Nursing Research
Presentation by:
Susan A. Bethel, MSN, RN, NE-BC
Manager of Nursing Scholarship & Research
Greenville Health System
Employee Service Center Building
701 Grove Rd/ Greenville, S.C. 29605
Office: 864-455-7007
sbethel@ghs.org I www.ghs.org
Trudy Ackard, MSN, RN
Education Consultant (RN) I Nurse Residency Program
Coordinator
Learning and Development I Greenville Health System
701 Grove Road I Greenville, SC 29605
Office: 864-455-6198 I Department: 864-455-6100
Fax: 455-6101
tackard@ghs.org I www.ghs.org
Current Research Involving New RN Graduates and
Faculty Participation In Delphi Study
Objectives
 Describe current research involving new graduates in our
nurse residency program
 Review ongoing Delphi study involving faculty and GHS
nurses
 Discuss proposed future study involving new RNs in their
second year of practice
Impact of Redesigned Competency Based Graduate
Nurse Residency Program on Critical Thinking and
Experience of New Graduate RNs during their
First Year of Transition into Practice
Research Questions
•
What is the difference in level of critical thinking of new
graduates who participate in the nurse residency program as
measured throughout the one year program?
• What is the level of readiness as perceived by the nurse
managers related to the new graduates’ clinical and non
clinical skills ?
• Is there a relationship with characteristics of new RNs (
education, age, clinical track) related to the perceptions of
their clinical competence?
• How are characteristics of new RNs related to their
performance in terms of critical thinking and clinical
competence as measured by assessors
Participants
•
•
•
•
Three cohorts enrolled
Hired September – February 2015
N= 59
Academic Degrees
– Associate Degree = 6
– BSN = 53
Measurement
• Partnered with Healthcare Advisory Board/ Nurse
Executive Center
– Critical Thinking Diagnostic Tool
• Self assessment by new grad at one year
• Assessors evaluate new grad @ 3mo,6mo & 1 yr.
• Problem Recognition, Clinical Decision Making, Prioritization,
Clinical Implementation & Reflection
• Completed inter rater reliability for the assessors
– Nurse Readiness for Practice Tool
• Nurse Manager completes at one year
• Casey Fink Graduate Nurse Experience Survey©
– Self assessment by new graduate at start of program, 6 months and
one year
– Frequently used tool – validity established and reliability of .71-.90
Casey Fink Survey
Preliminary- Casey Fink
Check the top three skills/procedures you are uncomfortable performing independently at
this time.
Critical Thinking Diagnostic
Creating a Nursing Research Agenda :
Clinical and Academia Collaborative Delphi Study
GHS: Susan Bethel MSN RN; Cathie Osika Landreth MSN RN;
Anita DeWeese MSN RN; Stephanie Pulis MSN RN
Greenville Technical College :
Debbie Lyles PhD RN; Alissa Samoya DNP RN
Clemson University: John Whitcomb PhD RN
USC Upstate : Lynette Gibson PhD RN
Bob Jones University: Ai Kato MSN RN
Lander University: Liz McDowell PhD RN
What are the priorities for development of
research studies that closely align with
improving patient care, nursing practice &
nursing education ?
 Explore priorities for building nursing research
over next 3 years
 Input from both clinical nurses in health system
and affiliated nursing faculty

Delphi technique method utilization

Future collaboration on mutual research studies
Round One Survey
OPEN ENDED QUESTIONS

What clinical / research question(s) do you have about patient/caregiver/ family or community
involvement that interests you?

What clinical/research question(s) do you have about communication in your practice?

What clinical /research question(s) do you have about the continuum of care in your specialty?

What clinical/research question(s) do you have about the use of technology in patient care, nursing
practice or nursing education?

What clinical /research question(s) do you have about the quality of care and/or patient safety in your
specialty?

What clinical / research question(s) do you have involving healthcare professional accountability?

What clinical/research question(s) do you have involving workforce structure, process or
environment?

What clinical /research question(s) do you have about education?
Please indicate any other research question(s) or clinical question(s) should be studied.
Impact of Reflective Practice as Learning Process
for New Graduate RNs Early in their Career
Research Team
Susan Bethel MSN RN NE-BC
Trudy Ackard MSN RN
Bobbie Rhodes MSN RN
Rev. John Hartman D.Min
Lynette Gibson PhD RN
Purpose
• Guide new nurses through the use of
reflective practice
• Facilitate the new nurse at the descriptive
level of reflection
– Three levels of reflection: descriptive, dialogic and
critical
• Use multi media approaches for reflection
Aims
• Qualitative Study
– Questions
• What is the learning associated with the application of
reflective practice for the new graduate RN during their
second year of employment in professional nursing
practice in a clinical setting?
• Do new RNs perceive that the use of reflective practice
as value-added in their nursing practice?
• Do new RNs perceive that the use of reflective practice
impacts quality and safety at the bedside?
Theoretical Framework
• Transformative Learning (Mezirow)
– Able to transform your frame of reference
– Occurs when one critically reflects on the assumptions upon which
their interpretations, beliefs and habits of mind are based
• Reflective practice is a process, deliberative
and continuously evolving
• Enables the growth of one’s self and
knowledge– increasing ability to integrate into
the deepening and expanded clinical practice
Design/ Method
• Qualitative design
• Conducted over one year
• Sample
– Recruited from 2 cohorts of new RNs from this year’s
nurse residency program
– Will be conducted during their second year of employment
at GHS on a patient care unit
• Educational session on reflective practice
• Tools for reflection
– Journaling
– Focus groups
– Online Survey
Questions?