The intuition measure for use with students showed evidence of construct validity and reliability. With further testing, the measure could serve as a stimulus to foster students' intuitive abilities.

Pennsylvania's response to adolescent suicide is its Student Assistance Program (SAP). SAP has been funded for 27 years although no statewide outcome studies using case-level data have been conducted. This study used logistic regression to examine drug-/alcohol-related behaviors and suspensions of suicidal students who participated in SAP. Of the 46 services, 10 best predicted (p<.01) that these undesirable outcomes would cease. Although no study subjects died by suicide, 42 of 374,626 referred students did die by suicide. Suicidal students who did not participate had double the rate of suicide of suicidal participants of SAP. Students referred for other reasons also killed themselves. Further work must be done to assess all referred students for suicide risk, examine educational outcomes, monitor substance-related crimes and overdoses, and examine school-related factors postmortem. Evidence from this study can be used by researchers to plan future studies and by Pennsylvania's school nurses when planning services.

Individual factors are known to influence engagement in research utilization and evidence-based practice (EBP). Cognitive maturity is one factor that may enhance interest in and willingness to engage in clinical inquiry, research utilization, and EBP. Adult cognitive development theory explains why research training alone may not suffice to prepare nurses for EBP. Epistemic assumptions held by pre-reflective and quasireflective thinkers interfere with openness to uncertainty and ambiguity in practice and accurate understanding of the value of research for practice. Nurses may use good formal logic, but they also believe in authority, or revealed truth, as the criterion for knowledge and sometimes fail to perceive the need to evaluate evidence. Developmentally oriented educational efforts informed by the reflective judgment model have the potential to foster the cognitive development required in students of EBP. Further inquiry into the relationship between cognitive maturity and EBP will enhance these educational efforts.

Recent shifts in the healthcare system reflect a shift in thinking from sickness to wellness. This article reviews the paradigm shift, incentive system, and issues related to cost and quality. The role of case management in facilitating this transition is discussed. The article concludes with a discussion of the challenge to use nursing's unique disciplinary perspective that is focused on health to develop new approaches and strategies and the opportunities for case management to expand its scope of practice.

No abstract