Critical analysis evaluation in nursing education

Measuring the Efficacy of Nursing Education in Preoperative Care: A Literature Review

In the nursing journal, The Critical Care Nurse, nurse Ruth M. Klienpell wrote in 2003 that the contemporary healthcare environment places an emphasis on measuring nursing performance in a process-based and quantificable fashion. The stress is upon "high-quality service at an affordable price,' and with "good outcomes." (Klienpell, 2003, p.1) But little guidance is given to nursing educators how to achieve these lofty but often separate focuses of saving money and providing quality care. Klienpell's article attempts to suggest that evaluating patient outcomes as a way of assessing the quality of care is superior, while Linda M. Sigsby and Hosseni Yanardi suggest that evaluating nursing knowledge is superior in their article in the AORN Journal geared to assessing preoperative nursing education specifically.

Given the strapped budgets of many facilities, Klienpell stresses that in nursing education there is a desire to show what methodologies are proven to work when teaching new nurses. "Measuring outcomes is especially important, as [nursing] roles are being scrutinized. (Klienpell, 2003, p.1) Clinical hands-on experiences for student nurses are being cut back in some areas, and being replaced by classes, to reduce costs. However, the AORN Journal, a monthly publication focusing on perioperative nursing information, states that this move is to the detriment of care for prospective preoperative nurses. A recent journal article by Linda M. Sigsby and Hosseni Yanardi attempted to address the fact that nursing students today have fewer hands-on opportunities to care for pre-surgical patients while they are students. They conducted a study was to determine if hands-on clinical experience created better preoperative nurses. In other words, that training in one's nursing field of specialty made a nurse a better healthcare provider later on.

The study evaluated the effects of using a perioperative clinical learning setting for a medical-surgical nursing course in a baccalaureate nursing program. "Two cohorts of students who entered the nursing program in academic years," 1998 and 1999, were measured at the end of their junior year and again at the end of their senior year. "The independent variable was the clinical learning setting for a medical-surgical nursing course -- either a perioperative or another medical-surgical setting. Dependent variables included knowledge of surgical patient care and employment in perioperative units after graduation." Although classes in preoperative care have been introduced into may curriculums for all nurses, Sigsby conceeds, there is a vital, clinal aspect to this form of preoperative nursing care that must be addressed for all individuals entering the field. (Sigsby & Yanardi, 2004, p.1) Thus, the study attempted to assess the ability of these students to dispense quality of care in a specific field of medicine, but addressed Klienpell's concerns of quality, efficacy, and cost-efficent procedures, as well as the issue of costs could be 'cut' when training nurses regarding the fields the nurses were considering specializing in later on.

The students in both groups were measured afterwards via a knowledge-based questionaire specific to preoperative patient care. "The surgical patient care questionnaire designed for this study consists of two parts. Part I includes 26 multiple-choice questions, 14 true-or-false questions, and 10 rank-order items. Questions relate to basic principles of nursing care of surgical patients." (Sigsby & Yanardi, 2004, p.1) The results were thus: "37.06% of students in the experimental group and 26.42% of students in the control group selected the correct answer. The difference in percentage of correct response is statistically significant (chi-square = 13.71, P = .0176)." (Sigsby & Yanardi, 2004, p.2)