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Learning is seen as a systems-level phenomenon that stays within the organization regardless of the "players" involved. However, this article reviews some of the history of organizational learning and the learning organization and makes a proposal for how health care organizations are becoming learning organizations.

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Evaluation of competency is a lot like competency itself: easy to talk about and difficult to pin down. There are no hard and fast guidelines, but evaluation will be an easier, if not easy, task if attention is given to (1) ensuring alignment with goals of the institution and patient care situation; (2) developing properly a valid and reliable form; (3) training of evaluators; and (4) choosing a reasonable timetable for re-evaluation.

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They are common comments from people facing a life-threatening or chronic illness: "Why did this happen to me? I don't deserve this." "Am I being punished for something? Why do I have to go through this?"

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The nurse's ability to use "benevolent power" can be a very useful tool in relating to patients. Use of "benevolent power" takes advantage of the nurse's power and authority by virtue of positions However, rather than focusing on the nurse's needs or manipulating the patient in a negative way, use of "benevolent power" allows the nurse to respond to the patient situation in a way which is beneficial and positive for the patient.

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This is the second article of a two-part series on patient education. This article builds on the first one by discussing some of the unique considerations in providing patient education in the nuclear medicine department. Concrete strategies for nuclear medicine technology practice are discussed here. After reading this article, the technologist should be able to: (a) describe the affective and technical aspects of the nuclear medicine technologist's role as a patient educator; (b) identify some strategies that nuclear medicine technologists can use to become better teachers; and (c) describe factors that affect patient learning in the nuclear medicine department and some approaches to overcome or minimize learning barriers.

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The case study method is a useful student-centered learning strategy that allows students to solve real-world problems in the safe environment of the classroom. The authors discuss the strengths and limitations of this method and strategies for developing and using case studies in the classroom.

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The purpose of this article is to explain the staff development approach as a means of enhancing the nurse manager's professional growth as well as the growth of employees. Staff development is growth-oriented, provides opportunity for self-direction, and integrates the needs of the learner and the facility while focusing on long-term goals. The author discusses integrating the goals of the adult learner and those of the health care organization as a means of meeting the needs of the institution and the individual employee.

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The authors describe the dynamics of change, barriers and resistance to change, and provide techniques for assisting staff cope with change. The nurse manager should provide support during change, intervene when change is a surprise, help staff find challenge in change, encourage staff to have courage and stamina while coping with change, and foster teamwork. Using these techniques enables the manager and staff to view change as a challenge and an opportunity rather than a threat.

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Nursing science is increasingly gaining recognition. Witness the growing use by other disciplines of nursing's models and ideas. One example is the adoption of the Giger and Davidhizar Model of Transcultural Assessment by non-nursing disciplines to understand and address the needs of a pluralistic multicultural society. Below the authors describe a model to understand culturally diverse clients and show how health professions are using it to provide culturally competent care.

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An inconsistent nursing assignment structure increases unsafe nursing care situations and patient and staff litigation. Using a holistic perspective when scheduling places value on subjectivity, accountability and continuity of care. The conflicts involved with the nursing assignment structure and its implications for nursing managers are identified.

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Although health care is changing, and probably always will be subject to change, there are certain basic themes present at the founding of the U.S. health care system that remain important today. Although these themes could be seen as working against each other, proper attention to both might lead to a "marriage" that could optimize the system and provide, if not a solution, at least a workable system for health care.

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Change seems to be the one constant in health care. This article examines how employees react to change and provides guidelines to help them and managers overcome barriers to change. These guidelines include providing support during change, using appropriate interventions, helping staff find the challenge in change, helping them find the stamina for change, and fostering teamwork.

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Humor has the potential to be positive or negative, character building or destructive. Many suggest that a sense of humor is necessary for good health, whether of an individual or an organization. This article presents ways in which managers can foster a "laughing with" (instead of "laughing at") attitude as a means of managing stress, enhancing teamwork, and maintaining employee satisfaction in the face of adversity.

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This article examines the changing nature of patient education and the reasons why radiologic technologists must take a role in educating patients. The elements of teaching and effective communication are discussed, along with barriers to learning and ways to assess patients' readiness to learn. The article concludes with teaching examples drawn from mammography, magnetic resonance imaging, angiography and radiography.

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Diversity among healthcare students is increasing as the population of the United States changes in composition. Preparation of the culturally diverse healthcare student presents a challenge for recruitment, education, and retention. The problems of education can be ameliorated by a thorough assessment of the culturally diverse student using the Giger and Davidhizar model. The student should be assessed for differences by considering six interrelated factors: communication, space, time, social organization, environmental control, and biological variations. Understanding the differences that exist in these areas is a first step toward appreciating the diversity among people of varied cultures.

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Euthanasia, whether active or passive, remains a controversial issue in health care, and allied health professionals are likely to encounter situations of potential active or passive euthanasia during their careers. This survey of allied health students sought to determine their attitudes toward euthanasia and whether their self-reported euthanasia ideology corresponded with their behavioral endorsement of euthanasia actions. Disciplines and educational levels were also compared to determine differences between the program groups and their pro- or anti-euthanasia beliefs. Differing attitudes about euthanasia were found from group to group, and a significant correlation was found between the euthanasia ideology scores and the euthanasia behavioral scores.

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The role of the surgical nurse has expanded to include a more significant role in patient education. Many crosscultural differences exist among patients. Nurses must assess for those differences that will affect educational needs and strategies. Communication elements, touching, personal space requirements, time orientation, and compliance all vary within cultural groups.

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One of the most challenging aspects of death education and grief counseling is providing care and education that is relevant to the cultural, racial, and ethnic needs of the client. Often appropriate responses are difficult due to the lack of a relevant model; otherwise practitioners tend to operate from facts collected in isolation. This article reports on an assessment model originally developed in nursing by Giger and Davidhizar and discusses its potential use in providing culturally relevant death education and grief counseling.

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