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The purpose of this study was to determine the effects of relaxation and imagery on the sleep of critically ill adults. The study was an experimental clinical trial with random assignment to two groups. Analysis used repeated measures ANOVA. Thirty-six adults (17 males and 19 females) with a variety of physical diagnoses in three critical-care units in two large metropolitan hospitals were studied. Outcome measures were scores on a visual analog sleep scale, measured on three mornings. The intervention was a combination of relaxation and imagery, delivered on two evenings. All subjects' sleep improved over time. There were significant interaction effects between the intervention, gender, and time, with males' scores improving rapidly, and females' scores first dropping, then improving rapidly. A combination of relaxation and imagery is effective in improving the sleep of the critically ill adult, with men responding immediately to relaxation and imagery with improved sleep, and women taking more time to respond to the intervention.

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Conceptual teaching in nursing education offers benefits over traditional content and fact-laden curricula, including the development of cognitive skills necessary for knowledge transfer across contexts and the ability to transform students into lifelong learners. The recent focus on active and learner-centered teaching techniques does not equate to learning conceptually, although it is a positive move away from teacher-centered techniques. A paucity of educational nursing literature exists that delineates both the theory and methods used to teach conceptually. We present a semiotic framework for teaching conceptually, in addition to outlining three core components necessary for conceptual learners: addressing misconceptions, developing enduring understandings, and acquiring metacognitive skills. Five teaching methods that are particularly fitting for concept-based curricula and useful across all program levels are described and outlined. Active and learner-centered activities can also be designed and adapted to develop the mindset necessary to learn conceptually.