Graduate education for nursing and midwifery has been debated for some years, with current opinion in favour of at least an increase in degree provision (Nursing and Midwifery Council (NMC), 1999). The professions as well as consumers and purchasers of nursing and midwifery education need to be sure, however, that they are getting "added value" with the graduate practitioner. Educationalists identify "critical thinking" as the level that distinguishes diploma from graduate preparation. This article intends to clarify whether academic achievements are restricted to the theoretical aspects of the award or whether a degree adds value to clinical practice. The study design was an experimental case-control cross-sectional survey carried out on samples of nursing and midwifery graduates and diplomates. The graduates were grouped as experimental cases, while the diplomates were controls. A measurement tool of 42 items covering a range of attributes and skills was employed in the study to provide a rating score for individual samples. Statistical analysis was carried out and showed that the scores from graduates were significantly different from the diplomates, indicating that there are genuine differences between the graduates and diplomates. Furthermore, from discriminant analysis of item scores, it appeared that the graduates' overall item scores were higher than the diplomates as indicated by the centroid of the functions being positive for the graduates and negative for the diplomats. The evidence from this study seems to support current thinking that a degree adds value to practice.

This article reports changes in mindset and attitudes of a cohort of 798 NHS managers in relation to the implementation of a new NHS trust-wide performance appraisal system. This was measured through two methods: the statistical analysis of data collected before and after an intensive training/orientation intervention by means of χ2 tests; and a corpus linguistic analysis of word associations and text comments that is novel to the literature.

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