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Nurses are a vital resource of health care systems, a resource that must be valued, bearing in mind that their work has a role in social indicators of health, and also determines topics such as equality and equity, fairness and justice, which support the kind of societies we all want to live in. In the training process, they learn, in the middle of a team, to plan, to put into practice and evaluate general medical care based on acquired knowledge and skills. Future nurses must not only be prepared to meet the needs of the individual, the family, the community, but also to have confidence in their own intellectual and clinical abilities so that they can work responsibly and autonomously, facing at the same time with increasingly complex requirements of healthcare. The refinement of medical training is subsequently achieved by developing the ability to solve problems, to make decisions, to practice leadership in medical care. The acquisition of leadership skills has been identified as a need in training nurses, both from the researches of internal and international professional bodies and from those of clinical units. By harmonizing this need with public educational policies, the unit of learning outcomes "Leadership and professional communication" was implemented in the professional training standard. This paper aims to gain insight into the relationship between the values of leadership and the development of a good educational policy in training nurses, with a fundamental impact on the provision of health care in an efficient, integrated and safe manner for the patient. [For the full proceedings, see ED654100.]

The integration of culturally relevant concepts into nursing education is essential for the effective delivery of health care in a modern, multi-ethnic, multi-racial, mobile society. Several key concepts from anthropology and specific areas of individual interpersonal behavior have particular relevance to nursing education. It is important, for instance, that nurses understand the culture of the hospital, clinic, or other health service setting in which they work. They need to recognize structures of power and authority and be able to function with skill and flexibility within complex hierarchical organizations. Nursing students themselves become involved in the processes of acculturation and resocialization once they finish their training, and an anthropological perspective may ease the transition. The effectiveness of the nurse as a practitioner is increased by awareness and understanding of cross-cultural differences in, for example, religion, territoriality, and attitudes toward family. Even within the same society, cultural components of wellness and illness, such as tolerance for pain, may vary greatly. Additionally, nurses must have an awareness of language differences and communication skills and the importance of understanding patients and being understood by them. Comprehension of these culturally relevant concepts and issues can be facilitated through the integration of learning experiences with obvious applicability into existing courses. Samples of such learning experiences are appended, including definitions of concepts, suggested readings, learning activities, and discussion topics. (KL)

The value of linking manpower analyses and educational policy formation is illustrated by the experience of the New Jersey Department of Higher Education in planning programs for professional nurses. After reviewing the history of manpower planning for nurses in New Jersey, the results of a 1980 nursing study and projections of the future need for registered nurses in New Jersey are examined. Among the areas addressed by the 1980 study are the following: the present supply and distribution of registered nurses in New Jersey by employment sector, geographic location, educational preparation, and age; and specific settings in which there is a nursing personnel shortage and contributing factors. Findings include the following: A total shortage of approximately 2,300 full-time equivalent nurses was identified as of January 1980 (primarily in acute and long-term care facilities and for specific shifts and specialty services); although the largest number of hospital nurses are graduates of the traditional hospital-based diploma schools, this percentage has been declining in recent years and the number of associate degree nurses in hospitals has been increasing; and total enrollments in nursing education programs in New Jersey declined by 6 percent between 1977 and 1979. In addition to projecting the demand for the total number of registered nurses through 1990, projections were developed for the distribution of nurses by educational degree and employment sector. Recommendations developed by the Department of Higher Education based on the study findings are briefly considered, and summary tables on trends and projection methods of the other states in the nation are presented. (SW)

Predictors of attrition from the nursing profession among graduates of an associate degree nursing program at Lakeland Community College, Ohio, were investigated during 1970-1979, based on an earlier study that identified predictors of attrition from the degree program. Two groups were evaluated: 91 nursing graduates for whom both file record and questionnaire data were available; and 228 graduates for whom only questionnaire data were available. Based on student interviews and a literature review, a 32-item questionnaire was constructed and pretested, and a version for graduates of the nursing program was developed. Based on analysis of file records, it was found that students who persisted and graduated had higher composite scores on the National League for Nursing examination, higher high school grade point averages, were more likely not to have come to the nursing program directly from high school, and were older than nonpersisters. In contrast, when looking at graduates for whom there were both a questionnaire and a file record, nursing graduates who stay in the profession could be distinguished from those who leave only on the basis of age. Graduates who entered the nursing program at an older age were more likely to stay in the profession after graduating. In addition, those individuals who perceived themselves as having a high degree of initiative tended to complete the nursing program and stay in the profession. No other major predictors of attrition from the college's nursing program appeared to be good predictors of attrition from the nursing profession. It is suggested that nurses with less realistic visions of their health care role do not remain in the profession. (SW)

This book contains a compilation of papers presented at the International Psychological Applications Conference and Trends (InPACT) 2021, organized by the World Institute for Advanced Research and Science (W.I.A.R.S.), that this year has been converted into a fully Virtual Conference as a result of the ongoing Coronavirus (COVID 19) pandemic. Modern psychology offers a large range of scientific fields where it can be applied. The goal of understanding individuals and groups (mental functions and behavioral standpoints), from this academic and practical scientific discipline, aims ultimately to benefit society. The International Conference seeks to provide some answers and explore the several areas within the Psychology field, new developments in studies and proposals for future scientific projects. The goal is to offer a worldwide connection between psychologists, researchers and lecturers, from a wide range of academic fields, interested in exploring and giving their contribution in psychological issues. We take pride in having been able to connect and bring together academics, scholars, practitioners and others interested in a field that is fertile in new perspectives, ideas and knowledge. We counted on an extensive variety of contributors and presenters, which can supplement the view of the human essence and behavior, showing the impact of their different personal, academic and cultural experiences. This is, certainly, one of the reasons there are nationalities and cultures represented, inspiring multi-disciplinary collaborative links, fomenting intellectual encounter and development. InPACT 2021 received 358 submissions, from more than 40 different countries from all over the world, reviewed by a double-blind process. Submissions were prepared to take form of Oral Presentations, Posters and Workshops. 117 submissions (overall, 33% acceptance rate) were accepted for presentation in the conference. The Conference addresses different categories inside Applied Psychology area and papers fit broadly into one of the named themes and sub-themes. This book contains the results of the different researches conducted by authors who focused on what they are passionate about: to study and develop research in areas related to Psychology and its applications. It includes an extensive variety of contributors and presenters that are hereby sharing with us their different personal, academic and cultural experiences. [This document contains the proceedings of the virtual International Psychological Applications Conference and Trends (InPACT) 2021. The proceedings were published by inScience Press. For the 2020 proceedings, see ED604955.]

This publication includes six papers presented at the 1979 meeting of the Council on Collegiate Education for Nursing. Specific presentations made were (1) Entry into Practice: History, Trends, and Issues, by Virginia Barker; (2) The Appropriate Preparation for Licensure Is the Associate Degree, by Virginia Allen; (3) The Appropriate Preparation for Licensure Is the Baccalaureate Degree, by Billye Brown; (4) The Appropriate Preparation for Licensure Is the Graduate Degree, by Marjorie Ramphal; (5) Registered Nurses as Caregivers at Veterans Administration Medical Center, San Antonio, Texas by Marguerite Burt; and (6) Entry into Practice from the Perspective of a State Board of Nursing, by Helen Pat Keefe. Also included is a summary of the council's activities and regional nursing projects' activities since 1976. (LRA)

This paper reflects on work-based mobile learning in the Canadian healthcare system for registered nurses' ongoing skills development and continuing professional development. It calls on distributed leadership to address the organizational contextual factors for making this mode of learning sustainable. [For the full proceedings, see ED571335.]

The 1979 report of a working group of the World Health Organization (WHO) in cooperation with the West German government, on the design of training in health planning and management in the European region is presented. The working group consisted of 15 temporary advisers from 11 countries, in addition to WHO staff and a consultant. The group was asked to: review experiences gained in a number of European training programs in health planning and management; determine training objectives for specific target groups; discuss training methods and curriculum development as related to each specific objective; and formulate recommendations for action at national and international levels. European countries in general are faced with the problem of how to make the best use of limited resources for their health services. The problems of developing health planning and management in two European countries, the United Kingdom and Romania, were reviewed, along with WHO activities at the global level and in the European Region. Attention was directed to identifying qualities of health managers who administered services as well as those of policy-makers and higher-level administrators, and the needs of the primary care general practitioner and the nurse at the first level of nursing management. Teacher training was considered in light of national program development and a national commitment to health management training, and a strategy that could be applied nationally and internationally was developed. Four working papers that served as background to the working group's discussions are appended. (SW)

Over the last two decades nurses have to face the need to be high qualified professionals with always updated competencies and practical skills. Learning on the Internet by the "e learning" method, fundamentally changed the way by which nurses can get information and be involved in educational activities designed to ensure their continuous medical education. The goal of our work was to provide e-education for ultrasound nurses by the use of a Learning Management Systems delivered through the Internet, within the framework e-EDUMED project. The project developed a virtual health educational center providing on-line education and training materials by 2 interactive training modules in ultrasound addressed to medical doctors and nurses and one module for patient education. The e-learning platform hosts asynchronous online courses - educational materials in a traditional style of presentation, PPT and course notes (text and images), questions and quizzes associated with each section, multimedia lessons. Synchronous online courses are implemented in the virtual class e-EDUMED allowing a tutor via the Internet to bring together a group of students in real time. The teacher can present materials (case studies, moving images, ultrasound examinations) and can receive information and feedback from students. The nurse training module is included in the e-learning platform and the learning pathway has been realized through an innovative methodological model combining both theoretical and practical aspects, in order to enhance the learning skills based on the study of real cases. Content is structured in the best way to build gradual competences. Another innovative approach in the development of our module is the importance of having a nurse as part of the ultrasound health team - a nurse whose presence conveys for the patient's psychosocial and physical needs. The usual patient reaction to illness is anxiety. Ultrasound can intensify anxiety by augmenting a feeling of alienation, creating a deficit of knowledge and/or invading personal space. In this way the module also promotes the belief that the nurse s role in ultrasound has one proeminent goal-positive patients relations. The conclusion drawn at the end of the project was that 3D images and virtual classrooms can support medical and nursing professionals in training without having the presumption to be exhaustive, but propaedeutic to practice. [For full proceedings, see ED571430.]

This document contains 33 papers from a conference on research in adult, continuing, and community education. Representative papers include the following: "Highlander Folk School: A Commune Based on Intellectual Property" (Keith B. Armstrong, Donna J. Martin); "Women, Welfare and Mandated Education: An Analysis of Single Mothers' Meaning of Learning and its Relevance to Successful Programming" (Irene C. Baird); "Metacognition, Metamemory, and Commitment to Change Strategy: Enhancing Adoption of Innovation of Staff Development" (Cynths S. Blodgett-McDeavitt, John M. Dirkx); "Planning Adult Basic Education within a Lifelong Education Framework: Insights from Taiwan: (Yau-Jane Chen); "Continuing Education Program Administration: A Study of Competent Performance Indicators" (Peter S. Cookson, John English); "The LEPP Model: A New Approach to Planning Adult Education Programs" (Peter S. Cookson); "Older Adult Basic Education Needs and Activities from a Developmental Perspective" (James C. Fisher); "Teaching Adults to Write: A Situated Activity" (Catherine A. Hansman-Fergusin, Arthur L. Wilson); "Developing a Mentoring Program Improvement Evaluation Model" (John A. Henschke); "Aspects of Arab Culture Affecting Adult Learners: Gender, Class, and Religious Issues" (Jenny Hopkins); "Whole Language and Adult Literacy" (Jiazhen Hu); "Teacher Beliefs about Staff Development via Distance Education: A Research Approach in Planning Practice" (Ruth Schmidle Lavin, John M. Dirkx); '"Delivering University Adult Education in a Contested Political and Ethnic Environment" (Winston Lawrence); "Incorporating Self-Directed Learning into the Classroom" (Huey B. Long); "Toward a Theory of Learning Science for Scientific Literacy among Professional Educators" (Daniel R. Olson); "Goal Setting for the 21st Century: A Study of Public Perceptions of Adult Basic Education" (Richard A. Orem, Patricia Hunsaker); "Metacognitive Dimensions of the Selection and Use of Learning Strategies by Adult College Students and Traditional Age College Students" (Mary Ann Rasnak); and "Preparation for Peer Mentoring: A Pilot Project" (Susan Timm, Keith Armstrong, George Gutierrez). Papers include abstracts and references. (KC)

Individuals who work in the helping professions (physicians, counselors, nurses, pastors, and social workers) often work with individuals in stressful crisis situations. In addition to working in high stress situations, helpers in rural areas also suffer from isolation from support networks and peers that are available to urban helpers. This isolation may contribute to rural helpers' burnout and symptoms of excessive stress. The Rural Health Outreach Program (RHOP) was developed to help these rural helpers cope with stress and burnout. The RHOP presents stress management programs through rural community agencies to identify stress, origins of stress, symptoms of excessive stress, and techniques to help manage stress and prevent burnout. The programs are skills-based and cover such topics as relaxation, massage, program development, confrontation, motivation, visualization, problem solving, conflict management, communication, and time management. The programs are presented in a basic format of "Tell, Show, Do." Results from the program thus far are encouraging. All community agencies that have started the program are continuing. The program seems successful in that the helpers in the rural areas report more satisfaction in their work and they are still on the job. (NB)

Noting that older patients are often vulnerable in the hospital setting because they may not comply with the nursing staff's instructions, this paper offers a systematic method for teaching nurses how to evaluate older patients in a sympathetic manner and to focus on the patient's norms of behavior rather than those of the hospital. The paper proposes a course that could be used for inservice training or as a component of a communication course in nurses training. The proposed course would use Mark Knapp's "Social Intercourse" as a textbook and would consist of ten one-hour sessions. A course outline, containing descriptions of the topics and activities of each session, is included. (FL)

These 21 papers share research findings on the link between practice and research in adult, continuing, community, and distance education. Nine invited papers are "Evolution of Activists" (Baird); "Toward a Phenomenology of Adults' Learning Experiences" (Baptiste et al.); "Quest for the Grail? Searching for Critical Thinking in Adult Education" (Boxler); "Adult Education as Snake Oil Under the Guise of Democracy" (Carr-Chellman, Carr-Chellman); "Production of Knowledge in Work Teams" (Howell); "Life Since Then: Reconstructing Korean Women's Educational Experiences and Their Lives" (Hyun); "Form or Flesh: Social Factors That Impact Women's Practice of Breast Self-Examination" (London); "Marketing God: Critical Inquiry into Spirituality in the Workplace" (Milacci, Howell); and"From Symbols, Stories, and Social Artifacts to Social Architecture and Agency" (Siegel). Twelve refereed papers are "Adult Learners' Perceptions of Teaching and Learning During Times of Crisis" (Amann); "Healthcare and Adult Education" (Beck); "Effectiveness of Workplace Diversity Training" (Bettinger); "Synthesis of Empirical Literature: In Distance Education What Is the Relationship Between Asynchronous Computer-Mediated Communication and the Adult Learning Process?" (Linda M. Black); "Identifying Theories on Practice in Adult Literacy Education" (Coro); "Use of Critical Thinking and Reflective Practice with an Experienced Occupational Therapy Assistant: Case Study" (Humbert); "Four Adult Literacy Classrooms" (Medina); "Contributions of Literacy to Employment" (Passmore et al.); "'From Many, One': Exploration of Religious Pluralism and the Religious Education of Young Adults" (Ritchey); "Factors Deterring Adult Undergraduate Students from Participation in Study Abroad" (Surridge); "Making Meaning of Nonformal Education in State and Local Parks" (Taylor); and "From Research to Practice: Toward a Spiritually Grounded and Culturally Relevant Pedagogy" (Tisdell). (YLB)

This paper explores the effects of the childbirth environment and demographic variables on the laboring woman's expressions of tension and pain. Four observable physical measures were combined into a behavioral index of pain and tension: irregular breathing, tension of the upper extremities (rigid muscle flexion), vocalizations of pain (a cry, scream, or moan), and agitated body movement. A mean pain-tension index was computed for the time units in which each woman had a uterine contraction and for periods of rest between contractions. These measures were correlated with the woman's age, race, childbirth training, and a list of observable labor room events (medical procedures and social interactions). Subjects were recruited upon entering a large hospital to deliver. Thirteen hours of data were collected. Results showed that age is inversely correlated with the pain index, older women expressing less pain than younger women, and white women expressing less pain than black women. Parental education and income levels were related to attitudes, expectations and anxieties of prospective parents during pregnancy. Training for childbirth through preparation classes was not significantly related to observable pain during labor, although it was found that women who were trained rarely showed great pain. Factors which might indicate physical difficulty of labor were considered in relation to the pain-tension index. Labor room events which significantly correlated with the pain-tension index were various verbal and behavioral interactions between father and mother. (SB)

These proceedings contain 102 papers, 32 roundtables, and 5 symposia. Among the papers are "Weathered by Their Experiences" (Aiken); "Politics of Knowledge and Theory Construction in Adult Education (AE)" (Alfred); "Self-Directed Learning as a Political Act" (Andruske); "All Things Bold and Beautiful" (Armstrong); "Violence Against Women" (Baird); "Learning to Unlearn White Supremacist Consciousness" (Barlas et al.); "Ontology at Work" (Beckett, Morris); "Adult Literacy Classroom as a Social System" (Beder et al.); "Action Research on Documenting Learner Outcomes" (Bingman); "Voices from the Deep" (Boshier); "Contesting Criticality" (Brookfield); "Making Mathematics Come Alive" (Brown, Uhde); "Telling Stories and Creating Participatory Audience" (Butterwick, Selman); "Motivation in AE" (Carre); "Researchers as Co-Learners" (Castleden, Kurszewski); "Women's Development at the Margins" (Clark); "Road Map or Mosaic" (Daley); "One Year After Enrollment in Literacy Programs" (Ebert, Bingman); "Lifelong Learning" (Edwards, Usher); "Interdictions & Benedictions--AIDS Prevention Discourses in Vancouver, Canada" (Egan); "Is the Learning Organization for Real?" (Ellinger et al.); "Women Crafting New Work" (Fenwick, Hutton); "Leadership for Adult and Continuing Education (ACE)" (Fleming, Caffarella); "AE in the End of the Century" (Fragoso, Lucio-Villegas); "Research That Hurts or Research That Helps?" (Gorman); "Feminine Pedagogies and Graduate Adult and Higher Education for Women Students" (Gouthro, Grace); "Modern Practice of Canadian and US Academic AE During the Brief American Century (1945-73)" (Grace); "Extension and Grassroots Educators' Approaches to Participatory Education" (Grudens-Schuck); "Factors Influencing Active Learning in Small Enterprises" (Hawke); "Low-Income African American Women's Cultural Models of Work" (Hayes, Way); "Rethinking Violence and Learning" (Heald, Horsman); "Unpaid Piper Calls the Tune" (Heaney); "Global Consciousness of Human Resource Development and Organization Development Practitioners" (Hill); "Menacing Feminism, Educating Students" (Hill); "Life Situations and Institutional Supports of Women University Students with Family and Job Responsibilities" (Home, Hinds); "Wyrd Questions" (Hunt); "Edge of Empire" (Hunt); "Researching Adult Learners' Reading Histories and Practices" (Jarvis); "Race and AE" (Johnson-Bailey, Cervero); "Towards a Generic Approach to Assessment in ACE" (Jones); "Educational Technology That Transforms" (King); "Mediating Meaning-Making" (Kritskaya, Dirkx); "Comparison of National Education and Training Cultures" (Kuhn); "Critical Autobiography of Moral Learning Across Four Generations of the Woman's Christian Temperance Union" (Lander); "Beyond Transformative Learning" (Lange); "Training and the New Industrial Relations" (Law, Piercy); "Refocusing Faculty Development" (Lawler, King); "Constructing Pedagogic Identities" (Malcolm, Zukas); "Adult Learner-Centered Institutions" (Mancuso); "Reconstituting the Agora" (Martin); "Questioning Research as a Contextual Practice" (McIntyre, Solomon); "Lifelong Learning Goes to the Movies" (Miller); "Ever Widening Gyre" (Milton et al.);"Models of Community Development Practice" (Moore, Hill); "Promise--and Peril--of Web-Based Course Delivery in ACE" (Mott); "Aging and Learning in a Non-Western Culture" (Muhamad, Merriam); "Transformation Toward What End?" (Narushima); "Cultures of Teaching" (Nesbit); "Control, Learning, and Resistance" (Newman); "Lifelong Learning as Metaphor" (Nicoll); "Lessons from Central America" (Nolan); "Cultivating Imagination in AE" (Norman); "Botswana Rural Women's Transition to Urban Small Business Success" (Ntseane); "Role of AE and Skills Training in Promoting Planned Change and Localization" (Odoch); "Postmodern Morality in AE" (Plumb); "'When You Act Like an Adult, I'll Treat You Like One...'" (Pomerantz, Benjamin); "Teaching Perspectives Inventory" (Pratt, Collins); "Making the Curriculum Culturally Relevant" (Preece); "La Tertulia" (Puigvert et al.); "Introducing the Community Development Concept in the Ukraine" (Pyrch); "Beyond Participation and Stereotypes" (Quigley); "Researching the Implementation of Work-Based Learning Within Higher Education" (Reeve, Gallacher); "Research Neoliberal Reforms in Child Protection Agencies" (Reich); "Literacy and Attitudes" (Ribeiro); and "Making Assumptions" (Rocco). (YLB)

The article presents a section of abstracts on conference papers in Health Care Management. They include "Understanding Mental Health Treatment in Primary Care with Patient-Physician Interaction Data," examining the mental health treatment process; "Vertical Integration Between Community Hospitals and Nursing Facilities," about resource dependancy theory; and "Downstream Integration and Competitive Strategies in the US Pharmaceutical Industry," regarding vertical integration.

Poetry therapy has been in use with adult psychiatric patients at Saint Elizabeths Hospital, Washington, D.C, for 10 years. The treatment used involves reading poetry, listening to recordings, studying poets, and writing poetry. The patients' choice of poems is not restricted by the staff, but different types of poetry appeal to different types of patients. The flexibility of poetry therapy has been found advantageous as a treatment modality in psychiatric nursing. (Author/PF)

The purpose of this study was to compare certain characteristics of multiple-choice (MC) and complex multiple-choice (CMC) achievement tests designed to measure knowledge in medical-surgical nursing. Each of 268 junior and senior nursing students from four midwestern schools responded to one of four test forms. MC items were developed by converting original CMC items with four different systematic procedures. Results showed that: (1) students responded to five MC items for every four CMC items, (2) MC tests were at least as reliable as CMC tests though they did not measure exactly the same traits, and (3) CMC tests were at least as difficult as MC tests. Recommendations were made for test users. (Author)

An exploratory study using interviews of 150 postpartum patients was conducted to determine their perceptions of the touching they received during labor. Answers to the interview questions were analyzed in terms of overall perceptions, positive experiences, and negative experiences, and selected demographic variables were examined for differences between those who had positive and those who had negative perceptions of touching during labor. The results show that, in general, being touched was a positive experience; young subjects (ages 15 through 19), nonwhites, and single or divorced subjects perceived touch more negatively than older, white, and married subjects. Variables were also analyzed regarding who gave the touch, the part of the body touched, and the meaning of touch to the receiver. Attitudes toward touch were shown to be context-related. Suggestions for hospital staff are given, based on the research results, and several hypotheses are presented for further research. (CC)

This publication is a compilation of highlights from papers presented at the Associate Degree Nursing (ADN) project's regional conferences during 1983-84. Papers address pertinent issues in ADN education and practice. "AD Education: Are the Parameters Real?" (Julia Perkins) examines the parameters of associate degree nursing education from a historical perspective, in terms of what the literature says regarding the parameters of this type of education and practice, and by performance and use of graduates. "Transition Shock" (Anastasia Hartley) discusses the need for cooperative planning between education and service personnel to ease transition into the workplace. "AD Education: Parameters Espoused and in Use" (Georgeen H. DeChow and Jo C. Pierce) discusses the espoused parameters (what educators say) and describes those in use (what educators do). "Expectations of AD Graduates: An Educator's Perspective" (Sarah L. Etkin) uses the competency statements and premises of the National League for Nursing to describe the expected characteristics of ADN practice. "Bridges to Success" (Ann Larowe) also examines the parameters and philosophyy of AD education. "A Competency-Based Curriculum: Process at Kennesaw College" (Ann Crutchfield and Vanice W. Roberts) describes the process of competency development in the AD program. "Performance Differences in Graduates of Associate and Baccalaureate Degree Programs" (Annette Bairan, Leslie Brown, Pamela Chally, and Beverly Farnsworth) reports findings from a study conducted at the University of Vermont to demonstrate performance differences of graduates from AD programs versus baccalaureate programs. "Proposed Solutions to Issues in ADN" (Zeila W. Bailey and Dorothy Scott) suggests improvements for ADN education. "Expectations of AD Graduates: A Nursing Service Director's Perspectives" (Jacqueline Mardan) cites necessary skills and standards of performance. "The Reality of the Workplace" (Mona Raborn) stresses the need for leadership training. "An Educational Clinical Preceptorship" (Marianne Crouse, Emily Slunt, and Brenda Carter) and "An Internship Program" (Frances E. Casillo) describe these programs. "AD/BSN Competency Differentiation" (S. Joan Gregory) compares competencies of nurses from AD and Bachelor of Science in Nursing programs. "Opportunities for Success in the 80s" (Katherine Vestal) considers nurse utilization in a changing health care environment. "Clinical Competence Validation" (Carol Singer) summarizes a method of validating clinical competence of AD students. A bibliography concludes the document. (YLB)

A review of the literature revealed that control (or placebo) vignettes are not used in numerous studies in all areas that employ vignette-based methodology, which is a serious methodological and theoretical flaw. The nature of this flaw and its methodological and theoretical importance is outlined in this paper, as well as procedures and a model for developing control vignettes. Two studies on the degree to which nurse professionals are perceived to be at fault when assaulted by patients are reported which employ control vignettes. In the first study, the use of control vignettes produced better and more objective validation of the assault vignettes than previously available in the literature. In the second study, female and male nurses were blamed as much for the incident that occurred with the patient in the control vignette as they were in the severe assault vignette, but they were blamed more in the mild assault vignette than they were in either the control or severe assault vignette. Female nurses, however, were blamed more than male nurses for the incident in the control and severe assault vignette, but not in the mild assault vignette. These complex findings are shown to fit the non-linear elliptic umbilic model of catastrophe theory, and not the linear models and interpretations of these variables currently in the literature. These significant and important results would not have been found if control vignettes had not been used. (Author)

This paper offers practical tips found useful in meeting the needs of children with special health problems within the classroom. It describes feeding techniques for children with gastrostomies or using nasal or oral gastric tubes. It outlines the implications of having a child with a tracheostomy in the classroom. Classroom management suggestions are provided, such as ways to prevent mix-ups of formulas and the importance of preparing emergency contingency plans. Considerations for the development of individualized education programs or individualized family services programs are outlined, such as empowering the child to assist in his or her care to the degree possible and being aware of the parents' needs. Suggestions are also offered for working with nurses in the classroom. (JDD)

The article presents abstracts on the topic of health care management which include the problems that are generated by supply chain management, how to use pay levels to determine the financial performance of a hospital, and the coping skills of nurses.

This article presents abstracts of several studies related to health care management. Jose Proenca and Michael D. Rosko investigated the relationship between service collaboration through health systems and networks and hospital cost performance examining both direct and moderating effects in a national sample of U.S. urban, general hospitals. Steven J. Spear, Marie Mackey and Vickie Pisowicz reported initial results from action research at a post-operative inpatient nursing-unit. Trish Reay, Karen Golden-Biddle and Kathy Germann investigated how nurse practitioners and middle managers worked together to create changes in the way health care services are provided. Louise Meret-Hanke and colleagues contributed to the literature on the relationship between nurse staffing and nursing homes. Amy L. Pablo and colleagues examined how value is both captured and created through the reorganization of a public health care system in a western Canadian province. Kevin Morrell, John Loan-Clarke and Adrian Wilkinson reported the findings from a study of nurse turnover at eight large hospitals in the National Health Service of England and Wales. Gary J. Young and colleagues reported results from the first empirical investigation of the effect of networks on hospital prices.

This paper explored attitudes toward death and dying revealed through interviews with members of the clergy, the medical profession, funeral directors, nursing home residents, and selected others. The sampling was small and results are not intended to be representative of the groups to which these people belong. Rather, the study may be used as a means for further investigation into the subject. Some questions asked were: (1) Do you ever feel emotionally involved, and if so, how do you maintain your professional perspective? (2) What is a most often felt response of the dying patient--anger or shock? (3) What is the grief process and is it necessary? (4) What is a most often felt response of the survivor--guilt or relief? In addition funeral directors were questioned concerning funeral and cremation costs, and directors' responsibilities to families. Results indicated that the ministry seems in best control of death situations while the medical profession appeared least able to respond to the psychological needs of the dying. Funerals remain highly acceptable; many services are becoming highly individualized. Fear of isolation and of dying alone was expressed by older citizens. Although most people prefer to die in familiar surroundings, an increasing majority die in hospitals. A short bibliography on the subject is included. (KC)

This paper discusses current differences in the nursing education community regarding the roles of associate degree and baccalaureate degree nurses and presents a critique of the "Position Paper on Nursing Roles--Scope and Preparation" issued in 1982 by the National League for Nursing (NLN). After a discussion of the history and background of associate degree nursing, objections are presented to the NLN position paper which calls for the baccalaureate degree in nursing as the academic preparation for professional nursing practice. These objections include: (1) that the NLN recommendation encourages groups advocating changes in licensure for nurses; (2) that changes in current nursing practice and the diversified skills demanded of a nurse do not warrant a change in licensure requirements; (3) that the quality of making "independent judgments and critical decisions" that the NLN stated was required of professional nurses does not exclude associate degree nurses; and (4) that the NLN position paper failed to take into consideration that the baccalaureate nursing programs are not in a position to supply the nursing needs of the nation. (HB)

The role of the nurse educator in curriculum design in the future is considered. Changing technology, shifts in patient care agencies, legislation and long-term care specialties in nursing are all factors that will have a significant impact on curricula. Plans for managing and utilizing various teaching methodologies will be an important role for the nurse educator. The following roles are discussed and the literature reviewed: leadership, goal-setting, motivation, perception, communication, power and political involvement, learning styles, teaching methodologies, and research. An outline of the paper is attached. 56 references. (KM)

Proceedings are presented from a research conference to promote nursing research as a basis for policymaking in nursing practice, education, and health care services. The keynote address, by Patricia Jones, describes issues in health care financing in the 1980s and urges researchers to provide the kind of data and guidelines needed to support professional nursing services. The second paper, by Ora L. Strickland, names establishment of an acceptable and stable economic base for the provision of nursing services as the most important public policy issue facing nursing and gives pointers on collaborative research as one approach to contributing to the knowledge base. The third presentation, by Jeanette Lancaster, exhorts nurse researchers to affect policy by identifying critical study areas and initiating research. Abstracts follow of 32 studies, with almost equal numbers focusing on clinical practice, education, and the delivery of health care areas; the majority have implications in all three areas. They generally underscore the interrelatedness of research, education, and service. Specific topics include nurse-patient negotiations, predictive factors of supply and salaries of nurse practitioners, cultural determinants of health and self-care, job satisfaction, skills of nurse administrators, continuing education, nursing gestalt, nurses' decision making, and factors related to student success in completing a baccalaureate nursing education. (YLB)

Proceedings of a workshop conducted by the Western Council on Higher Education for Nursing include: patterns of assessment of experiential learning (John R. Valley); physical assessment of ethnic people of color (Julie Sykes); introduction and integration of health assessment in the associate degree phase at Brigham Young University College of Nursing (Lana B. Riddle); health assessment content in the baccalaureate program at the University of Utah (Margaret Adamson); health assessment in the baccalaureate program for registered nurses at California State College, Sonoma (Vivian Malmstrom); and the nurse practitioner: graduate level (Marie Scott Brown). (Author/MSE)

A two course sequence on human anatomy and physiology using the audiotutorial method of instruction was developed for use by nursing students and other students in the health or medical fields at the Kingsborough Community College in New York. The project was motivated by the problems of often underprepared students coming to learn a new field and by the time constraints caused by students' part-time status. An elementary biology course was divided into 28 learning modules (14 per semester). The program included a student study guide, taped lessons, small and large assembly sessions, an independent learning center with 30 carrels, and performance tests for each module. An analysis of the program is being planned that will use student questionnaires, an analysis of student time, and a comparison with students taking the human anatomy and physiology courses without audio tutorial instruction. The audio tutorial approach is an ideal method of fostering individualized learning, particularly for those students who have experienced academic difficulty. (WH)

Congruency testing of stated curriculum objectives and their observed or measured affective behavior counterparts among current students and recent graduates of five nursing education programs revealed discrepancies ranging from slight to extreme. (The programs were representative of the three major types of nursing education: (1) diploma (hospital connected), (2) associate degree, and (3) baccalaureate.) The discrepancies were examined through content analysis of stated program goals, utilizing written summaries of faculty interviews and four testing instruments (Personal Orientation Inventory, 16PF, a Humanitarianism Scale, and a Rokeach Dogmatism Scale). Comparison of stated curriculum objectives with instructor-supervisor-environmental program components indicated that educational strategies of many instructional/supervisory personnel were a probable source of many of the discrepancies. Altering strategies in a direction more congruent to the affective behavior predicted in the curriculum goals, and/or adopting those strategies recommended by a panel of educational experts, improved the observational/measurement indicators of attained affect and, often, instructor-supervisor's interest in monitoring for congruence. The document concludes with 11 pages of testing result data and a two-page bibliography. (Author/BP)

The applicability of a factor analytic approach to explore the nature of a complex job performance criterion for nursing practice and to determine the dimensions of this criterion was investigated. A national sample of 1,038 nurse educators from 85 randomly selected programs judged performance criteria contained in the Clinical Nursing Rating Scale and the Nurses' Professional Orientation Scale. A common factor analysis was conducted to identify dimensions of nursing practice underlying the scales. Internal consistency estimates and item-total subscale score correlations were calculated to examine stability of item groupings across a sample from the same population. A nested design multiple analysis of variance was used to investigate whether the mean subscale scores differed among faculty members from the three types of nursing educational programs (diploma, associate degree, and baccalaureate). Four stable factors emerged. Factor I represented an interpersonal dimension. Misconceptions and myths about nursing loaded on Factor II. Factor III represented a cognitive-leadership component, and Factor IV represented dependent nursing functions. Internal consistency for these subscales using coefficient alpha ranged from .81 to .91. Item-subscale correlations consistently were highest for the subscale on which the item loaded. Faculty from the three types of nursing educational programs did not differ. Appended materials include a bibliography, sample items from the rating scales, and information on characteristics of participating nursing faculty members. (Author/SW)

The conference reported here was held for nurse faculty and physicians from twenty-five family nurse practitioner (FNP) programs based in twenty-one states to provide the participants with an opportunity to consider their common curriculum problems and successes in FNP education. The first half of this booklet contains five paper presentations with the fourth and fifth papers followed by comments made by a reactor panel and the audience. The titles of the papers are (1) "The Potential of the Family Nurse Practitioner Movement," (2) "Five Questions of Family Nurse Practitioner Evaluation," (3) "Nursing Present Tense," (4) "The Role of the Family Nurse Practitioner: Implication for Curriculum Development," and (5) "Clinical Evaluation: An Examination of the State of the Art and Its Application to Nurse Practitioners." The remaining half of this booklet consists of five reports of group discussions held during the conference on adult medicine; child health curriculum; determinants of obstetrics and gynecology curriculum in nurse practitioner training; family and community; and the state of the art in teaching role realignment. A brief summary of conference recommendations concludes the report. (EM)

Results of two projects concerned with pre-immigration screening procedures for foreign nurse graduates are included in this conference report along with summaries of conference discussion and conclusions. (Participants were representatives of organizations and agencies concerned with immigration of nurses and other health professionals.) The first report is of an investigation by the Division of Nursing on the possibility of establishing a pre-immigration examination for nurses in their home countries through a mechanism similar to that now in effect for foreign medical graduates. It includes findings of a survey of State Boards of Nursing on numbers, characteristics, and results of licensure applications of foreign nurse graduates. Information on provisions of the state nurse practice acts and on relevent immigration laws and regulations is also included. The second report is of a project contract with Pace University Foreign Nurse Center to develop a plan for establishment of a pre-immigration screening examination for foreign nurse graduates. The conference summary reports that there was concensus clearly expressed by the participants that an organization should be established as a central agency for all matters relating to immigration of graduates of foreign nursing schools and that pre-immigration/prelicensing examination would reduce the burden of individual evaluations now carried by State Boards of Nursing. Notes on a postconference meeting on formation of the organization is appended. (JT)

The Nurse-Parent Training Project, developed in cooperation with Children's Hospital of Buffalo (New York), was designed to provide developmental supportive care for premature infants, and to reduce stress while optimizing neurobehavioral development. A program was conducted to train nurses working in neonatal intensive care nurseries, to enable them to recognize infant signs of stress and use appropriate interventions to promote infant stability. The training employed a stress and coping model to address infant, family, and staff stress. Sixteen nurses were trained, and observation of their subsequent clinical behaviors supported the efficacy of the training. Compared to 10 nurses on a training wait list and 10 nurses who did not wish to undergo training, trained nurses showed more caring behaviors during medical interventions and showed more effective supportive behaviors following medical interventions. (JDD)

Nursing curricula and licensing examinations have shifted toward the skills and processes of nursing. When these components are overhauled, their predictive relationship must be reexamined. This research tests the causal influence of several antecedent and achievement variables on licensure test performance. A path model is developed from a theory of school learning, and the causal connections within the model are validated and cross-validated. Few significant paths are retained. Student age and transfer status show important influences on measures of school achievement and on licensure scores. Further, one broad measure of school achievement has a substantial direct effect on licensure scores. (Author)

The conference brought together 45 persons who have had extensive experience in nurse staffing research. After the leadoff paper by Myrtle K. Aydelotte, which presented an overview of nurse staffing research, 10 papers were presented on variables considered to be significant in influencing the quantitative and qualitative demand for nurse staffing. These included patients' requirements for nursing services, architectural design of the hospital, administrative and cost factors, and social-psychological factors. In addition, papers were presented on the evaluation of quality of nursing care and the impact of computerized information systems on staffing. The papers were followed by presentations by discussion leaders who addressed themselves to points raised in the papers. These presentaions, the opening remarks of Jessie M. Scott, and a summary and synthesis of the entire conference are also included in the publication. Appended are four task force reports offering recommendations on future directions for research. (Author/MW)

This text is designed to accompany a series of slides that present information on Missouri's attempts to reduce minority infant mortality. In Missouri, the rate of black infant mortality is twice that for whites, and blacks are twice as likely as whites to be born with low birthweight. Only 64.9 percent of black women receive prenatal care in the first trimester of pregnancy. In response to the disparity between minority and white infant mortality, the Missouri General Assembly appropriated funds to establish an infant mortality project in Southeast Missouri. Southeast Missouri was chosen because of its high infant mortality rate and minority population. To complement a mandated increase in Medicaid coverage of pregnant women, Missouri also increased its reimbursement for obstetric services. The infant mortality project, called "Healthy Mothers, Healthy Fathers, Healthy Babies," employs a community nurse who develops local coalitions, supervises community outreach workers, and develops educational materials. Indigenous minority community outreach workers recruit pregnant women into the project, distribute health and educational materials, provide assistance to individual clients, and assist in the development and implementation of health and education programs. (BC)

The article presents abstracts on health care management topics which include the role of managed networks as an organizational form in British health care, the management of hospital physician relationships, and racial disparities in patient care.

Counseling is an integral part of nursing, especially public health nursing. The normal day to day situations in which a public health nurse finds herself offer great potential for counselling. The technique used primarily by public health nurses is that of basic listening, which is so necessary for ascertaining and understanding situations and feelings of their clients. The quality of family functioning is the main concern of the public health nurse. The public health nurse is, above all, a generalist; in one and the same day she may serve families in which the main problems are tuberculosis, obstetrics, or the supervision of a well school child. In one and the same day a public health nurse will counsel individuals and families in homes, schools, church halls and by telephone. Prevention is the main emphasis of all public health nursing programs. A selection of these programs is briefly described, illustrating how the public health nurse uses her counseling skills. (Author)

Some of the problems encountered in nursing arise out of the multiplicity of preservice educational programs and the predominance of registered nurses (R.N.s) who are prepared below the baccalaureate degree level. To facilitate the efforts of nurses already in practice to earn a bachelor's degree, the Extended Degree Program in Nursing (ENURS) of the Pennsylvania State University was developed. Through a mobile system, computer-based courses are now available to ENURS students in Pennsylvania. Called Computer Managed Review and Examination (CMRE), it has evolved from a set of traditional paper-and-pencil "challenge exams" to a comprehensive, computer-managed, self-study and assessment program for each of seven basic Penn State nursing courses for which a registered nurse may accrue credit by examination. (Author/JY)

Little has been done to identify the communication needs of nurses. The development of a model to use in examining their communication behavior can be an important first step in identifying those needs. The proposed model identifies four members of the staff nurse's role-set: patients, doctors, family members, and other nursing personnel. Each role-set member has communication expectations for the nurse that must be taken into consideration. Role expectations are used to analyze communication behavior between persons occupying different status positions. Interaction begins as two individuals attempt to identify the status of the other by analyzing verbal and nonverbal cues. Status identification allows for the recall or formulation of role expectations associated with the position in question. The concept of role expectations provides a general framework for the analysis of communication between a nurse and a status occupant. The communication needs of the focal person when interacting with more than one status occupant can be analyzed by identifying the potential sources of conflicting expectations and variables which influence the ranking of conflicting expectations. (MKM)

Proceedings are presented from the American Nursing Association (ANA) conference for members and professional employees of state boards of nursing and the ANA advisory council. In addition to opening remarks and discussion comments, the following papers are presented: "The DHEW Secretary's Report on Licensure: A Summary," by Ronald J. Wylie; "A Study of Accreditation of Selected Health Education Programs: A Report," by William K. Selden; "Nursing Vis-A-Vis Medicine: A Proposal for Legislation," by Marvin S. Fish; "A Discussion of Occupational Licensing," by Charles E. Harmon; "The DHEW Report on Licensure: A Commentary," by Helen V. Connors; and "Remarks by Chairman, ANA Council of State Boards of Nursing," by Hazel Peeples. The first article summarizes the following departmental actions spelled out in the DHEW report: expanded information base and additional consulting capacity, review of health services and training programs, additional accreditation studies, and determination of the feasibility of a national health professions certification system. The second article concerns accreditation of 15 health fields including the following: radiologic technology, medical laboratory assistants, and medical record librarians. The third article discusses the following sources for answers to the question of what is within the scope of nursing practice: opinions of attorneys general, judicial decisions, private counsel, individual and joint statements of professional associations, national commission for the Study of Nursing Education, and other associations. (SW)

This report of a conference on state boards of nursing and education for nursing contains the following papers: "Relationship between State and Voluntary Accreditation," by Eloise R. Lewis; "Statewide Planning for Nursing Education," by Donald P. Draine; "Nursing Education Today and in the Future," by Irene S. Palmer; "The Professional Association's Responsibility for Nursing Education," by Hazle Blakeney; "The Role of State Boards of Nursing in Post-Basic Nursing Education," by Patricia A. Wagner; "The Development of Criteria for Accreditation and Curriculum Innovation," by Emily I. Gardner; "Examining Various Approaches to School Surveys and the Role of the State Board of Nursing Education," by Annie L. Lawrence; and a brief summary of group discussions. (SW)

Following a description of the facilities, programs, and students of El Centro College (Texas), this paper reviews the conflicts arising between the mandates of external certifying boards, the expectations of hospital administrators and other medical personnel, and the realities of community college philosophy, planning, staffing and budgeting for allied health programs, as seen from the perspective of the college president. The open admissions policy and the desire to provide minority students opportunities previously denied them require compensatory and mastery learning strategies which conflict with external expectations for fixed program length. Arbitrary requirements concerning class size, pass rates for graduates on state board exams, and faculty certification levels can cause probation, loss of accreditation, faculty and student attrition, and hardships on colleges in isolated areas. Such mandates, often having immediate effect, are made without consultation or opportunity for input, and ignore the requirements of contractual obligations, advance planning, the principles of good teaching and learning, and community health care needs. While El Centro's nursing and other allied health programs are successful, it is felt that the college deserves the right to be involved in the external decisions which affect it. (RT)

Health professionals tend to view dying patients with two intertwined attitudes. On one hand the patient possesses an irreversible pathological condition and the doctor is obliged to help that patient embrace death with as much dignity as possible. On the other hand, the patient's imminent death is daily testimony to the limits of the doctor's competence. To avoid negative criticism from both patient and peers, the doctor often engages in avoidance behavior by stereotyping patients as to how well or how poorly they react to knowledge of death. If a patient establishes a trust relationship with a nurse, the nurse is more likely to disclose details of the diagnosis. Many nurses, however, engage in avoidance behavior similar to that of the doctors. A successful course in effective communication between patient and professional would (1) reduce the defensiveness a professional may feel toward peer and patient evaluation, (2) acquaint the professional with death by exposing him or her to a dying patient, (3) enable the professional to listen effectively to the ways the patient is handling death, and (4) enable the professional to structure appropriate response to the above. These goals might best be achieved in a hospice setting by a counselor who can alert the professional to signals patients give indicating the extent to which they have structured their dying experience. (HTH)

The entry-into-practice movement in nursing education was triggered most recently by a bill known as the 1985 Resolution which would require a baccalaureate degree as preparation for licensure as a registered professional nurse in New York by 1985. Several related issues have implications for community college administrators and educators. Those issues related to registered nurse licensure for the associate degree nursing graduates include: each state determines the legislative mandates for licensure; differing regulations and requirements hinder interstate mobility of graduates; the legislative process may not be the best way to effect change in the standards and practice of nursing. Two additional issues have potential for impact on community colleges: (1) the need for separate licensure examinations for associate degree and baccalaureate (B.A.) graduates as opposed to a common core examination with further examination for the B.A. nurse; and (2) the problems of cost, accessibility, and quality of offerings that are associated with mandatory continuing education for relicensure. Issues relative to entry into practice are also of concern to administrators. These include the frequent utilization of graduates of B.A. and associate degree nursing programs in the same way by employers; statewide efforts toward differentiation of practice; and articulation from one level of nursing education to another. (MB)

Those in continuing education for professional nurses believe that higher education needs to be involved in programs such as continuing education. Not until 1955 and the onset of state and federal programs designed to assist universities with higher education provisions was the impact on continuing education for nurses felt. Between 1957 and 1962 the establishment of nursing education and continuing education components as integral parts of interstate higher education commissions constituted a major breakthrough. Continuing education for nursing has snowballed due to such things as recognition of advances in medical science and related fields. But moves for relicensure requirements have been slow; presently only eight states have mandatory laws. The recommended requirement for licensed R.N.'s is thirty contact hours every two years. Since the 1975 American Nurses Association accreditation process began, twelve university nursing schools now offer accredited continuing education programs. There are many barriers to university-based continuing education programs in nursing; for example, administration views continuing education as a money maker, yet continuing education is expected to be self-supporting. Many barriers can be overcome if program support is viewed similarly to support for academic programs. Continuing education programs which support the advancing nursing profession must be developed. (CSS)

Eighteen conversations between patients and nurses or physicians were videotaped to examine patterns that the interactants followed to maintain dominant or recessive roles. Physicians/nurses were viewed as the dominant interactants because of their greater control in the hospital setting whereas patients were viewed as the recessive interactants because of their lesser control and their dependence on others for resources necessary in the recovery process. Analysis of the conversations resulted in the following rules implicit in the relationship between a patient and a nurse or physician: (1) nurses/physicians talk first; (2) nurses/physicians select the first topic in the first utterance; (3) nurses/physicians ask questions, the recessive interactant answers questions; (4) when the nurse/physician asks about a topic, the patient is obliged to pursue the topic; (5) topics in dominant-recessive interactions have to do with personal information regarding the patient; (6) when the patient has answered the question, the nurse/physician can then ask the same or similar question; (7) the nurse/physician may ask a question and without waiting for a reply may ask a second question; (8) the nurse/physician may verbally evaluate or revise the answer or response of the patient in the next turn; (9) the nurse/physician proposes membership categories that are accepted by the patient; (10) the nurse/physician manages the timing of the episode by using bracket markers; (11) the nurse/physician may interrupt the patient's talk before a transition-relevance cue occurs; and (12) the nurse/physician initiates the closing of the episode. These rules demonstrate that patients do not control their own time and space in interactions with physicians and nurses. (HOD)

One important role performed by the hospital nurse is that of health teacher to elderly patients. Often nurses teach elderly patients the techniques of self-injection, how to monitor their dietary regimens, specialized hygiene techniques, and how to detect the physiological changes they may expect as a chronic disease advances. From the nurse's perspective, the efficacy of the teaching role may be hampered by elderly patients who ignore careful instructions, quiz the nurse about irrelevant matters, or shower the nurse with verbal or physical abuse. One cause of ineffective teaching interactions may be the nurse's inability to recognize the patient's salient norms, which include preferential treatment, empathy, acceptance of their "lay" assessment, and avoidance of derogatory labels. Communication specialists could meet the needs of the teaching nurse by offering a ten-session communication course for the systematic assessment of the salient norms the elderly patient might bring to the hospital. The sessions would focus on (1) a definition of norms, (2) verbatim techniques for gathering data, (3) the preparation for video taping data of norm violations, (4) reporting on the video tape sessions, (5) conducting a verbatim assignment, (6) preparing a norm profile, (7) practice with a surrogate patient, and (8) a final report on the encounters. (A sample verbatim practice is appended.) (HOD)