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Although preceptorship is the leading approach to the clinical education of senior undergraduate nursing students in the westernized world, few specific nursing preceptor-focused clinical teaching techniques are reported in the literature. One promising preceptor-specific teaching strategy is the Five Step "Microskills" Model of Clinical Teaching (J.O. Neher, K.C. Gordon, B. Meyer, & N. Stevens, 1992). This technique, also known as the One Minute Preceptor (OMP; J.O. Neher & N. Stevens, 2003), has been used for more than 15 years in clinical medical education. In this article, we trace the origins of the OMP and describe an adaptation to nursing education, referred to as the Five Minute Preceptor (5MP). The 5MP steps are the following: (1) get the student to take a stand, (2) probe for supporting evidence, (3) teach general rules, (4) reinforce the positives, and (5) correct errors or misinterpretations. In addition, we explore the relationship between the 5MP and experiential learning and provide a detailed example of the 5MP's use in undergraduate clinical nursing education. Recommendations are provided for the development of a 5MP educational package and the evaluation of the 5MP's use in baccalaureate nursing programs.

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This survey assessed the extent of and satisfaction with collaboration between physicians and nurse practitioners (NPs) working in Ontario long-term care homes. Questionnaires, which included the Measure of Current Collaboration and Provider Satisfaction with Current Collaboration instruments, were mailed to NPs and physicians with whom the NP most frequently worked. The 14 matched-pairs of NPs and physicians reported similar levels of collaboration; however, physicians were significantly more satisfied with collaboration than were NPs (z = -2.67, p = 0.008). The majority of physicians (85%) and NPs (86%) indicated that collaboration was occurring, and 96 per cent of physicians and 79 per cent of NPs were satisfied with their collaboration. About one third of physicians reported that the NP had a negative effect on their income, but their satisfaction with collaboration did not differ from those who reported a positive effect. Overall, these physicians and NPs collaborate in delivering care and are satisfied with their collaboration.

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Nursing preceptors are challenged by a broad set of teaching-learning diversity issues that are related to their role as clinical teachers of senior nursing students in clinical settings. A lack of awareness and understanding of these diversity issues may contribute to preceptor-student miscommunication and conflict. Ultimately, these factors can impact on the extent to which the educational objectives are achieved. Most of the health sciences literature focuses on diversity and patient care, and unfortunately, the literature that does address diversity and learning primarily examines the influence of culture and language in classroom education. Few resources are available to guide preceptors as they engage in "real life" real-time clinical learning encounters. To assist preceptors with their teaching strategies and skills, a diversity and learning workshop was developed to support preceptors in their critical role as both clinical teachers and role models. A diversity and learning framework is suggested and applied to the set of teaching-learning diversity issues.

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Organizational interventions are being suggested to increase the rate of quality research dissemination and uptake. This article describes how one tertiary institution is using an evidence-based nursing (EBN) committee as an organizational strategy to shift its nursing culture toward clinical scholarship. A number of approaches and activities that have stimulated the movement toward evidence-based practice (EBP) are examined: organizational commitment to EBP, strategic positioning of the EBN committee within nursing's administrative structure, articulation of a mission, conceptualization of a model for EBN practice, learning on the job, selection and adoption of an evidence-based model for implementing change, marketing for a change in culture toward clinical scholarship, and other selected examples of projects undertaken by the committee. Action-oriented principles associated with committee experiences are related to the approaches and activities.

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BACKGROUND: The study objective was to confirm a previous finding that patients with stage III/IV squamous head and neck cancer (SHNC) who smoke during radiotherapy (RT) experience reduced survival. METHODS: An observational cohort study. Patients' smoking status was assessed weekly by questionnaire plus blood cotinine. Patients were assessed every 3 to 4 months for survival. Logistic regression and Cox proportional hazards analyses were used to detect the independent contribution of smoking on survival. RESULTS: Of 148 patients, 113 smoked during RT. Blood cotinine and smoking questionnaire responses were highly correlated (Spearman R = .69; p < .0005). Abstainers and very light smokers experienced better survival than light, moderate, and heavy smokers (median, 42 vs 29 months; p = .07). Tumor and nodal status and years smoked were the most important prognostic factors. Smoking during RT was not an independent predictor of survival, but baseline smoking status was (p = .016). CONCLUSION: Smoking status should be documented in all future trials of RT in SHNC to allow for pooled analyses with sufficient power to address this question.

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