McMaster University

McMaster University

Past Projects

Constructing Peer to Peer Mentorship in a Collaborative Nursing Program
Principal Investigator: Charlotte Noesgaard
Co-Investigators: Barbara Brown, Barb Carpio, Michelle Drummond-Young, Ola Lunyk-Child, 
Nancy Matthew-Maich, Carrie Mines, Jeanette Linton, Jane McDonald
Funding: Reid Fund (Internal School of Nursing), 2001-2003

Peer mentoring fosters collaboration, improves faculty retention and demonstrates institutional commitment to teaching excellence. In implementing a collaborative baccalaureate nursing program nursing faculty from Conestoga College, Mohawk College and McMaster University participated in a peer to peer mentor program study. This program was designed to enhance educators’ expertise, as teachers who were not familiar with problem-based learning were partnered with teachers experienced in problem-based learning. The program for 26 mentees and 17 mentors included: recognition of mentorship activities as part of faculty workload by administration, selection of assigned peer partnerships in a structured context, an Orientation Workshop, on line access to a Coordinator of the mentorship Program, and a continuation of on line support through an internet conferencing program. 

The study research questions included:

  1. What are the mentorship experiences of faculty from different sites of the collaboration, specifically as a mentor/mentee?
  2. What mentoring behaviors of the participants may be identified using the self-assessment scale of the Principles of Adult Mentoring Inventory?
  3. What are the benefits and limitations of the Mentorship Program with either co-tutor relationships, dyad or cluster (groups of 3 or more) relationships? 
The Principles of Adult Mentoring Inventory (Gailbraith & Cohen, 1997) describe specific mentor communication behaviors relevant to sustaining a mentorship relationship. The PAMI has 55 item statements that identify six mentor functions: relationship building ability, advice and information giving, facilitating alternatives, providing challenge, motivating others and encouraging initiative. Faculty participated in audio-taped focus groups separately for mentees (Response rate 54%) and mentors (Response rate 65%). Analysis of data from the Mentorship workshop, the PAM Inventory Questionnaire, the Demographic and Short Answer Questionnaire and focus groups is underway.

Development of a Clinical Peer Evaluation Instrument for Nursing Tutors
Co-Investigators: Yvonne LawlorKathy Sleeth, David Keane

In order to meet the reflective practice requirements of the College of Nurses of Ontario Quality Assurance Program (1996), nurses are expected to have peers offer yearly feedback regarding their performance. The Professional Profile (1996) offers a peer feedback instrument that direct care practitioners can use; however, it is very general and not reflective of what clinical nurse educators do. 
For the purpose of this project, clinical nurse educators are individuals involved in the direct supervision and teaching of nursing students in a clinical setting. These individuals can be referred to as clinical faculty or clinical tutors. 
The decision was made to develop an instrument that could be used by one faculty member to evaluate another faculty member in their clinical setting. The following domains were considered in the design of this new instrument: Communication, Clinical Competence, and Student Learning/Educator Role. Based on a literature search and consultation with educational research experts items were selected that possessed good face validity. 
The instrument has undergone an initial trial and now requires further piloting to assess its reliability and validity. Some 25 to 30 evaluations of clinical tutors will be needed to do this. The process will involve the following steps:

  1. Discussion of clinical learning strategies and review of marked student work (30 minutes).
  2. Observation in the clinical setting with nursing students (60 minutes).
  3. Completion of instrument by 2 evaluators (20 minutes).
  4. Debriefing between evaluators and clinical tutor (10 minutes).

The entire process requires 2 hours of the evaluators’ time but only 1 hour and 40 minutes of the individual being evaluated.


Development of Professional Confidence by Post Diploma Nursing Students
Co-Investigators: Dauna Crooks, Barb CarpioBarbara Brown, Margaret Black, Linda O'Mara, 
Mabel Hunsberger, Susan French, Barbara Love, Charlotte Noesgaard

The development of professional confidence is an elusive goal of nurse educators. While its' importance is widely acknowledged, surprisingly little has been written about it in the nursing literature. During a study of nursing students in a BScN prgramme of a Canadian university two processes emerged- one for the basic stream students and a distinct process for registered nurses who were enrolled in a post diploma degree-completion stream.

Analysis of focus group data indicated that professional confidence for registered nurses evolved through a two-stage process, correspondingly roughly with the two years of the curriculum. The initial phase, becoming informed, involved the acquisition of knowledge, theory and thinking processes required to make decisions with solid evidence and expressed with both clarity and confidence. The ability to take risks in a supportive environment clearly fostered this development. In the second phase, students spoke of "finding a voice of my own" in both academic and clinical environments when they believed they could clearly articulate an evidenced-based nursing position. Both stages were further supported by four elements: feeling, knowing, doing and reflecting.

By successfully evolving through these phases, students felt preprared (i.e. confident) to assume leadership and advocacy roles in the health care system.


Exploring Emotional Intelligence in Baccalaureate Nursing Students
Co-InvestigatorsGerry Benson, Barbara Brown, Jenny Ploeg, Kathy Sleeth

Emotional Intelligence (EI) is an essential skill required for effective nursing leadership. Excellent leadership can influence the retention, motivation, job satisfaction and development of a nursing workforce. Goleman (1995) describes EI as an ability that includes self-awareness, impulse control, persistence, zeal, self-motivation, empathy and social deftness. Self-awareness, together with the ability to engage in active reflection and personal growth may enhance leadership skills, resulting in high quality professional practice. To date a critical appraisal of EI literature in nursing has been completed and EI measures to assess EI in nursing students have been identified. EI research in nursing is scant and mainly descriptive. Seven EI measures were located all demonstrating comprehensive psychometric properties. The next step is to identify areas for further investigation of emotional intelligence in nursing students and to propose potential research questions culminating in a grant proposal.


Fostering Reflection in Nursing Students using the College of Nurses of Ontario Professional Profile
Co-Investigators: Barbara Brown, Nancy Matthew-Maich

Nursing education must develop and evaluate innovative strategies to prepare nurses to meet the challenges of the rapidly changing health care system and for lifelong learning. Reflection and reflective practice are currently receiving attention as a strategy yet little is known about the process of becoming a reflective thinker, how to teach skills needed for reflection, or the barriers and facilitators to becoming a reflective practitioner. This qualitative study is exploring the experiences of baccalaureate and diploma nursing students while developing their Professional Profiles and analyzing the development of reflection and reflective practice abilities.

The following questions are being addressed:

  1. What are the experiences of selected baccalaureate and diploma nursing students while developing their Professional Profiles?
  2. What reflection and reflective practice abilities are evoked through the development of Professional Profile?
  3. What reflection and reflective practice abilities are requires as students develop Professional Profiles during each level of their programmes?
  4. What factors influence the reflective process and reflective practice while completing the Professional Profile
Participants have completed a CNO Professional Profile and participated in two focus groups to discuss their experiences in developing their profiles. Analysis for emergent themes related to reflective abilities and experiences with the process is underway.

Implementing a Collaborative Faculty Development Program in Problem-based Learning
Principal InvestigatorBarbara Brown
Co-Investigators: Barb Carpio, Michele Drummond-Young, Ola Lunyk-Child, Nancy Matthew-Maich, 
Carrie Mines, Bonnie Montieth, Charlotte Noesgaard
Funding: Reid Fund (Internal School of Nursing), 2001-2003

In this era of profound change in nursing education, driven by the newly legislated baccalaureate degree entry to practice and the concurrent implementation of college/university collaborative partnerships in Ontario, Canada, effective faculty development programs are of paramount importance. The purpose of this study was to design, disseminate and evaluate a faculty development program involving nursing faculty from Conestoga College, McMaster University and Mohawk College. Teaching as a Social Practice, Faculty Learning Committees, Faculty Development for Problem-based Learning and Context, Impact, Process and Product Evaluation conceptual models were incorporated. Faculty participated in a collaborative faculty development program which was designed in keeping with the models and the responses to a needs assessment and included a series of planned workshops, a mentorship program and regular faculty development activities. The program was assessed 1) quantitatively by single group prepost design using a questionnaire addressing knowledge and comfort as well as tutor evaluations; and, 2) qualitatively by gaining an understanding of experiences and meaning using focus groups and subsequent content analysis. Data analysis is underway.


Professional Confidence in Baccalaureate Nursing Students
Co-Investigators: Barbara Brown, Linda O’Mara, Mabel Hunsberger, Barbara Love, Margaret Black, Barbara Carpio, Dauna Crooks, Charlotte Noesgaard

"You need to develop more confidence" is a common refrain noted by students and faculty alike. As nurse educators, we believe that encouraging students to develop their professional confidence is an important role. Moreover, the nursing profession demands that nursing care be delivered with confidence. Although the importance of professional confidence is acknowledged in the literature, there is surprisingly little written about its development or strategies that promote professional confidence in nursing education. A qualitative study was conducted to explore the meaning and influences on professional confidence as perceived by nursing students enrolled in a four year generic baccalaureate nursing program 
[Full-text article]


The Development of an Instrument to Assess Individual Tutorial Performance
Co-Investigators
: Margaret Black, Dauna Crooks, Carolyn Ingram, Michael Ladouceur, Cottie Ofosu, Jenny Ploeg, Elizabeth Rideout, Catherine Tompkins

Background
Assessment of individual student performance in small group tutorials at McMaster University School of Nursing in Hamilton, Ontario, Canada has been a focus of concern for faculty and students. Our goal was to develop and explore the validity and reliability of a standardized instrument designed to assess individual tutorial performance of nursing students in a problem-based learning curriculum.

Method
The instrument, consisting of 31 items rated on a six-point Likert scale, was developed from theoretical frameworks and items used elsewhere. Three broad domains were identified as important for evaluation: Self-directed Learning (SDL), Critical Thinking (CT) and Group Process (GP). Scales were developed for each domain in consultation with students and teachers at McMaster University School of Nursing. In 1999, a sample of tutors and students were asked to use the instrument to evaluate students, self and peers in each of the four levels of the BScN program. Data were analysed to examine the internal consistency, reliability of the instrument and to document its correlation with grades assigned by currently used, but unvalidated methods. Results.
A total of 18 tutors and 167 students across four levels, completed evaluations at mid term. The scales were shown to be internally consistent with high alpha coefficients for each scale (SDL=.88, CT=.90, GP=.83). The tutor-student inter-rater reliability coefficients were estimated to be low (SDL=.16, CT=.18, GP=.14), primarily due to lack of variance on the response scale. The instrument showed high correlation (r=.82) with tutors' summative evaluation of tutorial performance.

Conclusion
The instrument was found to be a standardized and valid instrument that can be used as a statement of curricular values and can have a significant steering effect on student tutorial behaviours. The instrument in its present form however, is unreliable in differentiating strong from weak tutorial performance. Although recommended for formative evaluation only, the instrument is a good compromise between the inconsistent and unreliable methods currently being used and a more comprehensive but lengthier one.


The experience of nursing faculty making the transition from a traditional model of teaching and learning to a problem-based model of teaching and learning
Principal Investigator: Lynn Martin
Funding: Niemeier Fund (Internal School of Nursing), 2001-2003

The purpose of this study is to discover how nursing faculty understand and experience the mandated transition from a traditional (didactic) model of nursing education to a Problem-Based Model. To understand the experiences of faculty, a qualitative, life history approach was chosen. Seven full-time faculty (split between the two colleges involved in the collaborative program) participated in the study, resulting in a total of 26 interviews over the course of the 2001 / 2002 academic year. Following a preliminary analysis of the interview findings, a focus group was then conducted. Currently, more in-depth analysis and the final write-up is underway. Money received from the Niemeier Research Award has been extremely valuable in conducting and transcribing the interviews as well as implementing the focus group.


How do clinical faculty help Nursing students learn in the context of a self-directed program?
Co-investigatorsLinda O'Mara, Jane McDonald, Lynn Miles, Catherine Tompkins
Funding: Centre for Leadership in Learning, 
Teaching & Learning Grant (Internal McMaster University), 2003

A. What is the Learning Problem to be Solved? Clinical practice is a major component of nursing education and has been acknowledged as central to nursing education (Lofmark &Wikblad, 2001; Welland, Williams & Bethune, 2000). Clinical experience is essential in order to: integrate theory and practice, enhance problem solving and critical thinking skills, and promote self-directed learning and professional socialization (Royle, Sword, Black, Brown & Carr, 2001).

Nursing practice has been changing from an emphasis on the value of technical skills and abilities, to one where autonomy and decision-making components of nursing are assuming greater importance (Tompkins, 2001). All nurses today are required to be critical thinkers, problem solvers, and self-directed learners to face the changes and challenges in the health care system (Lunyk-Child, Crooks, Ellis, Ofosu, O’Mara and Rideout (2001).

Small group, problem-based, and self-directed learning are strategies that are foundational to the nursing curriculum at McMaster University. Six competencies for SDL have been identified; self-assessment of learning gaps, self-evaluation, reflection, critical thinking, information management, and group skills (Crooks, Lunyk-Child, Patterson and Legris 2001). It has been suggested that educators play a major role in assisting students to obtain these necessary self-directed learning skills.

Currently, little is known about tutor behaviours in the clinical setting that support students in becoming more self-directed as learners. As well, clinical care is becoming increasingly acute and issues of patient safety are paramount. Clinical faculty are consistently being faced with a challenge that could best be described as “holding on and letting go”. Therefore, the learning problem that we wish to solve is: “How do we help faculty teaching within the clinical practicum portion of the BScN programme best support student learning within a philosophical framework of self-directed learning (SDL) and within an increasingly acute clinical environment”?

This issue is of great interest at the present time, as the BScN programme is expanding with the introduction of the Collaborative BScN Programme being offered through McMaster University and its College partners – Mohawk College and Conestoga College. This expansion, in combination with retirements of nursing faculty, is leading to significant recruitment of new faculty and orientation of College faculty to a new approach to clinical education. Thus, the need for faculty development will be great.

We hope that through this project, we will be able to determine what clinical faculty perceive to be the most effective teaching strategies to enhance students’ learning within the clinical environment. This will then be used for faculty development activities to orient clinical faculty who are new to the philosophy of the McMaster BScN programme and to enhance clinical faculty’s existing teaching skills.

This project will potentially benefit large numbers of students. Currently there are 300 students in the 2nd and 3rd year clinical courses involved with direct clinical faculty supervision. Once maximum numbers of students are achieved within the Collaborative BScN programme, 525 students will be involved in clinical learning with direct faculty supervision in Level 2 and 3. Once we learn about effective faculty skills for direct supervision of students, we can investigate indirect supervision and preceptor support which is used in Levels 3 and 4 of the programme.

B. Educational Objectives: 

  • to provide the Faculty Development Committee with information necessary to design faculty development activities and resources to support faculty in their clinical teaching roles
  • to improve the faculty support for nursing students within the clinical experience

We will accomplish these through:

  • determining how clinical faculty define what student self-direction means in clinical learning experiences
  • determining what faculty perceive as the knowledge, skills and attitudes needed to enhance learning within a SDL philosophy
  • determining what specific strategies experienced clinical faculty use to promote self-directed learning within the clinical learning experience.

C. Alternative Solutions Considered: The literature was examined, and although there is significant literature about clinical teaching in general, there is very little on clinical teaching in SDL programs. One alternate solution considered to learn more about how clinical teachers support student learning is to engage in participant observation of selected clinical faculty members in actual clinical situations. This however is a difficult alternative. Another approach would be to interview students regarding what facilitated their learning however, we felt that this could be the second phase of this project. Another project being implemented concurrently is exploring, from a student’s perspective, the role of tutor feedback in supporting students’ self-directed learning in directly supervised clinical learning experiences.

D. Methods and Schedule: We plan to conduct focus groups and individual interviews to allow clinical faculty to share their perceptions of their roles and experiences in supporting student self-direction within clinical learning environment.

Faculty providing direct student supervision in courses with an in-hospital clinical component will be asked to participate in a focus group to share their experiences in clinical teaching. Faculty from each of the partner sites who have taught clinical for at least one year will be asked to participate. As the College partners are only teaching 2nd year clinical students at this time, the focus groups will be drawn from the following faculty groups: 
Conestoga College – Level 2 clinical faculty
Mohawk College – Level 2 clinical faculty
McMaster University - Level 2 and Level 3 Clinical faculty
We hope to obtain at least 8 clinical faculty to participate in focus groups in each level.

Faculty will discuss the following:

  • How does the SDL philosophy of the BScN programme define/influence your role as a clinical faculty?
  • How is self-directedness in the clinical learning environment the same/different than in other aspects of the nursing programme (i.e. PBL)?
  • What are the knowledge, skills and attitudes needed to enhance student learning in a clinical learning environment?
  • How do you promote self-directed learning through your interactions with students?
  • How does the acuity of the clinical learning environment impact on your ability/willingness to promote self-direction in students?
  • How do you evaluate your effectiveness as a clinical faculty member?

In addition, 4 faculty members from McMaster University (2 from Level 2 and 2 from Level 3) will be invited to participate in a semi-structured individual interview. These faculty must have taught the clinical component within the McMaster BScN programme for at least 5 years and will be seen as experienced in clinical teaching within a SDL learning environment. They will provide rich details of their roles in promoting clinical learning.

Questions to be posed during the individual interviews will include:

  • How have you come to define the critical aspects of your role in your years of teaching clinical in this programme?
  • What do you see as the greatest challenges in teaching clinical within a programme that is based on a SDL philosophy?
  • If you have been a mentor to other clinical tutors, what do you see as the challenges they face in assuming the role of clinical tutor within a SDL context?
  • If there are still aspects of your role that you struggle with, what are they and why do you think that they are such a challenge?
  • How do you know when you are doing a good job in your clinical teaching?
  • If there is one piece of advice that you could give to new clinical faculty in this programme, what would it be?
  • What would an “ideal” faculty development programme for new and continuing clinical faculty look like?

Schedule:
Focus groups and individual interviews April/May 2003
Data analysis June – August 2003
Present report & recommendations to the 
Faculty Development Committee October 2003

E. Evaluation: The outcome of this project will be used as a basis for discussion within the School of Nursing regarding faculty development. A report will be provided to the Faculty Development Committee with recommendations for workshops, resources, etc. It will also inform Phase Two of the project, which will examine students’ perceptions of faculty behaviours in the clinical setting which support self-directed learning.

Reference List

Crooks, D, Lunyk-Child, O., Patterson, C., Legris, J. (2001). Facilitating Self-Directed Learning. In E. Rideout (Ed.) Transforming Nursing Education Through Problem-Based Learning (pp.51-74). Boston, MA: Jones and Bartlett Publishers.

Lofmark, A., & Wikblad, K. (2001). Facilitating and obstructing factors for development of learning in clinical practice: A student perspective. Journal of Advanced Nursing, 34(1), 43-50.

Lunyk-Child, O.L., Crooks, D., Ellis, P.J., Ofosu, C., O’Mara, L., & Rideout, E. (2001). Self-directed learning: Faculty and student perceptions. Journal of Nursing Education, 40(3), 116-123.

Royle, J.A., Sword, W., Black, M., Brown, B., & Carr, T. (2001). Developing clinical opportunities and resources for problem-based learning. In E. Rideout (Ed.) Transforming Nursing Education Through Problem-Based Learning (pp.239-258). Boston, MA: Jones and Bartlett Publishers.

Tompkins, C. (2001). Nursing education for the twenty-first century. In E. Rideout (Ed.) Transforming Nursing Education Through Problem-Based Learning (pp.1-19). Boston, MA: Jones and Bartlett Publishers.

Wellard, S.J., Williams, A., & Bethune, E. (2000). Staffing of undergraduate clinical learning programs in Australia. Nurse Education Today, 20, 548-554.


Other Projects


A mentorshippProgram: Faculty development for a collaborative nursing education initiative
Co-investigators: 
Barbara Brown, Barbara Carpio, Mary Guise, Jeanette LeGris, Jane MacDonald, Colleen McKey
Funding: 
Reid Endowment Fund (2001-2003)

Fostering a collaborative nursing faculty development program
Principal Investigator: Barbara Brown
Co-investigator: 
Barbara Carpio, Michele Drummond Young, Ola Lunyk-Child, Nancy Matthew-Maich, Carrie Mines, Charlotte Noesgaard 
Funding:
 Reid Endowment Fund (2001-2003)

An exploration of the decision-making activities of fourth year baccalaureate nursing students in the clinical setting 
Co-InvestigatorsPamela Baxter & Sheryl Boblin
Funding: Niemeier Fund [Internal School of Nursing], 2001-2003 
[pdf]

What is the relationship between tutor feedback and self-directed learning in the clinical setting?
Co-InvestigatorsLinda O'Mara & Michele Drummond-Young
Funding: Niemeier Fund [Internal School of Nursing], 2001-2003
[pdf]


New Projects (2004-2005)

Niemeier Research Fund 

Program Evaluation of the McMaster-Mohawk-Conestoga Collaborative BScN Program: Use of Q-Methodology to Examine Faculty Experience of the Collaboration
Investigators: Elizabeth Rideout, Noori Akhtar-Danesh, Barbara Brown, Mary Brown, Lois Gaspar

The Clinical tutor in a challenging environment: Understanding the context and exploring strategies to promote self-directed learning
Investigators: Linda O'Mara, Jane McDonald, Lynn Miles

Exploring the Impact of a Service Learning Strategy on Attitudes of Nursing Students towards Poverty, Homelessness and Future Practice
Investigators: Dyanne Semogas, Catherine Ford Thomas, Mary Allan, Wendy Azzopardi, Kristin Cleverley

Exploring Emotional Intelligence in Baccalaureate Nursing Students
Investigators: Gerry Benson, Barbara Brown, Jenny Ploeg, Kathy Sleeth

Tauber Research Fund

Weight change in breast cancer survivors receiving adjuvant chemotherapy: Do pre-treatment factors play a role?
Investigator: Carolyn Ingram

Women Health Educators for Immigrant and Refugee Women's Health
Investigators: Margaret Black, Angela Frisina, Trisha Hack, Barbara Carpio, Lisa Chan-Wong, Judit Zsoldos

 

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