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The role of nursing inservice educators in acute care general hospitals in southwestern British Columbia Bass, Andrea 1978

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THE ROLE OF NURSING INSERVICE EDUCATORS IN ACUTE CARE GENERAL HOSPITALS IN SOUTHWESTERN BRITISH COLUMBIA by ANDREA BASS B.A., U n i v e r s i t y o f C a l i f o r n i a a t Los Angeles, 1968 A.A., Los Angeles C i t y C o l l e g e , 1970 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS In the F a c u l t y of Graduate S t u d i e s (Department of A d u l t Education) We accept t h i s t h e s i s as conforming to the r e q u i r e d standard: THE UNIVERSITY OF BRITISH COLUMBIA September, 1978 (c) Andrea Bass, 19 78 In p r e s e n t i n g t h i s t h e s i s in p a r t i a l f u l f i l m e n t o f the r e q u i r e m e n t s f o r an advanced degree at the U n i v e r s i t y o f B r i t i s h Co lumb ia , I ag ree that the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e and s tudy . I f u r t h e r agree t h a t p e r m i s s i o n f o r e x t e n s i v e c o p y i n g o f t h i s t h e s i s f o r s c h o l a r l y purposes may be g r a n t e d by the Head o f my Department or by h i s r e p r e s e n t a t i v e s . It i s u n d e r s t o o d that c o p y i n g o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l not be a l l o w e d w i thout my w r i t t e n p e r m i s s i o n . Department o f The U n i v e r s i t y o f B r i t i s h Co lumbia 2075 Wesbrook P l a c e V a n c o u v e r , Canada V6T 1W5 D a t e ^ X ^ ^ / ^ Jl,/J?^ ABSTRACT The purpose of t h i s study was to i n v e s t i g a t e and d e s c r i b e a c t u a l and i d e a l a c t i v i t y p r o f i l e s o f i n s e r v i c e educators i n h o s p i t a l s , e s t a b l i s h i n g time and frequency f o r each a c t i v i t y . The study a l s o examined some socioeconomic f a c t o r s t h a t d e s c r i b e d the p o p u l a t i o n i n r e l a t i o n to a c t i v i t y time and frequency s c o r e s . The f a c t o r s i n c l u d e d c h a r a c t e r -i s t i c s of the educators and t h e i r job s e t t i n g s . The instrument developed f o r data c o l l e c t i o n was assessed by a panel of judges w i t h e x p e r t i s e i n h e a l t h and education and then r e v i s e d . Twenty-four i n s e r v i c e educators employed i n acute care g e n e r a l h o s p i t a l s o f v a r y i n g s i z e i n Greater Vancouver and V i c t o r i a were surveyed u s i n g the r e -v i s e d i n t e r v i e w schedule. The data was analyzed and des-c r i b e d u s i n g a p p r o p r i a t e computer programs, non-parametric t e s t s and other c a l c u l a t i o n s . Socioeconomic data obtained d e s c r i b e d the popula-t i o n i n terms of age, m a r i t a l s t a t u s and e d u c a t i o n a l i n v o l v e -ment. Most respondents were s i n g l e and without dependents. Most had some formal t r a i n i n g beyond a n u r s i n g diploma, many had a Bachelor's degree, and they were a c t i v e l y i n v o l v e d i n t h e i r own c o n t i n u i n g e d u c a t i o n . The a c t u a l a c t i v i t y p r o f i l e f o r the group showed t h a t i n s t r u c t i o n a l a c t i v i t i e s claimed the most hours i n the educators' present jobs. S u p e r v i s i o n took up the next h i g h e s t number of hours, w i t h program p l a n n i n g , m i s c e l l a n e o u s and p o l i c y d e c i s i o n making a c t i v i t i e s r a n k i n g t h i r d to f i f t h . The i d e a l a c t i v i t y p r o f i l e d i f f e r e d from the a c t u a l . Respondents wanted to spend the most amount o f time i n program p l a n n i n g a c t i v i t i e s , f o l l o w e d by i n s t r u c t i o n , s u p e r v i s i o n , p o l i c y d e c i s i o n making and m i s c e l l a n e o u s a c t i v i t i e s . Comparison of a c t u a l and i d e a l p r o f i l e s suggested t h a t the educators f e l t some measure of d i s s a t i s f a c t i o n w i t h t h e i r p r e s e n t a c t i v i t i e s . They wanted to spend a s u b s t a n t i a l l y g r e a t e r number o f hours per year i n v o l v e d i n program p l a n n i n g than was p o s s i b l e under p r e s e n t circumstances. Conversely, they wanted a r e d u c t i o n of involvement i n a l l other c a t e g o r i e s of a c t i v i t y . Socioeconomic data such as age, h o s p i t a l s i z e , amount of time employed i n p r e s e n t job, and i n involvement i n c o n t i n u i n g education were t e s t e d f o r c o r r e l a t i o n with a c t i v i t y s c o r e s . No strong r e l a t i o n s h i p s were found, although there were a few s t a t i s t i c a l l y s i g n i f i c a n t c o r r e l a t i o n s . D i f f i c u l t i e s p r esented by the data, such broad ranges of responses and n o t i c e a b l e d i f f e r e n c e s i n mode and mean response, made i t necessary to s t a t e c o n c l u s i o n s i n the study as s u g g e s t i v e r a t h e r than d e f i n i t i v e . N e v e r t h e l e s s , i t was f e l t t h a t a c t u a l and i d e a l p r o f i l e s c o u l d be a t l e a s t i n d i c a t e d and then used as a s t a r t i n g point for more d e f i n i t i v e studies of nursing inservice educators. I t was pointed out that steps could be taken to c l a r i f y the inservice educator's role through standard job description and elimination of non-educational a c t i v i t i e s . TABLE OF CONTENTS Page ABSTRACT i i LIST OF TABLES v i i i ACKNOWLEDGEMENT x i Chapter I. INTRODUCTION 1 Background 1 Purpose 6 L i m i t a t i o n s 7 D e f i n i t i o n s 8 Procedure 12 I I . REVIEW OF THE LITERATURE 16 The I n s e r v i c e Educator 16 Demographic C h a r a c t e r i s t i c s 17 Education, Background and Con t i n u i n g E d u c a t i o n 18 The Job S e t t i n g 21 A c t i v i t i e s o f the I n s e r v i c e 2 3 Educator . I n t r o d u c t i o n 2 3 Program P l a n n i n g 2 4 I n s t r u c t i o n a l A c t i v i t i e s 32 Sup e r v i s o r y A c t i v i t i e s 34 v i . Chapter Page P o l i c y and Decision-Making A c t i v i t i e s 35 Mi s c e l l a n e o u s A c t i v i t i e s 3 6 Methodology of other A c t i v i t y and Role Stud i e s Summary • 4 ^ I I I . METHODOLOGY 4 4 Statement of Problems 4 4 Instrument Development 4 6 P o p u l a t i o n 4 ^ Data C o l l e c t i o n ^0 Data A n a l y s i s 5 0 IV. DATA ANALYSIS 5 1 C h a r a c t e r i s t i c s of Educators 5 3 C h a r a c t e r i s t i c s o f Work S e t t i n g s 6 2 A c t u a l A c t i v i t i e s 6 5 Program P l a n n i n g o y I n s t r u c t i o n 8 6 S u p e r v i s i o n 8 ^ a P o l i c y and D e c i s i o n Making 97 Mis c e l l a n e o u s -^2 Summary 1 0 8 Ideal'..Activities 10 8 Program P l a n n i n g . 112 12 8 I n s t r u c t i o n S u p e r v i s i o n 136 v i i . Chapter Page P o l i c y and D e c i s i o n Making 137 Mi s c e l l a n e o u s .<• 144 Summary 150 Comparison of A c t u a l and I d e a l A c t i v i t i e s 151 F a c t o r s A s s o c i a t e d w i t h A c t u a l A c t i v i t i e s 165 Summary 168 V. SUMMARY, CONCLUSIONS AND IMPLICATIONS 171 -Summary 17 2 Conclusions 176 I m p l i c a t i o n s 179 BIBLIOGRAPHY APPENDIX A. INITIAL QUESTIONNAIRE 187 B. REVISED QUESTIONNAIRE 201 C. JUDGING PANEL FOR INSTRUMENT DEVELOPMENT 221 D. HOSPITAL EMPLOYING RESPONDENTS 222 E. INTRODUCTORY LETTERS SENT TO RESPONDENTS 223 v i i i LIST OF TABLES TABLE Page 1 Age D i s t r i b u t i o n of Respondents 55 2 M a r i t a l Status of Respondents 56 3 Number of Dependents 57 4 Number of Short and Extended Courses ,. Taken by Respondents 5 8 5 Hours Spent on Co n t i n u i n g Education 6 0 6 Hours Spent on Reading P r o f e s s i o n a l L i t e r a t u r e 61 7 Length of Time Employed i n Present P o s i t i o n 6 3 8 H o s p i t a l Bed C a p a c i t y 6 4 9 A c t u a l Time by Category 66 10 A c t u a l Frequency by Category 67 11 A c t u a l T o t a l Hours per Year by , .......... Category 68 12 A c t u a l Time Spent i n Program P l a n n i n g A c t i v i t i e s 72 13 A c t u a l Frequency, of Program Planning A c t i v i t i e s 77 14 A c t u a l T o t a l Hours per Year Spent on Program Pl a n n i n g 82 15 A c t u a l Time Spent on I n s t r u c t i o n a l A c t v i t i e s 8 7 16 A c t u a l Frequency of I n s t r u c t i o n a l A c t i v i t i e s 89 17 A c t u a l T o t a l Hours per Year Spent on I n s t r u c t i o n a l A c t i v i t i e s 91 18 A c t u a l Time Spent on Supe r v i s o r y A c t i v i t i e s . 94 i x TABLE Page 19 A c t u a l Frequency o f S u p e r v i s o r y A c t i v i t i e s 95 20 A c t u a l T o t a l Hours per Year Spent on S u p e r v i s o r y A c t i v i t i e s 96 21 A c t u a l Time Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s 99 22 A c t u a l Frequency of P o l i c y D e c i s i o n Making A c t i v i t i e s 100 2 3 A c t u a l T o t a l Hours per Year Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s 101 24 A c t u a l Time Spent on M i s c e l l a n e o u s A c t i v i t i e s 103 25 A c t u a l Frequency of M i s c e l l a n e o u s A c t i v i t i e s 105 26 A c t u a l T o t a l Hours per Year Spent on M i s c e l l a n e o u s A c t i v i t i e s 107 27 I d e a l Time by Category 109 2 8 I d e a l Frequency by Category 110 29 I d e a l T o t a l Hours per Year by Category I l l 30 I d e a l Time Spent i n Program' . P l a n n i n g A c t i v i t i e s :'. ... ' . 31 I d e a l Frequency of Program Pl a n n i n g A c t i v i t i e s 119 3 2 I d e a l T o t a l Hours per Year Spent on Program P l a n n i n g 124 33 I d e a l Time Spent on I d e a l A c t i v i t i e s 130 34 I d e a l Frequency o f I n s t r u c t i o n a l A c t i v i t y 132 35 I d e a l T o t a l Hours per Year Spent on I n s t r u c t i o n a l A c t i v i t i e s . 134 X TABLE Page 36 I d e a l Time Spent on Supervisory-A c t i v i t i e s ; 138 37 I d e a l Frequency of S u p e r v i s o r y A c t i v i t i e s 139 38 I d e a l T o t a l Hours per Year Spent on S u p e r v i s o r y A c t i v i t i e s 140 39 I d e a l Time Spent on P o l i c y Decsion Making A c t i v i t i e s 141 40 I d e a l Frequency of P o l i c y D e c i s i o n Making A c t i v i t i e s 142 41 I d e a l T o t a l Hours per Year Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s 143 42 I d e a l Time Spent on M i s c e l l a n e o u s A c t i v i t i e s 144 43 I d e a l Frequency of M i s c e l l a n e o u s A c t i v i t i e s 147 44 I d e a l T o t a l Hours per Year Spent on M i s c e l l a n e o u s A c t i v i t i e s 149 45 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on Program P l a n n i n g A c t i v i t i e s 154 46 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on I n s t r u c t i o n a l A c t i v i t i e s 159 4 7 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on S u p e r v i s o r y A c t i v i t i e s 161 4 8 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s 16 2 49 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on M i s c e l l a n e o u s A c t i v i t i e s 163 50 C o r r e l a t i o n C o e f f i c i e n t s of F a c t o r s A s s o c i a t e d w i t h A c t u a l A c t i v i t i e s Using the Spearman Rank C o r r e l a t i o n 16 7 x i ACKNOWLEDGEMENTS My thanks to Dr. Gary D i c k i n s o n f o r h i s sound, p r a c t i c a l advice throughout the w r i t i n g o f t h i s t h e s i s . And my deepest g r a t i t u d e goes out to my f a i t h f u l t y p i s t s , Kaye C u r r i e and Lorna MacMurray, f o r t h e i r u n f a i l i n g p a t i e n c e w h i l e s o r t i n g out my u n i n t e l l i g i b l e h a n d w r i t i n g and c o n f e t t i t a b l e s . CHAPTER I INTRODUCTION Few n u r s i n g s t u d i e s have focused d i r e c t l y on attempts to e s t a b l i s h an a c t i v i t y p r o f i l e f o r the i n s e r v i c e educator f u n c t i o n i n g i n a h o s p i t a l s e t t i n g . The l i t e r a t u r e emphasized g e n e r a l areas concerning i n s e r v i c e e d u c a t i o n as a t o p i c , but l i t t l e o f i t d e a l s w i t h the r o l e and a c t i v i t i e s performed by the educators themselves. The main purpose of t h i s study was to d e s c r i b e the i n s e r v i c e educators' r o l e , as p e r c e i v e d by the educators themselves. Background of the Study As Nakamoto and Verner i n d i c a t e d (52:17), i n s e r v i c e e ducation i n the h o s p i t a l s e t t i n g i s one of the o l d e s t arid 2. most p r e v a l e n t forms of c o n t i n u i n g education i n n u r s i n g . Post-graduate n u r s i n g courses i n h o s p i t a l s , the p r e c u r s o r o f today's i n s e r v i c e e d u c a t i o n programs, appeared as e a r l y as 1905, a c c o r d i n g t o P f e f f e r k o r n 1 s h i s t o r i c a l review (52:17). There i s a p l e t h o r a of a r t i c l e s concerning the g e n e r a l s u b j e c t of i n s e r v i c e education, e s p e c i a l l y from 1950 to the presen t . However, very few of these a r t i c l e s or s t u d i e s focus d i r e c t l y upon the i n s e r v i c e educator's p e r c e p t i o n of the a c t i v i t i e s she performs, nor the time elements i n v o l v e d i n each a c t i v i t y . Many of the a r t i c l e s tend to focus on such matters as "How we p l a n our program" (52:17) and e v a l u a t i o n t o o l s ("We f e l t t h a t the t r a i n i n g program was very s u c c e s s f u l " ) — w i t h l i t t l e o r no s u b s t a n t i v e data to support the author's c o n c l u s i o n s (52:17). Other a r t i c l e s concern themselves w i t h t e a c h i n g techniques o f t e n sandwiched i n between d i s c u s s i o n s of p a r t i c i p a n t s a t i s f a c t i o n w i t h p a r t i c u l a r programs (3,8,28,36). Again, much o f what these a r t i c l e s d i s c u s s seem u n s u b s t a n t i a t e d by o b j e c t i v e evidence. Some a r t i c l e s and s t u d i e s appearing from 1966 to the pre s e n t p r o v i d e i n d i c a t o r s w i t h r e s p e c t to the i n s e r v i c e educators' a c t i v i t i e s . For example, Magner's d i s c u s s i o n of a job d e s c r i p t i o n a t M i s c o r d e r i a H o s p i t a l i n New York o u t l i n e d some g e n e r a l a c t i v i t y areas f o r the educator (18:38): p l a n n i n g and p r e s e n t i n g i n s t r u c t i o n , m a i n t a i n i n g i n s t r u c t u r a l equipment, d i r e c t i n g new personnel and p a r t i c i p a t i o n i n f o r m u l a t i n g i n s e r v i c e budgets. Magner a l s o suggested t h a t i n s e r v i c e educators may have performed many a c t i v i t i e s u n r e l a t e d to i n s e r v i c e e ducation. Included i n her sample job d e s c r i p t i o n , f o r i n s t a n c e , was the statement t h a t the i n s e r v i c e educator "assumes the r e s p o n s i b i l i t y o f a d m i n i s t r a t i v e s u p e r v i s o r when the need a r i s e s (e.g. week-ends, v a c a t i o n r e l i e f , evenings and n i g h t s ) " (18:39). In a d d i t i o n , May Shiga Hornback conducted a study r e v e a l i n g t h a t many i n s e r v i c e educators i d e n t i f i e d . • t h e i r ; primary r e s p o n s i b i l i t i e s as oth e r than i n s e r v i c e e d u c a t i o n (45). I s i l i n d i c a t e d t h a t t h i s phenomenon of the i n s e r v i c e educator's involvement i n other a c t i v i t i e s may have been more e v i d e n t i n s m a l l e r h o s p i t a l s ( 1 3 : 1 6 ) . She i m p l i e d t h a t the "wearing o f many hats" ( i e . a d m i n i s t r a t o r , s u p e r v i s o r , bedside nurse — and educator) a t one and the same time, may have o c c u r r e d f o r s e v e r a l other reasons as w e l l : 1) poor s t a f f i n g 2) r e s i s t a n c e to i n s e r v i c e e d u c a t i o n by n u r s i n g s t a f f as w e l l as n u r s i n g a d m i n i s t r a t i o n 3) i n -adequate f i n a n c i a l support and/or other r e s o u r c e s 4) poor p r e p a r a t i o n of the educator h e r s e l f . The i m p l i c a t i o n here, f o r l a r g e or s m a l l h o s p i t a l s , was t h a t an i n d i v i d u a l may have been h i r e d as an i n s e r v i c e educator based upon a premise other than a p e r c e i v e d need f o r s t a f f e d u c a t i o n , such as meeting i n s e r v i c e standards r e q u i r e d f o r h o s p i t a l a c c r e d i t a t i o n . "In e f f e c t , the agency, not s e n s i n g the need f o r an educator per se, shunted her a c t i v i t y i n t o n o n - i n s e r v i c e areas. 4. Meaningful i n f o r m a t i o n a v a i l a b l e on the a c t i v i t i e s of i n s e r v i c e educators i n h o s p i t a l s i s somewhat scarce and wide l y s c a t t e r e d . In few cases are there d i s c u s s i o n s of time allotments i n v o l v e d . Only one study s y s t e m a t i c a l l y l i s t e d statements of fu n c t i o n s performed by d i r e c t o r s of education i n h o s p i t a l s , but t h i s study d i d not i n v e s t i g a t e the time-frequency dimensions. ( Hole). A few other stud i e s i n the nursing f i e l d focused on nursing a c t i v i t i e s of p r a c t i c a l nurses and r e g i s t e r e d nurses (Goldsmith, Tomlinson), but only one ranked a c t i v i t i e s according to frequency, w i t h no i n c l u s i o n of the time element (Goldsmith). Some u s e f u l a c t i v i t y s t u d i e s have appeared i n other f i e l d s . Several s t u d i e s done i n a g r i c u l t u r a l economics, f o r example, have focused on job a c t i v i t i e s and the time i n v o l v e d i n those a c t i v i t i e s (46,49,51). However, these stud i e s d i d not express the time element i n terms of hours and minutes. Rather, the researchers used v e r b a l r a t i n g s c a l e , such as "Do you spend 1) much 2) some 3) l i t t l e 4) no time on "x" or "y" a c t i v i t y " ? (51). Morehouse d e a l t s p e c i f i c a l l y w i t h the a g r i c u l t u r a l extension agents' perception of the a c t u a l a c t i v i t i e s performed w i t h time i n v o l v e d i n each: t h i s he defined as r o l e behavior such as "what the agent a c t u a l l y does, regardless of what he t h i n k s he ought to be doing"(51: 12-15) . Morehouse a l s o asked the agent f o r an :ideal 5. a c t i v i t y p r o f i l e i n terms of "what he t h i n k s he ought to be doing" c a l l i n g t h i s r o l e p e r c e p t i o n (51:12). Job's study r e v e a l e d a c t u a l a c t i v i t y p a t t e r n s , showing which a c t i v i t i e s absorbed the most time and e f f o r t on the p a r t of the respondent ( 4 6 : i i ) . The amount o f time the respondent devoted to each a c t i v i t y i n d i c a t e d r o l e performance, a c c o r d -i n g to Job. In a d d i t i o n , Job asked agents to rank these a c t i v i t i e s i n order of importance, i n d i c a t i n g the agent's d e s i r e d , or i d e a l , a c t i v i t y p a t t e r n : ( 4 6 : i i ) . T h i s i d e a l a c t i v i t y p a t t e r n r e v e a l e d the agent's p e r c e p t i o n of h i s r o l e d e f i n i t i o n , t h a t i s , what he thought ought to be h i s r o l e (46:7). Few s t u d i e s i n the n u r s i n g f i e l d have i n v e s t i g a t e d a c t i v i t y p r o f i l e s of i n s e r v i c e educators. Some s t u d i e s have focused on a c t i v i t i e s i n v o l v e d i n n u r s i n g occupations other than i n s e r v i c e education and occupations i n other, non-h e a l t h r e l a t e d f i e l d s . No study has s p e c i f i c a l l y l i s t e d , c a t e g o r i z e d and v a l i d a t e d the i n s e r v i c e educator's job a c t i v i t i e s nor e s t a b l i s h e d time and frequency elements. A c t i v i t i e s t h a t appear to the n u r s i n g l i t e r a t u r e or i n -s e r v i c e education seem to f a l l i n t o f i v e major c a t e g o r i e s : 1) program p l a n n i n g 2) i n s t r u c t i o n 3) s u p e r v i s i o n 4) p o l i c y decision-making 5) m i s c e l l a n e o u s such as c l e r i c a l and c u s t o d i a l . < These f i v e c a t e g o r i e s . f o r m e d the b a s i c s t r u c t u r e f o r t h i s study g e n e r a l l y , and, more 6. s p e c i f i c a l l y , for the review of the l i t e r a t u r e which follows. Purpose of the Study As indicated e a r l i e r , few nursing studies have focused on attempts to est a b l i s h an a c t i v i t y p r o f i l e for the inservice educator who functions within a hospital s e t t i n g . In fact, Hornback stated in 19 70 that the emphasis on inser-vice i n the nursing l i t e r a t u r e has been on aspects of programming, rather than on teaching personnel involved (45:28). Much of Hornback's l i t e r a t u r e review focused on learning needs of nurses, not the inservice educator's r o l e (45: 10-24). Inservice education i n hospitals has expanded rapidly, with l i t t l e or no purposeful d i r e c t i o n . I t has been only one part of the t o t a l spectrum of continuing education. However, i t i s c r u c i a l i n helping to maintain competence of nursing personnel and consequently the quality of patient care delivered. The e f f i c a c y of inservice education i n a given hospital depends larg e l y upon the person responsible for i t s dissemination--- the inservice educator. In view of the importance'of inservice education in the hospital setting, the purpose of t h i s study was to investigate and describe the actual and i d e a l a c t i v i t y p r o f i l e s of nursing inservice educators, establishing time and frequency f o r each a c t i v i t y . L i m i t a t i o n s and Scope This study focused on the a c t i v i t i e s o f i n s e r v i c e educators i n g e n e r a l acute care h o s p i t a l s of v a r y i n g s i z e s l o c a t e d i n m e t r o p o l i t a n Vancouver and V i c t o r i a . Chronic care and s p e c i a l t y h o s p i t a l s were e l i m i n a t e d to r e s t r i c t the number of v a r i a b l e s with r e s p e c t to h o s p i t a l type and to maintain some c o n s i s t e n c y i n data c o l l e c t i o n . With a t o t a l a v a i l a b l e p o p u l a t i o n of l e s s than f i f t y , i n c l u d i n g i n s e r v i c e educators i n c h r o n i c s p e c i a l t y , and acute h o s p i t a l the a d d i t i o n of more than one h o s p i t a l type would have presented a number d i f f i c u l t i e s . For example, on l y f i v e of the t o t a l h o s p i t a l s employing i n s e r v i c e educators were s p e c i a l t y h o s p i t a l s , s i x were c h r o n i c care, and the r e -mainder were acute care. T h i s unequal d i s t r i b u t i o n of h o s p i t a l types c o u l d have produced skewed time and frequency r e s u l t s , as w e l l as complicated attempts a t comparison of the i n s e r v i c e educator's a c t i v i t i e s i n the three types of h o s p i t a l s . The major aim of t h i s study was not to compare the t h r e e types but r a t h e r to determine an a c t i v i t y p r o f i l e f o r a s p e c i f i c group of i n s e r v i c e educators and, to begin development of an instrument t h a t o t h e r r e s e a r c h e r s c o u l d use i n s u b s e r v i e n t s t u d i e s . Another r e s e a r c h e r , f o r example 8 . c o u l d apply such an instrument t o a l a r g e r p o p u l a t i o n and i n c l u d e a wider range of v a r i a b l e s . The study, then, focused p r i m a r i l y on the a c t u a l and i d e a l a c t i v i t y p r o f i l e s o f . s e l e c t e d i n s e r v i c e educators as they p r e c e i v e d them. I t d i d not however, emphasize c u r r i c u l u m or programming which appeared o n l y as one of the many a c t i v i t i e s as i n s e r v i c e educator may have performed. N e i t h e r d i d the study focus on types o f i n s e r v i c e programming. The study d e a l t with t h i s q u e s t i o n o n l y as an aspect of the i n s e r v i c e educator's i n s t r u c t i o n a l and p l a n n i n g a c t i v i t y . A l s o , the study d i d not c e n t r e upon the i n s e r v i c e educator's socioeconomic p r o f i l e . Questions on socioeconomic background were used only to determine i f such v a r i a b l e s were r e l a t e d to a c t u a l a c t i v i t y p r o f i l e s . D e f i n i t i o n o f Terms The d e f i n i t i o n of terms to f o l l o w should serve to f u r t h e r c l a r i f y the scope and l i m i t a t i o n s of t h i s study. acute care h o s p i t a l : an i n s t i t u t i o n d e l i v e r i n g h e a l t h c a r e to persons r e q u i r i n g constant p r o f e s s i o n a l n u r s i n g care f o r i l l -nesses r e q u i r i n g immediate i n t e r v e n t i o n , s p e c i a l d i a g n o s t i c procedurer and/or a planned c o n t r o l l e d t h e r a p e u t i c or edu-c a t i o n a l program of comparatively s h o r t d u r a t i o n . c o n t i n u i n g e d u c a t i o n : i n c l u d e s any planned, e d u c a t i o n a l a c t i -v i t y d i r e c t e d towards meeting the l e a r n i n g needs o f the nurse f o l l o w i n g her b a s i c n u r s i n g program. The c a t e g o r i e s of 9. continuing education include: a) inservice education b) postbasic education (degree-granting, institution-based f u l l - t i m e formal study following a basic nursing program) and c) extramural education (community-based continuing education directed at job-related needs of nurses and other personnel) (36:2). chronic (extended) care h o s p i t a l : a f a c i l i t y d e l i v e r i n g health care to persons with i l l n e s s e s requiring professional nurs-ing supervision and d a i l y nursing care over a comparatively extended time period regularly scheduled examination by a physician and specialized services and equipment available through occupational therapy and physiotherapy departments, device: aid or adjunct used to enhance the effectiveness of a technique, thereby a s s i s t i n g i n the learner's a c q u i s i t i o n of knowledge and subsequent transfer of learning. head nurse committee: a committee composed of a l l the head nurses i n charge of nursing units i n a given h o s p i t a l . This committee focuses on such matters as: standards of nursing care on s p e c i f i c units, application of new p o l i c i e s and procedures on each nursing unit, i n d i v i d u a l unit s t a f f i n g patterns, as well as relationships between each unit and other hospital departments. inservice education: education a c t i v i t i e s provided to employees by the employing agency (hospital) designed to a) improve on-the-job p r a c t i c e s of the nurse and other employed personnel b) to meet j o b - r e l a t e d l e a r n i n g needs of the nurse and other personnel (36:2) i n s e r v i c e educator: a r e g i s t e r e d p r o f e s s i o n a l nurse r e s p o n s i b l e f o r o r g a n i z i n g , implementing and e v a l u a t i n g i n s e r v i c e programs i n a h o s p i t a l . method: manner of o r g a n i z i n g l e a r n e r s i n t o a l e a r n i n g s i t u a t i o n . n u r s i n g s e r v i c e e x e c u t i v e committee: r e f e r s to a committee r e p r e s e n t i n g those i n v o l v e d i n a h o s p i t a l n u r s i n g s e r v i c e . T h i s committee focuses i t s a t t e n t i o n on such items as standards of n u r s i n g c a r e , s t a f f i n g p a t t e r n s , i n t e r r e l a t i o n -s h i p s i n v o l v i n g n u r s i n g s e r v i c e and other h o s p i t a l depart-ments, as w e l l as the o v e r - a l l p h i l o s o p h y of the n u r s i n g s e r v i c e . ..The D i r e c t o r o f Nursing, the n u r s i n g s u p e r v i s o r s , and ( i f a p p l i c a b l e ) the D i r e c t o r of the School o f Nursing would be members of such a committee. n u r s i n g procedure committee: r e f e r s to a committee r e -p r e s e n t i n g those i n v o l v e d i n a h o s p i t a l n u r s i n g s e r v i c e which focuses i t s a t t e n t i o n on s p e c i f i c p o l i c i e s and procedures governing such areaa as: a d m i n i s t r a t i o n o f medicat i o n s , treatment procedures, and procedures a s s o c i a t e d w i t h d i a g n o s t i c t e s t s . p r e l i m i n a r y and u l t i m a t e c r i t e r i o n b e h a v i o r : When no o p p o r t u n i t y e x i s t s f o r o b s e r v i n g u l t i m a t e use of 11. information provided i n a program, the educator determines what the l e a r n e r must be able to do at one time (pre-l i m i n a r y c r i t e r i o n ) to be able to perform'some s p e c i f i c a c t i v i t y at a l a t e r time (ultimate c r i t e r i o n ) . For example: a p a t i e n t i s unable to continue h i s own nursing care at home. Thus, the nurse must determine a s u b s t i t u t e plan f o r the p a t i e n t , accounting f o r h i s resources and l i m i t a t i o n s (ultimate c r i t e r i o n ) . The p r e l i m i n a r y c r i t e r i o n demands th a t the nurse be able to determine s u b s t i t u t e plans using sample s i t u a t i o n s i n an i n s t r u c t i o n a l s e t t i n g . s p e c i a l t y / c l i n i c a l area: r e f e r s to an area of study, a c t u a l p r a c t i c e , and h e a l t h care d e l i v e r y d e a l i n g w i t h a s p e c i f i c disease or disease groups, body systems or age groups. For example, p e d i a t r i c s as a s p e c i a l t y or c l i n i c a l area focuses on health-care d e l i v e r y to and f o r c h i l d r e n . Urology focuses on h e a l t h care d e l i v e r y to those persons experiencing diseases of the u r i n a r y system. s h i f t : r e f e r s , i n t h i s study, t o the d i v i s i o n of working hours f o r employees of a h o s p i t a l nursing s e r v i c e . For ex-ample, general duty nurses tend to work i n one (or more) of the f o l l o w i n g hourly schedules: 0700 - 1500 hours, 1500 -2300 hours, 2300 - 0700 hours. techniques: manner of t r a n s m i t t i n g knowledge, behaviour used by the i n s t r u c t o r to f a c i l i t a t e a c q u i s i t i o n of knowledge by 12. the l e a r n e r . Procedure The procedure f o r the study f o l l o w e d t h r e e major st e p s . The f i r s t was an e x t e n s i v e review of r e l e v a n t l i t e r a -t u r e on the g e n e r a l t h e s i s t o p i c . The second step was the f o r m u l a t i o n of r e s e a r c h problems and a n c i l l a r y sub-questions. The t h i r d step i n c l u d e d procedures a s s o c i a t e d w i t h data c o l l e c t i o n , t a b u l a t i o n , and a n a l y s i s . Review of the l i t e r a t u r e began wi t h a search i n t o m a t e r i a l c o n t a i n i n g i n f o r m a t i o n on i n s e r v i c e educators i n h o s p i t a l s , d a t i n g from 1960 to 1975. T h i s i n i t i a l review i n c l u d e d a c a r e f u l p e r u s a l of an a n a l y s i s of c o n t i n u i n g n u r s i n g education l i t e r a t u r e by Nak.a-moto and Verner. T h i s p e r u s a l e l i m i n a t e d those a r t i c l e s and books not d i r e c t l y r e l e v a n t to t h i s study. A review o f j o u r n a l a r t i c l e s f o l l o w e d , beginning with the most recent, as w e l l as an examination of some d o c t o r a l theses on i n s e r v i c e e d u c a t i o n programming. From t h i s i n i t i a l review, the g e n e r a l t o p i c area emerged. F u r t h e r r e s e a r c h i n t o areas o u t s i d e of n u r s i n g i n s e r v i c e e ducation c l a r i f i e d the c e n t r a l theme the study, t h a t i s , the a c t i v i t i e s o f i n s e r v i c e educators i n acute care g e n e r a l h o s p i t a l s . Role s t u d i e s i n a g r i c u l t u r a l economics, f o r example, were h e l p f u l i n i d e n t i f y i n g types of a c t i v i t y not d i s c u s s e d i n the n u r s i n g l i t e r a t u r e . At t h i s p o i n t , w i t h the major theme of the study established, a review began of masters' and doctoral theses, as well as other studies, which were more s p e c i f i c to role performance in various nursing professions other than inservice education. Other aspects of the l i t e r a t u r e review included an extensive E.R.I.C. search, and a perusal of the Canadian Nurses Association Bibliographies, with relevant sources l i s t e d therein reviewed v i a microfilm. The formulation of the research problems then followed. This formulation occurred i n several stages. In the beginning, the basic research problem.included not only the inservice educator's perception of her a c t i v i t i e s , but the perceptions of those working with her as well, such as the Director of Nursing and assorted head nurses. This i n i t i a l problem statement proved to be too broad for the purposes of a single study. The f i n a l formulation eliminated a l l respondents except the inservice educator. I t included the main research problem with a n c i l l a r y sub-questions to a s s i s t i n answering the main questions. Notes from the l i t e r a t u r e review aided i n organizing a l i s t of p o t e n t i a l inservice education a c t i v i t i e s into s i x categories. The f i n a l problem formulation included the inservice educator-' s perception of her i d e a l as well as actual a c t i v i t y p r o f i l e . This ideal p r o f i l e served to indicate job s a t i s f a c t i o n , as well as s p e c i f i c changes respondents wished to make i n the actual a c t i v i t y p r o f i l e . I d e n t i f i c a t i o n o f the p o p u l a t i o n f o r the study was the next task. T h i s r e q u i r e d use of l i s t i n g s from the B.C. D i r e c t o r y o f H o s p i t a l s to l o c a t e agencies i n which p o t e n t i a l respondents might be employed. E l i m i n a t e d from the p o p u l a t i o n were those h o s p i t a l s not i n the categor y of acute care g e n e r a l i n s t i t u t i o n s . The f i n a l study p o p u l a t i o n i n c l u d e d i n s e r v i c e nurse educators employed by acute care g e n e r a l h o s p i t a l s i n the Greater Vancouver and V i c t o r i a m e t r o p o l i t a n areas. Development of a p l a n f o r the c o l l e c t i o n and ana-l y s i s of data f o l l o w e d . T h i s i n c l u d e d the de s i g n o f an instrument f o r data c o l l e c t i o n . A panel o f s i x judges examined the instrument, and made suggestions f o r r e v i s i o n s . The r e s u l t was a r e v i s e d f i n a l d r a f t of the i n t e r v i e w schedule. I n t r o d u c t i o n l e t t e r s to p o t e n t i a l respondents f a c i l i t a t e d data g a t h e r i n g . Follow-up telephone c a l l s to p o t e n t i a l respondents were made to s e t up i n t e r v i e w appoint-ment times. The i n t e r v i e w s took approximately f o u r to s i x weeks to complete. The respondents completed P a r t I of the i n t e r v i e w schedule p r i o r to the appointment time with P a r t I I completed d u r i n g the a c t u a l i n t e r v i e w . The c o l l e c t e d data was then recorded on F o r t r a n coding forms and key-punched. A p p r o p r i a t e s t a t i s t i c a l t e s t s were i d e n t i f i e d to analyze and i n t e r p r e t the data and to answer the r e s e a r c h q u e s t i o n s . Computer programs a v a i l a b l e through the U n i v e r s i t y 15. of B r i t i s h Columbia f a c i l i t a t e d data analysis. CHAPTER I I REVIEW OF THE LITERATURE I n s e r v i c e education i n h o s p i t a l s e t t i n g s i s one of the o l d e s t and most p r e v a l e n t forms of c o n t i n u i n g education i n n u r s i n g . P r e c u r s o r s of today's i n s e r v i c e education programs appeared e a r l y i n t h i s century, and s i n c e then, there has been an outpouring of books, s t u d i e s and a r t i c l e s on the s u b j e c t . An i n i t i a l l i t e r a t u r e review r e v e a l e d t h a t very few of these a r t i c l e s or s t u d i e s focused d i r e c t l y upon the i n -s e r v i c e educator's p e r c e p t i o n of a c t i v i t i e s she performed, nor the time and frequency elements i n v o l v e d i n each a c t i v i t y . A l a t e r , more e x t e n s i v e review s u b s t a n t i a t e d t h i s l a c k . However, taken as a whole, t h i s l i t e r a t u r e review p r o v i d e d some i n d i c a t o r s with r e s p e c t to the i n s e r v i c e educator's a c t i v i t i e s , the i n s e r v i c e educator h e r s e l f and the method-ology used i n a c t i v i t y s t u d i e s i n v o l v i n g other n u r s i n g , and non-nursing r o l e s . The review of the l i t e r a t u r e to f o l l o w centered upon three major areas. The f i r s t area of d i s c u s s i o n con-cerned the i n s e r v i c e educator: her c h a r a c t e r i s t i c s , educa-. t i o n a l background, involvement i n c o n t i n u i n g education and the job s e t t i n g i n which she f u n c t i o n e d . The second s e c t i o n d e l i n e a t e d some of the a c t i v i t i e s performed by i n s e r v i c e educators. These a c t i v i t i e s f e l l i n t o f i v e main c a t e g o r i e s : 1) program p l a n n i n g 2) i n s t r u c t i o n 3) s u p e r v i s o r y a c t i v -i t i e s 4) p o l i c y decision-making and 5) m i s c e l l a n e o u s . The f i n a l s e c t i o n d e s c r i b e d some of the methodology and a n a l y s i s of a c t i v i t y s t u d i e s i n other f i e l d s . Demographic C h a r a c t e r i s t i c s The l i t e r a t u r e review r e v e a l e d l i t t l e c o n c e rning age, m a r i t a l s t a t u s and number of dependents. However, some s t u d i e s d i d document such data on i n s e r v i c e educators. One study done i n Wisconsin with 68 i n s e r v i c e educators, r e v e a l e d the f o l l o w i n g about the respondents (46:66): t h a t the mean age was 41 to 45 y e a r s , t h a t 66.2% were married and the average number of dependents was two to three c h i l d r e n . S e v e r a l s t u d i e s d i d not c o r r e l a t e or draw any c o n c l u s i o n s 18. concerning t h e i r f i n d i n g s , although a few s t u d i e s t h a t looked at other n u r s i n g occupations d i d so (42,44,53). E d u c a t i o n a l Background and C o n t i n u i n g E d u c a t i o n Moststudies reviewed t h a t d e a l t w i t h the i n s e r v i c e educator h e r s e l f seemed to focus on e d u c a t i o n a l p r e p a r a t i o n and involvement i n c o n t i n u i n g e d u c a t i o n . In terms o f b a s i c e d u c a t i o n a l p r e p a r a t i o n , most s t u d i e s showed t h a t the m a j o r i t y of respondents were graduates of a h o s p i t a l s c h o o l of n u r s i n g , w i t h fewer respondents p o s s e s s i n g advanced or u n i v e r s i t y degrees. In one study, l e s s t h a t 42% of respondents had a B.S. or A.B. degree and o n l y 10% possessed M.A. degrees (33:38). The study d i d not s p e c i f y i n what f i e l d the respond-ents earned these degrees. In another survey, l e s s than 20% of the respondents had M.A. degrees and l e s s than 30% had B.A.'s, but more than 50% had a diploma from a h o s p i t a l s c h o o l (1:91). Hornback's study showed most respondents to be h o s p i t a l diploma graduates; few had earned Bachelor's degree, although many had taken u n i v e r s i t y courses (46:66).none of the s t u d i e s reviewed i n d i c a t e d i n s e r v i c e educators with d o c t o r a t e s . I t was of i n t e r e s t to note t h a t a study conducted by the American Nurses A s s o c i a t i o n s t a t e d t h a t p o t e n t i a l employers found i t d e s i r a b l e f o r i n s e r v i c e educators to have an M.A., p r e f e r a b l y i n n u r s i n g education (40:40). A t l e a s t one h o s p t i a l , mentioned i n another a r t i c l e , r e q u i r e d a minimum of a Bachelor of S cience Degree (19:39). I t appeared t h a t a gap e x i s t e d between the p r e s e n t l e v e l of e d u c a t i o n a l p r e p a r a t i o n and t h a t which was d e s i r e d . S e v e r a l studies' d i s c l o s e d a l a c k of p r e p a r a t i o n i n areas such as p h i l o s o p h y o f a d u l t e d u c a t i o n , t e s t s and measure-ments, program p l a n n i n g and t e a c h i n g techniques. In one survey of f i v e hundred h o s p i t a l s 75% o f the respondents had l i t t l e o r no p r e p a r a t i o n i n education and t e a c h i n g s k i l l s (1:91). Those respondents were aware of t h i s inadequacy, s t a t i n g t h a t they r e q u i r e d a d d i t i o n a l background. Another study i n d i c a t e d t h a t most respondents had l i t t l e or no background i n A d u l t E d u c a t i o n (46:133). To assess the l e a r n i n g base i n c e r t a i n areas with a group of 36 students (one-half of whom were c u r r e n t l y employed as f u l l - t i m e i n s e r v i c e educators ) e n r o l l e d i n a two semester course e n t i t l e d " I n s e r v i c e E d u c a t i o n i n Nursing", d e l Bueno conducted a s m a l l survey (4:11). She asked l e a r n e r s to s t a t e whether or not they had taken courses i n the f o l l o w i n g areas: S u b j e c t Areas Number who had not taken the s u b j e c t E d u c a t i o n a l Psychology 15 P r i n c i p l e s of Teaching/Learning 21 C u r r i c u l u m Development 27 T e s t s and Measurements 24 B a s i c S t a t i s t i c s 25 E d u c a t i o n a l Philosophy 25 P r i n c i p l e s of A d u l t Education 30 Group Dynamics 2 5 A u d i o - V i s u a l M a t e r i a l s 29 20. The r e s u l t s showed the respondent's l a c k of background i n almost a l l of the s u b j e c t areas l i s t e d , most p a r t i c u l a r l y i n p r i n c i p l e s of a d u l t e ducation. Authors of a r t i c l e s i n n u r s i n g j o u r n a l s s t a t e d what they f e l t was d e s i r a b l e p r e p a r a t i o n . These authors f e l t i n s e r v i c e educators r e q u i r e d 1) advanced p r e p a r a t i o n i n t e a c h i n g techniques, 2)> a d u l t e d u c a t i o n p r i n c i p l e s and 3) program p l a n n i n g (40:40) and (33:35). Some authors a l s o remarked t h a t the educator needed to know how to w r i t e b e h a v i o u r a l o b j e c t i v e s and e v a l u a t e the e f f e c t i v e n e s s of programs (25:31) (47:22). Other authors noted t h a t l e a d e r -s h i p and communication s k i l l s were necessary (18:39). One author suggested t h a t a d m i n i s t r a t i v e background i n h o s p i t a l s should be a requirement f o r i n s e r v i c e educators (27:35). In the area of the i n s e r v i c e educators' involvement i n c o n t i n u i n g education, s e v e r a l j o u r n a l a r t i c l e s p o i n t e d out the need f o r nurses i n g e n e r a l to become more i n v o l v e d i n t h e i r own c o n t i n u i n g education (6,22,18,56). But few s t u d i e s l o c a t e d f o r t h i s review s t a t i s t i c a l l y documented a l a c k of p a r t i c i p a t i o n i n t h i s area by i n s e r v i c e educators. One study showed,lin i t s p r o f i l e of the i n s e r v i c e educator i n one s t a t e , t h a t the respondents as a whole d i d not read r e s e a r c h j o u r n a l s and d i d not belong to a p r o f e s s i o n a l o r g a n i z a t i o n o t h e r than the s t a t e R e g i s t e r e d Nurse A s s o c i a t i o n (46:133). The study d i d d i s c u s s such items as hours per week spent on c o n t i n u i n g e d u c a t i o n , and p a r t i c i p a t i o n i n s h o r t courses. The Job S e t t i n g of the I n s e r v i c e Educator S t u d i e s and a r t i c l e s i n d i c a t e d t h a t two elements i n the job s e t t i n g a f f e c t i n g the i n s e r v i c e educators', f u n c t i o n i n g were the s i z e of the h o s p i t a l and the budget p r o v i d e d f o r i n s e r v i c e education. H o s p i t a l s i z e seemed t o have a profound e f f e c t i n the f o l l o w i n g areas: 1) whether or not i n s e r v i c e c o n s t i t u t e d a separate department, or blended w i t h other d e p a r t -ments i n the h o s p i t a l 2)5 whether or not the i n s e r v i c e educator f u n c t i o n e d as a f u l l - or par t - t i m e worker and 3) the i n -s e r v i c e educator's i n v o l v e m e n t i i n non-educational a c t i v i t i e s . Morgan f o r i n s t a n c e s t a t e d t h a t a g r e a t many h o s p i t a l s w i t h l e s s than 200 beds had i n s e r v i c e education as a p a r t of the personnel and/or n u r s i n g s e r v i c e departments (27:3 5). Regarding the i n s e r v i c e educator's f u l l - or par t - t i m e s t a t u s , the N a t i o n a l Academy f o r H e a l t h I n s e r v i c e E d u c a t i o n Study found t h a t f u l l -time d i r e c t o r s of i n s e r v i c e education were i n c r e a s i n g l y the r u l e i n h o s p i t a l s with 200 or more beds (1:90). However, re g a r d -l e s s of h o s p i t a l s i z e , most h o s p i t a l s had a t l e a s t one f u l l - t i m e educator on s t a f f . In one study o f 500 i n s e r v i c e - educators, 91% of whom were from h o s p i t a l s , 72% of the i n s e r v i c e programs used a t l e a s t one f u l l - t i m e s t a f f member,-....several -used t h r e e , and the maximum was eleven f u l l - t i m e i n s e r v i c e i n s t r u c t o r s (33:38). The problem i n h o s p i t a l s o f 200 beds or l e s s , was t h a t o f t e n the i n s e r v i c e educator, w h i l e she may have been o f f i c i a l l y d esignated as a f u l l - t i m e i n s e r v i c e educator, o f t e n had to perform many f u n c t i o n s (13:16). I s i l p o i n t e d out t h a t , i n e f f e c t , the s o - c a l l e d f u l l - t i m e i n s e r v i c e educator became a "part-time", f i l l i n g i n a t d i f f e r e n t times i n o ther r o l e s such as an a d m i n i s t r a t o r o r bedside nurse (13:16). I s i l i n d i c a t e d t h a t the m u l t i p l e f u n c t i o n s syndrome e x i s t i n g i n small h o s p i t a l s , because of l i m i t e d s t a f f members and r e s o u r c e s , was p a r t of the cause f o r the i n s e r v i c e educator.'.sjinvolvement i n n o n - i n s e r v i c e a c t i v i t i e s (13:16, 26:543). Handling of the budget a l l o t t e d t o i n s e r v i c e edu-c a t i o n a c t i v i t i e s a l s o e f f e c t e d the f u n c t i o n i n g of the i n s e r v i c e educator. In the N a t i o n a l Academy f o r H e a l t h I n s e r v i c e Education, Kerr found t h a t a d m i n i s t r a t o r s would mot g i v e h o s p i t a l i n s e r v i c e departments s u f f i c i e n t money to plan and e s t a b l i s h programs (1 : 9 4 ) . As Kerr s t a t e d : "I've t a l k e d to a d m i n i s t r a t o r s who wouldn't t h i n k of p r o v i d i n g $2 0 , 0 0 0 - f o r i n s e r v i c e e d u c a t i o n , but who spend ten times t h a t much on a p u b l i c r e l a t i o n s program t h a t doesn't accomplish anything"(1: 9 0). As she r e i t e r a t e d , h o s p i t a l s were o f t e n w o e f u l l y underbudgeted f o r i n s e r v i c e e d u c a t i o n . In a d d i t i o n , Kerr found i n her study of f i v e hundred h o s p i t a l s t h a t 75% of a l l i n s e r v i c e programs were under the umbrella of the n u r s i n g department (1:90), which suggested t h a t i n s e r v i c e i n these cases came under the n u r s i n g s e r v i c e budget, r a t h e r than having i t s own separate budget. The l a c k of s u f f i c i e n t funds c o u l d have i n h i b i t e d and r e s t r i c t e d the i n s e r v i c e educator's l a t i t u d e i n p l a n n i n g and implementing needed programs. The l a c k o f a separate budget c o u l d have i m p l i e d l e s s c o n t a c t and communication w i t h those r e s p o n s i b l e f o r a l l o c a t i n g the o r i g i n a l funds thereby, l e s s c o n t r o l over budgetary a l l o c a t i o n . The educator then must have depended on the d i r e c t o r of n u r s i n g s e r v i c e s to i n c l u d e moneys f o r i n s e r v i c e taken from the n u r s i n g s e r v i c e budget. U n f o r t u n a t e l y the a c t u a l amount was v a r i a b l e , depending on the needs o f the t o t a l n u r s i n g s e r v i c e . A c t i v i t i e s of the I n s e r v i c e Educator Review of the l i t e r a t u r e on a c t i v i t y p r o f i l e s focused on m a t e r i a l a v a i l a b l e d e s c r i b i n g types of a c t i v i t i e s performed by i n s e r v i c e educators. In a d d i t i o n , those s t u d i e s t h a t d e a l t w i t h a c t i v i t y p r o f i l e s of r o l e s other than the i n s e r v i c e were reviewed f o r i n f o r m a t i o n concerning method-ology and a n a l y s i s o f j o b p o r f i l e s . A c t i v i t i e s r e p o r t e d i n the l i t e r a t u r e f e l l i n t o f i v e major c a t e g o r i e s : program pl a n n i n g , i n s t r u c t i o n , s u p e r v i s i o n , p o l i c y d e c i s i o n making and m i s c e l l a n e o u s a c t i v i t i e s . Program P l a n n i n g In terms of the a c t i v i t i e s i n v o l v e d i n the program p l a n n i n g p r o c e s s , Nakam oto and Verner r e p o r t e d t h a t a review of the l i t e r a t u r e from 1929-1970 on i n s e r v i c e edue c a t i o n "shows an emphasis on techniques of program p l a n n i n g " , but no p r e c i s e i n d i c a t i o n of the i n s e r v i c e educator's a c t i v i t i e s i n t h i s area (53:17). - L i t e r a t u r e from 1970 to the p r e s e n t seemed t o show l i t t l e change. Systematic pro-gram p l a n n i n g tended to be inadequate, i f not a l t o g e t h e r l a c k i n g . Cantor s t a t e d t h a t nurses j u s t i f i e d t h i s l a c k by arguing t h a t any e d u c a t i o n a l experience, no matter how p o o r l y planned and assessed, a u t o m a t i c a l l y r e s u l t e d i n l e a r n i n g (6': 50). In a c t u a l i t y , any l e a r n i n g r e s u l t i n g from such an experience was t . p u r e l y an a c c i d e n t . Condon, one of the few nurse-authors to suggest a workable program p l a n n i n g model, s t r u c t u r e d i t i n f i v e segments: 1) assessment of the s t a f f s ' l e a r n i n g needs 2) p l a n n i n g by b e h a v i o u r a l o b j e c t i v e s 2) implementation 4) e v a l u a t i o n 5) r e c y c l i n g (8:38). Some nurse educators suggested s e v e r a l a c t i v i t i e s n ecessary f o r the i n s e r v i c e educators to achieve s u c c e s s f u l assessment o f l e a r n i n g needs. Medearis and P o p i e l recommended d i r e c t o b s e r v a t i o n of personnel job performance as a s t a r t i n g p o i n t , f o r c u s i n g on such items as: 1) the p a t i e n t ' s r e a c t i o n to n u r s i n g care he r e c e i v e d ( d i r e c t p a t i e n t f e e d -25. back) 2) s t a f f ' s c o o r d i n a t i o n of the n u r s i n g care 3) resources used or not used on a n u r s i n g u n i t (25:33). Other authors supported the use of d i r e c t o b s e r v a t i o n as an assessment t o o l . M a r s h a l l and N u s i n o f f i n t h e i r r o l e s as i n s e r v i c e educators both d i r e c t l y observed s t a f f s ' c o o r d i n a -t i o n of n u r s i n g care on the wards (20:43, 31:22). Another i n s e r v i c e educator v i s i t e d g e r i a t r i c wards i n her h o s p i t a l , and observed t h a t p a t i e n t s had c o n s i s t e n t l y poor posture and speech impediments (12:250). By t h i s o b s e r v a t i o n of p a t i e n t s ' response to n u r s i n g c a r e , the educator r e c o g n i z e d t h a t s t a f f r e q u i r e d the l e a r n i n g of more adequate i n e r v e n t i o n techniques to meet p a t i e n t needs (12:250). Luciano f u r t h e r suggested review of n u r s i n g care plans to determine personnel's. adaption of n u r s i n g care to the i n d i v i d u a l p a t i e n t (17:78). Other assessment a c t i v i t y suggestions i n c l u d e d : 1) examina-t i o n of i n c i d e n t r e p o r t s 2) survey of employee performance e v a l u a t i o n s 3) d i s c u s s i o n s w i t h a d m i n i s t r a t i o n and n u r s i n g c o l l e a g u e s to v a l i d a t e the i n s e r v i c e educator's p e r c e p t i o n s of the s t a f f s ' l e a r n i n g needs (25:34). Cantor suggested t h a t , i n a d d i t i o n , the i n s e r v i c e educator may need t o spend time c o n f e r r i n g with content s p e c i a l i s t s on the p a r t i c u l a r s of a given program (6:52). Educators i n other f i e l d s engaged i n t h i s a c t i v i t y : Morehouse, i n h i s study on a g r i c u l t u r a l e x t e n s i o n agents, l i s t e d "seeking i n f o r m a t i o n from s p e c i -a l i s t s " as an a c t i v i t y area (52:14). F i n a l l y , most i n -s e r v i c e educators i n the l i t e r a t u r e mentioned meeting with and s u r v e y i n g the t a r g e t s t a f f as a v a l u a b l e a c t i v i t y i n a s s e s s i n g d e s i r e d l e a r n i n g o p p o r t u n i t i e s (15:78, 27:41, 32:100, 31:21, 12:254, 38:943, 10:13). Nusinoff' mentioned the use of a q u e s t i o n n a i r e as a t o o l t h a t she employed i n p l a c e of a group conference to h e l p . Nurses determine l e a r n i n g needs (31:21). Morgan, however, recommended r e v o l v e -ment of the- t a r g e t group i n conferences and q u e s t i o n n a i r e s to determine l e a r n i n g needs f o r the s t a f f (27:40). Toben viewed meetings with nurses to determine l e a r n i n g needs as one way of h e l p i n g the s t a f f l e a r n about the p a t i e n t s and i n c r e a s e p r o b l e m - s o l v i n g s k i l l s (38:943). Morgan a l s o suggested the educator's use o f job d e s c r i p t i o n s as an assessment t o o l . With a d e s c r i p t i o n i n hand, the i n s e r v i c e educator i n t e r v i e w e d the employee and reviewed the job d e s c r i p t i o n with him or her and compared t h i s w i t h what the employee knew. The d i f f e r e n c e , s a i d Morgan, r e p r e s e n t e d h i s or her l e a r n i n g needs (2.7:40). In one survey of f i v e hundred i n s e r v i c e educators, n e a r l y o n e - t h i r d s t a t e d t h a t i n t h e i r h o s p i t a l s , d e c i s i o n s about l e a r n i n g needs and what to teach became a committee f u n c t i o n , w i t h such committees as i n s e r v i c e , p l a n n i n g and programing. In o n l y twelve per cent of h o s p i t a l s were n u r s i n g s t a f f d i r e c t l y i n v o l v e d i n assessment and p l a n n i n g (34:5). In nine per cent of the h o s p i t a l s , other non-nursing i n d i v i d u a l s such as a d m i n i s t r a t o r s were the u l t i m a t e decision-makers as to what i n s e r v i c e i n s t r u c t o r s would teach (34:5). Based upon a l e a r n i n g needs assessment the l i t e r a t u r e reviewed suggested t h a t the i n s e r v i c e educator then spent time i n f o r m u l a t i n g a statement of o b j e c t i v e s f o r the programs by d e s c r i b i n g the intended outcomes. T h i s o c c u r r e d p r i o r t o s e l e c t i o n of content, procedure, methods, and techniques .. (3:6). However few i n s e r v i c e educators a c t u a l l y wrote o b j e c -t i v e s . Wood s t a t e d t h a t l a c k of p l a n n i n g i n g e n e r a l , much l e s s the use of o b j e c t i v e s , was widespread i n i n s e r v i c e e d u c a t i o n (40:39). T h i s s t a t e of a f f a i r s seemingly e x i s t e d i n the U n i t e d S t a t e s d e s p i t e the J o i n t C o u n c i l on A c c r e d i t a -t i o n of H o s p i t a l s requirement t h a t , a t the very l e a s t , o b j e c -t i v e s f o r o r i e n t a t i o n programs be pr o v i d e d i n w r i t i n g (33:34). Furthermore, Chamberlain p o i n t e d out t h a t many i n s e r v i c e educators i d e n t i f i e d content even b e f o r e a s s e s s i n g l e a r n i n g needs, r e s u l t i n g i n i r r e l e v a n c y of the program (7:11). A p o s s i b l e e x p l a n a t i o n f o r Chamberlain's o b s e r v a t i o n may o r i g i n a t e i n the f a c t t h a t many i n s e r v i c e educators l a c k a background i n p l a n n i n g and te a c h i n g s k i l l s (1,5,19). A few authors d i d a l l u d e to e s t a b l i s h i n g o b j e c t i v e s as a p l a n n i n g step i n t h e i r i n s e r v i c e programs; but only one of them a c t u a l l y s t a t e d t h a t her o b j e c t i v e s were w r i t t e n out (24:61, 31:21). Implementation i n v o l v e d a c o n s i d e r a t i o n o f methods, techniques, d e v i c e s and procedures (55:20). The l i t e r a t u r e 28. abounded i n such d i s c u s s i o n s , (3:7, 17:80, 48:171). But, much of the l i t e r a t u r e showed a lack of d i s t i n c t i o n among these v a r i o u s p r o c e s s e s . For example, Magner grouped " f i e l d t r i p s , e x h i b i t s , seminars and f i l m s " under the s i n g l e heading o f methods (19:40). Such c o n f u s i o n i n d e f i n i t i o n s l e a d many i n s e r v i c e educators to b u i l d t h e i r programs around a d e v i c e , such as a f i l m o r programmed t e x t (6:52), under the b e l i e f t h a t these d e v i c e s c o n s t i t u t e d methods of i n s t r u c t i o n . O f t e n , i n l i e u of a s s e s s i n g her t a r g e t groups l e a r n i n g needs and e s t a b l i s h i n g , o b j e c t i v e s , the i n s e r v i c e educator allowed a v a i l a b i l i t y o f these packaged programs to determine course content (6:52), r a t h e r than r e c o g n i z i n g such items as d e v i c e s to augment a program. F i n a l l y , l i t e r a t u r e reviewed i n d i c a t e d t h a t the i n s e r v i c e educator c o u l d u t i l i z e a c e r t a i n amount of time f o c u s i n g on p r o c e d u r a l aspects o f implementation. The l i t e r a t u r e suggested t h a t one of the most time-consuming a c t i v i t i e s f o r the educator was o r g a n i z i n g her programs around t i g h t s t a f f i n g schedules (33:35, 35:34). Rudnick and B o l t e s t a t e d t h a t t h i s procedure i n v o l v e d (35:34) 1) a r r a n g i n g w o r k s h i f t s so t h a t there was o v e r l a p between s h i f t s going o f f duty and coming on duty 2) a r r a n g i n g f o r r e l i e f by p a r t - t i m e p e r s o n n e l 3) a r r a n g i n g f o r n i g h t s h i f t involvement i n pro-grams. Experts recommended t h a t i n s e r v i c e educators spend time c o n s u l t i n g w i t h Head Nurses and S u p e r v i s o r s d u r i n g the program p l a n n i n g stage - p e r f e r a b l y as a committee to j o i n t l y p l a n s c h e d u l i n g (33:35); thus a l l had more of a v e s t e d i n t e r e s t i n encouraging s t a f f t o a t t e n d . In R o c k w e l l 1 survey i n v o l v i n g a l a r g e number of h o s p i t a l s , o n l y seven per c e n t made no s c h e d u l i n g e f f o r t s f o r i n s e r v i c e programs (33:5). However, t h i s survey d i d not i n d i c a t e time spent by the i n s e r v i c e educator h e r s e l f on t h i s t a s k . Systematic e v a l u a t i o n procedures i n the program p l a n n i n g process seemed absent, a c c o r d i n g to some authors. Hornback s t a t e d there was a " p a u c i t y of r e p o r t s on e v a l u a t i o n from i n s e r v i c e educators which "may be a r e f l e c t i o n of a l a c k of s t a t e d program o b j e c t i v e s , c r i t e r i o n measures o f d e s i r e d behaviour, or inadequate a t t e n t i o n to or knowledge of the e v a l u a t i o n process " (46:36). Dorothy Kerr s t a t e d i n her study t h a t most e v a l u a t i o n procedures used f o r i n s e r v i c e programs are o f t e n meaningless: i t u s u a l l y t r a n s p i r e s t h a t the nurses who take the treatment (program) are asked to t e l l 'what i t has meant' to them. Answers are vaque and suspect (1:92). Cantor p o i n t e d out t h a t e v a l u a t i o n s based on the number of people a t t e n d i n g or the o p i n i o n s of nurses a t t e n d i n g a program on how good i t was "doesi.not pro-v i d e assurance of l e a r n i n g having taken p l a c e , nor the p a t i e n t subsequently b e n e f i t t i n g by improved c a r e " (6:53). I t was suggested t h a t i n s e r v i c e educators may not have spent much time, i f any a t a l l , i n e v a l u a t i o n a c t i v i t i e s . However, 30. some authors d i d r e v e a l an awareness of e v a l u a t i o n procedures when they suggested, f o r example, o b s e r v a t i o n of the l e a r n e r d u r i n g i n s t r u c t i o n and i n the c l i n i c a l area a f t e r i n s t r u c t i o n . The e v a l u a t i o n was based upon observable b e h a v i o u r a l changes i n the l e a r n e r and the extent to which p a t i e n t care improved as a r e s u l t (14:340, 17:81, 23:5). In a d d i t i o n to e v a l u a t i n g a c t u a l care d e l i v e r e d , M a r s h a l l spent time i n 1) making rounds wi t h the ward s u p e r v i s o r 2) checking kardexes ( a c a r d d e l i n e a t i n g p a t i e n t ' s i n d i v i d u a l n u r s i n g care plan) f o r q u a l i t y o f n u r s i n g care plans 3) checking p a t i e n t ' s c h a r t s f o r recorded o b s e r v a t i o n s made by s t a f f (20:44). A l s o Cantor noted t h a t time must be spent i n v a l i d a t i n g the e f f i c a c y o f outcomes when p r e l i m i n a r y and u l t i m a t e c r i t e r i o n behaviours are used i n . e v a l u a t i o n (6:53). P r e l i m i n a r y c r i t e r i a needed to be checked i n i t i a l l y a g a i n s t u l t i m a t e c r i t e r i a i n order to e s t a b l i s h the c o r r e l a t i o n between the two. Once accomplished through o b s e r v a t i o n o f l e a r n e r behaviour i n i n s t r u c t i o n a l and c l i n i c a l s e t t i n g s , p r e l i m i n a r y c r i t e r i a became r e l i a b l e and v a l i d , and thus an i n t e g r a l p a r t of the r e c y c l i n g process i n e s t a b l i s h i n g subsequent programs. To ensure t h a t c r i t e r i a were met, e v a l u a t i o n a c c o r d -i n g to o b j e c t i v e s was e s s e n t i a l . A few authors r e c o g n i z e d t h i s (27,31); one of them a l s o sought out c o n t a c t s and sources c o n s u l t e d during the assessment phase to h e l p her determine i f o b j e c t i v e s were ..met i n a g i v e n program (31:26). Other nurse educators i n the l i t e r a t u r e spoke of u s i n g planned q u e s t i o n and answer p e r i o d s , w r i t t e n t e s t s and r e t u r n demon-s t r a t i o n s of procedures as e v a l u a t i o n t o o l s (24:62). Reynolds and Drake recommended meeting r e g u l a r l y with s u p e r v i s o r y p e r s o n n e l , e s p e c i a l l y head nurses, who had the c l o s e s t s t a f f c o n t a c t and so c o u l d b e s t observe s t a f f p e r-formance (32:100). Tabin s t a t e d t h a t the educator must take time to meet wi t h the i n d i v i d u a l l e a r n e r to e v a l u a t e the l e a r n e r ' s performance; H o l l i n g w o r t h shared t h i s view (12:254, 38:943). Rockwell's study of f i v e hundred i n s e r v i c e edu-c a t o r s , quoted e a r l i e r i n t h i s review, i n d i c a t e d t h a t about 50% of the respondents s t a t e d t h e i r l e a r n e r s t u r n i n a w r i t t e n e v a l u a t i o n o f a program; but the study d i d not s t a t e of what these e v a l u a t i o n s c o n s i s t e d nor t h e i r b a s i s (34:40). In g e n e r a l , the l i t e r a t u r e i n d i c a t e d awareness of e v a l u a t i o n , but l i t t l e i n d i c a t i o n o f the educator's perform-ance of e v a l u a t i o n a c t i v i t i e s , and with no statement of frequency or t i m e - a l l o t m e n t f o r such a c t i v i t i e s . In terms of long-range program p l a n n i n g , the l i t e r a u r e i n d i c a t e d t h a t the bulk o f the i n s e r v i c e educator's a c t i v i t i e s i n t h i s area had been l i m i t e d to ad hoc "crash p l a n n i n g " (36:45). In t h i s short-term approach, the f i v e phases o f program p l a n n i n g were, a t b e s t m i n i m a l l y u t i l i z e d , and a t worst, n e g l e c t e d e n t i r e l y (36:45). Only one i n s e r v i c e 32. educator mentioned i n the l i t e r a t u r e a c t u a l l y p r o gressed from an ad hoc s e l e c t i o n o f m i s c e l l a n e o u s items to an o r g a n i z e d p l a n of l e a r n i n g i n a l a r g e p s y c h i a t r i c h o s p i t a l (31:26). I t appeared t h a t l i t t l e long-range p l a n n i n g o c c u r r e d (30:344, 35:31). Hornback s u b s t a n t i a t e d t h i s i n her study, s t a t i n g t h a t most i n s e r v i c e education programs i n her sample were planned l e s s than three months i n advance (28:87). I n s t r u c t i o n a l A c t i v i t i e s The i n s e r v i c e educator's p e r s o n a l involvement i n i n s t r u c t i o n a l a c t i v i t i e s depended p a r t i a l l y upon the degree t o which she u t i l i z e d c e n t r a l i z e d or d e c e n t r a l i z e d i n s e r v i c e programs. In c e n t r a l i z e d programs (thoseconfined to one h e a l t h agency, i n v o l v i n g a l l l e v e l s of p e r s o n n e l , i n which programs were agency-wide), the educator tended to spend more time i n a c t u a l i n s t r u c t i o n than i n d e c e n t r a l i z e d p r o -grams. In the d e c e n t r a l i z e d approach, the i n s e r v i c e educator a s s i s t e d p e r s onnel on a g i v e n u n i t w i t h i n the agency t o design t h e i r own prgrams, l e a v i n g the major r e s p o n s i b i l i t y f o r i n s t r u c t i o n t o the n u r s e - s u p e r v i s o r and her p e r s o n n e l (2:716). Here the educator might have spent some time a s s i s t -i n g the s p e c i f i c u n i t ' s head nurse or s u p e r v i s o r w i t h i n s t r u c -t i o n a l a c t i v i t i e s (15-97), and perhaps s u p e r v i s i n g a c t u a l i n s t r u c t i o n but she acted p r i m a r i l y as a resource person (15:97). The c e n t r a l i z a t i o n / d e c e n t r a l i z a t i o n phenomenon a l s o determined who the i n s e r v i c e educator taught and the amount of time spent w i t h persons i n each "job c l a s s i f i c a t i o n . In sm a l l h o s p i t a l s , where programs tended to be c e n t r a l i z e d (13), the i n s e r v i c e educator i n s t r u c t e d those w i t h a v a r i e t y of job c l a s s i f i c a t i o n s : r e g i s t e r e d nurses, p r a c t i c a l nurses (.L.P.N.'s and L.V.N.'s), a i d e s , housekeeping, d i e t a r y and c l e r i c a l s t a f f . However, the l i t e r a t u r e suggested t h a t i n l a r g e h o s p i t a l s with l a r g e d e c e n t r a l i z e d i n s e r v i c e departments, each i n s e r v i c e educator c o u l d be r e s p o n s i b l e f o r one job c l a s s i f i c a t i o n a t Veteran's H o s p i t a l i n Washington, each of f o u r i n s e r v i c e educators was r e s p o n s i b l e f o r one job c l a s s i -f i c a t i o n (10:9). In a d d i t i o n , with l a r g e d e c e n t r a l i z e d i n s e r v i c e education departments, d e c e n t r a l i z a t i o n c o u l d occur a c c o r d i n g to s p e c i a l t y areas. At M i c h a e l Reese H o s p t i a l , where the department employed seven i n s t r u c t o r s , each was ass i g n e d permanently to the u n i t of her s p e c i a l t y . f ( 1 1 : 9 1 ) and the i n s t r u c t o r spent the bulk of her i n s t r u c t i o n a l time i n a c t i v i t i e s a s s o c i a t e d with her s p e c i a l t y . Tabin favoured the d e c e n t r a l i z e d approach i n such s e t t i n g s enabled n u r s i n g personnel to focus on the s p e c i f i c p a t i e n t p o p u l a t i o n to whom they gave care (38:942). The l i t e r a t u r e gave l i t t l e i n d i c a t i o n r e g a r d i n g the amount o f time spent and frquency of i n s t r u c t i o n i n s p e c f i c content areas. However, there i s some i n d i c a t i o n t h a t i n s e r -v i c e educators i n v o l v e d themselves l a r g e l y w i t h i n s t r u c t i o n a l a c t i v i t i e s concerning o r i e n t a t i o n and s k i l l t r a i n i n g (53:56-59). Rudnick and B o l t e mentioned an example of a study r e v e a l i n g t h i s emphasis. Of 143 h o s p t i a l s surveyed i n the Ohio V a l l e y Region, the bulk of program p l a n n i n g c e n t e r e d on o r i e n t a t i o n and i n i t i a l s k i l l ' t r a i n i n g , w i t h o n l y a few i n c l u d i n g ongoing i n s e r v i c e programs (3 5:31). The h i g h turnover r a t e o f n u r s i n g personnel i n many h o s p i t a l s may have c o n t r i b u t e d to t h i s s t a t e of a f f a i r s . In support of such a concept, Nakamoto and Verner quoted one i n s e r v i c e educator who s a i d : "Because of a r a p i d turnover of p e r s o n n e l , our audience i s a parade." (53:13). Rockwell.ls survey o f f i v e hundred i n s e r v i c e educators r e v e a l e d t h a t 87% of them focused on o r i e n t a t i o n , while o n l y seven per cent had any ongoing c o n t i n u i n g education programs (33:6). A few authors mentioned t h e i r i n s e r v i c e involvement as i n s e r v i c e educators i n some oth e r content a r e a s : 1) l e a d e r -ship and management 2) new drugs and equipment 3) s p e c i f i c n u r s i n g techniques (26,20:39,21:299). There was s l i g h t mention of m i s c e l l a n e o u s areas such as f i r e p r e v e n t i o n and d r i l l s , d i s a s t e r o p e r a t i o n s and g e n e r a l s a f e t y (26,38:942) but no i n d i c a t i o n s as to amount o f time the educators spent p l a n -ning and i n s t r u c t i n g such programs. S up e r v i s ory Ac t l v l t i e s The l i t e r a t u r e i n c l u d e d s c a t t e r e d r e f e r e n c e s to s u p e r v i s o r y a c t i v i t i e s performed by i n s e r v i c e educators (13/18,53). One?reference s t a t e d t h a t " c o n f u s i o n .... a r i s e s between a d m i n i s t r a t i v e and e d u c a t i o n a l f u n c t i o n s " (51:13) and went on to l i s t some s u p e r v i s o r y a c t i v i t i e s (51:13-14) o f t e n performed by i n s e r v i c e educators. I n d i c a t i o n s were t h a t i n s e r v i c e educators i n s m a l l h o s p i t a l s performed more o f these a c t i v i t i e s than those i n l a r g e r h o s p i t a l s (13:16). P a r t i c i p a t i o n i n P o l i c y Making and Decision-Making A c t i v i t i e s There was l i t t l e i n the l i t e r a t u r e to i n d i c a t e amount of time spent i n p o l i c y making and d e c i s i o n making a c t i v i t i e s by i n s e r v i c e educators. Some a c t i v i t i e s t h a t c o u l d suggest involvement i n p o l i c y d e c i s i o n s were as f o l l o w s : 1) Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee to e s t a b l i s h n u r s i n g p o l i c y and phulosopy 2) Meeting w i t h n u r s i n g procedure committee 3) Meeting with the head nurse committee (51) 4) Meeting w i t h the h o s p i t a l a d v i s o r y committee (46). As an a c t i v e member of the f i r s t committee, the educator became an i n f o r m a t i o n g i v e r , as w e l l as v o t e r , and thus became an a c t i v e p a r t i c i p a n t i n changing h o s p i t a l p h i l o s o p h y and p o l i c y . The same a p p l i e d to membership i n the n u r s i n g p r o-cedure committee. As a member o f the t h i r d committee, the i n s e r v i c e educator became an i n f o r m a t i o n t r a n s m i t t e r and p a r t i c i p a t e d i n implementation of new p o l i c y . F i n a l l y , as a member of the f o u r t h committee, u s u s a l l y composed of r e p r e s e n t a t i v e s from a l l departments o f the h o s p i t a l , the educator kept c u r r e n t on the l e a r n i n g needs and g o a l s o f oth e r h o s p i t a l departments. Other a c t i v i t i e s i n v o l v e d i n p o l i c y decision-making concerned establishment o f the budget f o r i n s e r v i c e education (51). Some of these a c t i v i t i e s c o u l d have i n c l u d e d : 1) meet-ings with the D i r e c t o r of Nursing and h o s p i t a l a d m i n i s t r a t o r to d i s c u s s budgetary problems 2) o r g a n i z i n g and p l a n n i n g u t i l i z a t i o n of budget. M i s c e l l a n e o u s A c t i v i t i e s The l i t e r a t u r e made l i t t l e or no mention of the v a r i o u s miscella:ny of the i n s e r v i c e educator's day..'' These a c t i v i t i e s i n c l u d e d such items as d r a f t i n g memos, re a d i n g and answering m a i l , and telephone a c t i v i t i e s . In a d d i t i o n , the l i t e r a t u r e reviewed d i d not suggest f r e q u e n c i e s or time a l l o t -ments f o r such a c t i v i t i e s . Methodology and Other A c t i v i t y and Role S t u d i e s A review of a c t i v i t y and r o l e s t u d i e s i n areas o t h e r than the nurse :as i n s e r v i c e educator r e v e a l e d some v a r i e t y i n methodology. Goldsmith's study concerned task a n a l y s i s of n u r s i n g f u n c t i o n s o f r e g i s t e r e d nurses, l i c e n s e d v o c a t i o n a l nurses and nurses a i d e s , o r g a n i z e d i n t o c a t e g o r i e s , such as d i v e r s i o n a l a c t i v i t i e s , s a f e t y and p r o t e c t i o n of the p a t i e n t , p e r s o n a l hygiene f o r the p a t i e n t and meeting p a t i e n t ' s n u t r i t i o n and e l i m i n a t i o n needs (44:3). The study used a panel of 48 h o s p i t a l s and drawn from t h a t panel was a p o p u l a t i o n r e p r e s e n t a -t i v e of a l l the aforementioned o c c u p a t i o n a l groups. The i n s t r u -ment i n c l u d e d a frequency s c a l e but no time a l l o t m e n t appeared. A c t i v i t i e s were ranked i n the a n a l y s i s a c c o r d i n g to frequency (44:100) with some c o r r e l a t i o n s made to demographic data o b t a i n e d such as type and s i z e o f h o s p i t a l , area o f p a t i e n t care, age, sex, m a r i t a l s t a t u s , e d u c a t i o n and e x p e r i e n c e ( 4 4 ) . C r o t i n ' s study focused on the n u r s i n g s u p e r v i s o r ' s p e r c e p t i o n of her f u n c t i o n s and a c t i v i t i e s (42). Sample s i z e was s m a l l , a t a t o t a l of e i g h t e e n . The r e s e a r c h e r drew her respondents from s i x g e n e r a l acute care h o s p i t a l s v a r y i n g i n s i z e from 301 beds to 600 beds (42). A c t i v i t i e s d i v i d e d i n t o f o u r a c t i v i t y c a t e g o r i e s from which were d e r i v e d 37 statements of f u n c t i o n . C r o t i n used a s t r u c t u r e d " f i x e d - a l t e r n a t i v e " q u e s t i o n i n which the respondent was l i m i t e d to s t a t e d a l t e r n a t i v e s such as: 1) "yes" or "no" 2) v a r y i n g degrees of approval or agreement 3) a s e r i e s of r e p l i e s , of which the respondent p i c k e d one as being c l o s e s t to h i s or her p o s i t i o n (42:20). Item #6 i n C r o t i n ' s q u e s t i o n n a i r e asked f o r the f i r s t two types o f f i x e d a l t e r n a t i v e s : 38. Item #6 A c q u i r e s p e c i a l equipment, s u p p l i e s and drugs f o r a p a t i e n t u n i t as needed p e r i o d i c a l l y a. Do you do t h i s ? Yes No ' b. Do you t h i n k you should do t h i s ? Disagree Agree ' Unsure (42:63) C r o t i n found t h a t the n u r s i n g s u p e r v i s o r s c o u l d not agree upon i d e a l f u n c t i o n s , and t h a t no c l e a r d e f i n i t i o n of f u n c t i o n emerged (42:47-50). No frequency s c a l e s or time a l l o t m e n t s appeared i n the q u e s t i o n a i r e . Tomlinson developed 99 statements of n u r s i n g func-t i o n to p r o v i d e a r e p r e s e n t a t i v e sample of a c t i v i t i e s t h a t l i c e n s e d p r a c t i c a l nurses (LPNs) might perform (54:178). In p e r s o n a l i n t e r v i e w , 688 LPNs s o r t e d out these statements of a c t i v i t i e s or f u n c t i o n s a c c o r d i n g to degree of r e s p o n s i -b i l i t y r e q u i r e d and t h e i r importance. Statements d i v i d e d i n t o f o u r c a t e g o r i e s : . "I perform t h i s f u n c t i o n ( a c t i v i t y ) 1) independently 2) with shared r e s p o n s i b i l i t y 3) under d i r e c t s u p e r v i s o n or 4) I never perform t h i s f u n c t i o n " (54:178). The LPNs then ranked a c t i v i t i e s a c c o r d i n g to importance. High, p o s i t i v e and s i g n i f i c a n t c o r r e l a t i o n s e x i s t e d between l e v e l of r e s p o n s i b i l i t y and importance rank-i n g (54:182). Thus, although the study concerns an a c t i v i t y p r o f i l e , a gain, no time a l l o t m e n t or frequency s c a l e appears. A number of other s t u d i e s f o c u s i n g on a c t i v i t i e s o f a g i v e n o c c u p a t i o n a l group appeared i n the l i t e r a t u r e . 39. Wood's study l i s t e d a c t i v i t i e s f o r the purpose o f h e l p i n g to e s t a b l i s h b e h a v i o u r a l o b j e c t i v e s f o r the b a s i c n u r s i n g c u r r i c u l u m a t U.C.L.A. Wood v e r i f i e d t h i s l i s t by a s k i n g r e g i s t e r e d nurses i n a n a t i o n a l survey to rank them i n order of frequency (57:3-24). However, she d i d not u t i l i z e time a l l o t m e n t s . C u l l e n ' s study, while i t l i s t e d a c t i v i t i e s o f pharmacy t e c h n i c i a n s i n the appendix focused l a r g e l y on procedures used by the pharmacies i n g e n e r a l , not upon the s p e c i f i c a c t i v i t i e s of the pharmacy t e c h n i c i a n s (43). Hole's study on d i r e c t o r s of h o s p i t a l e ducation i n v o l v e d 81 respon-dents who ranked 49 statments o f f u n c t i o n a c c o r d i n g to importance, however, the instrument d i d not use time a l l o t -ments or frequency s c a l e s (45). McLean'.s a c t i v i t y study focused on s e v e r a l c a t e g o r i e s of n u r s i n g personnel such as s u p e r v i s o r s , head nurses, s t a f f nurses, LPNs and o r d e r l i e s (49:4). Data was ob t a i n e d by o b s e r v a t i o n of each s u b j e c t d u r i n g a working day. Exact statements of time and f r e -quency d i d not appear i n t h i s study. However, t i m i n g o f the o b s e r v a t i o n p e r i o d was recorded. In the coding p r o c e s s , the a c t u a l time was "weighted", r e d u c i n g i t to one hour of o b s e r v a t i o n time f o r each member of the n u r s i n g s t a f f . Thus, one hour.became equal to 100% (49:1). In A l l e n ' s study of head nurse a c t i v i t i e s , he a l s o used d i r e c t o b s e r v a t i o n f o r one s p e c i f i c eight-hour s h i f t (41). Time f o r each a c t i v i t y was recorded i n minutes and transposed i n t o percentages o f the eight-hour p e r i o d . The major o b j e c t i v e was to determine the 40. head nurses' a c t i v i t e s which d i v i d e d i n t o : 1) d i r e c t p a t i e n t care 2) p e r s o n n e l a c t i v i t i e s 3) u n i t management 4) student education 5) i n d i r e c t care (41:8). Respondents were asked to r e p o r t socioeconomic data such as m a r i t a l s t a t u s educa-t i o n a l p r e p a r a t i o n , and experience: A l l e n used t h i s informa-t i o n to a s c e r t a i n i f such socioeconomic i n f o r m a t i o n had any b e a r i n g on amount of time the head nurse spent i n d i r e c t p a t i e n t care (41:16-17). Of a l l the a c t i v i t y s t u d i e s reviewed A l l e n ' s study most c l o s e l y approximated the methodology used i n t h i s study. The common f a c t o r s were: a) the major o b j e c t i v e , ..that i s to determine the a c t i v i t y p r o f i l e of the o c c u p a t i o n a l growing being s t u d i e d b) d i v i s i o n of a c t i v i t i e s i n t o c a t e g o r i e s c) u s i n g a time a l l o t m e n t i n minutes d) use of socioeconomic data f o r c o r r e l a t i o n . However, d i v e r g e n t elements i n c l u d e d a) use of o b s e r v a t i o n to o b t a i n a c t i v i t y data (not used i n t h i s study) b) A l l e n ' s l a c k of frequency s c a l e . Hornback's study focused on n u r s i n g i n s e r v i c e program not the i n s e r v i c e educator per se (46). She d i d ask a few q u e s t i o n s concerning time and frequency o f i n s e r v i c e programs; use of resource persons, and one g e n e r a l q u e s t i o n r e g a r d i n g the hours per week devoted to i n s e r v i c e a c t i v i t i e s i n g e n e r a l . (46:91) Con c l u s i o n s In g e n e r a l , t h i s review r e v e a l e d t h a t very few a r t i c l e s or s t u d i e s i n the f i e l d o f i n s e r v i c e education: focused d i r e c t l y upon the i n s e r v i c e educator's p e r c e p t i o n of a c t i v i t i e s she performs, nor the time and frequency elements i n v o l v e d i n each a c t i v i t y . ' However, the l i t e r a -t u r e d i d p r o v i d e some i n d i c a t o r s . With regard to the i n s e r v i c e educator h e r s e l f , t h e ' i n f o r m a t i o n a v a i l a b l e on socioeconomic and demographic data was r a t h e r sparse, with somewhat more a v a i l a b l e on her e d u c a t i o n a l background. Some s t u d i e s and a r t i c l e s a l s o spoke a t some l e n g t h about the nature of the i n s e r v i c e educator's job s e t t i n g . Much more appeared i n the l i t e r a t u r e on a c t i v i t i e s performed by the i n s e r v i c e educator. A rough approximation of a p r o f i l e thus emerged. The l i t e r a t u r e i n d i c a t e d t h a t the i n s e r v i c e educator was female, 41 t o 45 years of age, was married and had two to three dependents. She was a graduate of a h o s p i t a l s c h o o l of n u r s i n g and was u n l i k e l y to have had a u n i v e r s i t y degree. She probably had l i t t l e or no p r e p a r a t i o n i n such areas as a d u l t e d u c a t i o n , , s t a t i s t i c s and e d u c a t i o n a l psychology. Regarding involvement i n c o n t i n u i n g e d u c a t i o n , the l i t e r a -t u r e was not s p e c i f i c except to remark t h a t the i n s e r v i c e i n s t r u c t o r was not l i k e l y t o read r e s e a r c h j o u r n a l s or belong to a p r o f e s s i o n a l o r g a n i z a t i o n other, than her l o c a l nursing a s s o c i a t i o n . In her job s e t t i n g , the s i z e of the h o s p i t a l i n which she worked and the h a n d l i n g of the i n s e r v i c e e d u c a t i o n budget i n f l u e n c e d her f u n c t i o n i n g . I f she worked i n a s m a l l h o s p i t a l , she was l i k e l y t o be performing a l o t of n o n - i n s e r v i c e r e l a t e d t a s k s . In l a r g e h s o p i t a l s she worked f u l l - t i m e as an i n s e r v i c e educator. I f her budget came under another depart-ment, she found her a l l o c a t i o n s v a r y i n g , not a c c o r d i n g t o the i n s e r v i c e department's needs, but a c c o r d i n g to the larger:' department such as n u r s i n g s e r v i c e under which she f u n c t i o n e d . In terms of a c t i v i t i e s , she probably d i d not spend as much time as needed on systematic program p l a n n i n g although a d e f i n i t e awareness of the need to perform these a c t i v i t i e s e x i s t e d . The time spent i n i n s t r u c t i o n a l a c t i v i t i e s v a r i e d a c c o r d i n g to whether or not c e n t r a l i z e d or d e c e n t r a l i z e d programming e x i s t e d . I f the educator worked i n a l a r g e h o s p i t a l , d e c e n t r a l i z a t i o n tended to be the r u l e . A l s o i f the i n s e r v i c e educator worked i n a l a r g e h o s p i t a l , she per-formed fewer s u p e r v i s o r y a c t i v i t i e s than those i n s m a l l e r h o s p i t a l s . F i n a l l y , the l i t e r a t u r e reviewed gave l i t t l e or no i n d i c a t i o n of policy-making or decision-making and mis-c e l l a n e o u s a c t i v i t i e s performed by the i n s e r v i c e educator. The f i n a l s e c t i o n i n t h i s review on methodology of other a c t i v i t y and r o l e s t u d i e s r e v e a l e d c o n s i d e r a b l e v a r i a t i o n . S e v e r a l employed frequency s c a l e s and importance r a n k i n g s . Another used a " f i x e d a l t e r n a t i v e " method f o r the instrument. S t i l l another used r a n k i n g a c c o r d i n g to degree of r e s p o n s i b i l i t y r e q u i r e d i n performing the a c t i v i t y . Only one study o b t a i n e d p r e c i s e data r e g a r d i n g amount of time spent on v a r i o u s a c t i v i t i e s . S t u d i e s reviewed d i d not employ both time and frequency scales to determine a c t i v i t y p r o f i l e s i any occupational grouping. No study was•located on the inservice educator's a c t i v i t y p r o f i l e , described i n terms time i n minutes and frequency. Thus, since so few a r t i c l e or studies dealt d i r e c t l y with the inservice educator's a c t i v i t y p r o f i l e i n terms of time and frequency, i t was concluded that a study with such a focus would be of some value. 44. CHAPTER III METHODOLOGY After a determination of the main purpose of the study, which was to describe the inservice educator's actual and id e a l a c t i v i t y p r o f i l e , a statement of research problems was formulated. This was followed by a process of instrument development. A population of inservice educators was chosen for study, data was col l e c t e d and then analyzed. Statement of Problems The study attempted to answer the following two research questions: A. What was the inservice educator's perception of her present a c t i v i t y p r o f i l e i n terms of 1) type a c t i v i t y and 2) the time frequency elements involved i n each a c t i v i t y ? T h i s q u e s t i o n asked f o r the...frequency with which the educator performed given a c t i v i t i e s and amount of time spent on those a c t i v i t i e s . B. What was the i n s e r v i c e educator's p e r c e p t i o n of her i d e a l a c t i v i t y p r o f i l e i n terms of 1) type of a c t i v i t y and 2) the time/frequency elements i n v o l v e d ? The purpose f o r i n c l u d i n g q u e s t i o n B i n t h i s study was t o : 1) a s c e r t a i n the respondent's s a t i s f a c t i o n w i t h t h e i r a c t u a l a c t i v i t y p r o f i l e and 2) determine the s p e c i f i c changes respondents would make to c r e a t e an i d e a l a c t i v i t y p r o f i l e f o r the i n s e r v i c e educator. The study a l s o attempted to answer the f o l l o w i n g a u x i l i a r y q u e s t i o n s c e n t e r i n g upon f a c t o r s t h a t c o u l d d e s c r i b e the p o p u l a t i o n and might c o r r e l a t e w i t h responses to the main r e s e a r c h q u e s t i o n s : A. What were the c h a r a c t e r i s t i c of the agency i n which the i n s e r v i c e educator f u n c t i o n e d , i n c l u -ding bed c a p a c i t y , s i z e of the i n s e r v i c e edu-c a t i o n department, e x i s t e n c e of a s c h o o l of n u r s i n g , and l e n g t h of time i n s e r v i c e edu-c a t i o n has e x i s t e d i n the respondent's h o s p i t a l ? B. What were the socioeconomic c h a r a c t e r i s t i c s of the i n s e r v i c e educator, i n c l u d i n g age, m a r i t a l s t a t u s , number of dependents, e d u c a t i o n a l back-ground and l e n g t h o f time employed i n the p r e s e n t job p o s i t i o n . C. In what c o n t i n u i n g education a c t i v i t i e s d i d the i n s e r v i c e educator p a r t i c i p a t e ? These i n c l u d e d s h o r t and l o n g courses l e s s than 30 hours and more than 30 hours r e s p e c t i v e l y , p r o -f e s s i o n a l meetings, r e a d i n g o f p r o f e s s i o n a l j o u r n a l s and the respondent's own p l a n f o r c o n t i n u i n g e d u c a t i o n . Instrument Development The l i t e r a t u r e review i n d i c a t e d t h a t no study spec-i f i c a l l y l i s t e d and c a t e g o r i z e d the i n s e r v i c e educator's job a c t i v i t i e s , nor e s t a b l i s h e d time and frequency f o r those a c t i v i t i e s . However, the review was u s e f u l : f o r d e r i v i n g a c t i v i t y c a t e g o r i e s as f o l l o w s : 1) program p l a n n i n g 2) i n s t r u c t i o n 3) s u p e r v i s i o n 4) p o l i c y and decision-making and 5) mi s c e l l a n e o u s a c t i v i t i e s . These c a t e g o r i e s formed the b a s i c s t r u c t u r e of the i n i t i a l instrument. A pan e l of judges then assessed the i n i t i a l instrument as p a r t of the process i n v o l v e d i n producing a more c o n c i s e q u e s t i o n n a i r e . The major o b j e c t i v e d u r i n g the p e r i o d of instrument development was to d e r i v e an a p p r o p r i a t e l a y o u t f o r the q u e s t i o n n a i r e t h a t would maximize accuracy of data o b t a i n e d . I t was f u r t h e r hoped t h a t the r e s u l t i n g instrument would be of some use as a guide f o r subsequent r e s e a r c h e r s . The use 47. of a judging panel to review the i n i t i a l instrument;: seemed to be the most a p p r o p r i a t e method of a s s e s s i n g l a y -out and content i n the i n t e r e s t of i n c r e a s e d accuracy of the q u e s t i o n n a i r e i n o b t a i n i n g d e s i r e d data. The r e s u l t i n g q u e s t i o n n a i r e was designed so t h a t the two main r e s e a r c h q u e s t i o n s and the a u x i l i a r y sub-questions c o u l d be answered. A pa n e l of judges was chosen to assess the o r i g i n a l instrument (see Appendix C). Each pan e l member chosen had e x p e r t i s e i n one or more of the f o l l o w i n g areas: 1) b a s i c n u r s i n g education 2) c o n t i n u i n g education 3) i n s e r v i c e e d u c a t i o n . S e v e r a l p a n e l members had c o n s i d e r a b l e p r e v i o u s experience i n i n s e r v i c e education i n h o s p i t a l s e t t i n g s . The judges i n c l u d e d a h o s p i t a l a s s o c i a t i o n e d u c a t i o n d i r e c t o r , a c o l l e g e n u r s i n g department chairman and e x e c u t i v e a s s i s t a n t i n h e a l t h s c i e n c e s i n s t r u c t i o n , two a s s i s t a n t d i r e c t o r s of education s e r v i c e s i n the p r o v i n c i a l r e g i s t e r e d nurses' association,, and a c u r r i c u l u m c o o r d i n a t o r i n a c o l l e g e n u r s i n g department. The i n i t i a l q u e s t i o n n a i r e was d i s c u s s e d d u r i n g a p e r s o n a l i n t e r v i e w w i t h each judge a f t e r a d i s c u s s i o n of r e s e a r c h q u e s t i o n s to be answered. Judges were not asked to respond with s t a t i s t i c a l data, but r a t h e r to assess the l a y o u t and content w i t h r e s p e c t to the r e s e a r c h q u e s t i o n s . A s s e s s -ments, c r i t i c i s m s , and suggestions were noted, c o l l e c t e d and a p p r o p r i a t e a l t e r a t i o n s made. The d r a f t instrument, a c c o r d i n g to the judges, r e -48. q u i r e d s e v e r a l changes, d e l e t i o n s and a d d i t i o n to i n c r e a s e i t s c l a r i t y and accuracy (see Appendix A and B). Judges f e l t t h e r e were a number of redundancies. For example, i n P a r t I, Questions 14 to 22 i n c l u d e d a s e c t i o n a s k i n g the respondent to i n d i c a t e f e e l i n g s about her job. Judges f e l t t h i s c o u l d be more adequately d e a l t with by a n a l y z i n g responses to the i d e a l a c t i v i t y p r o f i l e i n P a r t I I , i n d i c a t -i n g the respondents 1 s a t i s f a c t i o n or d i s s a t i s f a c t i o n with a c t u a l a c t i v i t y p r o f i l e . In another i n s t a n c e , d e l e t i o n was r e q u i r e d when judges noted t h a t one s e c t i o n concerning frequency of c e r t a i n methods, techniques and dev i c e s seemed u n r e l a t e d t o the main r e s e a r c h q u e s t i o n s . Judges p o i n t e d out t h a t the study's focus was on a c t i v i t y p r o f i l e s , not methods and techniques. Judges suggested a number of important changes f o r the a c t i v i t y p r o f i l e s e c t i o n . For i n s t a n c e , the frequency s c a l e was a l t e r e d t o add "two times per week" between "once per week" and " d a i l y " . They noted t h a t some of the educator's a c t i v i t i e s would occur more f r e q u e n t l y than once a week but l e s s o f t e n than d a i l y . The panel a l s o a dvised t h a t the a c t i v i t y p r o f i l e s e c t i o n should not separate i n t o s e c t i o n s or c a t e g o r i e s . Removal of these a c t i v i t y headings was seen ,as be i n g l e s s c o n f u s i n g and p r e j u d i c i a l f o r the respondent. For example, some respondents might f e e l uneasy i f they p l a c e a high value on being a decision-maker, but f i n d they spend more time i n m i s c e l l a n e o u s a c t i v i t i e s , and so c o u l d 49. unintentionally bias t h e i r responses. I t was suggested that the headings appear on the researcher's own coding key for organizational purpose i n tabulating data. To ensure accuracy of time intervals and e d i t o r i a l change was made so that the term "minutes" appeared next to the "time" heading under actual and ide a l job headings. Judges f e l t that the entire a c t i v i t y p r o f i l e section required rewording, some reorganization and deletions. In addition, the panel pointed out problems with double-barrelled questions, such as one item r e f e r r i n g to "securing and main-, taining i n s t r u c t i o n a l material and references". In such questions, i t was almost impossible to discern which part of the question received response. In general, changes advised by the panel included rewording, more precise d e f i n i t i o n s and deletions of items not relevant to the study's research questions. The panel's responses were noted and incorporated into the revised instrument, which was then used for data, c o l l e c t i o n ; Population The population surveyed was comprised of twenty-four inservice educators from eleven acute care general hospitals of varying size i n the Greater Vancouver and Greater V i c t o r i a areas. Ten of the respondents came from one large teaching hospit a l , and fourteen respondents came from ten other 5 0 . h o s p i t a l s . Thus, t h i s study was not u s e f u l i n g e n e r a l i z i n g to p o p u l a t i o n s other than the s m a l l one s p e c i f i c a l l y i n v e s t -i g a t e d here. However, i t was hoped t h a t the i n v e s t i g a t i o n would serve a u s e f u l f u n c t i o n as an e x p l o r a t o r y study, estab-i s h i n g a p o s s i b l e a c t i v i t y p r o f i l e t h a t c o u l d be t e s t e d on l a r g e r p o p u l a t i o n s . Data C o l l e c t i o n The twenty-four i n s e r v i c e educator respondents were surveyed with an i n t e r v i e w schedule between J u l y and September, 1974 (see Appendix B - l , E - l and E-2),. The educators were i n t e r v i e w e d i n t h e i r employing h o s p i t a l s . None r e f u s e d to p a r t i c i p a t e as respondents i n t h i s study. The r a t i o n a l e f o r use of the i n t e r v i e w was t w o f o l d : 1) r e d u c t i o n i n amount of time r e q u i r e d on the p a r t of the respondent and 2) assurance and accuracy of r e t u r n , as the a l l o w a b l e a t t r i t i o n w i t h such a s m a l l p o p u l a t i o n was almost n e g l i g i b l e . Data A n a l y s i s The i n e r v i e w schedule i n c l u d e d nominal, o r d i n a l and i n t e r v a l data. T h i s i n f o r m a t i o n was analyzed on an O l i v e t t i -Underwood Programua 101 Computer. A program was used to c a l c u l a t e means standard d e v i a t i o n s , standard e r r o r and modes where a p p l i c a b l e . Data was t r a n s f e r r e d to the Texas I n s t r u -ment C a l c u l a t o r TI-30 to perform non-parametric t e s t s and other a p p l i c a b l e c a l c u l a t i o n s . 51. CHAPTER IV DATA ANALYSIS A n a l y s i s of data o b t a i n e d f o r t h i s study focused on two major r e s e a r c h q u e s t i o n s . The f i r s t q u e s t i o n concerned the i n s e r v i c e educators' p e r c e p t i o n of t h e i r a c t u a l a c t i v i t y p r o f i l e s i n terms of the type of a c t i v i t y , and the time as w e l l as frequency f a c t o r s i n v o l v e d i n each a c t i v i t y . The second major q u e s t i o n concerned the educators' p e r c e p t i o n o f t h e i r i d e a l p r o f i l e i n terms o f the type o f a c t i v i t y , and the time as w e l l as frequency, f a c t o r s i n v o l v e d . Other s o c i o -economic data was a l s o i n c l u d e d i n the a n a l y s i s . The f i n d i n g s are r e p o r t e d i n s e c t i o n s . The i n i t i a l s e c t i o n examined the c h a r a c t e r i s t i c s o f the i n s e r v i c e educators and t h e i r job s e t t i n g s . These c h a r a c t e r i s t i c s i n c l u d e d age, m a r i t a l s t a t u s , number of dependents, e d u c a t i o n a l back-ground and involvement, and l e n g t h of time i n p r e s e n t job p o s i t i o n . Aspects of the j c c o b s e t t i n g i n c l u d e d bed c a p a c i t y , s i z e of the i n s e r v i c e e ducation department, and the l e n g t h of time i n s e r v i c e e d u c a t i o n was i n e x i s t e n c e a t the respon-dent's h o s p i t a l . The s e c t i o n f o l l o w i n g d e a l t w i t h the i n s e r v i c e educators' p e r c e p t i o n of t h e i r a c t u a l and i d e a l a c t i v i t y p r o f i l e s , based on time and frequency v a l u e s they a s s i g n e d to a c t i v i t i e s l i s t e d i n the q u e s t i o n n a i r e . A l l a c t i v i t i e s were d i v i d e d i n t o the f i v e major c a t e g o r i e s of program p l a n n i n g , i n s t r u c t i o n , s u p e r v i s i o n , p o l i c y d e c i s i o n making and m i s c e l l a n e o u s . The s e c t i o n concerning a c t u a l a c t i v i t y p r o f i l e s f i r s t ranked a c t i v i t i e s w i t h i n t h e i r a s s i g n e d c a t e g o r i e s , a c c o r d i n g to mean amount of time spent on each c a t e g o r y as a whole. Then, the a c t i v i t i e s were ranked a c c o r d i n g to mean frequency, again w i t h a s s i g n e d c a t e g o r i e s , to determine the l e v e l of frequency f o r each a c t i v i t y and f o r each category as a whole. F i n a l l y , a c t i v i t i e s w i t h i n each category were ranked a c c o r d i n g to t o t a l hours per y e a r . I t was f e l t t h a t s i n c e t o t a l hours per year f o r each a c t i v i t y took i n t o account both time and frequency, a more complete view of a c t i v i t y ranks c o u l d be obrained. The s e c t i o n devoted to i d e a l p r o f i l e s used the same d e s c r i p t i o n process w i t h the a c t u a l p r o f i l e s , r a n k i n g a c t i v i t i e s a c c o r d i n g to mean time, mean frequency and t o t a l hours per ye a r . In the s e c t i o n comparing a c t u a l and i d e a l p r o f i l e s , the t o t a l hours per year were examined and d i s c r e p a n c y scores o b t a i n e d to determine those a c t i v i t i e s i n which educators wished to see a r e d i s t r i b u t i o n of time. The a c t i v i t i e s were then ranked i n c a t e g o r i e s a c c r o d i n g to amount of d i s c r e -pancy between a c t u a l and i d e a l hours per year. The l a s t s e c t i o n examined socioeconomic f a c t o r s a s s o c i a t e d w i t h a c t u a l a c t i v i t y p r o f i l e s t o determine c o r r e l a -t i o n s . These f a c t o r s i n c l u d e d age, h o s p i t a l s i z e , c o n t i n u i n g education and time employed i n p r e s e n t job. C h a r a c t e r i s t i c s of the I n s e r v i c e Educator The mean age of t h i s group of female i n s e r v i c e educators was 40, and approximately 58% were between 30 and 44 years o f age. The m a j o r i t y were s i n g l e , with o n l y 17% separated, widowed or d i v o r c e d . Over 79% had no dependents and only one respondent had t h r e e . A l l respondents had a b a s i c n u r s i n g diploma and i n a d d i t i o n 29% a l s o had non-nursing diplomas. Of those who had earned a Bachelor of Science i n Nursing, only three respondents out of the t o t a l e l e v e n had a b a s i c degree. The ot h e r s had taken t h e i r degree as a p o s t - b a s i c program, f o l l o w i n g a n u r s i n g diploma program. The major course o f study v a r i e d , w i t h the respondents majoring i n one of f i v e a r e a s : e d u c a t i o n , a d m i n s t r a t i o n , t e a c h i n g , p s y c h i a t r y or m a t e r i a l - c h i l d h e a l t h . In o n l y two i n s t a n c e s was there a minor, i n m e d i c a l - s u r g i c a l n u r s i n g . The le n g t h of program v a r i e d from one to four y e a r s . Those with a non-nursing diploma r e c e i v e d i t i n one of f i v e areas: n u r s i n g w i t h a d m i n i s t r a t i o n , t e a c h i n g and s u p e r v i s i o n , o p e r a t i n g room technique, a d m i n i s t r a t i o n of h o s p i t a l n u r s i n g u n i t s and p u b l i c h e a l t h . Only two respon-dents had Masters' degrees and there were none with d o c t o r a t e s . In a l l , twenty-one respondents had some k i n d o f formal edu-c a t i o n beyond a b a s i c n u r s i n g diploma. In a d d i t i o n , three respondents had o n l y a n u r s i n g diploma. More a d d i t i o n a l courses taken by t h i s group o f educators were l e s s than 30 c o n t a c t hours, w i t h the h i g h e s t percentage i n both s h o r t and longer courses being taken i n the s u b j e c t category e n t i t l e d "other". The respondents i n c l u d e d i n t h i s c a t e g o r y : E n g l i s h , i n t e r p e r s o n a l r e l a t i o n s , i n d u s t r i a l f i r s t a i d , p a t i e n t e d u c a t i o n , c o n t i n u i n g education conferences, n u r s i n g a u d i t , q u a l i t y care assurance and coronary and c r i t i c a l c a r e . E i g h t respondents of the t o t a l 24, approximat y 33%, took courses o n l y i n the category e n t i t l e d "other" and i n none of the s u b j e c t s s p e c i f i c a l l y l i s t e d . However, a l l b.ut one respondent had a t some p o i n t taken a s h o r t or extended course i n one or more of the sub-j e c t s l i s t e d i n Table IV. In a d d i t i o n t o the l a s t category TABLE 1 Age D i s t r i b u t i o n of Respondents Age Group No. Less than 2 5 0 0 25 - 29 3 13 30 - 34 4 17 35 - 39 5 21 40 - 44 5 21 45 - 49 1 4 50 - 55 5 21 More than 55 1 4 T o t a l 24 100 TABLE 2 M a r i t a l Status of Respondents Status No. % S i n g l e 13 54 Ma r r i e d 7 2 9 Other 4 17 (separated, widowed, divorced) T o t a l 34 100 TABLE 3 Number of Dependents Dependents per Respondent No. % 0 19 79 1 2 8 2 2 8 3 1 4 T o t a l 24 100 TABLE 4 Number of Short and Extended Courses Taken by Respondents Subject Area More than 30 c o n t a c t hours Less than 30 c o n t a c t hours E d u c a t i o n a l Psychology P r i n c i p l e s of Teaching and Learning T e s t s and Measurements Philosophy of E d u c a t i o n Group Dynamics Audio V i s u a l M a t e r i a l s P hilosophy and H i s t o r y of A d u l t E d u c a t i o n Program P l a n n i n g Teaching Techniques i n A d u l t E d u c a t i o n Other courses T o t a l X (courses/ respondent) 1 2 2 5 11 .45 9 18 18 45 100 2 3 1 6 10 19 63 2.62 14 3 5 14 2 10 16 30 100 appearing on the t a b l e , the other t h r e e s u b j e c t s i n which a h i g h e r percentage of courses were taken i n c l u d e d p r i n c i p l e s of t e a c h i n g and l e a r n i n g , a u d i o v i s u a l m a t e r i a l s and t e a c h i n g _ techniques i n a d u l t e d u c a t i o n . The h i g h e s t percentage of t h i s group spent one to 2.5 hours per week on t h e i r own c o n t i n u i n g e d u c a t i o n , w i t h the mean f o r the group being 4.9 hours per week. Approximately 39% spent three to 4.5 hours per week r e a d i n g p r o f e s s i o n a l l i t e r a t u r e , w i t h the mean f o r the whole group a t 3.8 hours per week. Most respondents, about 88%, d i d not have a w r i t t e n p l a n f o r t h e i r own c o n t i n u i n g e d u c a t i o n , but twelve per cent s t a t e d they d i d have such a p l a n . About 6 2% o f the group i n d i c a t e d t h a t they had p a r t i c i p a t e d i n a r e s e a r c h study i n the pr e v i o u s year. Some 58% s t a t e d t h a t they belonged t o a p r o f e s s i o n a l o r g a n i z a t i o n i n a d d i t i o n to t h e i r r e q u i r e d membership i n the l o c a l R e g i s t e r -ed Nurses A s s o c i a t i o n . These a d d i t i o n a l p r o f e s s i o n a l o r g a n i z a -t i o n s i n c l u d e d such groups as: B r i t i s h Columbia C o n t i n u i n g Nursing Education Group, C r i t i c a l Care Group, C a r d i o v a s c u l a r Care Group, B.C. H o s p i t a l A s s o c i a t i o n , I n s t r u c t i o n a l Media A s s o c i a t i o n and Extended Care N u r s i n g Group. In terms of le n g t h o f time employed i n t h e i r p r e s e n t jobs, the h i g h e s t percentage of the group were employed between twelve to 36 months. The mean was about 4 3 months o r th r e e and one-half y e a r s . There was a wide range here, from twelve weeks to ten years employed i n t h e i r p r e s e n t i n s e r v i c e education TABLE 5 Hours Spent on Co n t i n u i n g E d u c a t i o n Hours per week No. 1 - 2 . 5 9 39 3 - 4 . 5 5 22 5 - 6.5 5 22 7 - 8 . 5 2 9 9 - 1 1 . 0 2 . 9 T o t a l 23 (1 N.R.) 100 TABLE 6 Hours Spent on Reading P r o f e s s i o n a l L i t e r a t u r e Hours per week No. % 1 - 2.5 8 35 3 - 4 . 5 9 39 5 - 6.5 3 13 7 - 8.0 3 13 T o t a l 23 (1 N.R.) 100 jobs. C h a r a c t e r i s t i c s of the Job S e t t i n g The average bed c a p a c i t y of h o s p i t a l s employing respondents was 9 58. However, i t was noted t h a t t en of the respondents came from one l a r g e t e a c h i n g h o s p i t a l w i t h a bed c a p a c i t y of 1640. H o s p i t a l s i z e ranged from 154 to 1640 beds. In a d d i t i o n , 71% of the h o s p i t a l s employing respondents had a scho o l o f n u r s i n g , which had an average of 372 s t u d e n t s . The range of p o p u l a t i o n i n these h o s p i t a l s c h ools was wide from 150 to 500 students. I t was a l s o noted t h a t ten respondents came from h o s p i t a l s w i t h a student p o p u l a t i o n o f 500. The i n s e r v i c e departments had been i n e x i s t e n c e an average of t h i r t e e n y e a r s . Ten respondents came from one very l a r g e t e a c h i n g h o s p i t a l i n which such a department had e x i s t e d f o r twenty y e a r s , but 46% came from h o s p i t a l s i n which the department was between s i x to ten years o l d , and one came from a department t h a t had e x i s t e d f o r f i f t e e n y e a r s . With r e s p e c t to the number of persons employed i n the i n s e r v i c e e d u c a t i o n department, over h a l f had only one person, themselves employed i n the department. In th r e e cases i n which the respondents were e s s e n t i a l l y performing two func-t i o n s , t h a t of D i r e c t o r of Nursing and i n s e r v i c e educator, they l i s t e d themselves as h a l f - t i m e employees i n the i n s e r v i c e department. Four respondents,.about seventeen p e r c e n t had f u l l - t i m e c l e r i c a l a s s i s t a n c e and f o u r had h a l f - t i m e h e l p . 63. TABLE 7 Length of Time Employed i n Present P o s i t i o n Months No. % Less than 12 5 21 12 - 36 9 38 37 - 61 3 13 6 2 - 8 6 4 17 More than 87 3 13 T o t a l 24 100 3.5 y r . (42.75 mon.) 12 wks - 10 y r s . 9.11 TABLE 8 Hospital Bed Capacity Beds No. % Less than 200 1 4 200 - 400 4 17 401 - 600 6 25 601 - 800 2 8 801 - 1000 1 4 1001 - 2000 10 42 Total 24 100 65. Only two respondents out of 24 had one f u l l - t i m e a u d i o - v i s u a l t e c h n i c i a n t o a s i s t them. Eighteen respondents i n d i c a t e d they were i n a d i r e c t i n g p o s i t i o n i n t h e i r department; o n l y 25% were not i n such a r o l e . Job t i t l e s v a r i e d somewhat, but 4 6% r e f e r r e d to themselves as i n s e r v i c e i n s t r u c t o r s . Seven respondents bore the t i t l e of D i r e c t o r of I n s e r v i c e , three were D i r e c t o r - I n s t r u c t o r s and three were D i r e c t o r s o f Nursing a l s o f u n c t i o n i n g i n an i n s e r v i c e educators' r o l e . A c t u a l A c t i v i t i e s A c t u a l a c t i v i t i e s of respondents were ranked a c c o r d -i n g to time, frequency, and t o t a l hours per year w i t h i n c a t e g o r i e s . The means and t o t a l s o f c a t e g o r i e s were a l s o examined, as shown i n Tables nine to e l e v e n . In terms of the mean number of minutes spent on an a c t i v i t y each time i t was performed, i n s t r u c t i o n ranked h i g h e s t of the f i v e c a t e g o r i e s a t 110 minutes. T h i s suggested t h a t respondents spent the most number of minutes i n t h a t category. Program p l a n n i n g ranked l a s t , a t 32.55 minutes, i n d i c a t i n g the l e a s t mean number of minutes spent here. Frequency rankings of c a t e g o r i e s showed t h a t the h i g h e s t mean frequency o c c u r r e d i n the m i s c e l l a n e o u s a c t i v i t y area. Respondents performed such a c t i v i t i e s on an average of 65.8 times per year. But p o l i c y d e c i s i o n making a c t i v i t i e s ranked lowest, and were performed l e s s than 21 times per year. TABLE 9 A c t u a l Time by Category (Minutes per Instance Performed) Category X Minutes I n s t r u c t i o n 110.00 S u p e r v i s i o n 105.00 P o l i c y D e c i s i o n Making 63.64 M i s c e l l a n e o u s 36.24 Program Pl a n n i n g 32.55 TABLE 10 Actual Frequency By Category (Times per Year) Category X Frequency Miscellaneous 65.8 Instruction 41.3 Supervision 38.5 Program Planning 24.8 Policy Decision Making 20.3 68. TABLE 11 A c t u a l T o t a l Hours per Year by Category Category T o t a l Hours I n s t r u c t i o n 1177.86 S u p e r v i s i o n 871.95 Program Pl a n n i n g 732.43 Mi s c e l l a n e o u s 418.92 P o l i c y D e c i s i o n Making 258.00 A c t u a l a c t i v i t i e s were a l s o ranked a c c o r d i n g to t o t a l number of hours per year, a f i g u r e which combined both time and frequency. These rankings suggested t h a t respondents spent the bulk of t h e i r time on i n s t r u c t i o n a l a c t i v i t i e s . They spent s u b s t a n t i a l l y l e s s time program p l a n n i n g , and the l e a s t amount of time i n v o l v e d i n p o l i c y d e c i s i o n making a c t i v i t i e s . Program P l a n n i n g : A c t i v i t i e s occupying the h i g h e s t rankings i n t h i s category i n terms o f mean number of minutes i n c l u d e d : 1) s e l e c t i n g content f o r l e a r n i n g programs 2) w r i t i n g out o b j e c t i v e s f o r programs and 3) c o n f e r r i n g w i t h content s p e c i a l i s t s to g a i n background i n f o r m a t i o n f o r g i v e n programs. The mean number of minutes f o r each were 2 2 2, .16 2.7, and 130.4 r e s p e c t i v e l y . The a c t i v i t y r a n k i n g f o u r t h , r e v i e w i n g job d e s c r i p t i o n s , showed a r a t h e r s u b s t a n t i a l drop i n time to a mean of 6 7 minutes. Those a c t i v i t i e s with lowest rankings i n c l u d e d : 1) conferences w i t h other non-nursing departments, 2) examination of i n c i d e n t r e p o r t s to assess l e a r n i n g needs, 3) as w e l l as conferences and i n t e r v i e w s with non-nursing p e r s o n n e l . These rankings were viewed very c a u t i o u s l y however, f o r two reasons. F i r s t , the g r e a t m a j o r i t y of those a c t i v i t i e s showed a mode of zero minutes, with a few e x c e p t i o n s , which i n c l u d e d some bi-modal responses. In a d d i t i o n , the range of responses appeared to be q u i t e wide: f o r ' i n s t a n c e , the two most h i g h l y ranked a c t i v i t i e s had a range of 2400 minutes each. 70. I t was a l s o noted t h a t , i n terms of mean number of minutes, many of the e v a l u a t i v e and assessment a c t i v i t i e s i n v o l v i n g n u r s i n g s t a f f as l e a r n e r s occupied middle or lower middle rankings. These i n c l u d e d 1). conferences w i t h l e a r n i n g groups to develop .program o b j e c t i v e s 2) i n t e r v i e w s w i t h d e p a r t i n g employees t o seek suggestions f o r f u t u r e i n s e r v i c e and 3) reviewing e v a l u a t i o n of a program with the l e a r n i n g group. The o v e r - a l l mean minutes spent i n t h i s category was 32.55. T h i s mean was t r e a t e d w i t h due c a u t i o n , as the range of mean scores was broad: the uppermost rank was a mean o f 222 minutes, and the lowest r a n k i n g a c t i v i t y showed a mean of zero minutes. In terms of frequency, the h i g h e s t rankings i n c l u d e d : 1) d i r e c t o b s e r v a t i o n o f s t a f f performance i n d e l i v e r i n g n u r s i n g care 2) d i r e c t o b s e r v a t i o n o f non-nursing s t a f f i n performance o f d u t i e s 3) i n c i d e n t a l conferences w i t h n u r s i n g s u p e r v i s o r s to d i s c u s s s t a f f l e a r n i n g needs and 4) i n c i d e n t a l conferences w i t h g e n e r a l duty s t a f f t o d i s c u s s l e a r n i n g needs. Conferences with non-nursing personnel and o b s e r v a t i o n a l a c t i v i t i e s occupied middle r a n k i n g s . Involvement w i t h non-n u r s i n g s t a f f occupied the lowest r a n k i n g s . The o v e r - a l l mean times per year f o r performance o f these a c t i v i t i e s was 24.8. Again t h i s mean was viewed c a u t i o u s l y : rankings had a wide : range, from a top score of 113.9 times per year to zero c a t e -gory and most a c t i v i t i e s had a wide range of responses. In r a n k i n g program p l a n n i n g a c t i v i t i e s a c c o r d i n g to hours per year, the two h i g h e s t r a n k i n g a c t i v i t i e s were 1) s e l e c t i n g content f o r l e a r n i n g programs and 2) d i r e c t o b s e r v a t i o n of s t a f f performance i n d e l i v e r i n g n u r s i n g c a r e . C o n f e r r i n g w i t h content s p e c i a l i s t s , w r i t i n g o b j e c t i v e s , o b s e r v a t i o n a l a c t i v i t i e s and bedside a u d i t to assess n u r s i n g care standards a l s o had a f a i r l y h igh r a n k i n g . Those a c t i v i -t i e s i n which the respondents seemed to spend the fewest hours per year i n c l u d e d involvement w i t h non-nursing p e r s o n n e l , other departments and review of e v o l u a t i o n w i t h the l e a r n i n g group of a program. The t o t a l hours per year spent on the e n t i r e category of program p l a n n i n g was 732.43 hours. I t was noted however, t h a t s i n c e these t o t a l hours were based on mean number of minutes and mean f r e q u e n c i e s f o r each a c t i v i t y , the hour rankings were to be i n t e r p r e t e d with c a u t i o n . In summary, i n terms of time, frequency and t o t a l hours per year, there were some v a r i a t i o n s i n r a n k i n g s . But g e n e r a l l y a c t i v i t i e s i n v o l v i n g o b s e r v a t i o n , s e l e c t i o n of l e a r n i n g m a t e r i a l and c o n f e r r i n g w i t h content s p e c i a l i s t s occupied top rankings suggesting t h a t respondents spend more time i n these a r e a s . A c t i v i t i e s i n programming i n v o l v i n g non-nursing p e r s o n n e l , as w e l l as u t i l i z a t i o n of h i r i n g and t e r m i n a t i o n i n t e r v i e w s w i t h employees to assess and e v a l u a t e l e a r n i n g needs ranked the lowest. These rankings are, however, suggestive r a t h e r than d e f i n i t i v e because of the modal response and wide range of responses. TABLE 12 A c t u a l Time Spent i n Program P l a n n i n g A c t i v i t i e s A c t i v i t y X S.D, Mode Range S e l e c t i n g content f o r l e a r n i n g programs 2 2 2 . 0 W r i t i n g out o b j e c t i v e s f o r programs 1 6 2 . 7 C o n f e r r i n g w i t h content s p e c i a l i s t s t o g a i n back-ground i n f o r m a t i o n f o r give n programs 13 0 . 4 Reviewing job d e s c r i p t i o n s ' ( l i s t s of d u t i e s ) 6 7 . 0 4 8 4 . 0 C 60 2 4 0 0 4 8 2 . 0 C 0 2 4 0 0 4 0 3 . 0 0 30 2 0 0 0 1 4 6 . 3 7 2 0 D i r e c t o b s e r v a t i o n of s t a f f performance i n d e l i v e r i n g n u r s i n g care 6 2 . 5 9 5 . 4 1 2 Q 3 6 0 Keeping records of imple-mented programs 5 7 . 7 W r i t i n g e v a l u a t i o n r e p o r t s of l e a r n i n g programs 3 8 . 5 D i r e c t o b s e r v a t i o n of non-n u r s i n g s t a f f i n performance of d u t i e s 3 6 . 2 Meeting w i t h n u r s i n g super-v i s o r y p e r s o n n e l t o d i s c u s s s t a f f l e a r n i n g needs -planned meetings 3 4 . 3 H i r i n g i n t e r v i e w p a r t i c i p a t i o n to e s t a b l i s h employee l e a r n -i n g needs - n u r s i n g 3 1 . 6 Meeting with s u p e r v i s o r s of departments other than n u r s i n g t o d i s c u s s s t a f f l e a r n i n g needs - planned meetings 3 0 . 0 1 0 3 . 0 none 4 8 0 5 0 . 3 1 5 0 9 2 . 0 0 3 6 0 3 9 . 9 0 1 2 0 1 2 1 . 9 0 6 0 0 3 8 . 0 0 1 2 0 TABLE 12 (cont'd) A c t i v i t y X S.D. Mode Range D i r e c t o b s e r v a t i o n of n u r s i n g s t a f f performance a f t e r a program 29.5 77.9 0 360 Conferences w i t h other i n -s e r v i c e educators to develop program p l a n s 29.3 35.5 0 120 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f to d i s c u s s l e a r n i n g needs - planned 0 meetings 28.3 26.9 30 90 Terminal i n t e r v i e w s w i t h employees to seek sug-g e s t i o n s f o r i n s e r v i c e e ducation programs (nursing) 28.1 122.1 0 600 Conferences w i t h t a r g e t s t a f f (the l e a r n i n g group f o r a g i v e n program) to develop program o b j e c t i v e s f o r g i v e n l e a r n i n g programs (nursing) 27.5 40.5 0 120 Bedside a u d i t ( u n i t v i s i t s t o p a t i e n t s to determine the extent to which p a t i e n t care standards are being met) 27.2 73.4 0 360 P a r t i c i p a t i o n i n medical rounds to assess l e a r n i n g needs 25.0 38.2 0 120 C o - o r d i n a t i o n of program p l a n -ning a c t i v i t i e s i n i t i a t e d by 0 n u r s i n g s t a f f 23.4 21.4 30 60 Meeting w i t h n u r s i n g super-v i s o r y p e r s o n n e l to d i s c u s s s t a f f learning.needs ( i n c i -d e n t a l conferences) 22.5 25.3 15 120 Reviewing e v a l u a t i o n of a program with s u p e r v i s o r y 0 personnel 21.0 20.7 30 60 TABLE 12 (cont'd) A c t i v i t y X S.D Mode Range Reviewing e v a l u a t i o n of a program w i t h the l e a r n i n g group 20. 4 39. 7 0 180 Examination of employee performance e v a l u a t i o n s 18. 9 38. 7 0 150 Observation of u n i t nursing care conferences t o assess l e a r n -i n g needs 18. 1 25. 4 0 90 Conferences w i t h other de-partments to i d e n t i f y mutual l e a r n i n g needs (planned group conferences) 18. 1 21. 7 0 60 Conferences w i t h general duty nursing s t a f f to d i s c u s s l e a r n i n g needs (planned group conferences) 18. 0 12. 9 15 20 45 D i s c u s s i n g e v a l u a t i o n of given i n s e r v i c e programs wit h other i n s e r v i c e educa-t o r s i n your agency 17. 9 23. 0 0 60 Review of c h a r t i n g on nursing u n i t s (chart audit) 16. 8 19. 9 0 60 Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l conferences) 15. 0 15. 8 0 15 30 60 Conferences w i t h general duty nursing s t a f f t o discuss l e a r n i n g needs (planned i n d i v i d u a l conferences) 14. 5 15. 8 0 60 Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n i n g needs (planned i n d i v i d u a l conferences) 13. 7 20. 0 0 60 TABLE 12 (cont'd) A c t i v i t y X S.D. Mode Range Conferences with general duty nursing s t a f f to discuss learning needs (incidental group conferences) 13.3 16.2 0 60 Meeting with supervisory per-sonnel of departments other than nursing to discuss s t a f f learning needs (incidental conferences) 11.2 14.5 0 60 Co-ordination of program plan-ning a c t i v i t i e s i n i t i a t e d by s t a f f i n non-nursing depart-ments 9.1 16.3 0 6 0 Bedside audit.after an inservice program to evaluate e f f e c t i v e -ness of i n s t r u c t i o n 8.7 19.5 0 60-; Review of termination reports for suggestions on inservice education programs 8.3 26.9 0 120-', Conferences with other depart-ments to Identify mutual learning needs (Ie, medical s t a f f , c l e r i c a l , housekeeping, dietary, etc.) (incidental group conferences) 8.1 14.7 0 60 Direct observation of s t a f f performance after a program (follow-up) (non-nursing staff) 8.1 30.9 0 150 P a r t i c i p a t i o n i n nursing rounds to assess learning needs 7.7 15^4 0 60 Examination of incident reports 5.6 8.2 0 30 Conferences with target s t a f f (learning group for a given program) to develop program objectives (non-nursing) 5.0 14.5 0 60 76. TABLE 12 (cont'd) A c t i v i t y X S.D. Mode Range P a r t i c i p a t i o n i n h i r i n g i n t e r v i e w s t o e s t a b l i s h the p o t e n t i a l employee's l e a r n i n g needs (non-nursing) Terminal i n t e r v i e w s w i t h employees to seek sug-g e s t i o n s f o r i n s e r v i c e e d u c a t i o n programs (non-nursing) O v e r - a l l X 32.55 TABLE 13 A c t u a l Frequency of Program P l a n n i n g A c t i v i t i e s (Times per Year) A c t i v i t y X S.D '. Mode Range D i r e c t o b s e r v a t i o n o f . s t a f f . performance i n d e l i v e r i n g ' n u r s i n g care 113. 9 117. 3 0 260 260 D i r e c t o b s e r v a t i o n of non-n u r s i n g s t a f f i n p e r f o r -mance of d u t i e s 101. 8 116. 2 0 260 Meetings with n u r s i n g super-v i s o r y p e r s o n n e l t o d i s c u s s s t a f f l e a r n i n g needs ( i n c i -d e n t a l conferences) 101. 8 95. 3 none 260 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l conferences) 81. 1 85. 3 52 260 Bedside a u d i t ( u n i t v i s i t s to p a t i e n t s t o determine the extent t o which p a t i e n t care standards are being met) 67. 6 105. 3 0 260 Review of c h a r t i n g on n u r s i n g u n i t s ( c h a r t audit) 51. 3 80. 5 0 260 S e l e c t i n g content f o r l e a r n i n g programs 47. 9 •75. 3 none 260 Keeping r e c o r d s of implemented programs 46. 0 71. 2 52 260 D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program (nursing s t a f f ) 41. 5 87. 8 0 260 Observation of u n i t n u r s i n g care conferences to assess l e a r n i n g needs 39. 6 71. 4 0 260 TABLE 13 (cont'd) A c t i v i t y X S.D. Mode Range Conferences with general duty nursing s t a f f to discuss learning needs (planned i n d i v i d u a l meetings) Conferences with other i n -service educators to develop program plans Meeting with supervisors of non-nursing departments to discuss s t a f f learning needs (incidental meetings) Conferring with content s p e c i a l i s t s to gain back-ground information for given programs Co-ordination of program planning a c t i v i t i e s i n i t i -ated by nursing s t a f f Meeting with nursing super-visory personnel to discuss s t a f f learning needs (planned meetings) Writing out objectives for programs Conferences with general duty nursing s t a f f to dis-cuss learning needs (inci-dental group meetings) 36.0 Examination of incident reports 34.0 Conferences with other depart-ments to i d e n t i f y mutual learning needs (incidental i n d i v i d u a l meetings) 27.5 25.3 23.5 20.6 18.7 P a r t i c i p a t i o n i n nursing rounds to assess learning needs 16.8 16.0 15.4 73.5 0 260 74.2 0 260 56.1 none 260 60.2 59.9 18.3 21.3 44.3 53.1 32.5 0 260 0 260 37.1 12 156 19.4 12 52 52 0 156 2 260 0 156 TABLE 13 (cont'd) A c t i v i t y X S.D. Mode Range Direct observation of s t a f f performance aft e r a program (follow-up) (non-nursing personnel) 14.0 53.5 0 260 P a r t i c i p a t i o n i n medical rounds to assess learning needs 13.0 26.1 0 104 P a r t i c i p a t i o n i n h i r i n g i n t e r -views to est a b l i s h the poten-t i a l employees 1 learning needs (nursing staff) 10.9 33.0 0 156 Conferences with general duty nursing s t a f f to discuss learning needs (planned 0 group conferences) 10.6 14.6 12 52 Reviewing evaluation of a program with supervisory personnel 7.8 12.1 none 52 Discussing evaluation of given inservice programs with other inservice edu-cators i n your agency 7.4 14.9 " "0 52 Examination of employee performance evaluations 7.3 14.5 0 52 Bedside audit af t e r an i n -service program to evaluate -effectiveness of i n s t r u c t i o n 6.7 17.4 0 52 Co-ordination of program planning a c t i v i t i e s i n i t i a t e d by s t a f f i n other departments 6.0 14.7 0 52 Conferences with target s t a f f (learning group for a given program) to develop program objectives (nursing staff) 5.5 14.5 0 52 Reviewing evaluation of a program with the learning group 4.9 11.4 0 52 TABLE 13 (cont'd) A c t i v i t y X S.D. Mode Range Meeting with supervisory personnel of departments other than nursing to discuss s t a f f learning needs (planned meetings) 4.9 10.9 Conferences with other departments to i d e n t i f y mutual learning needs (incidental group confer-ences) 4.8 Reviewing job descriptions ( l i s t s of duties) 4.7 Conferences with other departments to i d e n t i f y mutual learning needs (planned group meetings) 4.2 7.2 Conferences with other departments to i d e n t i f y mutual learning needs (planned i n d i v i d u a l con-ferences) 4.0 10.5 Writing evaluation reports of learning programs 3.1 5.9 Terminal interviews with employees to seek sug-gestions for inservice education programs (nursing personnel) 0.4 1.0 Review of termination re-ports for suggestions on inservice education pro-grams 0.4 1.1 Conferences with target s t a f f (the learning group for a given program) to develop program objectives for given learning programs (non-nurs-ing staff) 0.2 0.6 52 12.0 0 52 10.7 none 52 24 52 24 TABLE 13 (cont'd) X S.D. Mode Range 24.8 A c t i v i t y T erminal i n t e r v i e w s w i t h employees to seek sug-g e s t i o n s f o r i n s e r v i c e e d u c a t i o n programs,(non-n u r s i n g personnel) P a r t i c i p a t i o n i n h i r i n g i n t e r v i e w s t o e s t a b l i s h the p o t e n t i a l employee's l e a r n i n g needs (non-n u r s i n g personnel) O v e r - a l l X TABLE 14 A c t u a l T o t a l Hours per Year Spent on Program Planning A c t i v i t y Hours/Year S e l e c t i n g content f o r l e a r n i n g programs 177.21 D i r e c t observation of s t a f f performance i n d e l i v e r i n g nursing care 118.64 D i r e c t observation of non-nursing s t a f f i n performance of d u t i e s 61.41 Confe r r i n g w i t h content s p e c i a l i s t s t o gain background information f o r given programs 44.77 Keeping records of implemented programs 44.24 W r i t i n g out o b j e c t i v e s f o r programs 43.38 Meeting w i t h nursing supervisory personnel to di s c u s s s t a f f l e a r n i n g needs (planned meetings) 38.17 Bedside a u d i t . ( u n i t v i s i t s to p a t i e n t s to determine the extent to which p a t i e n t care standards are being met) 30.64 Conferences w i t h general duty nurses to di s c u s s l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l meetings) 24.33 D i r e c t observation of s t a f f performing a f t e r a program (nursing s t a f f ) 20.40 Review of c h a r t i n g on nursing u n i t s (chart audit) 14.36 Conferences w i t h other i n s e r v i c e edu-cat o r s to develop program plans 12.35 TABLE 14 (cont'd) A c t i v i t y Hours/Year Observation of u n i t n u r s i n g care conferences to assess l e a r n i n g needs 11.94 Meeting with n u r s i n g s u p e r v i s o r y personnel to d i s c u s s s t a f f l e a r n i n g needs ( i n c i d e n -t a l meetings) 10.46 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs (planned i n d i v i d u a l meetings) 8.70 C o - o r d i n a t i o n of program p l a n n i n g a c t i v i t i e s i n i t i a t e d by n u r s i n g s t a f f 7.29 Conferences w i t h other departments to i d e n t i f y mutual l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l meetings) 6.87 P a r t i c i p a t i o n i n h i r i n g i n t e r v i e w s t o esta b -l i s h p o t e n t i a l employee's l e a r n i n g needs (nursing) 5.74 P a r t i c i p a t i o n i n medical rounds to assess l e a r n i n g needs 5.41 Reviewing job d e s c r i p t i o n s ( l i s t s of du t i e s ) 5.24 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f to d i s c u s s l e a r n i n g needs (planned group, conferences) 4.99 Meeting w i t h s u p e r v i s o r y personnel of d e p a r t -ments other than n u r s i n g t o d i s c u s s s t a f f l e a r n i n g needs ( i n c i d e n t a l meetings) 4.38 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f to d i s c u s s l e a r n i n g needs ( i n c i d e n t a l group conferences) 3.41 Examination of i n c i d e n t r e p o r t s 3.17 Reviewing^ e v a l u a t i o n of a program wi t h s u p e r v i s o r y p e rsonnel 2.73 TABLE 14 (cont'd) A c t i v i t y Hours/Year Conferences w i t h t a r g e t s t a f f t o develop program o b j e c t i v e s f o r l e a r n i n g programs (nursing s t a f f ) 2.52 Meeting w i t h s u p e r v i s o r y personnel of departments other than n u r s i n g to d i s c u s s s t a f f l e a r n i n g needs (planned meetings) 2.45 Examination of employee performance e v a l u -a t i o n s 2.29 D i s c u s s i n g e v a l u a t i o n of g i v e n i n s e r v i c e programs wi t h other i n s e r v i c e educators i n your agency 2.2 0 P a r t i c i p a t i o n i n n u r s i n g rounds to assess l e a r n i n g needs 2.15 W r i t i n g e v a l u a t i o n r e p o r t s of l e a r n i n g programs 1.98 D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program (follow-up) (non-nursing s t a f f ) 1.89 Reviewing e v a l u a t i o n of a program wi t h the l e a r n i n g group 1.66 Conferences with other departments to i d e n t i f y mutual l e a r n i n g needs (planned group meetings) 1.2 6 Bedside a u d i t a f t e r an i n s e r v i c e program to e v a l u a t e e f f e c t i v e n e s s of i n s t r u c t i o n 0.97 Conferences w i t h other departments to i d e n t i f y mutual l e a r n i n g needs (planned i n d i v i d u a l meetings) 0.913 C o - o r d i n a t i o n of program p l a n n i n g a c t i v i t i e s i n i t i a t e d by non-nursing s t a f f 0.910 Conferences w i t h other departments to i d e n t i f y m u t u a l ^ l e a r n i n g needs ( i e . medical s t a f f , c l e r i c a l , housekeeping, d i e t a r y , etc.) ( i n c i d e n t a l group conferences) 0.646 TABLE 14 (cont'd) A c t i v i t y Hours/Year Terminal i n t e r v i e w s w i t h employees to seek suggestions f o r i n s e r v i c e e d u c a t i o n pro-grams (nursing personnel) 0.18 6 Review of t e r m i n a t i o n r e p o r t s f o r suggestions on i n s e r v i c e e d u c a t i o n programs 0.055 Conferences w i t h t a r g e t s t a f f (the l e a r n i n g group f o r a g i v e n program) to develop program o b j e c t i v e s f o r g i v e n l e a r n i n g programs (non-nursing s t a f f ) 0.016 P a r t i c i p a t i o n i n h i r i n g i n t e r v i e w s t o e s t a b l i s h the p o t e n t i a l employee's l e a r n i n g needs (non-nursing s t a f f ) 0 Terminal i n t e r v i e w s w i t h employees to seek suggestions f o r i n s e r v i c e e d u c a t i o n pro-grams (non-nursing s t a f f ) 0 T o t a l hours 732.43 86. I n s t r u c t i o n : I n s t r u c t i o n a l a c t i v i t i e s r a n k i n g h i g h e s t i n terms of mean time i n c l u d e d 1). u t i l i z a t i o n o f e i g h t hour programs 2) use o f f o u r hour workshops 3) a s s i s t i n g another s t a f f member i n t e a c h i n g n u r s i n g p e r s o n n e l and 4) d i r e c t instruction of r e g i s t e r e d nurses. The mean minutes f o r these a c t i v i t i e s were 480, 240, 240, 174.20 r e s p e c t i v e l y . The respondents ranked experimentation w i t h new teachings techniques seventh a t 87.0 minutes. Lowest i n rank were 1) c o o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s of other i n s e r v i c e educators 2) a d v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s and 3) use o f p i l o t programs. O v e r - a l l mean number o f minutes f o r t h i s category was 110. The modal response i n some i n s t a n c e s was more c o n s i s t e n t w i t h the mean; but most modes bore l i t t l e r e l a t i o n s h i p t o the mean. In a d d i t i o n , the range of responses v a r i e d widely. Frequency rankings i n d i c a t e d t h a t the two a c t i v i -t i e s performed most o f t e n were 1) a d v i s i n g s t a f f i n ob-t a i n i n g r e s o u r c e m a t e r i a l s , which appeared amongst the low-e s t i n time rankings and 2) d i r e c t i n s t r u c t i o n of r e g i s t e r -ed nurses. As opposed to the time rankings, use of e i g h t hour programs, h a l f - d a y workshops and experimentation w i t h new t e a c h i n g techniques ranked lowest i n frequency. Again, modes seemed u n r e l a t e d to mean s c o r e s , and the range of scores was v e r y wide. Mean score f o r t h i s category was 41.3 per year. 86a. Rankings of a c t i v i t i e s a c c o r d i n g to t o t a l hours per year suggests t h a t educators spent the most time on 1) d i r e c t i n s t r u c t i o n o f r e g i s t e r e d nurses 2) a s s i s t i n g another s t a f f member i n t e a c h i n g n u r s i n g s t a f f and 3) u t i l i z i n g s h o r t programs. They spent the l e a s t amount of time u s i n g p i l o t programs t o t e s t i n s t r u c t i o n a l techniques and c o o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s of other educators. The t o t a l hours f o r t h i s category was 1177.86. In summary, these educators, a c c o r d i n g to mean scores ranked d i r e c t i n s t r u c t i o n a l a c t i v i t i e s the h i g h e s t , along with use of s h o r t workshops. T h i s suggested t h a t the respondent spent the g r e a t e r amount of time i n these a c t i v i t i e s . C o o r d i n a t i o n of i n s t r u c t i o n a l a c t i v i t i e s o f others and use of p i l o t programs occupied the lowest r a n k i n g s , i n d i c a t i n g areas i n which the l e a s t amount of time was spent. However, once again, these mean scores were merely s u g g e s t i v e , s i n c e modes were mostly i n r e l a t i o n to mean scores and the range of responses was wide. S u p e r v i s i o n : The s u p e r v i s o r y a c t i v i t y r a n k i n g h i g h e s t TABLE 15 Actual Time Spent on Instructional A c t i v i t i e s (in Minutes per Instance Performed) A c t i v i t y X S.D. Mode Range Use of 8 hour programs 480.0 0 480 0 Use of half-day workshop programs (4 hours i n length) 240.0 0 240 0 Ass i s t i n g another s t a f f member (ie. head nurse) i n teach- 0 ing nursing, personnel 240.0 239.7 30 4980 Direct i n s t r u c t i o n of registered nurses 174.2f 202.5. none 720 Use of programs 1 to 2 hours i n length 12 0.0 0 12 0 0 Selecting i n s t r u c t i o n a l resources (equipment, people, etc.) 109.3 242.9 Experimentation with new teaching techniques 87.9 239.9 Use of content s p e c i a l i s t s to help teach (under "time" state how long they spend i n actual teaching) 87.0 331.0 Direct i n s t r u c t i o n of nurses aides 85.7 158.6 Direct i n s t r u c t i o n of non-nursing personnel 78.7 246.8 Direct i n s t r u c t i o n of p r a c t i c a l nurses 74.5 151.2 Direct i n s t r u c t i o n of student nurses 45.0 82.8 60 1200 0 60 1200 30 510 0 600 0 1200 0 600 0 240 TABLE 15 (cont'd) A c t i v i t y X S.D. Mode Range Use of "mini-programs" (15 t o 45 minutes i n length) 30.0 0 30 0 A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g (non-nursing) 25.0 59.7 0 240 C o n s u l t a t i o n w i t h s t a f f t o determine a p p r o p r i a t e r e -sc h e d u l i n g r e q u i r e d t o cover wards d u r i n g an i n -s e r v i c e program 24.1 48.0 15 240 Use of p i l o t programs t o " t e s t out" an i n s t r u c t i o n a l technique b e f o r e u s i n g i n a formal program 22.5 41.9 0 18 0 A d v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s 20.1 13.8 15 60 C o - o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s of other i n s e r -v i c e educators 5.5 .'lit 0.7 0 32 Over - a l l X 110.0 TABLE 16 Actual Frequency of Instructional A c t i v i t i e s (Times per Year) A c t i v i t y X S.D. Mode Range Advising s t a f f i n obtaining resource materials 112.0 Direct i n s t r u c t i o n of registered nurses 105.6 Use of "mini-programs" (15 to 45 minutes i n length) 71.7 Direct i n s t r u c t i o n of nurses aides 67.3 Use of programs 1 to 2 hours i n length 59.2 Selecting i n s t r u c t i o n a l resources (equipment, people, etc'.) 56.3 Direct i n s t r u c t i o n of p r a c t i c a l nurses 54.0 Use of content s p e c i a l i s t s to help teach 49.6 Consultation with s t a f f to determine appropriate re-scheduling required to cover wards during an inservice program 35.0 Ass i s t i n g another s t a f f member (ie. head nurse) i n teaching nursing personnel 33.3 Co-ordinating i n s t r u c t i o n a l a c t i v i t i e s of other inser-vice educators 22.0 Direct i n s t r u c t i o n of non-nursing personnel 19.1 100.0 260 260 105.1 260 260 86.8 52 260 101.5 85.2 58.6 72.3 57.0 60.2 0 260 82.4 12 260 94.3 12 260 0 260 75.9 . none 260 none 2 60 0 260 0 260 0 260 TABLE 16 (cont'd) A c t i v i t y X S.D. Mode Range Use of h a l f - d a y workshop programs (4 hours i n length) 16.0 53.3 0 260 D i r e c t i n s t r u c t i o n of student nurses 15.5 53.5 0 260 Use of 8 hour programs 9.4 2 9.2 0 104 Experimentation w i t h new te a c h i n g techniques 8.9 21.4 0 104 A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g 5.2 14.6 0 52 Use o f p i l o t programs t o " t e s t out" an i n s t r u c t i o n -a l technique b e f o r e u s i n g i t i n a formal program 4.0 10.9 0 52 O v e r - a l l X 41.3 TABLE 17 A c t u a l T o t a l Hours per Year Spent on I n s t r u c t i o n a l A c t i v i t i e s A c t i v i t y ; ^ Hours/Year D i r e c t i n s t r u c t i o n of r e g i s t e r e d nurses 306.59 A s s i s t i n g another s t a f f member ( i e . head nurse) i n teaching nursing s t a f f 133.20 Use of programs 1 to 2 hours i n length 118.40 S e l e c t i n g i n s t r u c t i o n a l resources (equip-ment, people, etc.) 102.55 D i r e c t i n s t r u c t i o n of nurses'saides 96.12 Use of 8 hour programs 75.20 Use of content s p e c i a l i s t s to help teach 71.92 D i r e c t i n s t r u c t i o n of p r a c t i c a l nurses 67.05 Use of half-day workshop programs (4 hours i n length) 64.00 Ad v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s 37.52 Use of "mini-programs" 15 t o 45 minutes i n length 35.85 D i r e c t i n s t r u c t i o n of non-nursing personnel 25.05 C o n s u l t a t i o n w i t h s t a f f to determine appropriate rescheduling r e q u i r e d to cover wards during an i n s e r v i c e program 14.05 Experimentation w i t h new teaching techniques 13.03 D i r e c t i n s t r u c t i o n of student nurses 11.62 A s s i s t i n g another s t a f f member ( i e . head nurse) i n teaching 2.16 TABLE 17 (cont'd) A c t i v i t y Hours/Year Co-ordinating i n s t r u c t i o n a l a c t i v i t i e s of other inservice ^educators 2.01 Use of p i l o t programs to "test out" an i n s t r u c t i o n a l technique before using i n a f o r m a l program 1.50 Total hours 1177.86 a c c o r d i n g to mean number of minutes was a s s i s t i n g with super-v i s i o n i n c l i n i c a l areas. A s u b s t a n t i a l drop was e v i d e n t i n the second most h i g h l y ranked a c t i v i t y , t h a t of p a r t i c i p a t i o n i n a d m i n i s t a t i v e meetings: 39.3 mean minutes as opposed t o 629.3 mean minutes. The l e a s t number of minutes was spent i n performing p a t i e n t and drug census. The o v e r - a l l mean scor e here was 10 5 minutes. Most of the modes were u n r e l a t e d t o mean sc o r e s and the range of responses was very wide, e s p e c i a l i n the case of s u p e r v i s i o n i n c l i n i c a l areas where range was 10,800 minutes. Frequency rankings were somewhat s i m i l a r t o time rankings, the h i g h e s t being i n a s s i s t i n g w i t h s u p e r v i s i o n and the lowest, performing p a t i e n t and drug census. There were v a r i a t i o n s , however: f o r example c o r r e c t i n g and d i s c i -p l i n i n g p e r s o n n e l occupied second p l a c e f o r frequency but f o u r t h p l a c e f o r time.. These v a r i a t i o n s i n time and f r e -quency rankings f o r the same a c t i v i t i e s were due simply to the f a c t t h a t some a c t i v i t i e s were performed r e l a t i v e l y few times per year but r e q u i r e d a hi g h number of minutes to complete on each o c c a s i o n t h a t they were performed. Con-v e r s e l y , c e r t a i n a c t i v i t i e s were performed s e v e r a l times per year but r e q u i r e d r e l a t i v e l y few minutes to complete on each o c c a s i o n . Modal response was u n i f o r m l y zero and a l l but two a c t i v i t i e s showed a range of 260 times per year a g a i n u n r e l a t e d to mean s c o r e s . The o v e r - a l l mean frequency was TABLE 18 A c t u a l Time Spent on.. Supervisory. A c t i v i t i e s ( i n Minutes.per Instance Performed) A c t i v i t v X S.D. Mode Range A s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas 629.3 222.60 0 10800 P a r t i c i p a t i n g i n adminis- 0 t r a t i v e meetings 39.3 41.90 60 150 Performance e v a l u a t i o n s to determine promotion or t e r m i n a t i o n of an employee 29.1 48.40 0 180 C o r r e c t i n g and d i s c i p l i n i n g p e r s o n n e l 15.7 20.40 0 60 A s s i g n i n g n u r s i n g personnel ( u n i t assignments) 8.9 15.80 0 60 H i r i n g n u r s i n g personnel 1.2 6.12 0 30 Performing p a t i e n t and drug census 0.4 2.00 0 10 O v e r - a l l X 105.00 TABLE 19 A c t u a l Frequency of S u p e r v i s o r y A c t i v i t i e s (Times per Year) A c t i v i t y X S.D. Mode. Range A s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas 77.4 113.7 0 260 C o r r e c t i n g and d i s c i p l i n i n g p e rsonnel 75.1 111.3 0 260 A s s i g n i n g n u r s i n g personnel (unit, assignments) 56.8 100.1 0 260 P a r t i c i p a t i n g i n adminis-t r a t i v e meetings 47.0 77.9 0 @60 H i r i n g n u r s i n g personnel 10.8 53.0 0 260 Performance e v a l u a t i o n s t o determine promotion or t e r m i n a t i o n of an employee 2.2 3.9 0 260 Performing p a t i e n t and drug census 2.1 10.6 0 260 O v e r - a l l X 38.5 TABLE 20 A c t u a l T o t a l Hours per Year Spent on S u p e r v i s o r y A c t i v i t i e s A c t i v i t y Hours/Year A s s i s t i n g w i t h s u p e r v i s o r i n c l i n i c a l areas 811.79 P a r t i c i p a t i n g i n a d m i n i s t r a t i v e meetings 30.78 C o r r e c t i n g and d i s c i p l i n i n g p e r s onnel 19.65 A s s i g n i n g n u r s i n g personnel ( u n i t assignments) 8.42 Performance e v a l u a t i o n s t o determine promotion or t e r m i n a t i o n of an employee 1.06 H i r i n g n u r s i n g personnel 0.215 Performing p a t i e n t and drug census 0.013 T o t a l hours 871.95 38.5 times per year f o r s u p e r v i s o r y a c t i v i t i e s . Rankings u t i l i z i n g t o t a l hours per year bore s e v e r a l s i m i l a r i t i e s to time and frequency r a n k i n g s . Again, the s u b s t a n t i a l drop i n hours from a s s i s t i n g with super-v i s i o n i n c l i n i c a l areas to p a r t i c i p a t i n g i n a d m i n i s t r a t i v e meetings .was noteworthy from 811.79 hours per year to 30.78. The respondents a l s o seemed to make l i t t l e use of performance e v a l u a t i o n as a t o o l f o r promotion or t e r m i n a t i o n of employes: they ranked i t f i f t h on the l i s t , spending o n l y 1.06 hours per year. E v a l u a t i v e a c t i v i t i e s assured h i g h e r ranks i n the program p l a n n i n g area. T o t a l hours per year f o r t h i s category were 871.95. In summary, a s s i s t i n g with s u p e r v i s i o n occupied much of the educator's time a c c o r d i n g to mean score rankings whereas performing p a t i e n t and drug census i n v o l v e d ^ n e g l i g -i b l e amount of time. Once again , these rankings c o u l d o n l y be s u g g e s t i v e and viewed i n the l i g h t of a p p a r e n t l y u n r e l a t e d modal responses and wide range of s c o r e s . P o l i c y D e c i s i o n Making A c t i v i t i e s : Time rankings i n t h i s category showed t h a t respondents spent the most number of mean minutes i n a s s i s t i n g with r e v i s i o n o f n u r s i n g procedures and working i n the i n s e r v i c e e d u c a t i o n budget. Bottom rankings i n c l u d e d meeting with the d i r e c t o r of nurses and h o s p i t a l a d m i n s t r a t o r s . Mean scores v a r i e d w i d e l y from 247.5 minutes to ten minutes. Most of the modes were a t zero,, with'some 98. bi-modal responses. The range was wide and reached 4 800 minutes f o r the h i g h e s t r a n k i n g a c t i v i t y . A l s o noteworthy was the r a t h e r s u b s t a n t i a l drop i n mean scor e from the h i g h e s t (247.5) to the second h i g h e s t r a n k i n g (113.3). The o v e r - a l l mean score was 63.64 minutes. The h i g h e s t frequency scores a l s o showed r e v i s i o n of n u r s i n g procedures as r a n k i n g near the top, as w e l l as i n t e r p r e t a t i o n of h o s p i t a l p o l i c y i n the sec o n d . h i g h e s t rank. Meeting w i t h h o s p i t a l a d m i n i s t r a t o r s along with working on the i n s e r v i c e e d u c a t i o n budget ranked the lowest i n frequency. Mean scores again v a r i e d w i d e l y , from 80.7 times per year to one time per year. In f i v e i n s t a n c e s , most p a r t i c u l a r l y low r a n k i n g a c t i v i t i e s , modes seemed r e l a t e d to mean s c o r e s , but the others d i f f e r e d w i d e l y from the means. Range of scores was wide, d i f f e r i n g again from the means. Mean frequency was 20.3. T o t a l hours per year f o r t h i s category showed t h a t r e v i s i o n o f n u r s i n g procedures and i n t e r p r e t a t i o n of h o s p i t a l p o l i c y occupied the greates number of hours per year. Working on the i n s e r v i c e budget and meeting w i t h the h o s p i t a l adminis-t r a t o r each consumed l e s s than two hours per year. The t o t a l hours per year f o r t h i s category was 258. In summary, time, frequency and hours per year rank-ings seemed q u i t e s i m i l a r i n t h i s category, with some v a r i a -t i o n s . Modes, wit h some e x c e p t i o n s , d i f f e r e d g r e a t l y from mean TABLE 21 A c t u a l time Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s ( i n Minutes per Instance Performed) A c t i v i t y X S.D. Mode Range A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures 247. 5 970. 4 60 4800 Working on i n s e r v i c e education budget 113. 3 232 . 1 0 1040 Meeting w i t h n u r s i n g edu c a t i o n committee 78. 7 46. 6 60 240 Meeting w i t h the head nurse committee 58. 3 550. 1 0 60 180 Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee 52. 5 55. 4 0 150 Meeting w i t h the s a f e t y and d i s a s t e r committee 51. 8 30. 9 60 120 Meeting w i t h nursing.standards and p r a c t i c e committees 42. 5 42. 3 0 60 150 Meeting with the n u r s i n g procedure committee 31. 2 36. 9 0 60 120 Meeting w i t h the n u r s i n g a u d i t committee 28. 5 ^40 • 3 0 120 I n t e r p r e t a t i o n of h o s p i t a l p o l i c y t o employees 28. 4 47. 8 none 240 Meeting w i t h the D i r e c t o r of Nurses 21. 0 31. 5 0 90 Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r 10. 0 19. 6 0 60 O v e r - a l l X 63. 64 100. TABLE. 22 A c t u a l Frequency of P o l i c y D e c i s i o n Making A c t i v i t i e s (Times per Year) A c t i v i t y X S.D. Mode Range I n t e r p r e t a t i o n of h o s p i t a l p o l i c y t o employees A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee Meeting w i t h the D i r e c t o r of Nurses Meeting w i t h the head nurse committee Meeting w i t h n u r s i n g education committee, Meeting with n u r s i n g a u d i t committee Meeting w i t h s a f e t y and d i s a s t e r committee Meeting w i t h n u r s i n g standards and p r a c t i c e committee Meeting w i t h the n u r s i n g procedure committee Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r Working on i n s e r v i c e e ducation budget 80.7 100.8 none 0 26.8 59.6 12 24.5 .55311 0 22.8 56,1 0 0 22.5 22.6 522 18.4 14.9 12 12.6 10.5 12 12.6 11.3 12 11.8 12.7 12 10.1 41.6 0 9.0 33.0 0 0 1.0 2.4 1 260 260 260 260 52 52 52 52 52 52 156 12 O v e r - a l l X 20.3 TABLE 23 A c t u a l T o t a l Hours per Year Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s A c t i v i t y Hours/Year A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures 110.55 I n t e r p r e t a t i o n of h o s p i t a l p o l i c y to employees 38.19 Meeting w i t h n u r s i n g education committee 24.13 Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee 21.86 Meeting w i t h the head nurse committee 21.43 Meeting w i t h s a f e t y and d i s a s t e r committee 10.87 Meeting w i t h n u r s i n g standards and p r a c t i c e committees 8.35 Meeting w i t h the D i r e c t o r of Nurses 7.98 Meeting w i t h the n u r s i n g a u d i t committee 5.9 8 Meeting w i t h the n u r s i n g procedure committee 5.25 Working on i n s e r v i c e e ducation budget 1.88 Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r 1.50 T o t a l hours 258 102. scores, and range of scores was wide. Miscellaneous A c t i v i t i e s : A c t i v i t i e s w i t h h i g h e s t time ranks were: 1) performing c l e r i c a l tasks a s s o c i a t e d w i t h preparing and d u p l i c a t i n g handouts 2) securing i n s t r u c t i o n a l resources, and 3) buying and t e s t i n g audio-v i s u a l equipment. Lowest rankings were occupied by a c t i v i t i e s i n v o l v i n g maintenance of a u d i o - v i s u a l equipment and w r i t i n g memos and involvement w i t h nursing students. Modes were v a r i e d and range of scores was wide. The o v e r - a l l mean was 36.24 minutes. C l e r i c a l t a s k s , such as answering the telephone and reading m a i l , ranked high i n frequency. A s s i s t i n g i n co o r d i n a t i o n of l e a r n i n g experiences f o r students and employees from other i n s . t i t u t i o n s showed low rankings. Mean scores v a r i e d from a c t i v i t y to a c t i v i t y : the highest was 251.3 times per year and the lowest, 1.5 times per year. In some instances the mean and mode were s i m i l a r but others were not. Range of scores was v a r i e d and wide. The o v e r - a l l mean was 65.8. Rankings i n v o l v i n g t o t a l hours per year were q u i t e s i m i l a r to frequency score rankings. The t o t a l hours per year f o r t h i s category was 418.92. In summary, c l e r i c a l tasks seemed to occupy the most time and had the highest frequency i n t h i s category, whereas c o o r d i n a t i o n of l e a r n i n g experience f o r students and other nursing personnel not employed by the respondents h o s p i t a l 103. TABLE 24 A c t u a l Time Spent on M i s c e l l a n e o u s A c t i v i t i e s ( i n Minutes per Instance Performed) A c t i v i t y X S.D • Mode Range Performing c l e r i c a l t a sks asso-c i a t e d w i t h p r e p a r i n g and d u p l i c a t i n g hand-outs •53. 5 55. 5 none 240 Se c u r i n g i n s t r u c t i o n a l resources (other than a u d i o - v i s u a l aids) 53. 1 55. 4 none 240 Buying and t e s t i n g audio-v i s u a l equipment 52. 0 98. 7 0 :60: 480 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students from schools o u t s i d e your h o s p i t a l 45. 2 93. 0 0 360 W r i t i n g advance b r i e f i n g s to s t a f f on upcoming i n s e r v i c e programs (e.g. f o r p o s t i n g on b u l l e t i n boards, etc.) 41. 8 34. 3 none 120 P l a n n i n g and implementing t o u r s f o r n u r s i n g i n t e r e s t groups and other i n t e r e s t e d i n d i v i d u a l s 41. 3 41. 4 0 60 120 Telephone c a l l s ( i n and out-going) Reading/answering m a i l 34. 31. 0 5 18. 31. 2 2 none 15 30 53 120^ A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r r e g i s t e r e d nurses who are not h o s p i t a l employees (e.g. from community c o l l e g e r e -f r e s h e r courses) 30.6 50.8 0 160 104. TABLE 24 (cont'd) A c t i v i t y X S.D. Mode Range M a i n t a i n i n g i n s t r u c t i o n a l resources (other than a u d i o - v i s u a l aids) A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students i n your h o s p i t a l ' s s c h o o l of n u r s i n g M a i n t a i n i n g a u d i o - v i s u a l equipment W r i t i n g memos 28.1 20.0 20. 0 18.6 32.3 54.2 25.6 12.5 0 .0 60 15 120 240 60 60 O v e r - a l l X 36. 24 105. TABLE 25 A c t u a l Frequency of M i s c e l l a n e o u s A c t i v i t i e s (Times per Year) A c t i v i t y X S.D '. Mode Range Telephone c a l l s ( i n and outgoint) 251. 3 42. 5 260 208 Reading/answering m a i l 218. 6 94. 4 260 260 W r i t i n g memos 194. 3 -94. 5 260 260 Performing c l e r i c a l t asks a s s o c i a t e d w i t h p r e p a r i n g and d u p l i c a t i n g hand-outs . 48. 2 63. 9 52 260 M a i n t a i n i n g a u d i o - v i s u a l equipment 34. 7 77. 0 0 260 W r i t i n g advance b r i e f i n g s to s t a f f on upcoming i n s e r v i c e programs (e.g. f o r p o s t i n g on b u l l e t i n boards, etc.) 31. 8 19. 6 52 52 S e c u r i n g i n s t r u c t i o n a l r e -sources (other than audio-v i s u a l aids) 28. 0 59 . 2 12 260 M a i n t a i n i n g i n s t r u c t i o n a l resources (other than a u d i o - v i s u a l aids) 25. 1 44. 3 0 156 Buying and t e s t i n g audio-v i s u a l equipment 6. 8 21. 0 0 104 P l a n n i n g and implementing t o u r s f o r n u r s i n g i n t e r e s t groups and other i n t e r e s t e d i n d i v i d u a l s 6. 1 11. 9 . 0 52 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students from schools o u t s i d e your h o s p i t a l 5. 8 21. 0 0 104 TABLE 25 (cont'd) A c t i v i t y X S.D. Mode Range A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r r e g i s t e r e d nurses who are not h o s p i t a l employees (e.g. from community c o l l e g e r e f r e s h e r courses) 3.1 10.5 0 52 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students i n your h o s p i t a l ' s s c h o o l of nurs-i n g 1.5 4.9 0 24 O v e r - a l l X 65.8 TABLE 26 A c t u a l T o t a l Hours Per Year Spent on M i s c e l l a n e o u s A c t i v i t i e s A c t i v i t y Hours/Year Telephone c a l l s ( i n and outgoing) 1 4 2 . 2 0 Reading/answering m a i l 1 1 4 . 7 6 W r i t i n g memos 6 0 . 2 3 Performing c l e r i c a l tasks a s s o c i a t e d w i t h p r e p a r i n g and d u p l i c a t i n g hand-outs 4 2 . 9 7 Securing i n s t r u c t i o n a l resources (other than a u d i o - v i s u a l aids) 2 4 . 7 8 W r i t i n g advance b r i e f i n g s to s t a f f on up- , • coming i n s e r v i c e programs (e.g. f o r p o s t i n g on b u l l e t i n boards, etc.) 2 2 . 1 5 M a i n t a i n i n g i n s t r u c t i o n a l resources, (other than a u d i o - v i s u a l aids) 1 1 . 7 5 M a i n t a i n i n g a u d i o - v i s u a l equipment 1 1 . 5 6 Buyingdand t e s t i n g a u d i o - v i s u a l equipment 5.89 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g e x p e r i -ences f o r n u r s i n g students from schools o u t s i d e your h o s p i t a l 4.36 P l a n n i n g and implementing tours, f o r n u r s i n g i n t e r e s t groups and other i n t e r e s t e d i n d i -v i d u a l s 4.19 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g e x p e r i -ences f o r r e g i s t e r e d nurses who are not h o s p i t a l employees (e.g. from community c o l l e g e r e f r e s h e r courses) 1.58 A s s i s t i n g i n c o o r d i n a t i o n . o f l e a r n i n g e x p e r i -ences f o r n u r s i n g students i n your h o s p i t a l ' s s c h o o l of n u r s i n g 0.5 T o t a l hours 4 1 8 . 9 2 108. took the l e a s t amount of time and had the lowest f r e q u e n c i e s . Summary: A c t u a l a c t i v i t i e s of respondents were examined with r e s p e c t to the mean number o f minutes, frequency and t o t a l hours per year. In terms of mean time, i n s t r u c t i o n a l a c t i v i t i e s ranked h i g h e s t , while program plannings ranked as the lowest category. Frequency rankings showed t h a t the mis c e l l a n e o u s category had the h i g h e s t frequency, while p o l i c y d e c i s i o n making a c t i v i t i e s were performed the fewest times per year. T o t a l number of hours, when ranked, i n d i c a t e d t h a t the respondents spent most of t h e i r time on i n s t r u c t i o n a l a c t i v i -t i e s , and the l e a s t amount of time i n p o l i c y d e c i s i o n making a c t i v i t i e s . In g e n e r a l , r e s u l t s were viewed with c a u t i o n s i n c e i n the m a j o r i t y o f cases mean time and frequency f o r each a c t i v i t y d i f f e r e d n o t i c e a b l y from the mode response. In a d d i t i o n , i n most i n s t a n c e s the range of scores f o r each a c t i v i t y was r a t h e r wide and v a r i e d . Thus s c o r e s o b t a i n e d were c o n s i d e r e d s u g g e s t i v e r a t h e r than d e f i n i t i v e i n express-i n g the i n s e r v i c e educators p e r c e p t i o n of t h e i r a c t u a l a c t i v i t y p r o f i l e s . I d e a l A c t i v i t i e s I d e a l a c t i v i t i e s , as p e r c e i v e d by respondents were ranked a c c o r d i n g to mean numbers of minutes, frequency of per-formance, and t o t a l hours per year, w i t h i n c a t e g o r i e s , J 109 . TABLE.27 I d e a l Time by Category (Minutes per Instance Performed) Category X Minutes I n s t r u c t i o n 96.90 P o l i c y D e c i s i o n Making 49.50 Program P l a n n i n g 47.03 S u p e r v i s i o n 44.70 M i s c e l l a n e o u s 28.04 110. TABLE 2 8 I d e a l Frequency by Category Category X Frequency M i s c e l l a n e o u s 54.6 I n s t r u c t i o n 51.1 Program P l a n n i n g 33.49 S u p e r v i s i o n 38.40 P o l i c y D e c i s i o n Making 15.70 TABLE 29 Ideal Total Hours per Year by Category Category Total Hours Program Planning 1504.43 Instruction 945.11 Supervision 305.79 Miscellaneous 302.02 Policy Decision Making 117.21 C a t e g o r i e s themselves were then ranked as shown i n t a b l e s 27 to 29. In terms of number of mean minutes", the i n s t r u c t i o n category ranked h i g h e s t a t 96.9 minutes per i n s t a n c e o f a c t i v i t y performance, w h i l e m i s c e l l a n e o u s a c t i v i t i e s ranked lowest a t 28.04 minutes. Frequency scores showed m i s c e l -laneous a c t i v i t i e s r a n k i n g h i g h e s t a t 54.6 times per year, while p o l i c y d e c i s i o n making ranked lowest with a frequency of 15.7 times per year. In terms of t o t a l hours per year, respondents saw themselves i d e a l l y spending the l a r g e s t number of hours on program p l a n n i n g , with the t o t a l f o r t h i s category a t 1504.43 hours per year. In c o n t r a s t , respondents wanted to spend 117.21 hours per year on p o l i c y - d e c i s i o n making a c t i v i t i e s , the lowest r a n k i n g . Program P l a n n i n g : A c t i v i t i e s i n the program p l a n n i n category, when ranked a c c o r d i n g to mean time, showed t h a t 1) s e l e c t i o n o f content f o r l e a r n i n g programs 2) c o n f e r r i n g with content s p e c i a l i s t s and 3) w r i t i n g o b j e c t i v e s f o r pro-grams ranked h i g h e s t . Respondents i n d i c a t e d t h a t they spent the l e a s t time i n such areas as h i r i n g i n t e r v i e w s and termina-t i o n i n t e r v i e w s . E v a l u a t i v e and o b s e r v a t i o n a l a c t i v i t i e s i n v o l v e d i n l e a r n i n g assessment ranked i n the middle range of mean scores from 68.5 minutes t o 40.8 minutes. The h i g h e s t rank score i n mean number of minutes was 185.9, while the lowest was 2.1, i n d i c a t i n g a r a t h e r wide range o f mean s c o r e s , as a whole, modes v a r i e d i n t h i s category, there were a number modal responses and others i n which no mode e x i s t e d . 11 In most cases, modes d i f f e r e d from mean minutes. The range of scores was r a t h e r broad and i n most i n s t a n c e s d i f f e r e d c o n s i d e r a b l y from the means. The o v e r - a l l mean number of minutes f o r t h i s category was 4 7.03. Frequency scores i n d i c a t e d t h a t 1) d i r e c t ob-s e r v a t i o n of s t a f f performance i n d e l i v e r i n g n u r s i n g care 2) bedside a u d i t t o assess the standard of p a t i e n t care and 3) d i r e c t o b s e r v a t i o n o f non-nursing s t a f f i n performance of d u t i e s a l l ranked among the h i g h e s t . Those a c t i v i t i e s i n v o l v i n g employees i n other departments and non-nursing personnel ranked among the lowest i n frequency. Modes were v a r i a b l e , w i t h a number of modes i n f a i r l y c l o s e p r o x i m i t y to mean scores and others d i f f e r i n g w i d e l y . In a t l e a s t t h i r t e e n cases, modes c o u l d not be assigned as responses were q u i t e s c a t t e r e d . Over h a l f the a c t i v i t i e s had the top frequency range, 260, which, i n most i n s t a n c e s d i f f e r e d r a t h e r s u b s t a n t i a l l y from the means and modes. D i r e c t o b s e r v a t i o n of n u r s i n g and non-nursing s t a f f i n performance of t h e i r d u t i e s and s e l e c t i n g c ontent f o r l e a r n i n g programs ranked h i g h e s t i n terms of t o t a l hours per year. D e s i r e f o r involvement with non-nursing s t a f f , w ith o t h e r departments and p a r t i c i p a t i o n i n h i r i n g i n t e r -views seemed to be a t a minimum f o r these respondents. The t o t a l number of hours f o r t h i s category was 1504.43 per yea r . In summary, i d e a l time rankings were h i g h e s t i n the areas of s e l e c t i o n o f program content, w r i t i n g o b j e c t i v e s TABLE 30 I d e a l Time Spent i n Program Planning A c t i v i t i e s ( i n Minutes per Instance Performed) A c t i v i t y X S.D, Mode Range S e l e c t i n g content f o r l e a r n i n g programs 135.9 Conferring w i t h content s p e c i -a l i s t s to gain background informat i o n f o r given programs (e.g. c o n f e r r i n g w i t h an inha-l a t i o n t h e r a p i s t f o r background on a program i n r e s p i r a t o r y i n -s u f f i c i e n c y ) W r i t i n g out o b j e c t i v e s f o r programs D i r e c t observation of s t a f f performance i n d e l i v e r i n g n u r sing care Reviewing job d e s c r i p t i o n s ( l i s t s of duties) 215.2 none 930 30 171.5 441.9 60 2000 60 145.2 251.8 120 2000 119.0 198.3 none 900 84.2 164.6 60 360 D i r e c t observation of non-nursing s t a f f i n p e r f o r -mance of d u t i e s 72.8 205.0 0 900 D i r e c t observation of s t a f f performance a f t e r a program (nursing s t a f f ) W r i t i n g e v a l u a t i o n r e p o r t s of l e a r n i n g programs 68.5 120.8 none 450 66.5 40.0 60 150 Conferences w i t h other i n -s e r v i c e educators t o de-velop program plans Keeping records of imple-mented programs 60.0 56.1 60 240 60.0 105.7 none 480 TABLE.-30 (cont'd) A c t i v i t y X S.D. Mode Range Meeting w i t h s u p e r v i s o r y per-sonnel of departments other than n u r s i n g to d i s c u s s s t a f f l e a r n i n g , needs (planned conferences) 49.5 32.6 60 120 Bedside a u d i t a f t e r an i n -s e r v i c e program to e v a l u -ate e f f e c t i v e n e s s of i n s t r u c -t i o n 49.2 97.4 30 450 Meeting w i t h n u r s i n g s u p e r v i s o -ry p e r s o n n e l t o d i s c u s s s t a f f l e a r n i n g needs (planned meet-ings) 47.8 23.3 60 120 C o - o r d i n a t i o n , o f program p l a n -n i n g a c t i v i t i e s i n i t i a t e d by n u r s i n g s t a f f 46.2 37.7 60 180 Conferences w i t h t a r g e t group ( s t a f f ) t o develop program o b j e c t i v e s f o r given learn§ i n g programs (nursing s t a f f ) 45.7 35.0 60 120 D i s c u s s i n g e v a l u a t i o n of given I n s e r v i c e programs wi t h other i n s e r v i c e educators i n your agency 44.0 • 28.8., . 60. 120 Bedside a u d i t ( u n i t v i s i t s t o p a t i e n t s to-, determine the e x t e n t to which p a t i e n t care standards are being met) 44355 75.4 30 360 Review of c h a r t i n g on n u r s i n g u n i t s , (chart audit) 44088. 51.2 60 240 Conferences w i t h other de-partments t o i d e n t i f y mutual l e a r n i n g needs (planned group meetings) 38.5 30.7. .60 120 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f to d i s c u s s l e a r n i n g needs (planned group meetings) 38.3 26.1 30 120 TABLE 30 (cont'd) A c t i v i t y X S.D. Mode Range Examination of employee per-formance evaluations 37.0 35.3 none 12 0 D i r e c t observation of s t a f f performance a f t e r a program (follow-up) (non-nursing s t a f f ) 36.7 103.5 0 450 P a r t i c i p a t i o n i n medical rounds 0 to assess l e a r n i n g needs 36.4 33.7 60 120 Reviewing e v a l u a t i o n of a program w i t h supervisory 3 0 personnel 35.2 2 0.4 60 60 Review of t e r m i n a t i o n r e -ports f o r suggestions on 0 i n s e r v i c e education programs 34.0 44.4 30 ISO P a r t i c i p a t i o n i n nursing rounds to assess l e a r n i n g needs 33.0 2 4.3 60 6 0 Reviewing e v a l u a t i o n of a program w i t h the l e a r n i n g 3 0 group 33.0 22.2 60 60 Observation of u n i t nursing care conferences to assess l e a r n i n g needs 32.0 23.6 30 90 Conferences w i t h t a r g e t s t a f f (the l e a r n i n g group f o r a given program) to develop program o b j e c t i v e s f o r given l e a r n i n g programs (non-nurs-ing s t a f f ) 24.9 33.6 0 120 Conferences w i t h other de-partments to i d e n t i f y mutual l e a r n i n g needs (planned i n -d i v i d u a l meetings) 23.8 22.6 none 60 Conferences w i t h general duty nur.si'ng s t a f f to d i s c u s s learning"needs (planned i n d i v i d u a l meetings) 22.8 14.4 . 30 60 TABLE 30 (cont'd) A c t i v i t y X S.D. Mode Range Meeting with nursing s u p e r v i -sory personnel to d i s c u s s s t a f f l e a r n i n g needs ( i n c i -d e n t a l conferences) 22.8 Meeting w i t h supervisory personnel of departments other than nursing t o d i s -cuss s t a f f l e a r n i n g needs ( i n c i d e n t a l conferences) 21.9 22.1 15 90 28.7 none 120 Terminal i n t e r v i e w s w i t h employees to seek sugges-t i o n s f o r i n s e r v i c e educa-t i o n programs (nursing s t a f f ) 19.5 22.5 30 - 90 Examination of i n c i d e n t reports 19.2 Conferences w i t h general duty-nursing s t a f f to d i s c u s s l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l meetings) 19.0 Conferences w i t h other de-partments to i d e n t i f y mutual l e a r n i n g needs ( i n c i d e n t a l group conferences) 18.9 Co-ordineition of program. p l a n -ning a c t i v i t i e s i n i t i a t e d by s t a f f i n other departments 17.2 18.2 3 0 21.1 24.4 60 14.3 none 60 60 60 Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n i n g needs ( i e . . m e d i c a l . s t a f f , c l e r i c a l , housekeeping, d i e t a r y , e t c . ( i n c i d e n t a l i n d i v i d u a l meetings) 16.5 Conferences w i t h general duty nursing s t a f f to d i s c u s s l e a r n i n g needs ( i n c i d e n t a l group meetings) 16.4 18.5 none 60 13.0 30 30 TABLE 30 (cont'd) A c t i v i t y X S.D. Mode Range P a r t i c i p a t i o n i n h i r i n g i n t e r -views t o e s t a b l i s h p o t e n t i a l employee's l e a r n i n g needs (nursing s t a f f ) 14.7 21.7 0 60 Terminal i n t e r v i e w s w i t h em-ployees t o seek suggestions f o r i n s e r v i c e e d u c a t i o n pro-grams 2 . 8 5 . 6 0 15 P a r t i c i p a t i o n i n h i r i n g i n t e r -views t o e s t a b l i s h the poten-t i a l employee's l e a r n i n g needs (non-nursing s t a f f ) 2.1 7 7 i l 0 30 O v e r - a l l X 47.03 119. TABLE 31 I d e a l Frequency of Program P l a n n i n g A c t i v i t i e s (Times per Year) A c t i v i t y X S.D. Mode Range D i r e c t o b s e r v a t i o n of s t a f f performance i n d e l i v e r i n g n u r s i n g care 157. 7 123. 0 260 260 Bedside a u d i t ( u n i t v i s i t s t o p a t i e n t s to determine the e x t e n t t o which p a t -i e n t care standards are being met) 113.. 3 113. 6 260 260 D i r e c t o b s e r v a t i o n of non-n u r s i n g s t a f f i n p e r f o r -mance of d u t i e s 104. 1 121. 7 0 260 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs ( i n c i d e n t a l group conferences) 100. 5 109. 6 none 260 Meeting w i t h n u r s i n g s u p e r v i s o r y personnel to d i s c u s s s t a f f l e a r n i n g needs ( i n c i d e n t a l conferences) 86. 6 100. 6 24 52 260 Observation of u n i t n u r s i n g care conferences to assess l e a r n i n g needs 80. 9 99.0 none 260 D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program (nursing s t a f f ) 69. 7 96.9 52 260 Examination of employee per-formance e v a l u a t i o n s 67. 4 99.0 none 260 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r -n i n g needs (planned i n d i v i d u -a l meetings) 63. 2 89.2 none 260 TABLE 31 (cont'd) A c t i v i t y X S.D. Mode Range P a r t i c i p a t i o n i n nursing rounds to assess l e a r n i n g needs 57.3 Keeping records of imple-mented programs 55.9 S e l e c t i n g content f o r l e a r n i n g programs .51.9 Co-ordination of program p l a n n i n g . a c t i v i t i e s i n i -t i a t e d by s t a f f i n . n u r s i n g 45.0 Conferences w i t h other i n -s e r v i c e educators to develop program plans 44.8 Bedside au d i t a f t e r an i n -s e r v i c e program to evaluate e f f e c t i v e n e s s of i n s t r u c t i o n 43.2 Examination of i n c i d e n t r e p o r t s 37.7 Conferences w i t h general duty nursing s t a f f to d i s c u s s l e a r n i n g needs ( i n c i d e n t a l group meetings Discussing e v a l u a t i o n of given i n s e r v i c e programs wi t h other i n s e r v i c e educators i n your agency P a r t i c i p a t i o n i n medical rounds to assess l e a r n i n g needs 34.5 32.0 28.7 Reviewing e v a l u a t i o n of a pro-gram w i t h the l e a r n i n g group 28.5 Meeting w i t h nursing supervisory personnel t o d i s c u s s s t a f f l e a r n i n g needs (planned con-ferences) 25.7 Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n -i n g needs ( i n c i d e n t a l i n d i v i -dual conferences) 23.6 79.0 none 260 90.2 52 260 79.0 12 260 56.7 62.8 38.0 21.4 12 52 260 68.1 12 260 75.2 none 260 56.0 52 260 12 260 57.9 52 260 57.7 12 52 0 12 104 56.. 1 52 260 52 260 TABLE 31 (cont'd) A c t i v i t y X S.D. Mode Range Meeting w i t h s u p e r v i s o r y per-sonnel of non-nursing de-partments to d i s c u s s s t a f f l e a r n i n g needs ( i n c i d e n t a l conferences) W r i t i n g out o b j e c t i v e s f o r programs C o n f e r r i n g w i t h content s p e c i a l i s t s t o g a i n back-ground i n f o r m a t i o n f o r given programs (e.g. con-f e r r i n g with an i n h a l a t i o n t h e r a p i s t f o r background on a program i n r e s p i r a t o r y i n s u f f i c i e n c y ) Conferences w i t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs (planned group conferences) Reviewing job d e s c r i p t i o n s ( l i s t s of d u t i e s ) C o - o r d i n a t i o n of program p l a n n i n g a c t i v i t i e s i n i t i -ated by s t a f f i n other de-partments D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program (follow-up) (non-nursing personnel) Terminal i n t e r v i e w s w i t h em-ployees to seek suggestions f o r i n s e r v i c e e d u c a t i o n (nursing s t a f f ) Reviewing e v a l u a t i o n of a program wi t h s u p e r v i s o r y personnel 23.0 56.7 none 260 22.8 57.8 none 260 22.4 31.6 none 104 21.7 20.0 18.7 20.3 12.2 19.7 58.7 19.2 57.3 27.5 12 12 52 17.5 17.9 0 12 12 52 52 0 260 0 260 104 52 TABLE 31 (cont'd) 122, A c t i v i t y X S.D. Mode Range 52 none 52 52 W r i t i n g e v a l u a t i o n r e p o r t s of l e a r n i n g programs 14.6 17.0 12 Review of te r m i n a t i o n r e p o r t s f o r suggestions on i n s e r v i c e education programs 13.9 17.4 P a r t i c i p a t i o n i n h i r i n g i n t e r -views to e s t a b l i s h p o t e n t i a l employee's l e a r n i n g needs f o r nursing personnel 12.9 20.3 Terminal i n t e r v i e w s w i t h em-ployees to seek suggestions f o r i n s e r v i c e education pro-grams (non-nursing s t a f f ) 10.6 26.4 0 104 Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n i n g needs (planned i n d i -v i d u a l meetings) 10.3 15.9 none 52 Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n i n g needs ( i n c i d e n t a l group conferences) 10.1 16.5 0 52 Conferences w i t h t a r g e t s t a f f to develop program o b j e c t i v e s f o r given programs (nursing s t a f f ) 10.1 15.2 Meeting w i t h supervisory per-sonnel of departments other than nursing t o d i s c u s s s t a f f l e a r n i n g needs (planned meet-ings) 9.7 14.7 Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n i n g needs ( i e . medical s t a f f , c l e r i c a l , housekeeping, d i e t a r y , etc.) (planned group conferences) 7.5 7.5 12 24 none 52 none 52 Review of c h a r t i n g on nursing u n i t s (chart audit) 4.0 4.7 1 12 12 TABLE 31 (cont'd) A c t i v i t y X S.D. Mode Range P a r t i c i p a t i o n i n h i r i n g i n t e r -views to e x t a b l i s h the poten-t i a l employee's l e a r n i n g needs (non n u r s i n g personnel 1.7 5.7 0 24 Conferences w i t h t a r g e t s t a f f (the l e a r n i n g group f o r a g i v e n program) to develop program o b j e c t i v e s f o r given l e a r n i n g programs (non-nurs-i n g personnel) 1.4 1.8 0 4 O v e r - a l l X 38.49 TABLE 32 I d e a l T o t a l Hours per Year Spent on Program P l a n n i n g A c t i v i t y Hours/Year D i r e c t o b s e r v a t i o n of s t a f f performance i n d e l i v e r i n g n u r s i n g care 312.77 S e l e c t i n g content f o r l e a r n i n g programs 160.80 D i r e c t o b s e r v a t i o n of non-nursing s t a f f i n performance of d u t i e s 126.30 Bedside a u d i t ( u n i t v i s i t s t o p a t i e n t s t o determine the extent t o which p a t i e n t care standards are being met) 82.14 D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program (nursing s t a f f ) 79.57 C o n f e r r i n g w i t h content s p e c i a l i s t s t o g a i n background i n f o r m a t i o n f o r given programs (e.g. c o n f e r r i n g w i t h an i n h a l a t i o n t h e r a p i s t f o r background on a program i n r e s p i r a t o r y i n s u f f i c i e n c y ) 64.02 Keeping records of implemented programs 55.90 W r i t i n g out o b j e c t i v e s f o r programs 55.17 Conferences w i t h other i n s e r v i c e educators to develop program plans 44.80 Observation of u n i t n u r s i n g care conferences to assess l e a r n i n g needs 43.14 Examination of employee performance e v a l u a t i o n s 41.56 Bedside a u d i t a f t e r an i n s e r v i c e program t o ev a l u a t e e f f e c t i v e n e s s of i n s t r u c t i o n 35.42 C o - o r d i n a t i o n of program p l a n n i n g a c t i v i t i e s i n i t i a t e d by s t a f f i n n u r s i n g 34.65 Meeting w i t h n u r s i n g s u p e r v i s o r y personnel t o d i s c u s s s t a f f l e a r n i n g needs (planned con-ferences) 32.90 TABLE 32 (cont'd) A c t i v i t y Hours/Year Conferences w i t h general duty nursing s t a f f to d i s c u s s l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l conferences) 31.82 P a r t i c i p a t i o n i n nursing rounds to assess l e a r n i n g needs 31.51 Reviewing job d e s c r i p t i o n s ( l i s t s of duties) 28.06 Conferences w i t h general duty nursing s t a f f . t o " d i s c u s s learning, needs (planned i n d i v i d u a l meetings) 24.01 D i s c u s s i n g e v a l u a t i o n of given i n s e r v i c e programs w i t h other i n s e r v i c e educators i n your agency 23.46 Meeting w i t h nursing supervisory personnel to discuss s t a f f l e a r n i n g needs (planned confer-ences) 20.47 P a r t i c i p a t i o n i n medical rounds to assess l e a r n -ing, needs 17.41 W r i t i n g e v a l u a t i o n reports of l e a r n i n g programs 16.18 Reviewing e v a l u a t i o n of a program w i t h the l e a r n -i n g group 15.67 Conferences w i t h general duty nursing s t a f f to discuss l e a r n i n g needs (planned group meetings) 13.85 Examination of i n c i d e n t r e p o r t s 12.06 D i r e c t observation of s t a f f performance a f t e r a program (follow-up) (non-nursing s t a f f ) 11.74 Reviewing e v a l u a t i o n of a program w i t h super-v i s o r y personnel 10.2 6 Conferences w i t h general duty nursing s t a f f to discuss l e a r n i n g needs ( i n c i d e n t a l group meet-ings) 9.43 Meeting w i t h supervisory personnel of non-nursing departments to discuss s t a f f l e a r n i n g needs ( i n c i d e n t a l conferences) 8.39 TABLE 32 (cont'd) A c t i v i t y Hours/Year Meeting with s u p e r v i s o r y personnel of depar t -ments other than n u r s i n g t o d i s c u s s s t a f f l e a r n i n g needs (planned conferences) 8.00 Review of t e r m i n a t i o n r e p o r t s f o r suggestions on i n s e r v i c e e d u c a t i o n programs 7.87 Conferences w i t h t a r g e t s t a f f t o develop program o b j e c t i v e s f o r gi v e n l e a r n i n g programs (nursing s t a f f ) 7.69 Conferences w i t h other departments t o i d e n t i f y mutual l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l meetings) 6.49 Terminal i n t e r v i e w s w i t h employees t o seek sug-g e s t i o n s f o r i n s e r v i c e education programs (nursing personnel) 6.07 C o - o r d i n a t i o n of program p l a n n i n g a c t i v i t i e s i n i t i a t e d by s t a f f i n other departments 5.64 Conferences with other departments t o i d e n t i f y mutual l e a r n i n g needs (planned group meetings) 4.81 Conferences w i t h other departments t o i d e n t i f y mutual l e a r n i n g needs (planned i n d i v i d u a l meetings) 4.08 Conferences w i t h other departments t o i d e n t i f y mutual l e a r n i n g needs ( i n c i d e n t a l group con-ferences) 3.18 P a r t i c i p a t i o n i n h i r i n g i n t e r v i e w s t o e s t a b l i s h p o t e n t i a l employee's l e a r n i n g needs (nursing personnel) 3.16 Review of c h a r t i n g on n u r s i n g u n i t s (chart audit) 2.72 Conferences w i t h t a r g e t s t a f f t o develop program o b j e c t i v e s f o r given l e a r n i n g programs (non-n u r s i n g s t a f f ) 0.58 Terminal i n t e r v i e w s w i t h employees t o seek sug-g e s t i o n s f o r i n s e r v i c e educationz-programs (non-n u r s i n g s t a f f ) 0.49 TABLE 32 (cont'd) A c t i v i t y Hours/Year Pa r t i c i p a t i o n i n h i r i n g interviews to establish the potential employee's learning needs (non-nursing staff) 0.058 Total hours 1504.43 128. and c o n f e r r i n g w i t h content s p e c i a l i s t s . Lowest rankings were i n areas o f h i r i n g and t e r m i n a t i o n i n t e r v i e w s . Frequency scores were h i g h e s t i n o b s e r v a t i o n a l a c t i v i t i e s , whereas a c t i v i t i e s i n v o l v i n g non-nursing personnel ranked the lowest. S i m i l a r rankings r e s u l t e d when t o t a l hours per year were used. Modes i n gen e r a l were v a r i a b l e and range of scores was f a i r l y broad. Thus, mean score rankings were c o n s i d e r e d as sugges-t i v e r a t h e r than d e f i n i t i v e . I n s t r u c t i o n : I n s t r u c t i o n a l a c t i v i t i e s w i t h the h i g h e s t time rankings i n c l u d e d 1) use of e i g h t hour programs 2) use of h a l f day workshops 3) d i r e c t i n s t r u c t i o n o f r e g i s t e r e d nurses 4) s e l e c t i n g i n s t r u c t i o n a l r e s o u r c e s . Respondents i n d i c a t e d t h a t they wished t o spend the l e a s t amount of time on c o o r d i n a -t i n g i n s t r u c t i o n a l a c t i v i t i e s o f oth e r i n s e r v i c e e d u c a t i o n and on c o n s u l t i n g w i t h s t a f f t o determine s c h e d u l i n g r e q u i r e d to adequately s t a f f the wards duri n g i n s e r v i c e programs. Mean scores v a r i e d w i d e l y , the h i g h e s t b e i n g 4 80 minutes, and the lowest, 13.3 minutes. In many, i n s t a n c e s modes were i n c l o s e range t o the mean s c o r e s , but the range of response was very broad. The o v e r - a l l mean time f o r t h i s c a t e g o r y was 9 6.9 minutes. Frequency rankings d i s c l o s e d t h a t respondents wished i d e a l l y f o r h i g h e s t f r e q u e n c i e s i n 1) a d v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s , 2) u s i n g s h o r t "mini" programs and i n 3) d i r e c t i n s t r u c t i o n of r e g i s t e r e d nurses. 129 . Lowest f r e q u e n c i e s scores appeared i n use of e i g h t hour pro-grams and p i l o t programs to t e s t out i n s t r u c t i o n a l techniques. Modes seemed u n r e l a t e d to mean scores and the range was f a i r l y broad. Mean scores v a r i e d w i d e l y , w i t h the h i g h e s t a t 16 2.2 times per year and the lowest, 2.8. The o v e r - a l l score was 51.1 timer per year. Based on rankings of t o t a l hours per year, respondents wished to spend the g r e a t e s t number of hours per year d i r e c t l y i n s t r u c t i n g r e g i s t e r e d nurses and u t i l i z i n g one to two hour programs. Lowest rankings were occupied by use of p i l o t programs to t e s t out i n s t r u c t i o n a l techniques and a s s i s t other s t a f f members i n t e a c h i n g n u r s i n g p e r s o n n e l . T o t a l hours v a r i e d widely, w i t h the h i g h e s t a t 260.81 and the lowest a t 5.34. In summary, respondents i n d i c a t e d t h a t they wished to spend the most time on e i g h t and f o u r hour programs and on d i r e c t i n s t r u c t i o n , and the l e a s t i n c o o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s of o t h e r s , as w e l l as c o n s u l t i n g with s t a f f to determine s c h e d u l i n g of programs. Highest frequency scores appeared i n a d v i s i n g s t a f f r e g a r d i n g resource m a t e r i a l and d i r e c t i n s t r u c t i o n as w e l l as use of "mini" programs, w h i l e lowest f r e q u e n c i e s appeared i n use of e i g h t hour programs and p i l o t programs. The g r e a t e s t number of other hours per year as an i d e a l was occupied by d i r e c t i n s t r u c t i o n arid use of one to two hour.programs. Respondents wished to spend the l e a s t number of hours on a s s i s t i n g others w i t h i n s t r u c t i o n and use 130. TABLE 33 Ideal Time Spent i n Instructional A c t i v i t i e s (in Minutes per Instance Performed) A c t i v i t y X S.D. Mode Range Use of 8 hour programs 480. Of. 0 480 0 Use of half-day workshop programs (4 hours i n length) 240. 0." 0 240 0 Direct i n s t r u c t i o n of registered nurses 143. 7 246. 1 30 60 1100 Selecting i n s t r u c t i o n a l resources (equipment, people, etc.) 124. 5 258. 4 60 1190 Use of programs 1 to 2 hours i n length 120. 0 0 120 0 Direct i n s t r u c t i o n of non-nursing personnel 78. 0 269. 6 0 1200 Experimentation with new teaching techniques 59. 0 41. 4 60 120 Use of p i l o t programs to "test out" an ins t r u c -t i o n a l technique before using i n a formal program 50. •2- 41. 6 60 180 Use of content s p e c i a l i s t s to help teach 48. 9 21. 6 30 120 A s s i s t i n g another s t a f f member (ie. head nurse) i n teaching nursing personnel 43. 7 51. 5 30 60 240 Direct i n s t r u c t i o n of nurses' aides 43. 2 77. 2 0 240 Direct i n s t r u c t i o n of p r a c t i -c a l nurses 40. 2 60. 6 0 30 240 131. TABLE 33 (cont'd) A c t i v i t y X S.D. Mode Range D i r e c t i n s t r u c t i o n of student nurses 32.5 68.1 0 240 Use of "mini-programs" (15 t o 45 minutes i n length) 3 0.0 0 3 0 0 A d v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s 22.5 12.4 15 45 A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g (non-nursing personnel) 22.1 56.4 0 240 C o - o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s of Other i n s e r -v i c e educators 20.3 24.0 0 60 C o n s u l t a t i o n w i t h s t a f f to determine a p p r o p r i a t e r e -sc h e d u l i n g r e q u i r e d to cover wards d u r i n g an i n -s e r v i c e program 13.3 15.5 0 60 O v e r - a l l X 96.9 TABLE 34 I d e a l Frequency of I n s t r u c t i o n a l A c t i v i t i e s (Times per Year) A c t i v i t y X S.D. Mode Range A d v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s 162. 0 107. 3 260 260 Use of "mini-programs" (15 to 45 minutes i n length) 122. 4 98. 7 52 2609 260 D i r e c t i n s t r u c t i o n of r e g i s t e r e d nurses 108. 9 111. 1 12 260 260 Use of content s p e c i a l i s t s to h elp teach 73. 3 87. 0 52 260 Use of programs 1 to 2 hours i n l e n g t h 66. 7 101. 6 none 260 D i r e c t i n s t r u c t i o n of p r a c t i c a l nurses 62. 0 94. 0 0 260 D i r e c t i n s t r u c t i o n of nurs e s ' a i d e s 57. 2 96. 2 0 260 S e l e c t i n g i n s t r u c t i o n a l r e sources (equipment, people, etc.) 49. 2 76. 2 12 260 A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g n u r s i n g p e r s o n n e l 48. 1 82. 8 none 260 C o - o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s of other i n s e r v i c e educators 36. 3 76. 5 0 260 C o n s u l t a t i o n w i t h s t a f f t o determine appropriage r e -s c h e d u l i n g r e q u i r e d to cover wards d u r i n g an i n s e r v i c e program 32. 9 58. 6 0 260 TABLE 34 (cont'd) A c t i v i t y X S.D. Mode Range D i r e c t i n s t r u c t i o n of non-n u r s i n g p e rsonnel D i r e c t i n s t r u c t i o n of student nurses Experimentation withnnew t e a c h i n g techniques A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g non-nursing personnel Use of h a l f - d a y workshop programs (4 hours i n length) Use o f p i l o t programs t o " t e s t out" an i n s t r u c t i o n a l technique b e f o r e u s i n g i n a formal program Use of 8 hour.programs . 27.8 79.5 0 260 14.9 57.8 260 14.8 25.8 none 104 14.5 37.9 0 156 9.3 12.6 none 52 7.2 8.3 none 24 0 2.8. 4.5 1 12 O v e r - a l l X 51.1 TABLE 3 5 I d e a l T o t a l Hours per Year Spent on I n s t r u c t i o n a l A c t i v i t i e s A c t i v i t y Hours/Year D i r e c t i n s t r u c t i o n of r e g i s t e r e d nurses 260.81 Use of programs 1 to 2 hours i n l e n g t h 133.40 S e l e c t i n g i n s t r u c t i o n a l r esources (equipment, people, etc.) 102.09 Use of "mini-programs" (15 to 45 minutes i n length) 61.20 A d v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s 60.82 Use of content s p e c i a l i s t s to he l p teach 59.73 D i r e c t i n s t r u c t i o n of p r a c t i c a l nurses 41.54 D i r e c t i n s t r u c t i o n of. nurses' aides 41.18 Use of h a l f - d a y workshop programs (4 hours i n length) 37.20 D i r e c t i n s t r u c t i o n o f non-nursing personnel 36.14 A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g non-nursing personnel 35.03 Use of 8 hour programs 22.40 Experimentation w i t h new t e a c h i n g techniques 14.55 C o - o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s of oth e r i n s e r v i c e educators 12.28 D i r e c t i n s t r u c t i o n of student nurses 8.07 C o n s u l t a t i o n w i t h s t a f f to determine a p p r o p r i a t e r e s c h e d u l i n g r e q u i r e d to cover wards d u r i n g an i n s e r v i c e program 7.29 TABLE 35 (cont'd) A c t i v i t y Hours/Year A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g n u r s i n g personnel 6.02 Use of p i l o t programs to " t e s t out" an i n s t r u c -t i o n a l technique before u s i n g i n a formal pro-gram 5.34 T o t a l hours 945.11 of p i l o t programs. In g e n e r a l , modes tended to vary and d i f f e r from mean scores (except i n mean time scores) and the range of mean scores and responses was f a i r l y broad. Thus, as with other c a t e g o r i e s , r e s u l t s i n t h i s category were regarded w i t h due c a u t i o n . S u p e r v i s i o n : I d e a l time rankings f o r s u p e r v i s i o n showed a s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas occupying a top p o s i t i o n , and performing p a t i e n t and drug census a t the bottom. Mean scores v a r i e d s h a r p l y , from 2 0 8 . 5 minutes to 0 . 4 minutes. Most modes were a t zero, w i t h one bi-modal response. Range of responses was q u i t e broad. The o v e r - a l l mean f o r the category was 4 4 . 7 minutes. Frequency rankings showed c o r r e c t i n g and d i s c i p l i n e p ersonnel a t the top, and performing drug and: p a t i e n t census at the bottom. Mean scores again showed a broad range, from 8 2 . 1 times per year to 2 . 4 times per year. Range of responses f o r each a c t i v i t y was a l s o broad. Modes seemed u n r e l a t e d to mean s c o r e s , d i f f e r i n g r a t h e r w i d e l y . The o v e r - a l l mean frequency was 3 8 . 4 times per year. In terms of t o t a l hours per year, respondents i n d i -c a t e d t h a t they wished the g r e a t e s number of hours t o be spent on a s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas, and an almost n e g l i g i b l e amount on p a t i e n t and drug census. The range o f t o t a l hours was q u i t e broad, w i t h the h i g h e s t a t 2 6 2 . 0 1 hours per year and the lowest a t 0 . 0 1 5 . T o t a l hours per year were 305.79. In summary, i d e a l time and t o t a l hour rankings were q u i t e s i m i l a r , showing d i s t i n c t emphasis on s u p e r v i s i o n i n c l i n i c a l areas as an a c t i v i t y d e s e r v i n g of the most time. Frequency rankings s p e c i f i e d c o r r e c t i n g and d i s c i p l i n i n g of personnel as the h i g h e s t r a n k i n g item. Modes d i f f e r e d from means r a t h e r n o t i c e a b l y and th e r e was a f a i r l y broad range i n both mean scores and responses f o r each a c t i v i t y . P o l i c y D e c i s i o n Making: Educators ranked working on the i n s e r v i c e e d u c a t i o n budget as top p r i o r i t y i n terms o f time. Meeting with v a r i o u s committees a l s o ranked f a i r l y h i g h , although there was a gap between top score and the other i teams; the top scor e was 161.5 minutes, w h i l e the next i n rank was 71.4. I n t e r p r e t a t i o n of h o s p i t a l p o l i c y and meeting with h o s p i t a l a d m i n i s t r a t o r s ranked the lowest. Modal responses d i f f e r e d from mean scores i n most i n s t a n c e s and ranges o f both mean scores and responses were f a i r l y broad. The o v e r - a l l mean f o r the category was 49.5 minutes. Frequency rankings p l a c e d i n t e r p r e t a t i o n of h o s p i t a l p o l i c y a t the top and working on the i n s e r v i c e education budget a t bottom. Committee meetings occupied middle r a n k i n g s . Modes d i f f e r e d from mean scores and ranges of both mean scores and responses to each a c t i v i t y were broad. Mean scores ranged from 52.6 times per year t o 1.4 times per year. The o v e r - a l l mean was 15.7 times per year. Respondents i n d i c a t e d t h a t i d e a l l y they wished to TABLE 36 I d e a l Time Spent on S u p e r v i s o r y A c t i v i t i e s ( i n Minutes per Instance Performed) A c t i v i t i e s X S.D. Mode Range A s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas 208.5 559.7 0 2400 P a r t i c i p a t i n g i n a d m i n i s t r a - 0 t i v e meetings 43.7 45.9 60 150 Performance e v a l u a t i o n s to determine promotion or t e r m i n a t i o n of an employee 32.8 48.0 0 180 C o r r e c t i n g and d i s c i p l i n i n g p e r s o nnel 13.8 18.6 0 60 A s s i g n i n g n u r s i n g personnel ( u n i t assignments) 10.5 19.5 0 60 H i r i n g n u r s i n g personnel 6.0 18.4 0 60 Performing p a t i e n t and drug census 0.4 2.1 0 10 O v e r - a l l X 44.7 139. TABLE 37 I d e a l Frequency of S u p e r v i s o r y A c t i v i t i e s (Times per Year) A c t i v i t y X S.D. Mode Range C o r r e c t i n g and d i s c i p l i n i n g 0 personnel 82.1 120.0 260 260 A s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas 75.4 113.7. 0 260 A s s i g n i n g n u r s i n g personnel ( u n i t assignments) 67.6 114.5 0 260 P a r t i c i p a t i n g i n a d m i n i s t r a - 0 t i v e meetings 37.8 64.8 52 260 Performance e v a l u a t i o n s t o determine promotion or t e r m i n a t i o n of an employee 4.0 11.3 0 52 H i r i n g n u r s i n g personnel 3.2 25.7 0 52 Performing p a t i e n t and drug census 2.4 11.3 0 52 O v e r - a l l X 38.4 140 . TABLE 38 I d e a l T o t a l Hours per Year Spend on S u p e r v i s o r y A c t i v i t i e s A c t i v i t y Hours/Year A s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas 262.01 P a r t i c i p a t i n g i n a d m i n i s t r a t i v e meetings 27.53 A s s i g n i n g n u r s i n g personnel ( u n i t assignments) 11.83 Performance e v a l u a t i o n s t o determine promotion or t e r m i n a t i o n of an employee 2.18 C o r r e c t i n g and d i s c i p l i n i n g personnel 1.89 H i r i n g n u r s i n g personnel 0.32 Performing p a t i e n t and drug census 0.015 T o t a l Hours 305.79 141. TABLE 39 I d e a l Time Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s ( i n Minutes per Instance Performed) A c t i v i t y X S.D. Mode Range Working on i n s e r v i c e e ducation budget 161. 5 191. 9 0 600 Meeting w i t h the n u r s i n g education committee 71. 4 . 67. 4 . 60 240 Meeting w i t h the head nurse committee 65. 2 42. 8 60 180 A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures 49. 5 36. 7 60 120 Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee 48. 0 52. 7 0 60 150 Meeting w i t h the s a f e t y and d i s a s t e r committee 35. 0 31. 9 0 60 90 Meeting w i t h n u r s i n g standards and p r a c t i c e committees 34. 2 40. 5 0 120 Meeting w i t h n u r s i n g a u d i t committee 33. 5 40. 2 0 120 Meeting w i t h the n u r s i n g procedure committee 32. 8 32. 7 0 60 90 Meeting w i t h the D i r e c t o r of Nurses 31. 7 34. 6 0 120 I n t e r p r e t a t i o n of h o s p i t a l p o l i c y t o employees 21. 0 29. 0 0 120 Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r 14. 2 19. 1 0 60 O v e r - a l l X 49.5 TABLE 40 I d e a l Frequency of P o l i c y D e c i s i o n Making A c t i v i t i e s (Times per Year) A c t i v i t y S.D. Mode Range I n t e r p r e t a t i o n of h o s p i t a l p o l i c y t o employees Meeting with the D i r e c t o r of Nurses Meeting w i t h the head nruse committee Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r Meeting w i t h n u r s i n g education committee Meeting w i t h s a f e t y and d i s a s t e r committee Meeting w i t h the n u r s i n g procedure committee A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures Meeting w i t h n u r s i n g standards and p r a c t i c e committee Meeting w i t h the n u r s i n g a u d i t committee Working on i n s e r v i c e e d u c a t i o n budget 52.6 91.5 26.2 58.5 22.5 20.3 16.4 20.5 14.3 57.9 13.8 10.0 8.8 5.5 4.4 1.4 14.9 15.4 9.4 15.6 12.1 6.9 5.4 2.6 0 260 0 260 none 52 52 0 260 12 52 52 0 52 none 52 0 24 0 12 0 1 12 O v e r - a l l X 15.7 TABLE 41 I d e a l T o t a l Hours per Year Spent on Policy-D e c i s i o n Making A c t i v i t i e s A c t i v i t y Hours/Year Meeting w i t h the head nurse committee 24.45 I n t e r p r e t a t i o n of h o s p i t a l p o l i c y to employees 18.41 Meeting w i t h n u r s i n g education committee 16.42 Meeting w i t h the D i r e c t o r of Nurses 13.84 Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee 13.12 A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures 7.26 Meeting w i t h s a f e t y and d i s a s t e r committee 5.83 Meeting w i t h the n u r s i n g procedure committee 5.13 Working on i n s e r v i c e e ducation budget 3.76 Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r 3.38 Meeting w i t h n u r s i n g standards and p r a c t i c e committee? 3.13 Meeting w i t h n u r s i n g a u d i t committee 2.45 T o t a l hours 117.21 144 . spend the greatest number of hours per year i n t h i s category meeting with the head nurse committee and inte r p r e t i n g hospi-t a l p o l i c y to employees. The fewest number of hours per year were to be spent meeting with nursing audit, standards and practice committee. The t o t a l number of hours per year for t h i s category was 117.21. In summary, time rankings were highest on budgetary a c t i v i t i e s and lowest on interpreting hospital p o l i c y to employees. Rankings were reversed for frequency. Rankings for t o t a l hours per year showed meeting with the head nurse committee as the highest p r i o r i t y while meeting with a variety of other committees ranked the lowest. Mean scores could only be viewed as suggestive since modes d i f f e r e d rather noticeably from mean scores and range of responses was broad. Miscellaneous: Time rankings i n this category s p e c i f i e d securing of i n s t r u c t i o n a l resources as the highest rank. Respondents ranked as the next highest a s s i s t i n g i n coordination of learning experiences for registered nurses and students not employed by the respondent's h o s p i t a l . Audio-v i s u a l equipment maintenance was the least favoured. Modes, for the most part, d i f f e r e d from mean scores, and the range of mean scores, as well as responses to each a c t i v i t y , were noticeably broad. The o v e r - a l l mean for th i s category was 28.04 minutes. TABLE 42 I d e a l Time Spent on M i s c e l l a n e o u s A c t i v i t i e s ( i n Minutes per Instance Performed) A c t i v i t y X S.D. Mode Range Securi n g i n s t r u c t i o n a l resources (other than audio-v i s u a l aids) 53.8 56.6 60 240 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r r e g i s t e r e d nurses who are not h o s p i t a l employees (e.g. from community c o l l e g e r e f r e s h e r courses) 49.5 116.6 0 120 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students from schools o u t s i d e your hos-p i t a l 45.5 112.6 0 480 W r i t i n g advance b r i e f i n g s to s t a f f on upcoming i n s e r v i c e programs (e.g. f o r p o s t i n g on b u l l e t i n boards, etc.) 34.0 36.4 none 120 P l a n n i n g and implementing tours f o r n u r s i n g i n t e r e s t groups and other i n t e r e s t e d i n d i v i d u a l s 27.4 40.1 0 120 Telephone c a l l s ( i n and out-going) 27.2 15.7 30 60 Buying and t e s t i n g audio-v i s u a l equipment 26.6 35.4 0 120 15 Reading/answering \mail 25.2 15.3 30 60 M a i n t a i n i n g i n s t r u c t i o n a l resources (other than a u d i o - v i s u a l aids) 22.8 34.7 0 120 TABLE 42 A c t i v i t y X S.D. Mode Range Performing c l e r i c a l t a sks a s s o c i a t e d w i t h p r e p a r i n g and d u p l i c a t i n g hand^-outs 20. 7 31.9 0 105 W r i t i n g memos 17. 5 13.9 15 30 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students i n your h o s p i t a l ' s s c h o o l of nurs-i n g 10. 5 22.3 0 60 M a i n t a i n i n g a u d i o - v i s u a l equipment 2. 8 7.6 0 30 O v e r - a l l X 28.04 TABLE 43 Ideal Frequency of Miscellaneous A c t i v i t i e s (Times per Year) A c t i v i t y X S.D i. Mode Range Telephone c a l l s (in and out-going) 236. 6 72. 5 260 260 Reading/answering mail 210. 4 101. 8 260 260 Writing memos 165. 6 113. 4 260 260 Writing advance br i e f i n g s to s t a f f on upcoming inser-vice programs (e.g. for posting on-bulletin boards, etc.) 29. 3 22. 8 52 52 Performing c l e r i c a l tasks associated with preparing and duplicating hand-outs 24. 0 57. 7 0 260 Maintaining i n s t r u c t i o n a l resources (other than audio-v i s i o n a l aids) 20. 9 56. 8 0 440 Securing i n s t r u c t i o n a l resources (other than audio-v i s u a l aids) 17. 2 33. 2 12 156 Buying and testing audio-v i s u a l equipment 7. 8 22 . 8 0 104 Maintaining audio-visual equipment 5. 5 15. 6 0 52 Planning and implementing tours for nursing i n t e r e s t groups and other interested individuals 5. 2 12. 2 0 52 A s s i s t i n g i n coordination of learning experiences for registered nurses who are not hospital employees (e.g. from.community college re-fresher courses) 3. 9 11 . 5 0 52 TABLE 43 (cont'd) A c t i v i t y X S.D. Mode Range A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students i n your h o s p i t a l ' s s c h o o l of nur-s i n g 3. 1 11.2 0 52 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students from schools o u t s i d e your h o s p i t a l 2. 1 2.8 0 4 12 O v e r - a l l X 51.1 TABLE 4 4 I d e a l T o t a l Hours per Year Spent on M i s c e l l a n e o u s A c t i v i t i e s A c t i v i t y Hours/Year Telephone, c a l l s , ( i n and. outgoing) 1 0 7 . 2 5 Reading/answering m a i l 8 8 . . 3 6 W r i t i n g memos 4 8 . 3 0 W r i t i n g advance b r i e f i n g s t o s t a f f on upcoming i n s e r v i c e programs (e.g. f o r p o s t i n g on.bul-l e t i n boards, etc.) 1 6 . 6 0 S e c u r i n g i n s t r u c t i o n a l r esources (other than a u d i o - v i s u a l aids) 1 5 . 4 2 Performing c l e r i c a l t a sks a s s o c i a t e d w i t h p r e -p a r i n g and d u p l i c a t i n g hand-outs 8 . 2 3 M a i n t a i n i n g i n s t r u c t i o n a l r esources (other than a u d i o - v i s u a l aids) 7 . 9 4 Buying and t e s t i n g a u d i o - v i s u a l equipment 3 . 4 5 P l a n n i n g and implementing t o u r s f o r n u r s i n g i n t e r e s t groups and other i n t e r e s t e d i n d i v i d u a l s 2 . 3 7 A s s i s t i n g i n C o o r d i n a t i o n of l e a r n i n g experiences f o r n u rsing students from schools o u t s i d e your h o s p i t a l 2 . 3 5 A s s i s t i n g i n coordination:;,, of l e a r n i n g experiences f o r r e g i s t e r e d nurses who are not h o s p i t a l em-ployees (e.g. from community c o l l e g e r e f r e s h e r courses) 1 . 7 3 A s s i s t i n g i n c o o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students i n your h o s p i t a l ' s s c h o o l of n u r s i n g 0 . 6 8 M a i n t a i n i n g a u d i o - v i s u a l equipment 0 . 2 5 T o t a l hours 3 0 3 . 0 2 Telephone c a l l s ranked h i g h e s t i n freguency f o l l o w e d by r e a d i n g and answering m a i l and w r i t i n g memos. The succeed-i n g ranks drop s u b s t a n t i a l l y i n mean scores from 165.6 times per year f o r w r i t i n g memos to 29.3 times per year f o r w r i t i n g advance program b r i e f i n g s . A s s i s t i n g i n c o o r d i n a t i o n o f l e a r n i n g groups o t h e r than n u r s i n g s t a f f ranked lowest i n frequency. Modal responses d i f f e r e d from mean s c o r e s , and the range of mean scores as w e l l as range o f responses f o r each a c t i v i t y were broad. T o t a l hours per year f o r t h i s category d i s c l o s e d rankings s i m i l a r to frequency r a n k i n g s , except t h a t the lowest r a n k i n g a c t i v i t y was maintenance of' a u d i o v i s u a l equip-ment. T o t a l hours per year f o r each a c t i v i t y v a r i e d g r e a t l y i n t h i s category, ranging from 107.25 hours per year to 0.25. The t o t a l f o r the category was 30 3.02 per year. In summary, time rankings f o r t h i s category showed s e c u r i n g o f i n s t r u c t i o n a l r e s o u r c e s as the area i n which educators wanted to spend the most number of minutes, and c o o r d i n a t i o n of l e a r n i n g experiences of other than n u r s i n g s t a f f as lowest. In both frequency and t o t a l hour rankings telephone c a l l s were the top p r i o r i t y . A u d i o v i s u a l equipment maintenance was among the l e a s t favoured. G e n e r a l l y modes d i f f e r e d from mean scores and ranges o f mean scores and responses f o r each a c t i v i t y were f a i r l y broad. Summary: I d e a l a c t i v i t y times, f r e q u e n c i e s and t o t a l hours per year were ranked w i t h i n c a t e g o r i e s . Then, 151. the c a t e g o r i e s were ranked i n r e l a t i o n to one another., In terms of mean number of minutes, the i n s t r u c t i o n category ranked h i g h e s t , while m i s c e l l a n e o u s a c t i v i t i e s were viewed as the lowest p r i o r i t y . Frequency rankings p l a c e d m i s c e l l a n -eous a c t i v i t i e s as h i g h e s t i n p r i o r i t y compared to other c a t e g o r i e s , w h i l e p o l i c y d e c i s i o n making ranked lowest. F i n a l l y , rankings of t o t a l hours per year f o r each category d i s c l o s e d t h a t respondents saw themselves spending the g r e a t -e s t number of hours on program p l a n n i n g , and the l e a s t on p o l i c y d e c i s i o n making. In g e n e r a l most of the mean scores were t r e a t e d with c a u t i o n , s i n c e modes d i f f e r e d s u b s t a n t i a l l y from the means, and range of scores was q u i t e broad. I t was a l s o noted s i n c e the i d e a l rankings were by d e f i n i t i o n , s u g g e s t i v e of how the respondents wished t o f u n c t i o n as opposed to how they a c t u a l l y f u n c t i o n , these rankings c o u l d imply the r e l a t i v e importance of the a c t i v i t i e s and c a t e g o r i e s i n v o l v e d . Thus, f o r example program p l a n n i n g , with the h i g h e s t r a n k i n g i n t o t a l hours per year, of the f i v e major c a t e g o r i e s c o u l d be seen as the most important to these respondents. T h i s impor--tance i m p l i c a t i o n seemed most a p p l i c a b l e to rankings i n v o l v i n g t o t a l hours per year, s i n c e i t combined the mean frequency and mean time f o r each a c t i v i t y w i t h i n a category. • Comparison of A c t u a l and I d e a l _Ac,tivitie.s To determine those c a t e g o r i e s and s p e c i f i c a c t i v i - _ -152:. t i e s f o r which the i n s e r v i c e educators wished to see a r e -d i s t r i b u t i o n of time, i t was necessary to compare t o t a l hours per year f o r each a c t i v i t y and note the d i f f e r e n c e between i d e a l and a c t u a l hours. A c t i v i t i e s were noted i n which educators d e s i r e d to i n c r e a s e hours per year and i n which they wished a decrease. A c t i v i t i e s were then ranked a c c o r d i n g to the greatest decrease d e s i r e d to the l e a s t . For the program p l a n n i n g category i n g e n e r a l , an o v e r - a l l i n c r e a s e was i n d i c a t e d by the respondents. The t o t a l s f o r the category suggest t h a t educators f e l t they were not spending enough time program p l a n n i n g , and g i v e n the c h o i c e , would i n c r e a s e the amount of time spent i n the area. They i n d i c a t e d t h a t the top time p r i o r i t y e x i s t e d i n o b s e r v a t i o n a c t i v i t i e s of n u r s i n g care d e l i v e r y ; t o .1) help determine s t a f f l e a r n i n g needs, and 2) as an e v a l u a t i v e t o o l a f t e r a l e a r n i n g program. On the other hand the l a r g e s t r e d u c t i o n of time committment was d e s i r e d i n i n c i d e n t a l conferences w i t h s u p e r v i s o r y personnel and i n s e l e c t i n g content f o r l e a r n i n g programs. For the i n s t r u c t i o n c a t e g o r y as a whole, respondents i n d i c a t e d t h a t i n t h e i r i d e a l a c t i v i t y p r o f i l e they would reduce t h e i r time i n i n s t r u c t i o n . The s p e c i f i c a c t i v i t i e s where h i g h e s t r e d u c t i o n was d e s i r e d i n c l u d e d involvement i n d i r e c t i n s t r u c t i o n of most l e a r n e r s . They d i d however, i n d i c a t e they would i n c r e a s e time devoted to s h o r t programs 153. and i n v o l v e themselves more i n h e l p i n g s t a f f to o b t a i n r e -source m a t e r i a l s . In a d d i t i o n , respondents wanted to i n c r e a s e time spent i n s t r u c t i n g non-nurse l e a r n e r s , i n c o n t r a s t t o t h e i r d e s i r e to reduce d i r e c t i n s t r u c t i o n to a l l other learners.. In the s u p e r v i s i o n category, respondents s p e c i f i e d t h a t t h e i r i d e a l a c t i v i t y p r o f i l e would i n c l u d e f a r l e s s involvement i n s u p e r v i s i o n than e x i s t e d i n t h e i r p r e s e n t j o b s . The sharp decrease i n hours shown on the i d e a l p r o f i l e f o r a s s i s t i n g i n c l i n i c a l area s u p e r v i s i o n i n d i c a t e d t h e i r wish to move away from such s u p e r v i s o r y f u n c t i o n s . The p o l i c y d e c i s i o n making category showed a decrease o f hours i n the i d e a l p r o f i l e . Respondents p a r t i c u l a r l y wanted to_ spend f a r l e s s time r e v i s i n g n u r s i n g procedures and manuals. There was some i n d i c a t i o n , however t h a t more time meeting with the D i r e c t o r of Nurses would be d e s i r a b l e , perhaps to d i s c u s s and p a r t i c i p a t e i n the d e c i s i o n making process r e -ga r d i n g n u r s i n g procedures. In almost a l l of the a c t i v i t i e s i n the m i s c e l l a n e o u s area, respondents wanted r e d u c t i o n of time committment, with the g r e a t e s t r e d u c t i o n i n time spent on telephone c a l l s and other c l e r i c a l t a s k s . In g e n e r a l , a l l areas except program p l a n n i n g r e q u i r e d a r e d u c t i o n i n time committments as f a r as the respon-dents were concerned. In terms of c a t e g o r i e s i n which a reduc-t i o n was i n d i c a t e d . They seemed l e a s t s a t i s f i e d w i t h t h e i r 154 . TABLE 45 Comparison of Actual and Ideal Hours per Year Spent on Program Planning Actual Ideal D i f f e r -A c t i v i t y hours hours ence '"; Direct observation of s t a f f performance i n d e l i v e r i n g nursing care 1 1 8 . 6 4 3 1 2 . 7 7 1 9 4 . 1 3 Direct observation of non-nursing s t a f f i n performance of duties 6 1 . 4 1 1 2 6 . 3 0 6 4 . 8 9 Direct observation of s t a f f performance aft e r a program (nursing staff) 2 0 . 4 0 7 9 . 5 7 5 9 . 1 7 Bedside audit (unit v i s i t s to patients to determine the ex-tent to which patient care standards are being met) 3 0 . 6 4 8 2 . 1 4 5 1 . 5 0 Examination of employee per-formance evaluations 2 .29 41 .56 3 9 . 2 7 Bedside audit af t e r an inser-vice program to evaluate effectiveness of in s t r u c t i o n 0 .97 35 .42 34 .45 Conferences with other inser-vice educators to develop program plans 1 2 . 3 5 4 4 . 8 0 3 2 . 4 5 Observation of unit nursing care conferences to assess learning needs 1 1 . 9 4 4 3 . 1 4 3 1 . 2 0 P a r t i c i p a t i o n i n nursing rounds to assess learning needs 2 .15 3 1 . 5 1 2 9 . 3 6 Coordination of program plan-ning a c t i v i t i e s i n i t i a t e d by nursing s t a f f 7 .29 34 .65 2 7 . 3 6 TABLE 45 (cont'd) A c t i v i t y A c t u a l I d e a l D i f f e r -hours hours ence Reviewing job d e s c r i p t i o n s ( l i s t s of d u t i e s ) 5.24 D i s c u s s i n g e v a l u a t i o n of give n i n s e r v i c e programs wit h other i n s e r v i c e edu-c a t o r s i n your agency 2.20 C o n f e r r i n g w i t h content s p e c i -a l i s t s t o ga i n background i n f o r m a t i o n f o r giv e n pro-grams 44.77 Conferences wi t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs (planned i n d i v i d u a l meetings) 8.70 W r i t i n g e v a l u a t i o n r e p o r t s of l e a r n i n g programs 1.9 8 Reviewing e v a l u a t i o n of a program w i t h the l e a r n i n g group 1.66 P a r t i c i p a t i o n In med i c a l rounds t o assess l e a r n i n g needs 5.41 W r i t i n g out o b j e c t i v e s f o r programs 43.38 Keeping r e c o r d s of implemented programs 44.24 Meeting with n u r s i n g s u p e r v i s o r y personnel t o d i s c u s s s t a f f l e a r n i n g needs (planned con-ferences) 10.46 D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program (follow-up) (non-nursing personnel) 1.89 Examination of i n c i d e n t r e p o r t s 3.17 28.06 22.82 23.46 21.26 64.02 19.25 24.01 16.18 15.67 17.41 55.17 55.90 20.47 11.74 12.06 15.31 14.20 14.01 12.00 11/79 11.66 10.01 9.85 8.89 TABLE 45 (cont'd) A c t u a l I d e a l D i f f e r -A c t i v i t y hours hours ence Conferences w i t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs (planned group conferences) 4.99 13.85 8.86 Review of t e r m i n a t i o n r e p o r t s f o r suggestions on i n s e r v i c e e d u c a t i o n programs 0.055 7.87 7.81 Reviewing e v a l u a t i o n of a program wi t h s u p e r v i s o r y personnel 2.73 10.26 7.53 Conferences w i t h g e n e r a l duty n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l meetings) 24.33 31.82 7.49 Conferences w i t h g e n e r a l duty • n u r s i n g s t a f f t o d i s c u s s l e a r n i n g needs ( i n c i d e n t a l group conferences) 3.41 9.43 6.02 Meeting w i t h s u p e r v i s o r y per-sonnel of departments other than n u r s i n g to d i s c u s s s t a f f l e a r n i n g needs (planned con-ferences) 2.45 8.00 5.55 Conferences w i t h t a r g e t s t a f f to develop program o b j e c t i v e s f o r g i v e n l e a r n i n g programs (nursing personnel) 2.52 7.69 5.17 C o - o r d i n a t i o n of program p l a n -n i n g a c t i v i t i e s i n i t i a t e d by s t a f f i n other departments 0.910 5.64 4.73 Meeting w i t h s u p e r v i s o r y person-n e l of departments o t h e r than n u r s i n g to d i s c u s s s t a f f l e a r n -i n g needs ( i n c i d e n t a l c o n f e r -ences) 4.38 8.39 4.01 Conferences w i t h other d e p a r t -ments to i d e n t i f y mutual l e a r n -i n g needs (planned group c o n f e r -ences) 1.26 4.81 3.55 TABLE 45 (cont'd) A c t u a l I d e a l D i f f e r -A c t i v i t y hours hours ence Conferences w i t h other depart-ments to i d e n t i f y mutual l e a r n i n g needs (planned i n d i v i d u a l meetings) 0.913 4.08 3.16 Conferences w i t h other d e p a r t -ments to i d e n t i f y mutual l e a r n i n g needs ( i e . medical s t a f f , c l e r i c a l , housekeeping, d i e t a r y , . e t c . . ) ( i n c i d e n t a l group conferences) 0.646 3.18 2.53 Conferences w i t h t a r g e t s t a f f to develop program o b j e c t i v e s f o r given l e a r n i n g programs (non-nursing personnel) 0.016 0.58 0.56 Terminal i n t e r v i e w s w i t h em-ployees to seek suggestions f o r i n s e r v i c e e d u c a t i o n pro-grams (non-nursing personnel) 0 0.49 0.49 Terminal i n t e r v i e w s with.emplo-yees to seek suggestions f o r i n s e r v i c e e d u c a t i o n programs (nursing personnel) 0.186 0.49 0.30 = P a r t i c i p a t i o n i n h i r i n g i n t e r -views to e s t a b l i s h the poten-t i a l employee's l e a r n i n g needs (non-nursing personnel) 0 0.05 0.05 Meeting w i t h n u r s i n g . s u p e r v i s o r y personnel to d i s c u s s s t a f f l e a r n i n g needs ( i n c i d e n t a l conferences) 38.17 8.39 -29.78 * S e l e c t i n g content f o r l e a r n i n g programs 177.21 160.80 -16.41 * * r e d u c t i o n TABLE 45 (cont'd) A c t i v i t y A c t u a l hours I d e a l hours D i f f e r -ence Review of c h a r t i n g on n u r s i n g u n i t s (chart audit) 14.36 2.72 -11.64 P a r t i c i p a t i o n i n h i r i n g i n t e r -views t o e s t a b l i s h p o t e n t i a l employee's l e a r n i n g needs (nursing personnel) 5.75 0.05 - 5.69 Conferences w i t h other d e p a r t -ments to i d e n t i f y mutual l e a r n i n g needs ( i n c i d e n t a l i n d i v i d u a l conferences) 6.87 6.49 - 0.38 T o t a l hours 732.43 1504.3 771.00 * r e d u c t i o n 159. TABLE 46 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on I n s t r u c t i o n a l A c t i v i t i e s A c t u a l I d e a l D i f f e r -A c t i v i t y hours hours ence Use of "mini-programs" (15 to 45 minutes i n length) 35.85 61.20 25.35 A d v i s i n g s t a f f i n o b t a i n i n g resource m a t e r i a l s 37.52 60.82 23.30 Use of programs 1 t o 2 hours i n l e n g t h 118.40 133.40 15.00 D i r e c t i n s t r u c t i o n o f non-n u r s i n g personnel 25.05 36.14 11.09 C o - o r d i n a t i n g i n s t r u c t i o n a l a c t i v i t i e s o f other i n s e r -v i c e educators 2.01 12.28 10.27 Use of p i l o t programs, t o " t e s t out" an i n s t r u c t i o n a l technique b e f o r e u s i n g i n a formal program 1.50 6.02 4.52 A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g non-nursing p e r s o n n e l 2.16 5.34 3.18 Experimentation w i t h new te a c h i n g techniques 13.03 14.55 1.52 A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g n u r s i n g personnel 133.20 35.03 -98.17 * D i r e c t i n s t r u c t i o n of nurses' aides 96.12 41.18 -54.94 * * r e d u c t i o n 160 . TABLE 46 (cont'd) A c t i v i t y A c t u a l hours I d e a l hours D i f f e r -ence Use of 8 hour programs 75. 20 22. 40 -52. 80 * D i r e c t i n s t r u c t i o n of r e g i s t e r e d nurses 306. 59 260. 81 -45. 78 * Use of h a l f - d a y workshop programs (4 hours i n length) 64. 00 37. 20 -26. 80 * D i r e c t i n s t r u c t i o n of p r a c t i c a l nurses 67. 05 41. 34 -25. 51 * Use of content s p e c i a l i s t s to h e l p teach 71. 92 59. 73 -12. 19 * C o n s u l t a t i o n w i t h s t a f f t o determine a p p r o p r i a t e r e -s c h e d u l i n g r e q u i r e d to cover wards d u r i n g an i n s e r v i c e program 14. 05 7. 29 - 6. 79 * D i r e c t i n s t r u c t i o n of student nurses 11. 62 8. 07 - 3. 55 * S e l e c t i n g i n s t r u c t i o n a l r e -sources (equipment, people, etc.) 102. 55 102. 09 - 0. 46 * T o t a l hours 1177. 86 945. 11 -232. 75 * * r e d u c t i o n TABLE 47 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on S u p e r v i s o r y A c t i v i t i e s A c t i v i t y A c t u a l hours I d e a l hours D i f f e r -ence A s s i g n i n g n u r s i n g personnel ( u n i t assignments) 8.42 11.83 3.41 Performance e v a l u a t i o n s to determine promotion or t e r m i n a t i o n of an employee 1.06 2.18 1.12 H i r i n g n u r s i n g personnel 0.215 0.32 0.10 Performing p a t i e n t and drug census 0.013 0.015 0.002 A s s i s t i n g w i t h s u p e r v i s i o n i n c l i n i c a l areas 811.79 262.01 -549.78 * C o r r e c t i n g and d i s c i p l i n i n g p e r s o nnel 19.65 1.89 - 17.76 * P a r t i c i p a t i n g i n adminis-t r a t i v e meetings 30.78 27.53 - 3.35 * T o t a l hours 871.95 305.79 - 566.16 * r e d u c t i o n TABLE 48 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on P o l i c y D e c i s i o n Making A c t i v i t i e s A c t u a l I d e a l D i f f e r -A c t i v i t y hours hours ence Meeting w i t h the D i r e c t o r of Nurses 7.98 13.84 5.86 Meeting w i t h the head nurse committee 21.86 24.45 2.59 Working on i n s e r v i c e edu-c a t i o n budget 1.88 3.76 1.88 Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r 1.50 3.38 1.88 A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures 110.55 7.26 -103.29 * I n t e r p r e t a t i o n of h o s p i t a l p o l i c y - i t o employees 38.19 18.41 - 19.78 * Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e committee 21.43 13.12 - 8.31 * Meeting w i t h n u r s i n g e d u c a t i o n committee 24.13 16.42 - 7.71 * Meeting w i t h n u r s i n g standards and p r a c t i c e committees 8.35 3.13 - 5.22 £ Meeting w i t h s a f e t y and d i s a s t e r committee 10.87 5.83 - 5.04 * Meeting w i t h n u r s i n g a u d i t committee 5.98 2.45 - 3.53 * Meeting w i t h the n u r s i n g procedure committee 5.25 5.13 - 0.12 * T o t a l hours 258.00 117.21 -140.79 * * r e d u c t i o n TABLE 49 Comparison of A c t u a l and I d e a l T o t a l Hours per Year Spent on M i s c e l l a n e o u s A c t i v i t i e s A c t i v i t y A c t u a l hours I d e a l hours D i f f e r -ence A s s i s t i n g i n c o - o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students i n your h o s p i t a l ' s s c h o o l of nur-s i n g 0. 50 0 .68 0. 18 A s s i s t i n g i n c o - o r d i n a t i o n of l e a r n i n g experiences f o r r e g i s t e r e d nurses who are not h o s p i t a l employees (e.g. from community c o l l e g e r e -f r e s h e r courses) 1. 58 1 .73 0. 15 Telephone c a l l s ( i n and out-going) 142. 40 107 .25 -35. 15 Performing c l e r i c a l tasks a s s o c i a t e d w i t h p r e p a r i n g and d u p l i c a t i n g hand-outs 42. 97 8 .28 -34. 69 Reading/answering m a i l 114. 76 88 .36 -26. 40 W r i t i n g memos 60. 23 48 .30 -11. 93 M a i n t a i n i n g a u d i o - v i s u a l equipment 11. 56 0 .25 -11. 31 S e c u r i n g i n s t r u c t i o n a l r esources (other than a u d i o - v i s u a l aids) 24. 78 15 .42 - 9. 36 W r i t i n g advance b r i e f i n g s t o s t a f f on upcoming i n -s e r v i c e programs (e.g. f o r p o s t i n g on b u l l e t i n boards, etc.) 22. 15 - 16 .60 - 5. 55 * r e d u c t i o n TABLE 49 (cont'd) A c t i v i t y A c t u a l hours I d e a l hours D i f f e r -ence M a i n t a i n i n g i n s t r u c t i o n a l r esources (other than a u d i o - v i s u a l aids) 11.75 7.94 - 3.81 Buying and t e s t i n g audio-v i s u a l equipment 5.89 3.45 - 2.44 A s s i s t i n g i n c o - o r d i n a t i o n of l e a r n i n g experiences f o r n u r s i n g students from schools o u t s i d e your hos-p i t a l 4.36 2.35 - 2.01 Pl a n n i n g and implementing t o u r s f o r n u r s i n g i n t e r e s t groups and other i n t e r e s t e d i n d i v i d u a l s 4.19 2.37 - 1.87 T o t a l hours 418.92 302.02 -116.90 * r e d u c t i o n 165. present p r o f i l e i n s u p e r v i s i o n , i n d i c a t i n g a d e s i r e d r e d u c t i o n of 566.16 hour per y e a r . I n s t r u c t i o n a l a c t i v i t i e s were the next h i g h e s t i n number of hours to be reduced: 232.75. P o l i c y d e c i s i o n making a c t i v i t i e s ranked t h i r d i n r e d u c t i o n of hours, the t o t a l r e d u c t i o n being 140.79 hours per year. F i n a l l y , respondents wanted mis c e l l a n e o u s hours per year reduced by 116.9 hours per year. Program p l a n n i n g was the one category i n which an i n c r e a s e i n amount of time spent per year was d e s i r e d , and t h i s i n c r e a s e was s u b s t a n t i a l : 771 hours per year. T h i s suggests a d i s t i n c t d i s s a t i s f a c t i o n w i t h p r e s e n t involvement i n program p l a n n i n g a c t i v i t i e s . F a c t o r s A s s o c i a t e d with A c t u a l A c t i v i t i e s C e r t a i n socioeconomic data were c o r r e l a t e d with the f i v e major c a t e g o r i e s of program p l a n n i n g , i n s t r u c t i o n , s u p e r v i s i o n , p o l i c y d e c i s i o n making and m i s c e l l a n e o u s a c t i v i -t i e s . The f a c t o r s c o r r e l a t e d with these c a t e g o r i e s were age, hours per week respondents devoted to c o n t i n u i n g e d u c a t i o n , amount o f time employed i n t h e i r p r e s e n t job and h o s p i t a l s i z e . Using the Spearman Rank t e s t , most of the c o r r e l a t i o n c o e f f i c i e n t s were found to be very low, i n d i c a t i n g l i t t l e i f any c o r r e l a t i o n . However, there were four e x c e p t i o n s to t h i s p a t t e r n . For one, the amount of time t h a t educators were employed i n t h e i r p r e s e n t jobs and p o l i c y d e c i s i o n making a c t i v i t i e s showed some c o r r e l a t i o n . The longer the respondent was employed 166. i n the job, the more time she spent i n p o l i c y d e c i s i o n making a c t i v i t i e s . Perhaps t h i s c o r r e l a t i o n r e f l e c t e d the longer term employee's f a m i l i a r i t y w i t h h o s p i t a l p o l i c y and proce-dure, thus tending to i n c r e a s e d p a r t i c i p a t i o n i n d e c i s i o n -making p r o c e s s e s . Another . c o r r e l a t i o n i n v o l v e d age and p o l i c y d e c i s i o n making a c t i v i t i e s . The o l d e r the respondent, the more time was spent i n p o l i c y d e c i s i o n making endeavours. I t was specu-l a t e d t h a t t h i s c o r r e l a t i o n c o u l d have been based on the o l d e r employee's broader experience w i t h working i n a h o s p i t a l s e t t i n g and i n coping with i n s t i t u t i o n a l h i e r a r c h i e s . In a d d i t i o n , time employed i n p r e s e n t job and i n s t r u c t i o n a l a c t i v i t i e s showed some c o r r e l a t i o n . The l a r g e r term employee spent more time on i n s t r u c t i o n a l a c t i v i t i e s than those employed f o r a s h o r t e r time. T h i s c o r r e l a t i o n may have been based simply on the long term employees' deeper i n v o l v e -ment i n implementation of programs. F i n a l l y , h o s p i t a l s i z e and i n s t r u c t i o n a l a c t i v i t i e s demonstrated some c o r r e l a t i o n . I n s e r v i c e educators i n l a r g e r h o s p i t a l s spent more time on i n s t r u c t i o n a l a c t i v i t i e s than educators i n the s m a l l e r h o s p i t a l s . G e n e r a l l y , respondents i n l a r g e r h o s p i t a l s would have had a commensurately l a r g e r area to cover i n terms of the number of s t a f f who c o n s t i t u t e d her l e a r n e r s , r e q u i r i n g more hours o f i n s t r u c t i o n a l time. T h i s would have been e s p e c i a l l y t r u e i n those l a r g e r s i z e d h o s p i t a l s TABLE 50 C o r r e l a t i o n C o e f f i c i e n t s of F a c t o r s A s s o c i a t e d with A c t u a l A c t i v i t i e s Using the Spearman Rank C o r r e l a t i o n Program P o l i c y D e c i s i o n - P l a n n i n g I n s t r u c t i o n S u p e r v i s i o n Making M i s c e l l a n e o u s Age rs=.0239 P > .05. r s = .176 P > .05 r s = -.0824 p > .05 r s = .595 p < .01 #s= .260 p > .05 H o s p i t a l S i z e C o n t i n u i n g E d u c a t i o n r s = .144 p > . 0.5 r s = .283 p > .05 r s = .370 p < .05 p > .01 r s = .078 P > .05 r S = .039 r s = .096 p > .05 p > .05 219 > .05 r s = -.169 P T -05 r s = .160 p > .05 r s = ..141 P > -05 Time i n Present Job r s = -.0403 P > .05 r s = .357 P < .05 r s = -.193 p > .05 r s = .394 p < .05 r s = .292 p >'.05 i n which the respondent was the s o l e employee i n the i n s e r v i c e department. Summary A n a l y s i s of the date o b t a i n e d f o r the study focused on d e s c r i b i n g how the respondents saw themselves f u n c t i o n i n g i n t h e i r p r e s e n t job s e t t i n g s and how they would p e r f e r t o f u n c t i o n i d e a l l y as i n s e r v i c e educators. By o b t a i n i n g a d d i -t i o n a l socioeconomic data, i t was p o s s i b l e to d e s c r i b e charac-t e r i s t i c s of the group whose r o l e p e r c e p t i o n s were;;.-being analyzed. Using means and percentage o b t a i n e d , a g e n e r a l d e s c r i p t i o n of the i n s e r v i c e educators' c h a r a c t e r i s t i c s . As a whole the group was middle-aged, s i n g l e and wit h no de-pendents. They were a reasonably well-educated group, and i n d i c a t e d a t l e a s t some involvement i n c o n t i n u i n g education endeavours, such as r e a d i n g p r o f e s s i o n a l l i t e r a t u r e , belong-i n g to p r o f e s s i o n a l o r g a n i z a t i o n s and t a k i n g a d d i t i o n a l s h o r t and extended courses. C h a r a c t e r i s t i c s o f the respondents' job s e t t i n g were a l s o examined. Most respondents were i n a d i r e c t i n g p o s i t i o n i n t h e i r department, and over h a l f had employed one person i n the department; t h a t one person was the respondent. I n s e r v i c e departments had been i n e x i s t e n c e f o r an average of t h i r t e e n y e a r s . Most of the employing h o s p i t a l s had a s c h o o l o f n u r s i n g , and average h o s p i t a l bed c a p a c i t y was f a i r l y l a r g e a t 9 58 beds. 169. By reviewing and summarizing mean number of minutes, f r e q u e n c i e s and t o t a l hours per. year, i t was p o s s i b l e to suggest a g e n e r a l p r o f i l e of what the i n s e r v i c e educators i n t h i s group d i d i n t h e i r work s e t t i n g s . They spent r t h e g r e a t e s t amount of t h e i r working year on i n s t r u c t i o n a l a c t i v i -t i e s . S u p e r v i s i o n took up a s u b s t a n t i a l amount of time, and program a c t i v i t i e s ranked t h i r d . M i s c e l l a n e o u s a c t i v i t i e s ranked f o u r t h , and f i n a l l y , p o l i c y d e c i s i o n making emerged as an area i n which educators s t a t e d t h a t they spent the l e a s t amount of time. The i d e a l job p r o f i l e , again based on mean number of minutes, mean f r e q u e n c i e s and t o t a l hours per year, seemed to d i f f e r markedly from the a c t u a l p r o f i l e . Respondents wanted to spend the g r e a t e s t amount of time on program p l a n n i n g . I n s t r u c t i o n ranked second, s u p e r v i s i o n t h i r d , with p o l i c y d e c i s i o n making and m i s c e l l a n e o u s c a t e g o r i e s occupying bottom ranks. S i n c e by d e f i n i t i o n the term i d e a l suggested a statement of what the i n s e r v i c e educators wished t h e i r r o l e s t o be, i t c o u l d be s a i d t h a t the i d e a l rankings were a l s o suggested of r e l a t i v e importance. Thus, f o r example, educators perhaps a t t a c h e d h i g h e s t v a l u e to proforming program p l a n n i n g a c t i v i -t i e s and lower importance to m i s c e l l a n e o u s a c t i v i t i e s . Comparison of a c t u a l and i d e a l p r o f i l e s i n terms of t o t a l hours per year suggested t h a t respondents f e l t some mea-sure of d i s s a t i s f a c t i o n w i t h t h e i r p r e s e n t j o b s . They f e l t t h a t not enough time was devoted to program p l a n n i n g and t h a t 170 . g i v e n the c h o i c e , would spend the bulk o f t h e i r working hours i n v o l v e d i n such a c t i v i t i e s . In a d d i t i o n , a wish to see a r e d u c t i o n i n t o t a l hours per year i n the other four a c t i v i t y c a t e g o r i e s . When socioeconomic data and s c o r e s of a c t u a l a c t i v i -t i e s were t e s t e d u s i n g the Spearman Rank C o r r e l a t i o n , f o u r c o r r e l a t i o n s were found. The amount of time respondence were employed i n - t h e i r present jobs was c o r r e l a t e d w i t h the i n s t r u c -t i o n a l and p o l i c y d e c i s i o n making c a t e g o r i e s . Age was a l s o c o r r e l a t e d w i t h p o l i c y d e c i s i o n making and f i n a l l y , h o s p i t a l s i z e and i n s t r u c t i o n a l a c t i v i t i e s demonstrated some c o r r e l a t i o n . Statements d e r i v e d from the data o b t a i n e d were c o n s i d e r e d p r i m a r i l y s u g g e s t i v e r a t h e r than d e f i n i t i v e because mode response o f t e n d i f f e r e d n o t i c e a b l y from mean s c o r e s . In a d d i t i o n , the range of responses f o r each a c t i v i t y was f a i r l y broad, thereby skewing the r e s u l t s . 171. CHAPTER V SUMMARY, CONCLUSIONS AND IMPLICATIONS Review- of the l i t e r a t u r e i n d i c a t e d t h a t few n u r s i n g s t u d i e s have d e a l t w i t h the r o l e and a c t i v i t i e s proformed by i n s e r v i c e educators. I t was thus the purpose o f t h i s study to i n v e s t i g a t e and d e s c r i b e a c t u a l and i d e a l a c t i v i t y p r o f i l e s of i n s e r v i c e educators, e s t a b l i s h i n g time and frequency f o r each a c t i v i t y . Socioeconomic f a c t o r s t h a t d e s c r i b e the p o p u l a t i o n i n r e l a t i o n t o a c t u a l a c t i v i t y p r o f i l e s were i n -cluded. Data a n a l y s i s y i e l d e d a d e s c r i p t i o n of a c t u a l and i d e a l a c t i v i t y p r o f i l e s . These were compared to d i s c l o s e the types of changes respondents wished to see i n time and frequency d i s t r i b u t i o n s . F i n a l l y , some socioeconomic f a c t o r s were found t o be c o r r e l a t e d with c e r t a i n a c t i v i t y c a t e g o r i e s . Summary T h i s e x p l o r a t o r y study attempted to answer two main r e s e a r c h q u e s t i o n s or problems: 1) the i n s e r v i c e edu-c a t o r s ' p e r c e p t i o n of t h e i r p r e s e n t a c t i v i t y p r o f i l e s i n terms of type o f a c t i v i t y , and time and frequency elements i n v o l v e d and 2) the i n s e r v i c e e d u c a tors' 1 p e r c e p t i o n of t h e i r i d e a l a c t i v i t y p r o f i l e s i n terms of type of a c t i v i t y , and time and frequency elements i n v o l v e d . The study a l s o used socioeconomic f a c t o r s t h a t c o u l d d e s c r i b e the p o p u l a t i o n and c o r r e l a t e w i t h responses to main r e s e a r c h q u e s t i o n s . These socioeconomic f a c t o r s i n c l u d e d a number of items. For one, c h a r a c t e r i s t i c s of the agency i n which the educator f u n c t i o n e d were examined. These were bed c a p a c i t y , s i z e o f i n s e r v i c e e d u c a t i o n department, e x i s t e n c e of a sc h o o l of n u r s i n g and l e n g t h of time i n s e r v i c e e ducation had e x i s t e d i n the respondents' h o s p i t a l . C h a r a c t e r -i s t i c s o f the educators themselves were a l s o examined, and these i n c l u d e d age, m a r i t a l s t a t u s , number of dependents, edu-c a t i o n a l background, l e n g t h of time employed i n prese n t job p o s i t i o n , and involvement i n c o n t i n u i n g e d u c a t i o n . An a p p r o p r i a t e instrument was developed f o r the purposes of data c o l l e c t i o n . A p a n e l of judges, which i n c l u d e d i n d i v i d u a l s with e x p e r t i s e i n education and h e a l t h , assessed the i n i t i a l instrument. A number of a l t e r a t i o n s were made as a c o n s e q u e n c e , r e s u l t i n g i n a more c o n c i s e r e v i s e d q u e s t i o n n a i r e to maximize the accuracy of data o b t a i n e d . 173. The p o p u l a t i o n was comprised of twenty-four i n s e r -v i c e educators from acute care g e n e r a l h o s p i t a l s of v a r y i n g s i z e i n m e t r o p o l i t a n Vancouver and V i c t o r i a . These educators were i n t e r v i e w e d u s i n g the r e v i s e d q u e s t i o n n a i r e . Data ob-t a i n e d i n c l u d e d nominal, o r d i n a l and i n t e r v a l data. T h i s data was analyzed by computer and c a l c u l a t o r ; where a p p l i c a b l e , a p p r o p r i a t e non-parametric t e s t s were u t i l i z e d , c h i e f l y the.. Spearman Rank C o r r e l a t i o n . Other a p p l i c a b l e c a l c u l a t i o n s were made to d e s c r i b e the data. Using means and percentages o b t a i n e d , the i n s e r v i c e educators' c h a r a c t e r i s t i c s were d e s c r i b e d . The average age of the educators was approximately 40 . Most were s i n g l e and the m a j o r i t y had no dependents. As a whole, they were a'. . reasonably w e l l - e d u c a t e d group. A l l had n u r s i n g diplomas, n e a r l y h a l f had Bachelor's degrees i n n u r s i n g or non-nursing f i e l d s , and n e a r l y a l l had some k i n d o f formal t r a i n i n g beyond a b a s i c n u r s i n g diploma. However, on l y two had advanced degrees i n any f i e l d . The m a j o r i t y of the group seemed to take an i n t e r e s t i n t h e i r own c o n t i n u i n g e d u c a t i o n . A l l but one respondent had taken s h o r t or extended courses i n areas r a n g i n g from a d u l t education techniques to the use of a u d i o v i s u a l m a t e r i a l s . The group means f o r hours spent on t h e i r own continuing' education and r e a d i n g p r o f e s s i o n a l l i t e r a t u r e were 4.9 and 3.8 hours per week r e s p e c t i v e l y . However, most d i d not have a s t a t e d 174. p e r s o n a l p l a n f o r c o n t i n u i n g t h e i r own ed u c a t i o n . Most belonged to p r o f e s s i o n a l o r g a n i z a t i o n s other than'the l o c a l nurses a s s o c i a t i o n , and a t l e a s t h a l f had p a r t i c i p a t e d i n r e s e a r c h s t u d i e s , other than t h i s one,,during the pre v i o u s year. F i n a l l y , although the ranges f o r l e n g t h o f employment i n the p r s e n t job were v a r i e d , the mean of 3.5 years suggested t h a t these educators were f a i r l y s t a b l e , s e t t l e d employees. Respon-dents worked i n h o s p i t a l s with a f a i r l y l a r g e average bed c a p a c i t y and which t h e r e was a s c h o o l of n u r s i n g . They worked i n i n s e r v i c e departments t h a t had been i n e x i s t e n c e an average of t h i r t e e n y e a r s , i n which they were the s o l e employee and were de s i g n a t e d as d i r e c t o r s o f i n s e r v i c e e d u c a t i o n . By reviewing and summarizing mean minutes, f r e q u e n c i e s and t o t a l hours per year, i t was p o s s i b l e to suggest a g e n e r a l p r o f i l e of what the i n s e r v i c e educators i n t h i s group d i d i n t h e i r working s e t t i n g s . They spent the g r e a t e s t amount of t h e i r working year on i n s t r u c t i o n a l a c t i v i t i e s , e s t a b l i s h i n g i n d i r e c t l y i n s t r u c t i n g l e a r n i n g groups. S u p e r v i s i o n a l s o took up a s u b s t a n t i a l amount of time, e s p e c i a l l y w i t h r e s p e c t to s u p e r v i s i o n i n c l i n i c a l areas. A p p a r e n t l y , the educators were f r e q u e n t l y borrowed by Nursing S e r v i c e to f i l l i n as head nurses or s u p e r v i s o r s . Program p l a n n i n g as a category ranked t h i r d , m i s c e l l a n e o u s f o u r t h , and f i n a l l y , p o l i c y d e c i s i o n making, an area i n which educators i n d i c a t e d they spent the l e a s t amount of time. 175. The i d e a l job p r o f i l e , again based on mean number of minutes, mean f r e q u e n c i e s and t o t a l hours per year, seemed to d i f f e r r a t h e r markedly from the a c t u a l p r o f i l e . Respondents wanted to spend the bulk o f t h e i r time on program p l a n n i n g , as opposed to i n s t r u c t i o n , which here ranked second, and s u p e r v i s i o n . They p l a c e d p a r t i c u l a r emphasis on o b s e r v a t i o n of n u r s i n g s t a f f to h e l p assess and e v a l u a t e l e a r n i n g needs. I n s t r u c t i o n ranked as second and s u p e r v i s i o n t h i r d , with p o l i c y d e c i s i o n making and m i s c e l l a n e o u s c a t e g o r i e s a t the bottom. Since by d e f i n i t i o n the term i d e a l suggested a s t a t e -ment of what the i n s e r v i c e educators wished t h e i r r o l e s to be, the i d e a l rankings i n d i c a t e d the r e l a t i v e importance of v a r i o u s a c t i v i t i e s . Thus, educators a t t a c h e d a h i g h e r v a l u e and import-ance to performing more program p l a n n i n g a c t i v i t i e s i n t h e i r jobs and a lower importance to m i s c e l l a n e o u s and p o l i c y d e c i s -i o n making a c t i v i t i e s . Comparison of a c t u a l and i d e a l p r o f i l e s i n terms of t o t a l hours per year suggested t h a t educators f e l t some measure of d i s s a t i s f a c t i o n w i t h t h e i r p r e s e n t j o b s . These educators f e l t they were not spending enough time engaged i n program pl a n n i n g a c t i v i t i e s , and t h a t g i v e n the c h o i c e , they would devote the bulk of t h e i r working hours to a c t i v i t i e s i n t h a t category. But i n the f o u r other c a t e g o r i e s , educators wanted to spend l e s s time then they d i d i n t h e i r p r e s e n t j o b s . In s h o r t , educators i n d i c a t e d a wish to a l t e r t h e i r p r e s e n t job 176 . p r o f i l e s i n a number of areas. When socioeconomic data and a c t u a l a c t i v i t i e s s c o r e s were t e s t e d u s i n g the Spearman Rank C o r r e l a t i o n , most items were found to be u n r e l a t e d . However, there were f o u r e x c e p t i o n s . The amount of time t h a t educators were employed i n t h e i r p r e s e n t jobs and p o l i c y d e c i s i o n making were c o r r e -l a t e d : the longer the respondent was employed, the more time was spent i n p o l i c y d e c i s i o n making. In a d d i t i o n , the o l d e r the respondent, the more time was spent i n p o l i c y making d e c i s i o n making a c t i v i t i e s . A l s o , time i n p r e s e n t " j o b and i n s t r u c t i o n a l a c t i v i t i e s were c o r r e l a t e d : the longer term employee spent more time on i n s t r u c t i o n . H o s p i t a l s i z e a l s o seemed t o i n f l u e n c e time spent on i n s t r u c t i o n , as respon-dents i n l a r g e r h o s p i t a l s spent more time on i n s t r u c t i o n a l a c t i v i t i e s than those i n s m a l l e r h o s p i t a l s . Conclusions A number of c o n c l u s i o n s were drawn from comparison of a c t u a l and i d e a l a c t i v i t y p r o f i l e s and c o r r e l a t i o n s o f socioeconomic data w i t h a c t u a l a c t i v i t y c a t e g o r i e s . In a d d i t i o n , c e r t a i n d i f f i c u l t i e s encountered with the data were c o n s i d e r e d . Comparison of a c t u a l and i d e a l p r o f i l e s suggested t h a t the respondents f e l t some measure of d i s s a t i s f a c t i o n with t h e i r p r e s e n t jobs. C h i e f l y , scores r e f l e c t e d the view t h a t they were not spending s u f f i c i e n t time i n a s s e s s i n g and 177 e v a l u a t i n g l e a r n e r s , and i n performing o t h e r f u n c t i o n s necessary f o r 'adequate p l a n n i n g of e d u c a t i o n a l programs. They expressed a d i s t i n c t d i s s a t i s f a c t i o n w i t h b e i n g used as c l i n i c a l area s u p e r v i s o r s , s u g g e s t i n g t h a t f o r them such an a c t i v i t y ought to be a t a minimum. P o l i c y d e c i s i o n making a c t i v i t i e s showed some c o r r e -l a t i o n w i t h age of respondents and l e n g t h of time they were employed i n t h e i r present jobs.. Older respondents spent more time ,in p o l i c y d e c i s i o n making. T h i s c o r r e l a t i o n was perhaps based on the o l d e r respondents' broader experience w i t h work-ing i n a h o s p i t a l s e t t i n g and coping with i n s t i t u t i o n a l h i e r a r c h i e s . In a d d i t i o n , longer term employees a l s o spent more time i n p o l i c y d e c i s i o n making. T h i s might have r e f l e c t e d the l o ng term worker's f a m i l i a r i t y w i t h h o s p i t a l p o l i c y and procedure, thus i n c r e a s e d p a r t i c i p a t i o n i n d e c i s i o n making p r o c e s s e s . •- • • I n s t r u c t i o n a l a c t i v i t i e s demonstrated c o r r e l a t i o n w i t h time i n p r e s e n t job and h o s p i t a l s i z e . Longer term employees spent more time on i n s t r u c t i o n probably because of t h e i r deeper involvement i n program implementation. F i n a l l y , respondents i n l a r g e r h o s p i t a l s spent more time on i n s t r u c t i o n than those i n s m a l l e r ones, mainly caused by a problem i n l o g i s t i c s . That i s , respondents i n l a r g e r h o s p i t a l s had a commensurately l a r g e r area to cover i n terms of number of s t a f f as l e a r n e r s and s i z e of the p h y s i c a l p l a n t . 178. Statements and c o n c l u s i o n s i n t h i s study were co n s i d e r e d p r i m a r i l y s u g g e s t i v e r a t h e r than d e f i n i t i v e because of c e r t a i n d i f f i c u l t i e s presented by the data. F i r s t , mode responses o f t e n d i f f e r e d n o t i c e a b l y from mean s c o r e s , and secondly, the range o f response to each a c t i v i t y tended to be f a i r l y broad, thereby skewing mean r e s u l t s . A l a r g e r respondent group would have e l i m i n a t e d some of t h i s d i f f i c u l t y . Thus, mean scores were viewed w i t h due c a u t i o n . In a d d i t i o n , the educators expressed some d i s c o m f o r t w i t h t h e i r responses. Some f e l t , as one respondent s t a t e d , t h a t "the c o m p l e x i t i e s of my pr e s e n t job d e s c r i p t i o n " made i t d i f f i c u l t to i s o l a t e one a c t i v i t y from another i n order t o a s s i g n time and f r e -quency. In f a c t , many commented t h a t t o s t a t e time and f r e -quency was d i f f i c u l t due to a lack o f a c l e a r - c u t job d e s c r i p -t i o n . In a number of cases the educators were i n h o s p i t a l s t h a t were i n the midst of a d m i n i s t r a t i v e upheaval and o r g a n i z a -t i o n a l change. As one educator put i t : "we are i n the process of change with no c l e a r - c u t r o l e d i f f e r e n t i a t i o n , t h e r e f o r e my accuracy i s q u e s t i o n a b l e . " T h i s s i t u a t i o n a l s o a f f e c t e d some responses to the i d e a l job d e s c r i p t i o n . As one respondent wrote: "Due to a d m i n i s t r a t i v e changes i n e f f e c t a t t h i s time I am unable to p r o j e c t how I would p l a n my time." F i n a l l y , i t was kept i n mind t h a t the data expressed the educators 1 p e r c e p t i o n o f what a c t i v i t i e s were performed a t given f r e q u e n c i e s and amounts of time. Without o b s e r v i n g respondents d i r e c t l y i n performance of t h e i r j o b s , v a l i d i t y of the data c o u l d not be assured. However, d e s p i t e these c a u t i o n a r y notes and r e s e r v a t i o n s , i t was f e l t t h a t p r o f i l e s , _ as p r e c e i v e d by the educators themselves, c o u l d a t l e a s t be suggested as a s t a r t i n g p o i n t f o r more d e f i n i t i v e s t u d i e s i n t h i s a r e a . I m p l i c a t i o n s R e s u l t s o f t h i s study suggested t h a t the respondents were d i s t i n c t l y d i s s a t i s f i e d w i t h p r e s e n t job p r o f i l e s . A number of steps c o u l d be taken to c l a r i f y and r e s o l v e the problems i n v o l v e d i n the r o l e s of the i n s e r v i c e educators i n t h i s group. To begin w i t h , a l l h e a l t h p r o f e s s i o n a l s and h o s p i t a l a d m i n i s t r a t o r s need to r e c o g n i z e the importance of the i n s e r v i c e educator. I t i s t h i s educator, a f t e r a l l , who i s r e s p o n s i b l e f o r o r g a n i z e i n g and d i s s e m i n a t i n g e d u c a t i o n a l i n f o r m a t i o n to both n u r s i n g and non-nursing p e r s o n n e l . T h i s group of educators f e l t t h a t they d i d not have enough time to p l a n programs to pr e s e n t t h i s i n f o r m a t i o n . I f they were allowed t h i s time to more adequately assess plan and e v a l u a t e programs, t h e i r l e a r n e r s would be more l i k e l y t o a c q u i r e and r e t a i n the i n f o r m a t i o n . Increased program p l a n n i n g time f o r these edu-c a t o r s c o u l d l e a d to improved p a t i e n t c a r e . In a d d i t i o n , t h i s group of educators i n v o l v e d them-s e l v e s i n a number of a c t i v i t i e s t h a t were e s s e n t i a l l y i r r e l e v a n t to i n s e r v i c e e d u c a t i o n . Respondents wanted to reduce g r e a t l y 1 80. t h e i r involvement i n s u p e r v i s o n as w e l l as i n c l e r i c a l and maintenance t a s k s , which d e t r a c t e d from a c t i v i t i e s i n which they perhaps should have been more i n v o l v e d . These educators were being i n a d e q u a t e l y u t i l i z e d : i f they c o u l d focus on e d u c a t i o n a l areas, i n c l u d i n g i n s t r u c t i o n and program p l a n n i n g , s t a f f would be knowledgeable and more e f f e c r i v e w i t h r e s u l t i n g improved p a t i e n t c a r e . For t h i s s i t u a t i o n to e x i s t , the educator would -need some r e g u l a r a s s i s t a n c e w i t h c l e r i c a l and a u d i o v i s u a l maintenance t a s k s . The m a j o r i t y of t h i s group d i d not have such r e g u a l r a s s i s t a n c e , and i n some i n s t a n c e s they themselves were^assuming dual r o l e s o f d i r e c t o r s o f n u r s i n g and i n s e r v i c e . To be e f f e c t i v e a t a l l , the i n s e r v i c e department of any s i z e h o s p t i a l needs, a t the very l e a s t , one f u l l - t i m e q u a l i f i e d i n s e r v i c e educator. The educators p r o p e r l y p l a c e d t h e i r p r i o r i t i e s i n e d u c a t i o n a l l y centered a c t v i t i e s . But the r a t h e r sharp i n c r e a s e d e s i r e d and program p l a n n i n g coupled w i t h a d e s i r e d decrease i n i n s t r u c t i o n a l a c t i v i t i e s i n d i c a t e d some i n b a l a n c e . I t i s o b v i o u s l y p o i n t l e s s to plan programs, and then inade-q u a t e l y implement them. Perhaps a g r e a t e r e q u a l i z a t i o n o f time spent i n these two very important areas would be more d e s i r a b l e . Another step towards c l a r i f y i n g the i n s e r v i c e educator's p o s i t i o n i n a h o s p i t a l s e t t i n g would be a c l e a r d e f i n i t i o n of her r o l e . The educators themselves c o u l d , w i t h i n i t i a t i v e , form an i n t e r e s t group to express goals and develop 181. a standard job d e s c r i p t i o n as a g u i d e — l i n e . At l e a s t one respondent f e l t a w r i t t e n job d e s c r i p t i o n of the i n s e r v i c e educator was s a d l y l a c k i n g . She requested a copy of the q u e s t i o n n a i r e developed f o r t h i s study to use as a b a s i s f o r her own job d e s c r i p t i o n . In a d d i t i o n , i t might be h e l p f u l f o r the Labour R e l a t i o n s D i v i s i o n of the R e g i s t e r e d Nurses' A s s o c i a t i o n of B r i t i s h Columbia to d e f i n e the i n s e r v i c e educator as a c a t e -gory i n t h e i r c o n t r a c t s with h o s p i t a l s . C u r r e n t l y , there i s no such category, and i n s e r v i c e educators are c u s t o m a r i l y p a i d a t the s u p e r v i s o r ' s l e v e l . I f h o s p i t a l a d m i n i s t r a t o r s found themselves faced with a d i s t i n c t wage category, they might be more l i k e l y to seek a c l e a r d e f i n i t i o n of the r o l e and r e s p o n s i b i l i t i e s of the i n s e r v i c e educators. BIBLIOGRAPHY 182 . ARTICLES 1 . __ # "The Most Promising Manpower Resource Is the Manpower that's Already There." Modern Hospital, 90-94, October 1970 (based on results of a study conducted by Dorothy Kerr for The National Academy for Health Inservice Education). 2. 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I n s e r v i c e E d u c a t i o n . f o r H o s p i t a l  Personnel, N a t i o n a l League f o r Nursing (U.S.A.); Depart-ment of H o s p i t a l Nursing, 1958. 52. Morehouse, Ralph Ernest,, A Study of Role P e r c e p t i o n  and Performance Among A g r i c u l t u r a l E x t e n s i o n Personnel  i n Nova S c o t i a ( t h e s i s ) , U n i v e r s i t y of B r i t i s h Columbia, A p r i l 1968. 53. Nakamoto,. June and Verner, C o o l i e . C o n t i n u i n g Education  i n N ursing: A Review of North American L i t e r a t u r e , 1960- 1970. A d u l t Education Research Centre and D i v i s i o n of C o n t i n u i n g Education i n the H e a l t h S c i e n c e s , U n i v e r s i t y of B r i t i s h Columbia, W.K. K e l l o g g P r o j e c t Report #4, 1972. 54. Tomlinson, Robert M., e t , a l . O c c u p a t i o n a l P a t t e r n s and  F u n c t i o n s of Employed LPNS: F i n a l Report P a r t 1, Iowa U n i v e r s i t y , Iowa, January 1969. 55. Verner, C o o l i e . A Conceptual Scheme f o r the I d e n t i f i c a t i o n  and C l a s s i f i c a t i o n of Processes, A d u l t Education A s s o c i a t i o n (U.S.A.), February 1962. 56. Wadsworth, P a t r i c i a M. Document on S t a f f Development (prepared f o r the Canadian Nurses' A s s o c i a t i o n ) , " September 19 72. 57. Wood, L u c i l e A. The Nursing Program i n the U.C.L.A. A l l i e d  H e a l t h P r o f e s s i o n a l s P r o j e c t s : Summary Report, Los Angeles, A p r i l 1970. 187. APPENDIX A. INITIAL QUESTIONNAIRE PART 1 Background Data 1. What i s the bed c a p a c i t y o f t h i s h o s p i t a l ? 2. What i s the h o s p i t a l type? a. g e n e r a l b. p s y c h i a t r i c ' c. p e d i a t r i c d. o b s t e t r i c 3. Does t h i s h o s p i t a l maintain i t s own sch o o l of nursing? a. Yes b. No. 4. I f the h o s p i t a l has i t s own s c h o o l of n u r s i n g , what i s the student p o p u l a t i o n ? 5. What i s the annual percentage of turnover f o r each of the f o l l o w i n g job c a t e g o r i e s ? a. R e g i s t e r e d Nurses % b. L i c e n s e d P r a c t i c a l Nurses % c. Nurses' Aides % 6. How many persons are employed i n the i n s e r v i c e e d u c a t i o n department? 7. Does the i n s e r v i c e education have a separate budget? a. Yes B. No. I f the budget i s separate, what i s the annual a l l o c a t i o n ? • ' • $ 8. How long has i n s e r v i c e e d u c a t i o n been i n e x i s t e n c e as an i d e n t i f i a b l e e n t i t y i n t h i s h o s p i t a l ? 9. How many i n s e r v i c e programs have been c a r r i e d out i n the l a s t twelve months? 10 . How many p a r t i c i p a n t s were there i n i n s e r v i c e progams f o r the l a s t twelve months, i n t o t a l ? In t h i s next s e c t i o n of the i n t e r v i e w , I would l i k e to o b t a i n some i n f o r m a t i o n on your background: 1. What i s your age? 188. What i s your m a r i t a l s t a t u s ? a. s i n g l e b. married c. widowed d. d i v o r c e d e. separated How many c h i l d r e n do you have? What i s your e d u c a t i o n a l background? a. Nursing diploma b. Diploma i n a f i e l d o ther than n u r s i n g ' (sta t e f i e l d ) c. Bachelor of Science i n n u r s i n g d. Bachelor's degree i n a f i e l d o ther than n u r s i n g (state f i e l d ) e. Master's degree i n n u r s i n g f . Master's degree i n a f i e l d o ther than n u r s i n g (state f i e l d ) g. Doctorate i n n u r s i n g h. Doctorate i n a f i e l d o t h e r than n u r s i n g ( s t a t e f i e l d ) P lease p l a c e a check-mark by any o f the f o l l o w i n g s u b j e c t s i n which you have taken a c o l l e g e / u n i v e r s i t y course or a s h o r t course (e.g. workshop): U n i v e r s i t y / Short C o l l e g e Course E d u c a t i o n a l Psychology P r i n c i p l e s o f Teaching/Learning C u r r i c u l u m Development Tes t s and Measurements Ba s i c S t a t i s t i c s .  E d u c a t i o n a l Philosophy Group Dynamics _____ A u d i o - V i s u a l M a t e r i a l s _____ Foundations o f A d u l t E d u c a t i o n Program P l a n n i n g _ Methods i n A d u l t E d u c a t i o n Are you a member of any of the f o l l o w i n g committees i n your h o s p i t a l (check which)? a. n u r s i n g s e r v i c e e x e c u t i v e committee b. n u r s i n g procedure committee c. head nurse commitee ' d. h o s p i t a l a d v i s o r y committee 189 . 7. Are you the d i r e c t o r / c o - o r d i n a t o r of the i n s e r v i c e e ducation department? a. Yes ' b. No 8. How many hours per week do you spend on your own c o n t i n u i n g education? 9. Are you p a r t i c i p a t i n g , or have you p a r t i c i p a t e d , i n any r e s e a r c h s t u d i e s i n the l a s t twelve months? a. Yes b. No 10. Do you have a w r i t t e n p l a n f o r c o n t i n u i n g your own education? a. Yes b. No 11. Are you a member of any p r o f e s s i o n a l o r g a n i z a t i o n s ? a. Yee--b. No _____ I f "yes" s t a t e which 12. How many hours per week do you spend r e a d i n g p r o f e s s i o n a l j o u r n a l s ? ' 13. What i s the approximate number of s h o r t courses ( i . e . work-shops) t h a t you have attended i n the l a s t twelve months? In the next s e c t i o n , I would l i k e to f i n d out how you f e e l about your job. Please r e p l y t o each statement u s i n g the number corresponding to one of the f o l l o w i n g f i v e phrases: 1 - s t r o n g l y agree 2 - agree 3 - undecided 4 - d i s a g r e e 5 - s t r o n g l y d i s a g r e e 14-.', My job i s l i k e a hobby to me. 15. I t seems my f r i e n d s are more i n t e r e s t e d i n t h e i r jobs than I am. 16. I enjoy my work more than my l e i s u r e time. 17. I am o f t e n bored with my job. 18. I f e e l f a i r l y w e l l s a t i s f i e d w i t h my j o b . 19. I f e e l my job i s no more i n t e r e s t i n g than o t h e r s I c o u l d get. 20. I d e f i n i t e l y d i s l i k e my work. 21. Each day of my work seems l i k e i t w i l l never end. 22. I f i n d r e a l enjoyment i n my work. 19 0. PART 11 T h i s p a r t o f the i n t e r v i e w w i l l focus on the a c t i v i t i e s i n which you are engaged d u r i n g your working hours. A. Hours of Work 1. Please estimate the t o t a l number of hours you work each week ( i n c l u d e o v e r t i m e ) . - hrs./week 2. How many days out of a working week do you work "across s h i f t s " i e . hours o t h e r than those e s t a b l i s h e d by your agency f o r g e n e r a l duty n u r s i n g s t a f f : 0 1 2 3 4 5 3. Out of the t o t a l number of hours you work per week, please estimate the number of hours you a c t u a l l y spend i n each of the f o l l o w i n g areas;.then estimate the number o f hours you would l i k e t o spend ( I n t e r -viewer w i l l s t a t e examples of eachhere). The t o t a l s i n each column below should add up to the "hours per week" s t a t e d i n q u e s t i o n #1. Area A c t u a l Hours I d e a l Hours Program P l a n n i n g A c t i v i t i e s I n s t r u c t i o n a l A c t i v i t i e s S u p e r v i s o r y A c t i v i t i e s P o l i c y Decision-making A c t i v i t i e s M i s c e l l a n e o u s A c t i v i t i e s TOTAL 191. B. Content Areas: Program P l a n n i n g Using 10 0% to encompass the t o t a l amount of time you spend p l a n n i n g programs i n a l l of the f o l l o w i n g areas, show what "percentage of time you a c t u a l l y spend p l a n n i n g i n each area and i d e a l l y would p r e f e r to spend p l a n n i n g i n each a r e a . Subject Area A c t u a l % I d e a l % 1. O r i e n t a t i o n of new employees 2. S k i l l t r a i n i n g 3. S p e c i a l t y Areas State areas 4. Programs of g e n e r a l i n t e r e s t 5. F i r e p r e v e n t i o n 6. D i s a s t e r / S a f e t y 7. Leadership/Management ( i e . Team leading) 100% 100% Content Areas: I n s t r u c t i o n Using 100% to encompass the t o t a l amount o f time you spend i n s t r u c t i n g i n a l l of the f o l l o w i n g areas, show what percentage of time you a c t u a l l y spend i n s t r u c t i n g i n each; then, show what percentage you would i d e a l l y p r e f e r t o spend. Subject Area A c t u a l % I d e a l % 8. O r i e n t a t i o n of new employees 9. S k i l l t r a i n i n g 10. S p e c i a l t y Areas State areas 11. Programs of g e n e r a l i n t e r e s t . 12. F i r e p r e v e n t i o n 13. D i s a s t e r / S a f e t y 14. Leadership/Management ( i e . Team leading) 100% 100% 19 3. D. In the following section, please state how. frequently you use the following methods, techniques and devices i n implementing inservice programs, using the following scale: 5 - very frequently 4 - frequently 3 - sometimes 2 - infrequently 1 - rarely 0 - not at a l l 1. Directed individual i n s t r u c t i o n of a single s t a f f member, 2. Programmed i n s t r u c t i o n 3. Classes 4. Discussion Groups 5. Workshop 6. Seminar 7. Lecturing 8. Panel discussion 9. "Buzz" groups 10. Role play 11. Demonstration 12. Practice 13. Group discussion 14. Photos 15. Posters 16. Slides 17. Films 18. F i l m - s t r i p s 19. Chalk-board 20. Use of radio-TV closed c i r c u i t 21. Use of cassettes 22. Use of actual equipment u t i l i z e d on wards 19 4. In the f o l l o w i n g s e c t i o n p l e a s e use the f o l l o w i n g s c a l e i n s t a t i n g "frequency": 0 - Never 1 - Once a year 2 - Every 6 months 3 - Every 3 months 4 - Every month 5 - Every week 6 - Twice a week 7 - D a i l y PROGRAM PLANNING Actual Job Ideal Job A c t i v i t y Frequency Time Frequency Time 1. Conferences with s t a f f to discuss learning needs '  2. Review of nursing care plans. 3. Meeting with supervisory personnel to discuss s t a f f learning needs 4. Direct observation of s t a f f performance i n de-l i v e r i n g nursing care 5. Bedside audit (unit v i s i t s to patients to determine the extent to which patient care stan-dards are being met) 6. Examination of incident reports 7. Examination of employee evaluation forms 8. Conferring with content s p e c i a l i s t s 9. Reviewing job descrip-t i o n s / l i s t s of duties 10. Review of charting pro-cedures on nursing units 11. Observation of unit nursing care conferences 12. P a r t i c i p a t i o n i n i n i t i a l (hiring) employee i n t e r -views (to establish learning needs) 196 . A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time 13. Terminal i n t e r v i e w s with employees to seek sug-g e s t i o n s f o r i n s e r v i c e programs 14. Conferences w i t h other departments to i d e n t i f y mutual l e a r n i n g needs ( i e . medical s t a f f ) _____ 15. P a r t i c i p a t i o n i n medi-c a l rounds 16. P a r t i c i p a t i o n i n nur-s i n g rounds (to assess l e a r n i n g needs) 17. Conferences w i t h i n d i -v i d u a l s t a f f memebers to i d e n t i f y p e r s o n a l l e a r n -i n g needs 18. Conferences w i t h s t a f f to d i s c u s s program ob-j e c t i v e s 19. W r i t i n g our o b j e c t i v e s f o r programs 19a. Do you w r i t e out o b j e c t i v e s p r i o r t o s e l e c t i n g con-t e n t : Yes No 20. D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program (follow-up) 21. Bedside a u d i t /.after .an i n s e r v i c e program to evaluate e f f e c t i v e n e s s of i n s t r u c t i o n 22. W r i t i n g e v a l u a t i o n r e -p o r t s 23. Recording accounts of program plans A c t i v i t y A c t u a l Job I d e a l Job Frequency Time Frequency Time 24. Experimenting with new t e a c h i n g techniques (with a s m a l l group) 25. T e s t i n g l e a r n e r s ( s t a f f ) on m a t e r i a l l e a r n e d 26. C o n s u l t a t i o n with s t a f f t o determine t i m i n g and r e s c h e d u l i n g of s t a f f to cover u n i t s d u r i n g an i n -s e r v i c e program 27. Use o f h a l f - d a y work-shop programs (4 hours i n length) 28. Use of 8-hour programs 29. Use of "mini-programs" ( i e . 15 minutes - 45 minutes) 30. C o - o r d i n a t i o n of the program p l a n n i n g a c t i -v i t i e s of o t hers INSTRUCTIONAL ACTIVITIES 31. I n s t r u c t i o n of RNs 32. I n s t r u c t i o n o f LPNs 33. I n s t r u c t i o n of nur-s i n g a i d e s / o r d e r l i e s 34. I n s t r u c t i o n o f house-keeping s t a f f 35. I n s t r u c t i o n of c l e r i c a l s t a f f 36. Instruction-^of new em-ployees i n a l l c a t e g o r i e s 37. I n s t r u c t i o n of student nurses 19 8. \ A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time 38. I n s t r u c t i o n of d i e t a r y s t a f f 39. A s s i s t i n g another s t a f f member ( i e . head nurse) who i s performing i n -s t r u c t i o n a l a c t i v i t i e s 40. I n s t r u c t i n g s t a f f i n ob-t a i n i n g r esource m a t e r i a l s 41. C o - o r d i n a t i n g i n s t r u c t i o n -a l a c t i v i t i e s of oth e r i n -s e r v i c e educators SUPERVISORY ACTIVITIES 42. A s s i s t i n g w i t h super-v i s i o n i n c l i n i c a l areas 43. H i r i n g new personnel 44. A s s i g n i n g personnel (un i t assignments) 45. C o r r e c t i n g and d i s c i -p l i n i n g personnel 46. Performanance e v a l u a t i o n s to determine promotion or t e r m i n a t i o n of an employee 47. Conducting a d m i n i s t r a -t i v e meetings POLICY DECISION-MAKING ACTIVITIES 48. Meeting w i t h the n u r s i n g s e r v i c e e x e c u t i v e commit-tee 49. Meeting w i t h the n u r s i n g procedure committee 19 9.. A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time 50. Meeting with the head nurse committee 51. Meeting with the h o s p i t a l a d v i s o r y committee 52. Meeting w i t h the D i r e c -t o r o f Nurses 52a. P l e a s e s t a t e who i n i t i a t e s meetings (you or D i r e c t o r ) 53. Meeting w i t h the h o s p i t a l a d m i n i s t r a t o r 53a. Please s t a t e who i n i t i a t e s meetings (you o r a d m i n i s t r a t o r ) 54. A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures 55. Working on budget 56. I n t e r p r e t a t i o n o f hos-p i t a l p o l i c y to employees MISCELLANEOUS ACTIVITIES 57. Reading/answering m a i l 58. Telephone c a l l s 59. W r i t i n g memos 60. M a i n t a i n i n g A-V equip-ment 61. W r i t i n g advance b r i e f i n g s to s t a f f on upcoming pro-grams 62. Buying and t e s t i n g A-V equipment 200 . A c t u a l Job I d e a l Job —-£ Frequency Time Frequency Time Orde r i n g and d i s t r i b u t i n g h o s p i t a l s u p p l i e s P l a n n i n g and implementing tours f o r n u r s i n g i n t e -r e s t groups or other i n -d i v i d u a l s v i s i t i n g your agency A s s i s t i n g i n c o - o r d i n a -t i o n o f l e a r n i n g e x p e r i -ences f o r a f f i l i a t i n g n u r s i n g students from schools o u t s i d e your h o s p i t a l A s s i s t i n g i n c o - o r d i n a -t i o n of l e a r n i n g e x p e r i -ences f o r students i n the h o s p i t a l ' s s c h o o l of nur-s i n g S e c u r i n g and m a i n t a i n -i n g i n s t r u c t i o n a l ma-t e r i a l s and r e f e r e n c e s APPENDIX B. REVISED QUESTIONNAIRE I - 1 Respondent __ H o s p i t a l PART I - A Background Data (Obtained from the h o s p i t a l ' s annual r e p o r t ) What i s the bed c a p a c i t y of t h i s h o s p i t a l ? Does the h o s p i t a l m a i n tain i t s own s c h o o l of nursing? a. Yes b. No I f the h o s p i t a l has i t s own sc h o o l of n u r s i n g , what i s the student p o p u l a t i o n ? Does the i n s e r v i c e e d u c a t i o n department have a separate budget? a. Yes b. No I f the budget i s separate, what i s the annual a l l o c a t i o n ? How long has i n s e r v i c e education been i n e x i s t e n c e a t an i d e n t i f i a b l e e n t i t y i n t h i s h o s p i t a l ? 1 - 2 202. Respondent H o s p i t a l PART I - B  Background Information In t h i s s e c t i o n , I would l i k e to o b t a i n some i n f o r m a t i o n about your background and a b i t about your i n s e r v i c e e d u c a t i o n department: 1. What i s your age? 2. What i s your m a r i t a l s t a t u s ? a. s i n g l e b. married c. other (e.g. widowed, d i v o r c e d , separated) 3. How many dependents do you have? 4. What i s your e d u c a t i o n a l background? (please check a l l t h a t are a p p l i c a b l e ) a. Nursing diploma b. Diploma i n a f i e l d o t h e r than n u r s i n g (s t a t e f i e l d ) c. Bachelor of Science i n n u r s i n g (as a b a s i c degree) d. Bachelor of Science i n n u r s i n g (as a p o s t - b a s i c degree) s t a t e major s t a t e minor len g t h of program e. Bachelor's degree i n a f i e l d o t h e r than n u r s i n g ( s t a t e f i e l d ) ) f. Master's degree i n n u r s i n g g. Master's degree i n a f i e l d o ther than n u r s i n g (state f i e l d ) h. Doctorate i n n u r s i n g i . Doctorate i n a f i e l d o ther than n u r s i n g ( s t a t e f i e l d ) 203. 1 - 3 Respondent H o s p i t a l 5. P l e a s e p l a c e a check-mark by any of the f o l l o w i n g s u b j e c t s i n which you have taken a c o l l e g e / u n i v e r s i t y course or a sh o r t course (e.g. workshop) w i t h i n the l a s t two y e a r s : U n i v e r s i t y / C o l l e g e Short Course or or -more :than .30 l e s s than 30 co n t a c t hours c o n t a c t hours E d u c a t i o n a l Psychology P r i n c i p l e s of Teaching/Learning T e s t s and Measurements Philosophy of Education Group Dynamics (Leadership) A u d i o - V i s u a l M a t e r i a l s _____ Philosophy and H i s t o r y o f A d u l t E d u c a t i o n Program P l a n n i n g ' Teaching Techniques (Methods) i n A d u l t E d u c a t i o n '  Other courses r e l a t e d to ed u c a t i o n : 6. How many hours per week do you spend on your own c o n t i n u i n g education? h r s . 7. Do you have a w r i t t e n p l a n f o r c o n t i n u i n g your own education? a. Yes b. No. 8. How many hours per week do you spend r e a d i n g p r o f e s s i o n a l j o u r n a l s and books? h r s . 204. II - 1 Respondent. H o s p i t a l PART I I T h i s s e c t i o n w i l l focus on the a c t i v i t i e s i n which you are engaged d u r i n g your "on the job" working hours. A. Hours of Work 1. Please estimate the t o t a l number of hours you work each week (inc l u d e o v e r t i m e ) . hrs./week. 2. How many days out of a working week do you work "across s h i f t s " i e . hours other than those e s t a b l i s h e d by your agency f o r g e n e r a l duty n u r s i n g s t a f f : 0 1 2 3 4 3. Please note t h a t t h i s q u e s t i o n has two p a r t s : Out of the t o t a l number of hours you work per week, a) p l e a s e estimate the number of hours you a c t u a l l y spend i n each of the f o l l o w i n g areas; b) then estimate the number of hours you would l i k e to spend. The t o t a l s i n each column below should add up to the "hours per week" s t a t e d i n q u e s t i o n #1. Area A c t u a l Hours I d e a l Hours Program P l a n n i n g A c t i v i t i e s I n s t r u c t i o n a l A c t i v i t i e s ' Su p e r v i s o r y A c t i v i t i e s (e.g. a s s i g n -ing p e r s o n n e l , doing employee perform-ance e v a l u a t i o n s , etc.) P o l i c y Decision-making A c t i v i t i e s (e.g. committee meetings, r e v i s i n g n u r s i n g procedures, etc) '  M i s c e l l a n e o u s A c t i v i t i e s (e.g. c l e r i c a l , A-V maintenance, t e l e p h o n i n g , etc) TOTAL 205. II - 2 Respondent H o s p i t a l B. Content Areas: Program Pl a n n i n g P l e a s e note t h a t t h i s q u e s t i o n has two p a r t s . Using 100% to encompass the t o t a l amount of time you spend p l a n n i n g programs i n a l l of the f o l l o w i n g areas, a) show what percentage of time you a c t u a l l y spend p l a n n i n g i n each area and then b) the percentage of time you would i d e a l l y p r e f e r t o spend p l a n n i n g i n each area. Subject Area 1. S k i l l t r a i n i n g (manipulative as w e l l as s p e c i f i c v e r b a l s k i l l s ) 2. S p e c i a l t y Areas ( c l i n i c a l areas e.g. p e d i a t r i c s , surgery, obste-t r i c s , urology, etc) S t a t e areas A c t u a l % I d e a l % 3. Programs of g e n e r a l i n t e r e s t (e.g. g e n e r a l procedures or t o p i c s such as c h a r t i n g , or communication workshops) 4. F i r e p r e v e n t i o n 5. S a f e l y 6.. Leadership/Management ( i e . team leading) 7. D i s a s t e r 8. O r i e n t a t i o n of new employees (in a l l areas of #1 to #7 i n c l u s i v e ) 100% 100% 2 0 6 . II - 3 Respondent Hospital C. Content Areas: Instruction Please note that t h i s question has two parts. Using 10 0% to encompass the t o t a l amount of time you spend on d i r e c t  i n s t r u c t i o n i n a l l of the following areas, a) show what percentage of time you a c t u a l l y spend i n s t r u c t i n g in each b) then, show what percentage you would i d e a l l y prefer to spend. Subject Area Actual % Ideal 1. S k i l l t r a i n i n g (Manipulative as well as s p e c i f i c verbal s k i l l s ) Specialty Areas ( c l i n i c a l areas e.g. p e d i a t r i c s , surgery, obste-t r i c s , urology, etc) State areas 3. Programs of general i n t e r e s t (e.g. general procedures or topics such as charting, or communication workshops) 4. F i r e prevention 5. Safety 6. Leadership/Management (ie. team leading) 7. Disaster 8. Orientation of new employees (in a l l areas #1 to #7 inclusive) 100% 100% 207. 1 - 4 Respondent H o s p i t a l 9. What i s the approximate number of s h o r t courses ( i . e . workshops) t h a t you have attended i n the l a s t twelve months? 10. Are you p a r t i c i p a t i n g , or have you p a r t i c i p a t e d , i n any r e s e a r c h s t u d i e s i n the l a s t twelve months (other than t h i s study)? a. Yes b. No 11. Are you a member of any p r o f e s s i o n a l o r g a n i z a t i o n s (other than the R.N.A.B.C.)? a. Yes b. No I f "yes," s t a t e which ones 12.„ Are you i n a d i r e c t i n g / c o - o r d i n a t i n g p o s i t i o n i n your i n s e r v i c e education department? a. Yes b. No 13. What i s your job t i t l e ? 14. How long have you been employed i n your p r e s e n t p o s i t o n 15^. Are you a member of any of the f o l l o w i n g committees i n your h o s p i t a l ? (check which ones) a. n u r s i n g procedure committee b. n u r s i n g s e r v i c e e x e c u t i v e committee c. head nurse committee d. other committees (please s t a t e ) : 208. 1 - 5 Respondent Hospital 16. How many persons are employed i n your inservice education department? ' Of those, how many are: a. inservice educators b. c l e r i c a l personnel ' c. audio-visual technicians d. Others not l i s t e d above: 17. How many planned, organized inservice programs have been carried out i n the l a s t twelve months, approximately? 18. How many participants were there i n planned, organized inservice programs for the l a s t twelve months? Respondent H o s p i t a l I n s t r u c t i o n s f o r P a r t I I I Please s t a t e "time" in'terms o f minutes. I f l e s s than 60 minutes, round o f f the f i g u r e to the n e a r e s t q u a r t e r hour (e.g. 15 minutes, 30 minutes, 45 minutes). Please use the f o l l o w i n g s c a l e i n s t a t i n g "frequency": 0 - Never 1 - Once a year 2 - Every 6 months 3 - Every 3 months 4 - Every month 5 - Every 2 weeks 6 - Every week 7 - Two times per week 8 - Three times per week 9 - D a i l y I l l - 2 210. Respondent Hospital Actual Job' Ideal Job A c t i v i t y Frequency Time Frequency Time (min.) (min.) 1. Conferences with general duty nursing s t a f f to discuss learning needs: a. Planned group con-ferences b. Planned i n d i v i d u a l conferences (with an i n d i v i d u a l s t a f f member) _ c. Incidental group conferences d. Incidental i n d i v i d u a l conferences 2. Conferences with other departments to i d e n t i f y mutual learning needs (ie. medical s t a f f , c l e r i c a l housekeeping, dietary, e t c . ) : a. Planned group conferences b. Planned i n d i v i d u a l con-ferences c. Incidental i n d i v i d u a l conferences d. Incidental i n d i v i d u a l conferences 3. Meeting with nursing super-visory personnel to discuss s t a f f learning needs: a. Planned conferences b. Incidental conferences 4. Meeting with supervisory personnel of departments other than nursing ~ to discuss s t a f f learning needs: a. Planned conferences b. Incidental conferences _____ 5. Direct observation of s t a f f performance i n del i v e r i n g nursing care 6. Direct observation of non-nursing s t a f f i n per-formance of duties 211. I l l - 2 Respondent H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (min .) (min. ) 7. Bedside a u d i t ( u n i t v i s i t s to p a t i e n t s to determine the extend to which p a t i e n t care standards are being met) 8. Examination o f i n c i d e n t r e p o r t s 9. Examination of employee performance e v a l u a t i o n s 212. I l l - 3 Respondent H o s p i t a l ! A c t u a l Job , • I d e a l Job  A c t i v i t y ' Frequency Time Frequency Time (min.) (min.) 10. Reviewing job d e s c r i p t i o n s ( l i s t s o f d u t i e s ) 11. Review of c h a r t i n g on n u r s i n g u n i t s (chart a u d i t ) 12. o b s e r v a t i o n of u n i t n u r s i n g care conferences to assess l e a r n i n g needs 13. P a r t i c i p a t i o n i n h i r i n g i n t e r v i e w s to e s t a b l i s h the p o t e n t i a l employee's l e a r n i n g needs: a. Nursing personnel b. Non-nursing personnel 14. Terminal i n t e r v i e w s w i t h employees to seek suggestions f o r i n s e r v i c e e d u c a t i o n programs: a. Nursing b. Non-nursing 15. Review o f t e r m i n a t i o n r e p o r t s f o r suggestions on i n s e r v i c e e d u c a t i o n programs 16. P a r t i c i p a t i o n i n medical rounds to assess l e a r n i n g needs 17. P a r t i c i p a t i o n i n n u r s i n g rounds to assess l e a r n i n g needs 18. Conferences with t a r g e t s t a f f (the l e a r n i n g group f o r a given program) to develop program ob-j e c t i v e s f o r g i v e n l e a r n i n g programs: a. Nursing b. Non-nursing 213. I l l - 3 Respondent H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (min.) (min.) 19. Conferences w i t h other i n s e r v i c e educators to develop program plans 20. W r i t i n g out o b j e c t i v e s f o r programs 21. S e l e c t i n g content f o r l e a r n i n g programs 214. I l l - 4 Respondent H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (rtin.) (min.) 22. C o n f e r r i n g w i t h content s p e c i a l i s t s t o g a i n back-ground i n f o r m a t i o n f o r given programs (e.g. c o n f e r r i n g w i t h an i n h a -l a t i o n t h e r a p i s t f o r background on a program i n r e s p i r a t o r y i n s u f f -iency) 23. S e l e c t i n g i n s t r u c t i o n a l r esources (equipment, people, etc.) 24. Experimentation w i t h new t e a c h i n g techniques 25. C o n s u l t a t i o n with s t a f f t o determine a p p r o p r i a t e r e s c h e d u l i n g r e q u i r e d to cover wards d u r i n g an i n s e r v i c e program 26. Use of h a l f - d a y workshop programs (4 hours i n length) 27. Use of 8 hour programs 28. Use of "mini-programs" (15 to 45 minutes i n length) 29 Use of programs 1 to.2 hours i n l e n g t h 30. Use of p i l o t programs to " t e s t out" an i n s t r u c t i o n a l technique b e f o r e u s i n g i n a formal program 215. I l l - 4 Respondent H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (min.) (min.) 31. D i r e c t o b s e r v a t i o n of s t a f f performance a f t e r a program ( f o l l o w - u p ) : a. Nursing s t a f f b. Non-nursing personnel __ 32. Bedside a u d i t a f t e r an i n s e r -v i c e program to e v a l u a t e e f f e c t i v e n e s s of i n s t r u c t i o n 33. W r i t i n g e v a l u a t i o n r e p o r t s of l e a r n i n g programs 34. D i s c u s s i n g e v a l u a t i o n of given i n s e r v i c e programs wi t h other i n s e r v i c e educators i n your agency 216. I l l - 5 Respondent H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (min.) (min.) 35. Reviewing e v a l u a t i o n of a program with the l e a r n i n g group 36. Reviewing e v a l u a t i o n of a program with s u p e r v i s o r y p e r s o n n e l 37. Keeping r e c o r d s of implemented programs 38. C o - o r d i n a t i o n of program p l a n n i n g a c t i v i t i e s i n i t i a t e d by: a. S t a f f i n n u r s i n g b. S t a f f i n other departments 39. D i r e c t i n s t r u c t i o n o f : a. R e g i s t e r e d Nurses b. P r a c t i c a l Nurses c. Nurses a i d e s d. Student Nurses e. Non-nursing personnel 40. Use of content s p e c i a l i s t s to h e l p teach (under "time" s t a t e how long they spend i n a c t u a l teaching) 41. A s s i s t i n g another s t a f f member ( i e . head nurse) i n t e a c h i n g : a. Nursing personnel b. Non-nursing 42. A d v i s i n g s t a f f i n o b t a i n -i n g resource m a t e r i a l s 217. I l l - 5 Respondent H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (min.) (min.) 43. C o - o r d i n a t i n g i n s t r u c -t i o n a l a c t i v i t i e s o f other i n s e r v i c e educators 44. A s s i s t i n g with super-v i s i o n i n c l i n i c a l areas 45. H i r i n g n u r s i n g person-n e l 46. A s s i g n i n g n u r s i n g personnel (u n i t a s s i g n -ments) 47. C o r r e c t i n g and d i s -c i p l i n i n g personnel 218. I l l - 6 Respondent H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (min .) '. (min .) 48. Performance e v a l u a t i o n s to determine promotion or t e r m i n a t i o n of an employee 49. P a r t i c i p a t i n g i n a d m i n i s t r a t i v e meetings 50. Performing p a t i e n t and drug census 51. Meeting with the n u r s i n g s e r v i c e e x e c u t i v e committee 52. Meeting with the n u r s i n g procedure committee 53. Meeting, w i t h the head nurse 54. Other committees (please s t a t e ) a. b. c. d. 55. Meeting w i t h the D i r e c t o r of Nurses 56. Meeting with the h o s p i t a l a d m i n i s t r a t o r 57. A s s i s t i n g i n r e v i s i o n of n u r s i n g procedures 58. Working on i n s e r v i c e education budget 59. I n t e r p r e t a t i o n of h o s p i t a l p o l i c y to employees 219 . I l l - 6 Respondent _ H o s p i t a l A c t u a l Job I d e a l Job A c t i v i t y Frequency Time Frequency Time (min.) (min.) 60. Reading/answering m a i l 61. Telephone c a l l s ( i n and outgoing) 62. W r i t i n g memos 63. Buying and t e s t i n g audio-v i s u a l equipment 220. I l l - 7 Respondent H o s p i t a l A c t u a l Joy I d e a l Job A c t i v i t y Frequency Time Frequency Time 64. M a i n t a i n i n g a u d i o - v i s u a l equipment 65. S e c u r i n g i n s t r u c t i o n a l r esources (other than a u d i o - v i s u a l aids) 66. M a i n t a i n i n g i n s t r u c t i o n a l r esources (other than . a u d i o - - v i s u a l aids) 67. Performing c l e r i c a l tasks a s s o c i a t e d w i t h p r e p a r i n g and d u p l i c a t i n g hand-outs 68. W r i t i n g advance b r i e f i n g s to s t a f f on upcoming i n s e r v i c e programs (e.g. f o r p o s t i n g on b u l l e t i n boards, etc.) 69. P l a n n i n g and implement-i n g tours f o r n u r s i n g i n t e r e s t groups and other i n t e r e s t e d i n d i v i d u a l s 70. A s s i s t i n g i n c o - o r d i n a -t i o n of l e a r n i n g ex-p e r i e n c e s f o r : a. n u r s i n g students from schools o u t s i d e your h o s p i t a l b. n u r s i n g students i n your h o s p i t a l ' s s c h o o l of n u r s i n g c. r e g i s t e r e d nurses who are not h o s p i t a l •employees (e.g. from community c o l l e g e r e f r e s h e r courses) APPENDIX C. JUDGING PANEL FOR INSTRUMENT DEVELOPMENT Mrs. Kathleen C l a r k , RN Con t i n u i n g p u r s i n g Education, Interim,- D i r e c t o r U n i v e r s i t y of B r i t i s h Columbia School o f Nursing Ms. Jean Cranstoun, RN Chairman, Nursing Department Vancouver Community C o l l e g e Mrs. Pat C u t s h a l l , RN A s s i s t a n t D i r e c t o r of Ed u c a t i o n S e r v i c e s R e g i s t e r e d Nurses A s s o c i a t i o n o f B.C. Joan McCullough, RN A s s i s t a n t D i r e c t o r o f Ed u c a t i o n S e r v i c e s R e g i s t e r e d Nurses A s s o c i a t i o n o f B.C. Dr. Lee S t r y s l e c k i E d u c a t i o n D i r e c t o r B r i t i s h Columbia H o s p i t a l A s s o c i a t i o n Mrs. Judy White, RN Cu r r i c u l u m C o o r d i n a t o r , Nursing Department Vancouver Community C o l l e g e APPENDIX D. HOSPITALS EMPLOYING RESPONDENTS Burnaby General H o s p i t a l 3800 I n g l e t o n Avenue Burnaby, B.C. Lio n s 1 Gate Bridge 230 E a s t 13th S t r e e t North Vancouver, B.C. Mt. S t . Joseph H o s p i t a l 3080 P r i n c e Edward S t r e e t .Vancouver, B.C. Queen V i c t o r i a H o s p i t a l 841 C o l l i n s o n S t r e e t V i c t o r i a , B.C. Richmond General H o s p i t a l 700 Westminster Highway Richmond,:'. B. C(.-Royal Columbian H o s p i t a l 330 E a s t Columbia S t r e e t New Westminster, B.C. St. Mary's H o s p i t a l 220 Royal Avenue New Westminster, B.C. St. P a u l ' s H o s p i t a l 10 81 B u r r a r d S t r e e t Van couver, B.C. St. V i n c e n t s ' H o s p i t a l 749 West 33rd S t r e e t Vancouver, B.C. Royal J u b i l e e H o s p i t a l 1900 F o r t S t r e e t V i c t o r i a , B.C. Vancouver General H o s p i t a l 855 - 12th Avenue Vancouver, B.C. 223. APPENDIX E - l . Int r o d u c t o r y L e t t e r (Form sent to i n s e r v i c e educators not known p e r s o n a l l y by the researcher) J u l y 31, 1974 Dear Miss/Mrs. I am a r e g i s t e r e d nurse and a graduate student i n the F a c u l t y of Education a t the U n i v e r s i t y of B r i t i s h Columbia. At present, I am i n the process of doing a study on n u r s i n g i n s e r v i c e education f o r my Master's t h e s i s i n A d u l t E d u c a t i o n . In my study, I w i l l be l o o k i n g a t the job f u n c t i o n s o f i n s e r v i c e educators i n acute care g e n e r a l h o s p i t a l s e t t i n g s i n the Greater Vancouver and V i c t o r i a areas. P o t e n t i a l l y , there are about twenty i n s e r v i c e educators who c o u l d be i n c l u d e d i n the study. I would be very p l e a s e d i f you c o u l d p a r t i c i p a t e i n t h i s study. I would need around 45 minutes of your time f o r the i n t e r v i e w i t s e l f , with an a d d i t i o n a l 40 minute s e c t i o n to be completed at your l e i s u r e . To my knowledge, a study o f t h i s k i n d has not y e t been done i n B.C., and i f s u c c e s s f u l , c o u l d y i e l d some u s e f u l i n f o r m a t i o n about i n s e r v i c e e ducation. I would very much a p p r e c i a t e your c o n s i d e r a t i o n o f t h i s matter. In about a week, I w i l l be c o n t a c t i n g you by telephone to d i s c u s s your involvement i n the study. Please f e e l f r e e to c o n t a c t me a t , should you wish to do so. I look forward t o t a l k i n g with you. Thank you, Miss Andrea Bass APPENDIX E-2. In t r o d u c t o r y L e t t e r (Form sent to i n s e r v i c e educators known p e r s o n a l l y by the researcher) J u l y 31, 1974 Dear As I may have mentioned to you a t some p o i n t i n the past , I'm i n the process of doing a study on n u r s i n g i n s e r v i c e educators i n h o s p i t a l s f o r my Master's t h e s i s . In the study, I ' l l be l o o k i n g a t the job f u n c t i o n s o f i n s e r v i c e educators i n acute care g e n e r a l h o s p i t a l s e t t i n g s i n the Greater Vancouver and V i c t o r i a areas. P o t e n t i a l l y , there are about twenty i n s e r v i c e educators who c o u l d be i n c l u d e d i n the study. I'd be very p l e a s e d i f you would p a r t i c i p a t e i n the study. I would need around 45 minutes of your time f o r the i n t e r v i e w i t s e l f , with an a d d i t i o n a l 40 minute s e c t i o n to be completed a t your l e i s u r e . To my knowledge, a study of t h i s k i n d has not y e t been done i n B.C., and i f s u c c e s s f u l , c o u l d y i e l d some u s e f u l i n f o r m a t i o n about i n s e r v i c e education i n Vancouver and V i c t o r u a acute care general h o s p i t a l s . I'd r e a l l y a p p r e c i a t e your c o n s i d e r a t i o n o f t h i s matter. In about a week, I w i l l be c o n t a c t i n g you by telephone to d i s c u s s your involvement i n the study and to s e t up an appointment time convenient to you. Please don't h e s i t a t e to c a l l me a t should you wish to do so. I'm l o o k i n g forward t o t a l k i n g w i t h you and seein g you again I Many thanks, Andrea Bass 

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