BACKGROUND & AIMS: OBJECTIVES:To evaluate first-year doctor of pharmacy (PharmD) students' communication apprehension, outcome expectations, and self-efficacy for communication over the duration of a 15-week patient-counseling course. DESIGN:First-year PharmD students (n=94) were asked to complete a 47-item, self-administered questionnaire on 3 occasions over the duration of the Nonprescription Drugs/Patient-Counseling course during the fall 2009 and 2010 semesters. ASSESSMENT:Eighty-seven of 94 students completed the survey instrument across data collection periods. There were significant reductions in total communication apprehension scores and in the communication apprehension subscores for meetings and public speaking, and significant increases in self-efficacy over time. No differences were found for outcome expectations of communication scores or the subscores for interpersonal conversations and group discussion. CONCLUSIONS:Communication apprehension may be decreased and self-efficacy for communication increased in first-year PharmD students through a 15-week Nonprescription Drugs/Patient-Counseling course using small-group practice sessions, case studies, and role-play exercises in conjunction with classroom lectures.

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BACKGROUND & AIMS: OBJECTIVES:To evaluate and assess the impact of pharmacy students' electronic device (e-device) use during a lecture-based pharmacotherapeutics sequence. METHODS:A validated survey instrument to assess e-device use was e-mailed to 238 second- (P2) and third-year (P3) pharmacy students. Grades were reviewed retrospectively and correlated with e-device use to determine its impact on academic performance. RESULTS:Of 140 responding students (59% response rate), 106 reported using e-devices during class for course-related (91.5%) and non-course-related (81.1%) activities. When P2 and P3 students were combined, e-device use was not associated with academic performance (p = 0.70). Academic performance was not impacted among P3 students (p = 0.86), but P2 students performed better academically if they refrained from using e-devices during class (mean grade = 88.5% vs. 83.3%; p=0.019). CONCLUSIONS:The impact of e-device use on overall academic performance was negligible. Use of e-devices by students enrolled in their first pharmacotherapeutics course may negatively impact academics.

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BACKGROUND & AIMS: BACKGROUND:Mental distress is a common finding among University students. Empirical research has confirmed that the University student population has a higher prevalence of mental disorder than the general population. However, no previous study has examined the mental health conditions of students in Somaliland. METHODS:An institution based cross-sectional study was conducted on a sample of 570 undergraduate students at the University of Hargeisa in October, 2013. Study subjects were selected using a stratified random sampling. The Self-reporting questionnaire (SRQ-20) was used to assess mental distress. Multiple logistic regression analysis was carried out to identify factors independently associated with mental distress. RESULTS:The point prevalence of mental distress was found to be 19.8%. Mental distress was associated with being female (AOR = 3.52, 95% CI 1.94, 6.39), having a monthly income of 100 United States dollars (USD) or less (AOR = 2.19, 95% CI 1.12, 4.28), and not having a satisfying relationship with the family (AOR = 11.52, 95% CI 3.18, 41.72) and friends (AOR = 7.33, 95% CI 2.83, 18.93). Nearly one in five students (18.6%) has been using Khat in the previous 12 months. Khat use was also associated with greater likelihood of mental distress (AOR = 2.87, 95% CI 1.26, 6.56). In addition, financial difficulties and the poor prospect of finding a job were common sources of stress among the students. CONCLUSIONS:A significant proportion of the students at the University of Hargeisa suffer from mental distress which might have a detrimental effect on their academic performance. The mental health needs of the University students require attention with special emphasis on female students, students experiencing financial hardships, students who use Khat and those who have interpersonal problems.

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BACKGROUND & AIMS: :A pilot study was conducted to determine changes in Native American high school students' knowledge and opinions about nursing after attending a 6-day residential summer nursing institute. To date, Native American high school students, particularly those interested in nursing, have not been well researched. Seventeen high school students affiliated with nine Northwest tribes participated in this study. A 66-item, investigator-constructed, pretest-posttest survey included 38 scaled (4-point Likert type) and 20 dichotomous items. Reliability estimates (Cronbach's alpha) were 0.72 and 0.85 for the pretest and posttest, respectively. This pilot study showed an increase in students' knowledge and opinions of professionalism, autonomy, and role importance in nursing after attending the summer nursing institute. A salient and culturally related reason for choosing nursing was to be important to one's tribe. Although the sample was small, the findings provide initial evidence supporting the effectiveness of a nursing education intervention with Native American high school students and an instrument that can measure its success.

背景与目标： : 进行了一项初步研究，以确定参加为期6天的住宿夏季护理学院后，美国原住民高中生对护理的知识和看法的变化。迄今为止，美国原住民的高中生，尤其是对护理感兴趣的学生，还没有得到很好的研究。西北九个部落的十七名高中生参加了这项研究。一项66项，由研究者构建，前测-后测调查包括38项缩放 (4点李克特类型) 和20项二分项目。分别0.72和0.85前测和后测的可靠性估计值 (Cronbach's alpha)。这项初步研究表明，进入夏季护理学院后，学生对护理中的专业精神，自主权和角色重要性的知识和见解有所增加。选择护理的一个重要且与文化相关的原因对一个部落很重要。尽管样本很小，但研究结果提供了初步证据，支持对美国原住民高中生进行护理教育干预的有效性以及可以衡量其成功程度的工具。

BACKGROUND & AIMS: :This study, funded by the National Institute on Alcohol Abuse and Alcoholism, examines psychosocial mediators to explain discrepancies in past-30-day drinking between African American and White college student drinkers in the United States. Between 2008 and 2010, 5,845 college drinkers completed an online survey about their alcohol use. Using latent variable structural equations modeling, we investigated the relationships between ethnicity, drinking beliefs, and students' past 30-day alcohol use. Drinking beliefs-i.e., positive expectancies, perceived norms, and disapproval of alcohol use-fully mediated the relationship between ethnicity and drinking behaviors. Study limitations and directions for future research are discussed.

背景与目标： : 这项研究由美国国家酒精滥用和酒精中毒研究所资助，研究了社会心理调解人，以解释美国非裔美国人和白人大学生饮酒者过去30天饮酒的差异。在2008年至2010年之间，5,845大学饮酒者完成了有关其酒精使用情况的在线调查。使用潜在变量结构方程建模，我们调查了种族，饮酒信仰和学生过去30天饮酒之间的关系。饮酒beliefs-i.e，积极的期望，感知的规范和对饮酒的不赞成-完全介导了种族与饮酒行为之间的关系。讨论了研究的局限性和未来研究的方向。

BACKGROUND & AIMS: INTRODUCTION:This study aimed to assess whether the method of teaching endodontology influenced the quality of root fillings made by undergraduate students. MATERIALS AND METHODS:The method of teaching endodontology at our institution was revised. Changes concerned: the programme (ie method of clinical training and summative assessment), and the supervision whilst performing root canal treatment on patients. An intermediate cohort (N=91) comprised partly students attending the former programme (involving patients) and partly students attending the revised programme (without patients). After succeeding in the summative assessment, the quality of the first root filling made by the student in a patient under supervision of either a general dental practitioner or an endodontist was evaluated according to pre-determined criteria. Data were analysed using Cohen's Kappa, Chi-square, Fisher's exact, Mann-Whitney and Kruskal-Wallis tests. RESULTS:Sixty-two per cent (47 of 76) of root fillings made by students who attended the revised programme were of good quality, in comparison with 47% (seven of 15) of those made by students who attended the former programme (P=.274). Less complex treatments had better quality root fillings if students were supervised by endodontists (88% (14 of 16) good quality) than supervised by general dental practitioners (59% (22 of 37) good quality) (P=.045). Complex treatments did not differ in quality of root fillings for the supervision types (P=.825). CONCLUSION:The quality of root fillings made by students who attended the revised programme seems at least as high as that of those who attended the former programme. Higher quality root fillings might be obtained under supervision of endodontists than under supervision of general dental practitioners.

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BACKGROUND & AIMS: AIM:To explore nursing students' experiences of patient safety and peer reporting using hypothetical medication administration scenarios. BACKGROUND:Pre-registration nurse training is tasked with the preparation of students able to provide safe, high quality nursing care. How students' contextualise teaching related to patient safety, risk recognition and management in the clinical setting is less clear. METHOD:A total of 321 third year students enrolled in the final semester of an adult branch pre-registration nursing programme in 2011 in a UK university were surveyed. Using free texts, the questionnaire contained hypothetical medication administration scenarios where patient safety could potentially be at risk. Students' qualitative responses were analysed using thematic analysis. FINDINGS:The response rate was 58% (n = 186). Four themes were identified from the scenarios: (1) Protecting patient safety (2) Willingness to compromise; (3) Avoiding responsibility; (4) Consequences from my actions. CONCLUSION:The findings underscore the importance of contextual teaching about risk management, practical techniques for error management and leadership for optimal patient safety in nursing curricula. IMPLICATIONS FOR NURSING MANAGEMENT:Nurse managers are role models for nursing students in the clinical setting. Nursing management must lead, by example, the patient safety agenda in the clinical setting.

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BACKGROUND & AIMS: PURPOSE:To examine the trends of substance use and correlated variables in high-school students in Southern Thailand. METHODS:Surveys of high-school years 7, 9 and 11 and vocational school year 2 students in four provinces in Southern Thailand were conducted in 2002-2004 to examine lifetime substance use, use within 1 year and 30 days before the interview, using a self-completed questionnaire. RESULTS:The prevalence of lifetime use of any illicit substance was 5-7% overall (about 7%, 9% and 13% in boys and 2%, 1% and 3% in girls in 2002, 2003 and 2004, respectively). Krathom, a local addictive plant, and cannabis were the most commonly used illicit substances on a lifetime basis with prevalences of 2.3%, 2.8%, 4.9% (p<0.01) and 2.6%, 2.3%, 3.4% (p>0.05) in the surveyed years. The rates of alcohol consumption in the past 30 days were 19.3%, 17.3% and 15.2% (p>0.05) while smoking rates were 14.6%, 8.8% and 10.8% (p<0.05). The significant correlates of current illicit substance use were surveyed year, male, vocational school, school level, and school performance. CONCLUSION:The problem of substance abuse is increasing among Thai adolescents. School-based interventions seem desirable, especially in boys, vocational and public school students.

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BACKGROUND & AIMS: BACKGROUND:Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals. OBJECTIVES:The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline. METHODS:A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline. RESULTS:Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions. DISCUSSION:These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.

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BACKGROUND & AIMS: BACKGROUND:Prelicensure nursing education has generally emphasized acute care; however, as primary care changes in the United States, academia must transform. The national call for transforming primary care requires innovation in the education of prelicensure nursing students. PROBLEM:To ensure future RNs can function in the primary care setting and assume enhanced roles within the interprofessional team, prelicensure nursing students need to be exposed to primary care. A key barrier to providing this essential education is the lack of partnerships with primary care facilities. APPROACH:The purpose of this project was to collaborate with rural practice partners to provide a primary care clinical experience for prelicensure nursing students. OUTCOMES:Collaboration between academic-practice partners to develop a clinical experience for prelicensure nursing students allowed exposure to the role of RNs in rural primary care. CONCLUSIONS:By sharing the process for planning the clinical experience, other interested academic institutions may replicate similar opportunities.

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BACKGROUND & AIMS: :Blended online and digital learning includes a variety of activities that combine engaging classroom-based education with online learning. The aim of this study is to evaluate undergraduate students' perceptions of a blended online and digital curriculum for anatomy and physiology in the nursing degree program. A quantitative methodology was used with a sample of 100 undergraduate nursing students from a single Australian University. Descriptive statistics are and presented in this article. Of the 100 participants, 90% were enrolled in the standard mode compared to 10% in a flexible mode of delivery. Results indicated that 29% of participants preferred laboratory classes as having the most impact. Participants (46%) also agreed that recorded lectures were useful, with 36% indicating that the online platform was easy to navigate going as far as wanting more online quizzes (49%). More than half of the participants (54%) acknowledged that anatomy and physiology was important for their future careers. The blended online and digital learner preferences in delivering anatomy and physiology-related courses should be adjusted in order for learning to be effective for undergraduate students in the future.

背景与目标： : 混合在线和数字学习包括各种活动，这些活动将基于课堂的引人入胜的教育与在线学习相结合。这项研究的目的是评估本科生对护理学位课程中解剖和生理学的在线和数字混合课程的看法。使用定量方法对来自一所澳大利亚大学的100名护理本科生进行了抽样。本文介绍了描述性统计。在100名参与者中，90% 名以标准模式登记，而10% 名以灵活的分娩方式登记。结果表明，29% 的参与者更喜欢实验班，因为实验班的影响最大。参与者 (46%) 还同意录制的讲座很有用，36% 表明在线平台很容易导航，甚至想要更多的在线测验 (49%)。超过一半的参与者 (54%) 承认解剖学和生理学对他们未来的职业很重要。在提供解剖学和生理学相关课程时，应调整在线和数字学习者的混合偏好，以便将来对本科生有效学习。

BACKGROUND & AIMS: THE AIM OF THE STUDY:The aim of this study is to examine the effect of critical thinking education on nursing students' problem-solving skills. MATERIALS AND METHOD:This study was conducted with 93 nursing students, 49 in the control group and 44 in the education group. The California Critical Thinking Disposition Inventory and the Problem-solving Inventory were administered to them before and after 12 weeks of critical thinking education. RESULTS:The education group's mean critical thinking score was 253.61 on the pretest and 268.72 on the posttest. This increase was statistically significant (p < .001). The posttest mean score of the control group fell to 258.18 on the posttest after a pretest mean score of 260.79, and this difference was statistically significant (p < .001). According to the posttest results, the problem-solving skills of education group increased significantly (p < .001), while the control group's score fell significantly (p < .001). CONCLUSION:This study determined that critical thinking education improves problem-solving skills.

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BACKGROUND & AIMS: CONTEXT:Diagnostic efficiency is important in daily clinical practice as doctors have to face problems within a limited time frame. To foster the clinical reasoning of students is a major challenge in medical education research. Little is known about students' diagnostic efficiency. On the basis of current theories, scaffolds for case representation (statement of the case as far as it is summarised in the mind) could be a promising approach to make the diagnostic reasoning of intermediate medical students more efficient. METHODS:Clinical case processing of 88 medical students in their fourth and fifth years was analysed in a randomised, controlled laboratory study. Cases dealing with dyspnoea were provided in an electronic learning environment (CASUS). Students could freely choose the time, amount and sequence of clinical information. During the learning phase the intervention group was asked to write down case representation summaries while working on the cases. In the assessment phase diagnostic efficiency was operationalised as the number of correct diagnoses divided by the time spent on diagnosing. RESULTS:Diagnostic efficiency was significantly improved by the representation scaffolding (M = 0.12 [SD = 0.07], M = 0.09 [SD = 0.06] correct cases/time, p = 0.045), whereas accuracy remained unchanged (M = 2.28 [SD = 1.10], M = 2.09 [SD = 1.08], p = 0.52). Both groups screened the same amount of clinical information, but the scaffolding group did this faster (M = 20.8 minutes [SD = 7.15], M = 24.6 minutes [SD = 7.42], p = 0.01; Cohen's d = 0.5). CONCLUSION:Diagnostic efficiency is an important outcome variable in clinical reasoning research as it corresponds to workplace challenges. Scaffolding for case representations significantly improved the diagnostic efficiency of fourth and fifth-year medical students, most likely because of a more targeted screening of the available information.

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