published between 1999 and 2013 from periodicals indexed Ovid Medline, CINAHL, PubMed, RISS, KISS and other databases were selected, using the following key words: Osteoarthriti* OR OA, self-(management OR care OR help). A selection of 11 studies(7 randomized controlled trials and 4 quasi-experimental interventions that were used were exercise, education, massage and self-help group. As a result of mera-analysis, self-management significantly effected pain, physical function, activities of daily living, and self-efficacy. In particular, self-management showed great effect on ADL, and moderate effect on pain and physical function. Based upon these result, it is necessary to develop a standardized self-management program for knee osteoarthritis patients.

Do Low Self-Esteem and High Stress Lead to Burnout Among Health-Care Workers? Evidence From a Tertiary Hospital in Bangalore, India

  • Johnson, Avita R.;Jayappa, Rakesh;James, Manisha;Kulnu, Avono;Kovayil, Rajitha;Joseph, Bobby
    • Safety and Health at Work
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    • v.11 no.3
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    • pp.347-352
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    • 2020
  • Background: Low self-esteem can be an issue among health-care workers due to the hierarchical medical system. Health-care workers are also in a high pressure environment that can lead to stress and burnout. This study was conducted to estimate the proportion of health-care workers with low self-esteem, high stress, and burnout and the factors associated with these in a private hospital in Bangalore city. Methods: This cross-sectional study included a random sample of health-care workers of various cadres - doctors, nurses, nursing aides, technicians, and workers in ancillary departments such as laundry, dietary, central sterile supply department, and pharmacy, with probability proportional to size. Rosenberg Scale for Self-esteem, Cohen's Perceived Stress Scale, and Shirom-Melamed Burnout Measure were used as study tools. Results: Among the 306 health-care workers, there were high levels of low self-esteem (48.4%), stress (38.6%), and burnout (48.7%), with the lowest levels being among doctors. Those aged younger than 30 years had significantly lower self-esteem and greater stress. Conclusions: Health-care workers with low self-esteem were nearly thrice more likely to suffer high stress, Odds Ratio (OR) = 2.84 (1.36-5.92), and those who were stressed had more than three times higher chance of experiencing burnout, OR = 3.6 (2.02-6.55). Path analysis showed that low self-esteem among health-care workers had a direct effect on burnout, as well as an indirect effect through stress (mediator variable). This study indicates the need for screening and counseling for low self-esteem, stress, and burnout as part of a periodic medical examination of all cadres of health workers.

Mediating Effect of Self-Leadership and Career Decision-Making Self-Efficacy on the Relation between Critical Thinking Disposition and Career Preparation Behavior in Nursing Students (간호대학생의 비판적 사고성향과 진로준비행동 간의 관계에서 셀프리더십과 진로결정 자기효능감의 매개효과)

  • Moon, Ji-Young
    • The Journal of the Korea Contents Association
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    • v.19 no.11
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    • pp.462-473
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    • 2019
  • This study examined the evidence on how self-leadership and career decision-making self-efficacy scale can produce a mediating effect on the relation between critical thinking disposition and career preparation behavior of nursing students. The subjects were college students majoring in nursing in Gwangju. The data collected was for 263 such students. It was analyzed with SPSS 23.0 for windows. To examine the mediating effect, the study used Sobel. The findings were as follows. First, critical thinking disposition positively influences career preparation behavior of nursing students. Secondly, self-leadership and career decision-making self-efficacy show a complete mediating effect on the relation between critical thinking disposition and career preparation behavior in nursing students. These findings suggest that in order to promote career preparation behavior of nursing students, educational programs should improve subjects on critical thinking disposition. It also suggests self-leadership and career decision self-efficacy should be provided in nursing education field.

Structural Model of Evidence-Based Practice Implementation among Clinical Nurses (임상간호사의 근거기반실무 실행 구조모형)

  • Park, Hyunyoung;Jang, Keum Seong
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.697-709
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    • 2016
  • Purpose: This study was conducted to develop and test a structural model of evidence-based practice (EBP) implementation among clinical nurses. The model was based on Melnyk and Fineout-Overholt's Advancing Research and Clinical Practice through Close Collaboration model and Rogers' Diffusion of Innovations theory. Methods: Participants were 410 nurses recruited from ten different tertiary hospitals in Korea. A structured self-report questionnaire was used to assess EBP knowledge/skills, EBP beliefs, EBP attitudes, organizational culture & readiness for EBP, dimensions of a learning organization and organizational innovativeness. Collected data were analyzed using SPSS/WINdows 20.0 and AMOS 20.0 program. Results: The modified research model provided a reasonable fit to the data. Clinical nurses' EBP knowledge/skills, EBP beliefs, and the organizational culture & readiness for EBP had statistically significant positive effects on the implementation of EBP. The impact of EBP attitudes was not significant. The dimensions of the learning organization and organizational innovativeness showed statistically significant negative effects on EBP implementation. These variables explained 32.8% of the variance of EBP implementation among clinical nurses. Conclusion: The findings suggest that not only individual nurses' knowledge/skills of and beliefs about EBP but organizational EBP culture should be strengthened to promote clinical nurses' EBP implementation.

A Case Study on Statistic-Based Policy: Use of the Housing Purchase Price Indices (통계기반 정책사례 연구: 주택가격지수 통계의 구축, 개선, 활용을 중심으로)

  • Park, Jin-Woo
    • The Korean Journal of Applied Statistics
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    • v.22 no.3
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    • pp.635-651
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    • 2009
  • Democratization and advancement of a society requires the Government's commitment to evidence-based policy. Though statistic is known as one of the best available evidence, there has been only a few case studies to tell real stories about using statistics for policy making. The object of this study is to suggest some real stories about using the Housing Purchase Price Survey for some property policies. By reviewing the origin and development of the survey, we evaluate the design and analysis strategies adopted in the survey. In addition, we describe how the Housing Purchase Price Indices have been used by the Government for some property policies.

Reassessing Statin Therapy in Elderly Dyslipidemia: A Literature Review

  • Lee, Kyung-Hwa
    • Perspectives in Nursing Science
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    • v.8 no.2
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    • pp.139-147
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    • 2011
  • Purpose: An integrative literature review was done to identify the best interventions for older adults with dyslipidemia in an effort to promote nursing involvement in the prevention of statin-induced symptoms (SIS). Such awareness could increase the capacity of interventions by geriatric nurses using evidence-based practices in the reassessment of statin therapy. Methods: CINAHL, Pubmed, and ProQuest were searched using these terms: dyslipidemia in, elderly, statins, adverse effects, and quality of life. Eleven articles fitting the inclusion criteria were identified and analyzed. Results: The findings indicate no evidence for the benefit of statin therapy for morbidity/mortality in a high-risk primary prevention set-up, specifically in the elderly population. Although SIS prevails among older adults, there are limited data that confidently support this observation along with nursing interventions specifically for the geriatric nursing community. Conclusion: Future research is necessary to shift nursing intervention with statin users (specifically in older adults) from an illness-based intervention to a preventive care plan to provide optimal care based on evidence. It is essential to involve self-reporting, cooperation, and communication with health care professionals, specifically with geriatric nurses. Additional studies are needed to further direct practice interventions in elderly statin users.

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The Effects of Corporate Entrepreneurship on Self-Efficacy and Firm Performance in Small and Medium-sized Firms of Gyeongnam Region (조직 내 기업가정신이 자기효능감과 기업성과에 미치는 영향 -경남지역 중소 제조업체를 대상으로-)

  • Hwang, Sang-Kyu
    • Journal of the Korea Safety Management & Science
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    • v.15 no.4
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    • pp.345-356
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    • 2013
  • The purpose of this study includes: the relationships between corporate entrepreneurship(innovation, proactiveness, risk-taking) and firm performance(non-financial performance, financial performance) and the mediating effect of the self-efficacy on the relationship between corporate entrepreneurship and firm performance. In order to verify the relationships and mediating effect, data were collected from 368 individuals in employees working in small and medium-sized firms at Gyeongnam region to test theoretical model and its hypotheses. All data collected from the survey were analyzed using with SPSS 18.0. This study reports findings as follows: first, the relationship between the corporate entrepreneurship(except innovation) and the employee's self-efficacy is positively related. Second, there was also a positive correlation between the employee's self-efficacy and firm performance. Third, the relationship between the corporate entrepreneurship and the non-financial performance is positively related. The relationship between the corporate entrepreneurship(except innovation) and the financial performance is positively related. Finally, the employee's self-efficacy played as a partial mediator on the relationship between risk-taking and firm performance. The employee's self-efficacy played as a fully mediator on the relationship between proactiveness and non-financial performance. The employee's self-efficacy played as a partial mediator on the relationship between proactiveness and financial performance. However, there was no empirical evidence for the mediating effect of employee's self-efficacy on the relationship innovation and firm performance. Based on these findings, the implications and the limitations of the study were presented including some directions for future studies.