No abstract

Problem based learning (PBL) has been widely used in the United States, United Kingdom and Australasia in undergraduate nursing education to develop critical thinking and problem solving skills. PBL has been used since 1996 in a Bachelor of Nursing course at a New Zealand tertiary institution, and several modifications have been made to foster effective learning. The 'pure' PBL process has been adapted to move students gradually from teacher direction to taking responsibility for their learning. This has provided the opportunity for students to develop critical thinking, problem solving, information retrieval and evaluation skills, and group process skills over an 18-week period. Because rigorous evaluation of these changes had not been formally undertaken, the purpose of this study was to evaluate how the current format was developing students' understanding and integration of knowledge. Two cycles of the action research method (Cardno and Piggot-Irvine, 1994) were used, involving 4 lecturers and 17 students. Data was collected both quantitatively and qualitatively over a 16-week period. Findings indicated the importance of: explaining the purpose and process of PBL; communicating in detail the role of both students and lecturers; keeping communication lines open; addressing timetabling issues and valuing this method of learning for nursing practice. Implications for nursing education are addressed.

Presents suggestions from a medical team of nurse, physicians, and a social worker about how a minister, priest, or rabbi might be helpful in aiding parents through a stillbirth. Focuses on grief and aftercare as the most important areas for the functions of the clergy.If any death in our culture goes unnoticed, it is that of a stillborn child. Societal indifference to the event of stillbirth is reflected in the problems confronting the parents of a stillborn son or daughter. Parents of stillborns often feel obligated to push aside their deep feelings of grief, as though the mourning of a stillborn baby is abnormal or uncalled for. A high percentage of these parents choose in-hospital cremation for their infants, instead of private burials.' The choice of cremation in and of itself is not unique, but this choice is almost always accompanied by the choice of no memorial service of any kind. This effort to cease grieving the stillborn baby is fruitless and sometimes has devastating consequences.As members of a professional team which provides crisis intervention and information to these bereaved parents, we have become particularly concerned by the lack of social support available to most of these families. While crisis intervention has its benefits, a hospital usually has neither the staff nor the resources to provide the emotional support so critical to these families. Unfortunately, in too many cases relatives and friends may do more to hinder parental grieving than to facilitate it. Members of the clergy, especially those who have had contact with a family before the death of their baby, may be the only source of support available to the parents. A caring minister, rabbi, or priest may playa crucial role in the adjustment of families of stillborns. For this reason, we would like to share what we and others have learned from working with parents of stillborns, and offer suggestions to aid clergy in this difficult task.

uterine activi-ty were significantly greater in the oxytocin group than in the PGE2 group.In the augmentation series2 the difference between the two drugs was even nore apparent. The augmentation-to-delivery interval, the mean basal uterine tone, the mean frequency of contractions, nausea, vomiting, ketosis, pyrexia, and late fetal heart decelerations were all significantly higher in the oxytocin group than in the PGE2 group.Returning to Mr. Charnberlain's observation that preselection of high-risk infants may explain the findings of Mr. Liston and Mr. CaQbell, our data demonstrate that the oxytocic used is undoubtedly a contributory factor. They also show that this is less significant with PGE2 than with oxy,tocin. We therefore support Mr. Liston and Mr.Campbell's sugestion that the use of oxytocin can be hazardous and, while PGE2 appears to be kinder to the uterus and fetus, the possible dangers of all oxytocics should never be forgotten.-We are, etc.,