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Background: Building on previous work undertaken in developing the clinical learning environment and supervision (CLES) scale this report outlines the development of a new sub-dimension to the CLES scale., Objectives: The aim was to develop an additional sub-scale to the CLES scale for measuring the quality of nurse teacher's co-operation with the crucial actors in the clinical practice of student nurses., Design, Setting and Methods: The original CLES scale and the subsequent CLES+T scale have been validated in two different empirical studies (N=416 and 549). Construct validity of the instrument was assessed with explorative factor analysis (EFA) and principal components analysis (PCA)., Results: The structure of the CLES+T scales factor model followed theoretical presumptions and the factors' eigenvalues and explanation percentages (64%) were sufficient., Conclusions: A validated evaluation tool-the CLES+T scale-can be used as a part of the total quality assessment of nurse education perceived by student nurses in Finland.

This article describes a methodological study concerning the development of a test instrument that can be used for measuring the effects of a course in palliative care on registered nurses and licensed practical nurses. This test instrument is comprised of two parts: an expertise and insight test and a self-efficacy instrument and is tested in three panels. The expertise and insight test appears to be usable for measuring the effects of a course in palliative care. The reliability and validity of the test were found to be adequate for evaluation of the effects of a post-basic palliative care course. The generality of the self-efficacy instrument was reduced because high-scoring items in the area of communication had to be removed. Moreover, the scores of the various categories of respondents discriminate less than expected on the basis of their previous education and the test results. Many respondents, regardless of their background, believed themselves to have a high level of competency. The self-efficacy instrument must therefore be used cautiously.

Clinical education is a vital component in the curricula of pre-registration nursing courses and provides student nurses with the opportunity to combine cognitive, psychomotor, and affective skills. Clinical practice enables the student to develop competencies in the application of knowledge, skills, and attitudes to clinical field situations. It is, therefore, vital that the valuable clinical time be utilised effectively and productively. Nursing students' perception of the hospital learning environment were assessed by combining quantitative and qualitative approaches. The Clinical Learning Environment Inventory, based on the theoretical framework of learning environment studies, was developed and validated. The quantitative and qualitative findings reinforced each other. It was found that there were significant differences in students' perceptions of the actual clinical learning environment and their preferred learning environment. Generally, students preferred a more positive and favourable clinical environment than they perceived as being actually present.

Professional curriculum planning is beginning to address issues of equity. The authors report on findings from a research initiative to begin to integrate antiracism into an undergraduate curriculum. Theory and methods of Essed, Fanon, Frankenberg, Hall, van Dijk and Woodward are synthesized for interpreting racialist discourse. The findings support the principle of normalizing accountability for discourse practices which construct whiteness and otherness in their representations. Essentialist discourse practices are implicated in the perpetuation of racism, ableism, heterosexism, ageism, etc. Hence, the ideal of equity is expanded to include the enactment of non-essentialist discourse. The logic is revealed as either/or; either equity or dominance through normalized perpetuation of essential categories assigning negative value to others constructing difference, marginalization, problematization, exclusion and containment. The confused, middle or neutral position is one of condoning racism and other forms of dominance.

The purpose of this paper is to describe the results of a questionnaire which indicated that hospital employed Registered Nurses (RNs) in the Southern Ontario areas of Hamilton and Toronto (Canada) demonstrated greater interest in attending conferences and workshops, than in any other continuing educational activities over the previous 3 years. The continuing education activities that were evaluated were: upgrading courses offered by colleges; credit courses provided by universities; in-service education presented at hospitals; reading professional journals; as well as attendance at conferences and workshops. The section of the questionnaire presented in this report explored whether any relationships exist between age, marital status, parental status and RNs participation in conferences and workshops. The questionnaires also explored whether the formal education at the time of the initial registration as an RN, and the number of years employed as an RN influenced RNs participation in the two continuing educational activities (conferences and workshops). Concerns or barriers to continuing education as identified by the RNs were also surveyed.

Twelve studies on the effects of pain programmes for nurses were reviewed. Most of the programmes focused on aspects of pain, pain medication or pain assessment. Only two programmes (Ferrell et al., 1993, J. Pain Symptom Management, Vol. 8, No. 8, pp. 549-556; Sofaer, 1983, Nurs. Times, Vol. 79, No. 47, pp. 38-42; 1984, Ph.D. Thesis, University of Edinburgh) also paid attention to non-pharmacological nursing interventions. Randomized control groups, established measurement instruments, testing statistics, and long-term follow-up measurements, were not often used in the effect evaluation of the programmes. Effects reported on both nurses and patients were for the most part positive. Given the small number of studies and their methodological limitations, further research into the effectiveness of continuing pain education in nursing is indicated.

This paper aims to communicate a particular methodology which was devised in an attempt to identify particular influences on the patient centredness of student nurse decision making in the practice setting utilising a quasi experimental approach. The major variables of ward sister student orientation and patient centredness are described in the context of the development of the experimental conditions and the patient centredness measuring tool. The video presentation of experimental conditions is also described. The study supported the hypothesis that student nurse patient centredness could be positively or negatively influenced by the student orientation of the significant nurse teacher in the clinical setting (The Ward Sister). On a consistent basis this is likely to produce nurses who learn that clinical decision making need not always be in the best interests of the patient. A cause and effect relationship between teacher orientation, student behaviour and practitioner outcomes is postulated.

Nursing students have revealed that one of the most anxiety-producing aspects of their clinical experience is the initial clinical experience. In order to help students through their initial clinical experience, faculty must first understand more fully the meaning of this experience for nursing students. A phenomenological study was conducted to explore the lived experience of nursing students' first clinical experience. Eighteen undergraduate nursing students described in writing an experience they had during their first day of clinical. Data were analyzed using Colaizzi's phenomenological method. Six theme clusters emerged: pervading anxiety, feeling abandoned, encountering reality shock, envisioning self as incompetent, doubting choices, and uplifting consequences. Implications for nurse educators are addressed.

In this paper, the history of educational evaluation is considered through a review of the literature, in order to try and understand how current evaluation methods have developed. It is important that a historical perspective is gained, as there has been a big shift in thinking from a strongly behaviourist code of practice to a more investigative and less prescriptive approach, during the relatively short time span that evaluation has had to develop as a subject in its own right. The application of the theory to practice is also considered in terms of a working evaluation model developed through work on continuing education courses in Scotland.