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Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth
Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth One of the areas where organizations face the greatest challenge today is in the growth of employees, especially those in the entry-level position. Many firms fail in this sector because their leadership is not well trained to deal with the increasing demands of the modern economic times when it comes to maintaining a certain level of employee growth. Leadership behavior have a direct correlation to employees growth from the entry-level position (Bayram, & Dinc, 2015). Organizational cultures can lack innovation with leadership development and growth for entry-level employees (Joo, & Lim, 2013). The general business problem is organization have a high turnover rate for entry-level employees that are a misguided by leadership. The specific business problem is the lack of the leadership strategies to educate and retain entry-level employees. Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth lit_review_needed.doc Assessing the Correlation between Leadership Behavior and Employee Growth from Entry-Level Position Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Abstract In the modern times of economic struggles and trouble, layoffs, pay cuts and reduction of budgets are very common in the employment sector. Leadership behaviors have a direct effect on employees growth from the entry-level position. Therefore, misinformed and reckless behavior from the leaders can adversely affect employee growth in a negative way. The purpose of this study was to describe how leadership behavior correlates to the growth of employees from the entry-level position due to the working environments and the nature of leadership strategies in an organization. Conducting a research was be essential for this study because it sought to gather an in-depth understanding of the factors that shape leadership behaviors, and providing information about the experiences of several employees as well as leaders through questionnaires and interviews. The sample was provided with questionnaires with open-ended questions where they were required to give a full response to the questions in order to provide more details about the subject matter. From there, the researcher conducted interviews with questions shaped from the responses given in the questionnaires. This study would lead to social change since it would benefit the individual employees who would receive better treatment from their leaders and improve their social lives and interactions with leaders and fellow employees. The results of the study revealed that leadership behavior correlated with employee growth from the entry-level position. Key words : Social change, interviews, data, sample. Table of Contents List of Tables. iv Section 1: Foundation of the Study. 1 Background of the Problem.. 1 Problem Statement 2 Purpose Statement 3 Nature of the Study. 3 Research Question (Qualitative Only) 4 Interview Questions (Qualitative Only) 5 Theoretical or Conceptual Framework. 5 Operational Definitions. 6 Assumptions, Limitations, and Delimitations. 6 Assumptions. 6 Limitations. 7 Delimitations. 7 Significance of the Study. 7 Contribution to Business Practice. 7 Implications for Social Change. 8 A Review of the Professional and Academic Literature. 8 Transition. 9 Section 2: The Project 10 Purpose Statement 10 Role of the Researcher 10 Participants. 10 Research Method and Design. 11 Research Method. 11 Research Design. 11 Population and Sampling (Qualitative Only) 12 Ethical Research. 12 Data Collection Instruments (Qualitative Only) 13 Data Collection Technique. 13 Data Organization Technique (Qualitative Only) 13 Data Analysis (Qualitative Only) 14 Reliability and Validity (Qualitative Only) 14 Reliability. 14 Validity. 15 Transition and Summary. 15 Section 3: Application to Professional Practice and Implications for Change. 16 Introduction. 16 Presentation of the Findings (Qualitative Only) 16 Applications to Professional Practice. 17 Implications for Social Change. 17 Recommendations for Action. 18 Recommendations for Further Research. 18 Reflections. 18 Conclusion. 19 References. 20 Appendix: Correlation of Leadership Behavior and Employee Growth. 22 List of Tables Table 1. Correlation Coefficients Among Study Predictor Variables. 17 Section 1: Foundation of the Study Background of the Problem In the modern times of economic struggles and trouble, layoffs, pay cuts and reduction of budgets are very common in the employment sector. The employee morale reduces among those people who are lucky enough to retain their jobs and positions in different organizations. Productivity levels reduce, employee satisfaction and employee growth also suffers, as well as an increased loss of faith in the traditional model of the business sector (Bouckenooghe et al., 2014). At such times, many leaders and executives cower behind their prestigious positions and authority until the economic storm calms down. By so doing, they condemn the employees at the entry-level position to a state of retarded growth both in their performance at the work place and individual economic development. Leadership behaviors have a direct effect on employees growth from the entry-level position. Therefore, misinformed and reckless behavior from the leaders can adversely affect employee growth in a negative way. The main area where leaders fail to fulfill their responsibilities and ensure engagement and total commitment from employees is their failure to demonstrate respect. No other leadership behavior has as much effect on employee growth like treating them with respect. Appreciation and recognition are very paramount for any employee to motivate them and enhance their growth. However, several leaders still disregard the significance of respect towards their employees hence act as the root cause to the problem of retarded employee growth economically (Hartmann, Stephens, & Jahren). Many leaders tend to focus their efforts to find a solution for the hard times by laying most of the blame on the employees. Because of this, most employees end up being terminated from their employments and or being subjected to pay cuts to accommodate the reduction in organizational budgets. If leaders do the exact opposite and focus on their own leadership duties and effectiveness, they can increase employee satisfaction and commitment, productivity and profitability of the organization even during the challenging times, and consequently enhance the growth of employees from the entry-level position. The lack of respect is therefore the main cause of the problem of reduced employee growth from the entry-level position (Hartmann, Stephens, & Jahren). Problem Statement One of the areas where organizations face the greatest challenge today is in the growth of employees, especially those in the entry-level position. Many firms fail in this sector because their leadership is not well trained to deal with the increasing demands of the modern economic times when it comes to maintaining a certain level of employee growth. Leadership behavior have a direct correlation to employees growth from the entry-level position (Bayram, & Dinc, 2015). Organizational cultures can lack innovation with leadership development and growth for entry-level employees (Joo, & Lim, 2013). The general business problem is organization have a high turnover rate for entry-level employees that are a misguided by leadership. The specific business problem is the lack of the leadership strategies to educate and retain entry-level employees. Purpose Statement The purpose of this qualitative study is to describe how leadership behavior correlates to the growth of employees from the entry-level position due to the working environments and the nature of leadership strategies in an organization. This will be achieved using interviews and questionnaires based on open-ended questions as well as records and observations from different firms or organizations. Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth This study will be piloted in Maryland and will apply the use of secondary data as well as applying theoretical skills and abstract knowledge in the application of the several prevailing data to address the specific research questions. This study has the potential of affecting social change by revealing the main reasons why employees in the modern world find it very challenging to grow in their places of business both economically and individually and come up with the alternative solutions that can be implemented to remedy the situation. In such tough economic times as today, leaders would be encouraged to apply new strategies in their day to day leadership roles and ensure that their employees attain the required level of growth from the entry-level position. Nature of the Study This study is about how leadership behavior correlates with the growth of employees from the entry-level position. Therefore, qualitative research will be essential because it seeks to gather an in-depth understanding of the factors that shape leadership behaviors, and providing information about the experiences of several employees as well as leaders through questionnaires and interviews. A qualitative methodology would be essential for this study because it will describe different phenomena related to the subject matter hence enabling people to clearly understand it and report the totality of the situation. A qualitative study will use the responses and experiences of different employees and leaders and help the researchers to analyze the complex relationships between employees and their leaders. The study will also apply the use of a case study which will give detailed consideration to the development and growth of each individual participant. A quantitative study would also be essential because it would measure the relationship between variables and find a correlation between leadership behavior and employee growth from the entry-level position through h results of the experiences and responses of the different employees and leaders question during the interviews. It would apply the use of smaller samples that are focused on getting the required information and data to help the researchers observe the behavior of both leaders and employees through personal interviews while seeking a better understanding of the relationship between employees and leaders (Cegielski & Jones-Farmer, 2016). Research Questions (Qualitative Only) This study will be guided by the following research questions; Does leadership behavior directly correlate to employees growth from the entry-level position? How does the relationship between employees and leaders result in a reduction in the rate of employee growth? What Sample size will be appropriate for conducting a well-focused and widely beneficial qualitative research? Do organization cultures innovation with leadership development and growth for entry-level employees? Does the high turnover rate for entry-level employees that are a misguided by leadership lead to the problems faced during the employees growth from the entry-level position? Is the lack of the leadership strategies to educate and retain entry-level employees the main cause of the problem? Interview Questions (Qualitative Only) How much importance do you lay on good and functional employee-employer relationships? How does your organization go about the training and innovation sectors for both employees and their leaders to ensure that their relationship results in employee growth? How do you suppose leadership behavior correlates to employees growth from the entry-level position? Theoretical or Conceptual Framework The motivation theory applies to this study since there is a very close interconnection between employee motivation and their growth. As discussed before, treating employees with respect and rewarding or recognizing their efforts in the workplace helps to boost their morale and motivate them to improve further. As employees improve, they grow in their workplace, economically and individually hence are capable of moving upwards from the entry-level position to more established positions. Operational Definitions Data : Statistics collected for reference or analysis purposes Social change : Alterations in societal mechanisms in the form of behavioral changes, changes in cultural symbols, social institutions and social relations. Leadership strategies : The techniques that leaders in an organization use when dealing with the day to day governance of the organizations. Sample : A smaller category of a larger population picked during a study in accordance with specific attributes and characteristics. Assumptions, Limitations, and Delimitations Assumptions are facts considered to be true but are not actually verified. Limitations refer to potential weaknesses of the study, while delimitations refer to the bounds or scope of the study. Assumptions All kinds of leadership behavior correlates with employee growth from the entry-level position. Employees will always perform better in their jobs and improve when they receive the right amount of motivation from their leaders. Limitations Some of the potential weaknesses of this study would arise from receiving false and inadequate information from the sample audience which may lead to the collection of less or misinformed data, hence interfering with the credibility of the study. Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth Delimitations The main scope of this study would be focused on the relationship between employees and leaders and how this relationship can promote or reduce growth of employees. Significance of the Study Contribution to Business Practice This study will fill the gaps that are often present in trying to understand the effective practice of businesses by clearly indicating and explaining the important aspects and factors that shape the employee-leader relationships and how both parties are required to relate with each other when it comes to the day to day running of the organization and the fulfillment of their duties (Hill, 2014). It will clearly indicate the numerous problems that employees face in their endeavors to achieve growth from the entry-level position. By identifying these issues and the leadership behaviors that hinder their growth, this study will provide solutions to the most serious problems facing businesses in the modern day and make people understand business practice better. Implications for Social Change Treating employees with respect makes them feel more worthy and dignified. This study focuses on incorporating respect in the relationship between leaders and employees in an attempt to develop them individually, improve their dignity and promote a business oriented culture where everyone is valued regardless of their position. It will therefore enable organizations to improve the productivity of their employees and consequently improve their profitability. This would lead to economic development and hence social change and the improvement of human social conditions (Hill, 2014). A Review of the Professional and Academic Literature To further understand this study, we can apply the theories of motivation which can also be looked at from a cognitive stance to try and understand employee satisfaction levels which is a major contributing factor to employee growth (Yidong & Xinxin, 2012). It doesnt however assess the fulfillment and happiness that an entry-level employee draws from his or her job in an organization; but rather assesses to degree to which certain jobs are viewed as satisfactory by the employee in comparison to their own objectives or the expectations they set with other jobs. The Existence, Relatedness and Growth theory can also be used when considering the internal or individual growth of employees, including the esteem needs and the needs for self-actualization in each individual employee. These needs are the ones that often drive them towards growth. The transformational leadership theory is also essential in examining the phenomenon which concerns the way leaders and their behavior or leadership skills and responsibilities can affect the growth of individual employees. Leadership in the modern business sector has been eroded with the beliefs that the leader is the one with all the authority and the employees must be submissive. However, without a combined effort from both parties, the organization is doomed to fail. The transformational leadership theory can therefore enlighten the leaders on the significance of a more involving form of leadership that would enhance increased productivity and profitability by making employees feel relevant and valued (Joo & Lim, 2013). Transition Based on the above discussions, it is clear that this study will be very influential in enhancing growth on both the economic and individual fronts and enlightening the leaders on how to relate with their employees to ensure higher levels of profitability. The next section will focus on the main purpose of the project as well as methodologies used in data collection and analysis. Section 2: The Project This section will be primarily focused on the primary aspects of the main study or research; including the different methods of data collection, the ethical considerations while collecting the data, the participants and the main objective and duty of the researcher. Purpose Statement The purpose of this qualitative study is to describe how leadership behavior correlates to the growth of employees from the entry-level position due to the working environments and the nature of leadership strategies in an organization. This will be achieved using interviews and questionnaires based on open-ended questions as well as records and observations from different firms or organizations. Role of the Researcher The role of the researcher will be to identify the correlation between employee growth from the entry-level position to a more established position and leadership behaviors. These two variables will be the main subjects guiding this study since all the research and data collection will be directed towards determining the correlation between the two variables. Participants The participants will be selected from a broader population into samples. The sample for this particular study will entail executive leaders from a high performing textile industry in Maryland as well as a few other leaders from a manufacturing industry that is not as well established as the former. We will also include a few employees from both organizations; from those with high wages to those who are paid lesser wages. The leaders will be a combination of Chief Executive Officers from both organizations as well as the managers and supervisors who have direct interactions with the employees in their places of work. Research Method and Design Research Method In the qualitative study, the employees and the leaders will be provided with questionnaires with open-ended questions where they will be required to give a full response to the questions in order to provide more details about the subject matter. From there, the researcher will conduct interviews with questions shaped from the responses given in the questionnaires. The main purpose of the interviews will be to get more information about some important parts which were not well explained in the questionnaires. At least two leaders and two employees; each from very organization will be interviewed. Research Design The use of the questionnaires and interviews will ensure that the employees reveal more information than they would reveal to their leaders; as well as enabling the leaders to present some of the obstacles they encounter from employees during their day to day interactions. Qualitative research would therefore ensure that more personal information is revealed, hence ensuring the success of the study (Hartmann, Stephens, & Jahren). Population and Sampling (Qualitative Only) The qualitative sampling method that will be used in this study will be the quota sampling; where the researcher will identify the type and size of the sample prior to the research. Characteristics such as the type of leader, whether manager or CEO, employee status in the organization including their wage limits will be pre-identified before the beginning of the study to ensure a much more organized data collection and research process. The sample will be identified depending on their communication skills and coherency, especially those to be interviewed. Ethical Research There wont be too much ethical issues since most of the study will be conducted while making reference to past discoveries on the subject matter such as journals and other past research findings which have already been approved for referencing. The authorization for the different sites on employee-leader relations have already been obtained and the studies already published and approved for review by the Institutional Review Board. For this reason, there is no need to seek consent from the researchers who conducted and published their research findings (Bouckenooghe et la., 2014). Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth Data collected during this study will be maintained in a safe place for 5 years to protect rights of participants. For credibility and ethical purposes, the final doctoral manuscript will include the Walden IRB approval number. Data Collection Instruments (Qualitative Only) Most of the data collected in this study will be extracted from an examination of samples which include leaders and employees from the two organizations stated earlier, through open ended questionnaires and interviews in order to allow for a better understanding of the phenomenon; which is the correlation between leadership behaviors and growth of employees from the entry-level position. The instruments to be used will include paper stacks on which the questionnaires will be printed and pens for writing, as well as sound recording equipment to be used during interviews to allow for reviews whenever a something is not well explained. The intended population will be around 50 individuals, to be slashed to 30 during sampling. The scaling system will be between 1-10, and the study will take close to one week to be wholly completed. Data Collection Technique Some of the data collected will be extracted from published research findings from past studies. However, most of the data will be collected using the interviewing technique where the researcher will conduct a face to face conversation with the interviewees in the sample population and ask them questions related to the phenomenon being studied (Cegielski & Jones-Farmer, 2016). The questions asked will be particularly based on the specific opinions of individual interviewees and the most recurring responses from both sides noted down for use in the final draft of the research findings. Data Organization Technique (Qualitative Only) The data will be organized according to the position of the respondent in their respective organizations, such as leaders or employees; who are further categorized into CEOs or supervisors and low or high positioned employees. The data will be stored electronically and destroyed after 5 years. Data Analysis (Qualitative Only) Data analysis will be done through involving all the employees and leaders in the sample population and providing them with questionnaires with open-ended questions to answer and then conducting interviews. The data will then be analyzed through the instruments of data collection mentioned in the prior section. This study will provide the basic characteristics of the data and a brief summary of the sample. The main steps of data analysis will include the following; Comparison and analysis of data among employees and leaders in the sample. An analysis of the major negative aspects of the relationship between employees and leaders. Thematic analysis of data Thematic data coding to help understand the phenomenon. Reliability and Validity (Qualitative Only) Reliability Reliability will involve the checking for the dependability of the research data and findings by inviting an expert to validate the interview questions, direct observation of leadership behaviors, and checking of the data interpretation by the members of the research team. Collecting enough data to the extent of reaching data saturation would ensure the dependability of the findings. Validity Validity of qualitative findings refers to the credibility and confirmability of the research findings. Reaching data saturation will ensure validity of the findings, as well as checking for data interpretation and participant transcript review. Transition and Summary The data collection process and the analysis should all be done in an ethical manner to ensure that no unauthorized information about the sample population is left for public consumption. The information stored electronically must be protected by log in passwords to avoid any unauthorized access. After effective data collection, the data should be presented in an organized manner with recommendations, applications of the study to professional practice and its implications for social change well examined and indicated. Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth Section 3: Application to Professional Practice and Implications for Change Introduction The purpose of this qualitative study is to describe how leadership behavior correlates to the growth of employees from the entry-level position due to the working environments and the nature of leadership strategies in an organization. The results of the study revealed that leadership behavior is directly linked to employee growth from the entry-level position. Some of the leadership behaviors that impact employee growth directly include management and supervision activities. The findings indicate that leaders who treat their employees with respect enable the employees to work more freely and increase their productivity, and also their growth. Organizations which offer much adequate training and innovation to both leaders and employees boast the highest rate of employee growth since they offer a conducive environment for the development of employees as individuals and as workers in a company. Presentation of the Findings (Qualitative Only) I received 56 surveys in total. One of the records was however eliminated due to missing data; resulting in the analysis of 55 surveys. Table 1 below contains the descriptive statistics of the study variables. The findings confirm that the correlation between leadership behaviors of CEOs strongly correlates with employee growth, whereas organizational cultures are weakly correlated to the activities and behaviors of CEOs and supervisors. Since coordinators and supervisors often interact closely with employees, their leadership behavior strongly correlate to employee growth. Table 1 Correlation Coefficients Among Study Predictor Variables Variables Leadership behavior Employee growth Turnover rate Organizational cultures Employees .541 1.00 .151 1.00 CEOs 1.00 .321 .561 -.010 Supervisors .432 1.00 .130 -.010 Coordinators 1.00 .151 .562 .151 Note . N=55 Applications to Professional Practice The study findings can be used to clearly understand the complexities in the relationship between leaders and employees, as well as the specific ways through which leadership behaviors affect employee growth. These are important variables which are very essential in the business sector which can make business owners capable of understanding the business environment hence enhancing development and profitability (Joo & Lim, 2013). Implications for Social Change As organizations grow, so does the economy. Economic developments promotes social change in the society as the behaviors of people change with the changing status. Similarly, individuals, especially the employees experience a certain sense of worth and feel appreciated s the attitudes and behaviors of their leaders towards them changes. This study will enlighten organization leaders to treat their employees better, hence improving their self-esteem and enabling them to develop as individuals in their social lives (Hill, 2014). Recommendations for Action For better action, leaders need to treat employees as part of the organization and interact with them with more respect and appreciation to ensure that they reciprocate by giving their best work output and improving the profit level of the organization. The employees will grow from lower positions to higher ones in the organization and their levels of job satisfaction will also improve (Hill, 2014). The employees also need to improve on their cooperation with their leaders to ensure that the organization runs smoothly and everyone performs their duties. Recommendations for Further Research To ensure that the researcher does not receive false or inadequate information from the sample, the interview protocol or questionnaires must no include leading questions or closed questions. This is because closed questions would limit the interviewees to specific answers which may not reveal the entire scope of the study and enable the researcher to understand the phenomenon better. Reflections The possible biases in this study would arise while choosing the sample. The researcher might select more individuals from a given category, such as employees or leaders, which would result in collection of data that is skewed towards a particular side. This might lead to misinformed research findings which would affect the results and convince leaders and employees to interact in a manner that would lead to more negative repercussions on either side. My opinion on leadership behavior and its effects on employees has changed after this study since it has made the scope of business more expansive and easy to understand from the perspectives of both the leaders and the employees on how they wish to be treated in the workplace. Assignment: Assessing the Correlation between Leadership Behavior and Employee Growth Conclusion Leadership behaviors strongly influence the way employees react to the conditions of their jobs and job satisfaction. Leaders in every organization must therefore pay close attention to the manner in which they interact with their employees in order to improve organizational performance. Organizational cultures also need to be shaped in such a way that they favor every side; employees and leaders. Training of entry-level employees and employees, as well as innovation protocol should be top priority for any organization to ensure success in growth of employees from entry-level position. References Bayram, H., & Dinç, S. (2015). Role of Transformational Leadership on Employees Job Satisfaction: the Case of Private Universities in Bosnia and Herzegovina. European Researcher , 93 (4), 270-281. doi:10.13187/er.2015.93.270 Bouckenooghe, D., Zafar, A., & Raja, U. (2014). How Ethical Leadership Shapes Employees Job Performance: The Mediating Roles of Goal Congruence and Psychological Capital. Journal of Business Ethics , 129 (2), 251-264. doi:10.1007/s10551-014-2162-3 Cegielski, C. G., & Jones-Farmer, L. A. (2016). Knowledge, Skills, and Abilities for Entry-Level Business Analytics Positions: A Multi-Method Study. Decision Sciences Journal of Innovative Education , 14 (1), 91-118. doi:10.1111/dsji.12086 Hartmann, B., Stephens, C., & Jahren, C. (n.d.). Surveying Industry Needs for Leadership in Entry-level Engineering Positions. 2015 ASEE Annual Conference and Exposition Proceedings . doi:10.18260/p.24784 Hill, R. W. (2014). Virtual Reality and Leadership Development. Using Experience to Develop Leadership Talent , 278-304. doi:10.1002/9781118829417.ch13 Joo, B. & Lim, T. (2013). Transformational Leadership and Career Satisfaction. Journal of Leadership & Organizational Studies , 20 (3), 316-326. doi:10.1177/1548051813484359 Joshi, P., Kaur, H., & Jain, A. (2016). Leadership Behaviour
Discussion: Access Cost and Quality for APNs
Discussion: Access Cost and Quality for APNs ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Access Cost and Quality for APNs Im studying for my Nursing class and dont understand how to answer this. Can you help me study? Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1 Vocabulary of Quality Please see chapter attached). Student is to reflect on the relationship between quality measures and evaluation and role development. In addition, describe this relationship and note how the role of the APN might change without effective quality measures. United States University MSN560 Access Cost and Quality for APNs Discussion Length: 4 pages, double-spaced, excluding title and reference pages (required) Chapter 24 of Joel, L.A., (2018). Advanced practice nursing. Essentials for role development (4th Ed.). Philadelphia, PA: F.A. Davis. [ISBN-13: 978-0-8036-6044-1] Format: APA 6th Edition Discussion: Access Cost and Quality for APNs chapter_24.docx Learning Outcomes Learning outcomes expected as a result of this chapter: Describe the value, quality, and accountability context surrounding advanced practice registered nurse (APRN) practice. Understand APRN performance expectations in general and those specific to specialty practice. Develop quality and performance measures for use in practice at the individual, group, systems, and societal levels. Demonstrate the ability to design a model for assessing structures, processes,United States University MSN560 Access Cost and Quality for APNs Discussion and outcomes within a framework of national standards. Plan actions to enhance the APRN impact in patient care, education, research, administration, and advocacy or policy. Chapter 24 Measuring Advanced Practice Nurse Performance 367 INTRODUCTION Performance measurement in the health-care system is ubiquitous and complex. Whomever the provider, whatever the geographic location, whatever the setting, whatever the organization, whomever the stakeholder, whomever the payer, advanced practice nurses (APNs) can expect to have their performance evaluated. APNs, along with other individuals and organizations, must demonstrate that their performance enhances the triple aims of improving care experiences for patients and families, improving the health of populations, and reducing the per capita costs of health care (Berwick, Nolan, & Whittington, 2008). As Whittington, Nolan, Lewis, and Torres (2015) suggest, the triple aims are an integral part of the United States strategies to improve health outcomes and health care. These aims provide a framework for state and federal initiatives and the work of credentialing, accrediting, and regulatory agencies at all levels influencing the organization, delivery, and financing of health-care services. To improve care experiences, individual patients and families are encouraged to become more engaged in care and to participate in planning and assuring they receive quality, safe care. To improve outcomes for population health, providers and communities are expected to transform the organization and delivery of services. To reduce health-care costs, care providers and payers are engaged in payment reforms and developing more cost-effective interventions. Reimbursement structures are also being modified. These aims are influenced by several trends related, in part, to the implementation of the Patient United States University MSN560 Access Cost and Quality for APNs Discussion Protection and Affordable Care Act (PPACA; Public Law [PL] 111-148) and subsequent policy and administrative changes. Trends and issues include increased access and, thus, more demand for services; drug pricing; mergers of providers, organizations, and insurers; technologies such as telehealth and mobile apps; and data security (Blumenthal, Abrams, & Nuzum, 2015; Lorenzetti, 2015). Superimposed on all these changesand influencing themare political and power issues. Given the demands facing the health-care system, the voice of nurses and the leadership of APNs are essential to meet our professional and societal obligations to improve health and health care. APNs are uniquely positioned to contribute critical knowledge, skills, and attitudes, as well as their values of civic professionalism and compassion, to political and decision-making dialogues. The purpose of the health-care system is to continuously reduce the impact and burden of illness, injury, and disability and to improve the health and functioning of the people of the United States. Although providing direct care and influencing the direct care provided by others are necessary work and contribute to meeting this goal, they are not sufficient to meet growing professional and societal quality and accountability demands. By demonstrating their contributions; continuously improving their performance; and being accountable to the profession, employers, and the public for all components of their role, APNs canUnited States University MSN560 Access Cost and Quality for APNs Discussion make a difference. As the nurse moves from novice to expert, responsibility for and accountability to self and others for the structures, processes, and outcomes of health care increase proportionally. Achieving the status of APN is not a terminal event and the role assumes ongoing and increasing professional and societal obligations. Responsibility for meeting the triple aims means that the APN must serve the profession and society as a primary agent contributing at the level of individual care, in the practice setting, and at the tables where organizational and public policies are made and implemented. In addition, the professional and societal trust afforded to the APN obliges meaningful contributionsbeyond individual patient careto meet the purpose of the health-care system. APNs must not only do good, they must demonstrate their value to society through performance assessment and its documentation and dissemination at every level of care and decision making so their voices are heard. The importance to health outcomes, the profession, and society cannot be underestimated or ignored. The Case for Accountability Why should APNs be concerned about these issues? A Web search of the terms health care AND accountability resulted in more than 130 million hits. This reflects the importance of this issue in our society. The search revealed that accountability for the quality and costs of health careits valueare of interest to consumers, purchasers/payers, employers, insurers, the government, and professional provider organizations. Although the demand for accountability for the value of health care is not new, growing complexity and changes in the health-care 368 Unit 4 Ethical, Legal, and Business Acumen of pay-for-performance determinations. The Institute of Medicine (IOM) (1999, 2001, 2006) identified problems with the quality of care and safety concerns that continue to be reported in the literature. Reports of consumer satisfaction or experience with the health-care system, such as those of the Commonwealth Fund (Commonwealth Fund, 2016b; Davis et al, 2002), found that patients were not satisfied with the quality of care they were receiving and reported continuing concerns on their summaries of assessment data. Hero, Blendon, Zaslavsky, and Campbell (2016) found that concerns about access to preferred care were a major concern. Managed care, cost concerns, and the growing consumer movement in health care have increased the demand for information about the value (quality in relation to cost) of health-care services and the performance of health-care providers in delivering quality, cost-effective services across all components of the health-care system. Led by advocacy organizations, consumers are demanding greater accountability from health-care providers and the health-care system. They want quality, cost-effective services delivered from a patient-centered perspective. Federal and state government agencies and other purchasers want to know if the services they pay for are achieving the best possible outcomes at the best price. Organizations that accredit health-care organizations are increasingly seeking evidence that the structures and processes of care produce positive health outcomes. All these demands to demonstrate and be accountable for value- and cost-effective high-quality care require individuals and groups of providers to measure performance and share their assessments with stakeholders. Organizations such as the National Committee for Quality Assurance (NCQA), the National Quality Forum (NQF), The Joint Commission (TJC), and several agencies of the federal government lead efforts to measure and report on the quality of care provided by various health-care system components. Federal and state agencies, independently and in collaboration with private sector organizations, are collecting and disseminating information about the quality of services provided by the health-care systems various providers. Health-care report cards are mechanisms widely employed to address the concerns of consumers, payers, employers, and others about the quality of health care being provided. Report cards are done for hospitals, system raise the issue to a level that cannot be denied or minimized. This demand requires the APN to measure and disseminate information on the value of the role. Nurses in advanced practice, similar to other providers and health-care system components, need knowledge and skills to assess and measure quality and determine the costs of their services if they are to demonstrate value. It is not enough to do good; the APN must demonstrate how doing good translates into outcomes and costs. Accountability for practice has been and continues to be embedded in APN standards, education, and position descriptions. As Buerhaus and Norman (2001) suggest, the improvement of health-care quality is an authentic commitment (p. 68) for all stakeholders and will shape how health-care services are delivered. Given the definition of advanced practice and its role components, APNs must contribute to and lead broad efforts to improve quality. Their actions in defining, measuring, and reporting on their performance will determine their future and that of the health-care system. The advanced practice framework includes patients, health care, nursing, and individual outcomes. Thus, the APN is accountable for performance in all these domains. These concepts and obligations are further reflected for the graduate-level student (American Association of Colleges of Nursing [AACN], 2011). Prepared at this level, the nurse is expected to have advanced role skills, possess refined analytical skills, operate from a broad-based perspective, have the ability to articulate views and positions, and connect theory and practice. He or she is expected to engage in quality and safety initiatives and collaborate inter-professionally to improve patient and population health outcomes. The Quality Context If the health-care system is to reduce the effect and burden of illnesses, injuries, and disabilities and improve outcomes and functioning, all involved in the system must be responsible for identifying and improving the structures and processes for achieving positive outcomes. Research has shown that consumers and society are not getting what they want or need from the health-care system. Errors continue to occur and patient experiences with care continue to be issues with outcomes becoming part Chapter 24 Measuring Advanced Practice Nurse Performance 369 health plans, and provider groups with the intent of United States University MSN560 Access Cost and Quality for APNs DiscussionUnited States University MSN560 Access Cost and Quality for APNs Discussion informing consumers and improving quality. Public reports of health-care quality are done by state and federal governments and private sector organizations. Implementation of the PPACA has resulted in greater reporting at the state and federal levels. Although these reports, especially those related to patient satisfaction and experience with care, remain controversial (Rosen & Chen, 2016), they are being widely reported and linked to pay-for-performance initiatives. Quality in service is demanded by anyone seeking that service. This is especially true for health-care services, both by the person receiving services and also for regulating bodies. Nurses must recognize the part they play in quality and safety in an obvious way, measuring, reporting, and articulating their role. The importance of quality and safety is evident in the APN Consensus Document (NCSBN, 2008) that articulates the parameters and standards for licensure, accreditation, certification, and education (LACE). The APNs performance will be measured and reported; thus, he or she must be engaged in determining best practices to meet patient and outcome expectations. Values and Value in Health Care To contribute effectively to fulfilling the purpose of the health-care system, the APN needs a clear vision derived from personal and professional values. The APN needs to embrace societys mandate for health-care value and clarify how the quality and cost issues relate to personal and professional goals. Explicit incorporation of quality and cost values and critical thinking about these issues will result in actions and activities consistent with social demand. Therefore, the APN role can be justified and the needs of society will be better served. APNs will be well positioned to provide leadership in affecting quality and costs, the bottom line of health-care system performance. To be effective leaders and advocates for value issues associated with patients and the role, the APN must know and appreciate what other stakeholders want. Thus, it will be easier to understand their behavior and thinking about health and health care and to develop and implement strategies to address value conflicts, thereby resulting in better health-care outcomes. For example, the APNs employer may value reducing costs to ensure organizational survival, whereas the APNs highest value is meeting the diverse needs of patients served by the organization. Negotiation, compromise, and collaboration are necessary to incorporate both values into strategic planning efforts. Awareness of the importance of values, understanding the value equation, and possessing the skills to address value conflicts are critical for APN survival and health-care system improvement. The purposes of this chapter are to introduce APN students to quality frameworks, performance measurement, and accountability and to suggest approaches to current issues and responses to trends. For the graduate APN, this chapter can enhance knowledge and skills that will promote the quality activities, better demonstrate accountability, and foster actions to justify the role of the APN in meeting societal demands for quality, cost-effective health care. The complexity of the quality movement and the value equation are discussed. As the health-care system becomes increasingly complex, as stakeholders values and visions clash, and as there is growing dissatisfaction with the health-care system, APN leadership is critical. The challenge to establish value and be accountable at all levels may appear daunting, but it is exciting and potentially rewarding for the APN, the profession, and our society. THE QUALITY ENVIRONMENT Beginning with Florence Nightingale, nursing has always given attention to quality issues. Despite our historical roots as leaders in this area, the profession has drifted to a more internal, narrow perspective. Until recently, this mirrored the attention our society gave to the quality of health care. In the United States especially, the values of individualism and self-determination, science and technology, a disease and medical focus, the free-market economy, and nongovernmental interference shaped both the structures and processes of the health-care system, thus influencing its outcomes. Access and cost issues have, until recently, received more attention than quality, particularly at the societal level. As cost concerns increased and new delivery systemssuch as managed carewere implemented, greater attention focused on quality and value. In addition, industry and quality theories and practices in business suggested that lessons learned in these arenas could be applied to the health-care sector. 370 Unit 4 Ethical, Legal, and Business Acumen practice behavior, collaboration, and APN satisfaction. The outcomes related to APN structures and processes include mortality, morbidity, patient knowledge, patient satisfaction, service use, and health status. Quality of care can be viewed from a micro or macro perspective. At the micro level, quality is conceptualized and assessed for the patient, the provider, or the institution. Clinical and technical care, satisfaction with care, and quality of life represent components of a micro view (Shi & Singh, 2005). Although always an important component of any quality approach, increasing attention is being given to the macro levellooking at outcomes and cost effectiveness for populations and society. Examples include the efforts of private sector organizations such as TJC (formerly the Joint Commission on Accreditation of Healthcare Organizations), NQF, NCQA, and the work supported by private foundations. State and federal legislatures and the agencies implementing public policy decisions are also involved in macro-level quality approaches. Definitions and Frameworks With greater attention being given to quality, long-standing terms and processes were dusted off and a new vocabulary evolved. As shown in Table 24.1, a plethora of terms are used to describe quality concepts. The APN, to operate effectively in the new health-care quality climate, must be fluent in the new language. One of the earliest conceptual frameworks to describe quality was developed by Donabedian (1966). It is widely used by the nursing community and others in the health-care system as a way to identify the structural and process factors that affect outcomes. Hamric (1983, 1989) provided a model for APN patient care evaluation using Donabedians framework. Girouard (2000) identified structural elements that include the APNs education, the time the APN spends in role components, reimbursement levels, and organizational characteristics. Process elements include APN behaviors, referral patterns, prescriptive Table 24.1 The Vocabulary of Quality Access Ability to obtain care or health and related services (also defined as use or insurance coverage) Accountability The demonstration of value (e.g., quality care, patient satisfaction, resource efficiency, and ethical practice); liability for actions Cost To the individual paying for services; to the provider to produce services; for society Outcome The end result of structures and processes of care; the goal or objective of health and health care Performance Assessment of how individual providers behave; measurement assessment of processes of care; may be compared against standards or benchmarks Process Method in which health care is provided; provider behaviors; includes technical and interpersonal elements Quality How well services increase chance for desired outcomes; knowledge based and evidence based Quality assessment Process of defining and measuring quality Quality assurance Process of measurement and quality improvement; may also be defined as the minimum standards approach Quality indicator Trait or characteristic linked with evidence to desirable health outcomes; may serve as proxy for outcome Report cards Collection and reporting of performance and other quality-related data to the public or other targeted groups Structure Tools and resources for care (e.g., facilities, licensing and regulation, staffing, equipment) Total quality Includes an environment for quality, involves continuous measurement and improvement activities (often called total quality management or continuous quality improvement) Chapter 24 Measuring Advanced Practice Nurse Performance 371 their insurance costs, loss of productive work time, and health-care program administration costs are considered as a percentage of expenditures needed to conduct their business. Individual consumers, although most often focused on their out-of-pocket costs, are also concerned about the costs of insurance, the price of services and goods needed, and pharmaceutical costs. A third approach when considering health-care costs is the perspective of the health-care professional or health-care organization in which the focus is on expenditures, such as costs for personnel, administration, physical plants, and supplies and equipment, to produce services for groups of patients. To adequately assess quality at the individual, societal, or organizational level, the APN must be cognizant of access and cost issues and the role they play in determining outcomes. Access and cost issues reflect structural and process elements, the factors that influence health-care outcomes. In addition, this approach holds opportunities for representing the APN as a solution to access and cost concerns. Thus, the APN can make a strong case for the roles value in the health-care system. Recent Quality Initiatives A growing number of national quality initiatives reflect the importance of this issue and support the assertion that quality efforts will remain a significant factor in shaping the future of the health-care system. The identification of standards and expected outcomes for access, costs, and quality; their measurement; and public dissemination and discourse are ongoing and expanding. To ensure quality and cost-effective care, quality must be defined; performance expectations specified; and performance and outcomes measured. These are the bases for the quality efforts of national health-care organizations. Quality measurement is needed to understand the effects of services on individuals and populations and to make improvements in the organization, delivery, and financing of health care. According to the IOMs National Health Care Quality Roundtable (Donaldson, 1999), still valid today, health-care quality measurement objectives include: Gathering and analyzing data to inform quality improvement efforts Assessing facilities and individual performance in relation to established standards One example of such an approach is the Child and Adolescent Health Measurement Initiative (CAHMI), a national initiative based out of the Bloomberg School of Public Health at Johns Hopkins University. In collaboration with consumers, they developed an experience of care framework and measures for children and adults. This framework and the measures developed to date are widely used by such organizations as the NCQA, the NQF, the IOM, and the Robert Wood Johnson Foundation (RWJF) for measuring the quality of care provided to large population groups. In addition, federal government agencies, such as the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare and Medicaid Services (CMS), and state government agencies have adopted the framework and adapted the measures for a macro approach to quality. Access, Cost, and Quality The growing demand for quality requires that attention also be given to access because improved health status and other outcomes of care depend on the individuals ability to receive needed services across the continuum of care. Although often discussed as an issue of access to insurance for the uninsured and the underinsured, a payment mechanism is not sufficient to improve outcomes. The providers, services, and goods individuals and groups have access to are major factors in achieving desired outcomes and cost efficiencies. Thus, payment levels, what is paid for, and who gets paid are important access considerations in the quality equation. Well-known deficiencies currently exist in mental health-care services, oral health-care services, and care of persons with chronic conditions. The APN should pay particular attention to and justify the needs and benefits resulting from advanced practice nursing services in all health-care settings and for all levels of care. Cost issues are the third component (along with access and quality) of the health-care system triangle and are essential to establish the value of health care. Cost can be considered from the perspective of the society at largethe total costs of health care or the percentage of national dollars for health-care expenditures. Global expenditures include provider services, insurance, goods and supplies, pharmaceuticals, research, education, core public health services, and institutional costs for delivering health-care services. Consumers and employers are concerned about the direct costs of care. For employers, 372 Unit 4 Ethical, Legal, and Business Acumen improvement and health services management in managed care organizations (MCOs). To address quality in nursing homes, the CMS is assessing and disseminating information about quality in Medicare- and Medicaid-certified long-term care facilities. Through the collection and analysis of uniform patient level data (outcome and assessment information set [OASIS]), the CMS is fostering outcome-based quality improvement in home health care. The initiatives described previously reflect only a few of the federal governments quality-related activities. Other Health and Human Services departments, such as the Centers for Disease Control and Prevention (CDC) and the Maternal and Child Health Bureau (MCHB), are actively engaged in similar activities. State governments are also involved in quality measurement and reporting. For example, New York, Florida, and Washington are measuring provider performance in childrens health care. Private sector organizations representing foundations, purchasers, employers, and professional organizations also measure and report on quality. Accrediting organizations, such as TJC, are moving from assessing only structures and processes of care to outcome evaluation. For example, TJC-accredited organizations, through the ORYX initiative, are required to measure specific patient outcomes and provider performance standards. ORYX is TJCs performance measurement and improvement initiative, first implemented in 1997. Safety, medical errors, and infection rates are also being used by TJC as performance indicators. Through annual reports on health-care quality, NCQA looks at plan performance related to quality, access, and consumer satisfaction. NCQAs health plan report cards are shared with employers and purchasing groups and are made available for consumer use in choosing health-care plans. They have played a major role in accrediting medical homes and advanced medical homes. Three national organizations exemplify the private sectors role and collaboration with government agencies to address quality: the CAHMI, the American Health Quality Association (AHQA), and the NQF. The CAHMI evaluates health system performance for children covered by Medicaid and private insurance and reports on gaps in care to consumers. It is dedicated to helping parents and children make better decisions and choices by informing them about what to expect from the health-care system and by fostering their involvement in holding the health-care system accountable. Comparing providers to inform purchaser and consumer choice of providers Informing all stakeholders about decisions and choices Identifying, rewarding, and sharing best practices Monitoring and reporting on quality over time Addressing the health-care needs of communities In response to the demand for quality, performance measurement, and accountability, federal and state governments and the private sector have taken action. Government agencies, with congressional policy direction and as major purchasers of health-care services, need information about the quality of health care to guide policy and program decision making. Two government agencies, the AHRQ and CMS, are worthy of particular attention because quality is a major focus of their activities. The AHRQ, through its internal and external research programs and educational initiatives, is charged to improve the outcomes and quality of health care. In addition, the AHRQs goals include addressing patient safety and errors, increasing access to effective services, and reducing costs. As a major purchaser (Medicare and Medicaid), CMS must ensure that its program beneficiaries receive quality, cost-effective care. In addition, through its regulatory functions it sets quality standards for the health-care industry. An example of a recent AHRQ initiative is a synthesis of completed research to answer questions about which prescriptive drugs reduce costs and improve outcomes. AHRQ is also evaluating pilot projects that reward providers for delivering high-quality health-care services. They have disseminated a synthesis of studies so clinicians can make better decisions about treating patients with community-acquired pneumonia. Clinicians will also find AHRQs Child Health Tool Box and other collections of guidelines and measures useful in establishing their own performance measurement and quality programs. AHRQs more than 10 years of reports on health-care quality and disparities (AHRQ, 2015) provide the APN with important information to guide thinking about the foci of quality initiatives. Because Medicare and Medicaid beneficiaries use a wide array of health-care services, the CMSs quality efforts are far reaching. Among its initiatives are programs to assess quality and performance in hospitals, home care, and long-termUnited States University MSN560 Access Cost and Quality for APNs Discussion care. The quality improvement system for managed care sets regulatory standards and guidelines for quality assessment and Chapter 24 Measuring Advanced Practice Nurse Performance 373 recent years and are a priority in the health-care system. Quality in service is demanded by anyone seeking a service this is especially true for health-care services. The person receiving service, the organization providing the service, those paying for the service, and those regulating the service (and providers) are demanding performance assessment and accountability. The APN, given the components and core competencies required of the role, is expected to be engaged in all aspects of the quality and safety movement including the development, implementation, and evaluation of the performance measurement and reporting process. As reflected in the LACE discussion in the APRN Consensus Model (2008), quality and safety activities, assessment, and accountability are essential for all APNs. It is not sufficient for the APN to simply be aware of quality improvement initiatives and requirements; the APN must now be an active participant in the process. The National Quality Strategy, part of the current health-care reform initiatives, is the first policy to set national goals to improve the quality of health care. It serves as a guide for all HHS quality improvement programs and regulationsUnited States University MSN560 Access Cost and Quality for APNs Discussion and sets standard criteria to measure the quality of health and health care to align national quality and safety efforts. Most of the tasks APNs will be completing in providing care to patients in this new role intersect with some aspect of the National Quality Strategy. The APN is responsible for meeting the demands of patient care while adhering to requirements that have emerged from this strategy. APNs must also be able to define quality in their own practice. Quality has many definitions, but there is consensus among researchers and policy makers that high-quality care occurs when providers give patients the right care when they need it, such as regularly monitoring chronic conditions to prevent compl
Assignment: acknowledge and identify grants and other means of financial support
Assignment: acknowledge and identify grants and other means of financial support Assignment: acknowledge and identify grants and other means of financial support Assignment: acknowledge and identify grants and other means of financial support Details: The literature review is the second chapter of your dissertation. It is a place where you synthesize the information you have been reading and demonstrate how it all connects to your dissertation topic. This assignment will allow you to begin developing, if you have not already started, your literature review around your chosen dissertation topic. Assignment: acknowledge and identify grants and other means of financial support General Requirements: Use the following information to ensure successful completion of the assignment: Refer to the most current dissertation prospectus template in the DC (dc.gcu.edu) for details and criteria for literature review (Chapter 2). Instructors will be using a grading rubric to grade the assignments. It is recommended that learners review the rubric prior to beginning the assignment in order to become familiar with the assignment criteria and expectations for successful completion of the assignment. Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. Directions: Draft the Introduction to your literature review (Chapter 2). The Introduction should include, among other items, An opening sentence that describes the topic to be investigated A description of the importance of the topic to the field Asummary of the themes to be addressed in the chapter (the literature review). Revise any draft pieces from the 10 Strategic Points related to the Literature Review (Chapter 2) that you created in previous courses incorporating the feedback from your instructor. Complete criteria for the literature review draft are available in the most current prospectus template located in the DC. Draft the Summary to your literature review (Chapter 2). Among other ideas, the Summary should note Conflicting information (tensions)in the existing literature Omitted information (gaps) in the existing literature How the study you are doing is new and different How your study will add scholarly value to the field of study. Please follow instructions of assignment based on what is listed above. Please also cite any references in APA 6th edition format. I have attached the dissertation template for reference. This assignment only focuses on Chapter 2. I have also included my 10 research strategic points. Please let me know if further info is needed. dissertation_template_v_8_01.03.18.docx original_research_10_str The Dissertation Title Appears in Title Case and is CenteredSubmitted byInsert Your Full Legal Name (No Titles, Degrees, or Academic Credentials) Equal Spacing~2.0 2.5 A Dissertation Presented in Partial Fulfillmentof the Requirements for the DegreeDoctorate of Education(or) Doctorate of Philosophy(or) Doctorate of Business Administration Equal Spacing~2.0 2.5 Grand Canyon UniversityPhoenix, Arizona[Insert Current Date Until Date of Deans Signature] © by Your Full Legal Name (No Titles, Degrees, or Academic Credentials), 2017All rights reserved.GRAND CANYON UNIVERSITY The Dissertation Title Appears in Title Case and is Centered byInsert Your Full Legal Name (No Titles, Degrees, or Academic Credentials) Approved [Insert Current Date Until Date of Deans Signature] DISSERTATION COMMITTEE:Full Legal Name, Ed.D., DBA, or Ph.D., Dissertation ChairFull Legal Name, Ed.D., DBA, or Ph.D., Committee MemberFull Legal Name, Ed.D., DBA, or Ph.D., Committee Member ACCEPTED AND SIGNED: ________________________________________Michael R. Berger, Ed.D.Dean, College of Doctoral Studies_________________________________________Date GRAND CANYON UNIVERSITY The Dissertation Title Appears in Title Case and is Centered I verify that my dissertation represents original research, is not falsified or plagiarized, and that I accurately reported, cited, and referenced all sources within this manuscript in strict compliance with APA and Grand Canyon University (GCU) guidelines. I also verify my dissertation complies with the approval(s) granted for this research investigation by GCU Institutional Review Board (IRB). _____________________________________________ ______________________[Type Doctoral Learner Name Beneath Signature] Date AbstractThe abstract is required for the dissertation manuscript only. It is not a required page for the proposal. The abstract, typically read first by other researchers, is intended as an accurate, nonevaluative, concise summary, or synopsis of the research study. It is usually the last item completed when writing the dissertation. The purpose of the abstract is to assist future researchers in accessing the research material and other vital information contained in the dissertation. Although few people typically read the full dissertation after publication, the abstract will be read by many scholars and researchers. Consequently, great care must be taken in writing this page of the dissertation. The content of the abstract covers the purpose of the study, problem statement, theoretical foundation, research questions stated in narrative format, sample, location, methodology, design, data sources, data analysis, results, and a valid conclusion of the research. The most important finding(s) should be stated with actual data/numbers (quantitative) or themes (qualitative) to support the conclusion(s). The abstract does not appear in the table of contents and has no page number. The abstract is double-spaced, fully justified with no indentations or citations, and no longer than one page. Refer to the APA Publication Manual , 6th Edition, for additional guidelines for the development of the dissertation abstract. Make sure to add the keywords at the bottom of the abstract to assist future researchers. Keywords : Abstract, assist future researchers, 150 to 250 words, vital information Criterion *(Score = 0, 1, 2, or 3) Learner Score Chair Score Methodologist Score Content Expert Score ABSTRACT (Dissertation OnlyNot Required for the Proposal) The abstract is typically read first by other researchers and is an accurate, non-evaluative, concise summary or synopsis of the research study. The abstract provides a succinct summary of the study and MUST include the purpose of the study, theoretical foundation, research questions (stated in narrative format), sample, location, methodology, design, data analysis, and results, as well as, a valid conclusion of the research. Abstracts must be double-spaced, fully justified with no indentions. (one page) The abstract provides a succinct summary of the study and MUST include: the purpose of the study, theoretical foundation, research questions stated in narrative format, sample, location, methodology, design, data sources, data analysis, results, and a valid conclusion of the research. Note: The most important finding(s) should be stated with actual data/numbers (quantitative) ~or~ themes (qualitative) to support the conclusion(s). The abstract is written in APA format, one paragraph fully justified with no indentations, double-spaced with no citations, and includes key search words. Keywords are on a new line and indented. The abstract is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. Assignment: acknowledge and identify grants and other means of financial support Assignment: acknowledge and identify grants and other means of financial support *Score each requirement listed in the criteria table using the following scale: 0 = Item Not Present or Unacceptable. Substantial Revisions are Required.1 = Item is Present. Does Not Meet Expectations. Revisions are Required.2 = Item is Acceptable. Meets Expectations. Some Revisions May be Suggested or Required.3 = Item Exceeds Expectations. No Revisions are Required. Reviewer Comments: DedicationAn optional dedication may be included here. While a dissertation is an objective, scientific document, this is the place to use the first person and to be subjective. The dedication page is numbered with a Roman numeral, but the page number does not appear in the Table of Contents. It is only included in the final dissertation and is not part of the proposal. If this page is not to be included, delete the heading, the body text, and the page break below. AcknowledgmentsAn optional acknowledgements page can be included here. This is another place to use the first person. If applicable, acknowledge and identify grants and other means of financial support. Also acknowledge supportive colleagues who rendered assistance. The acknowledgments page is numbered with a Roman numeral, but the page number does not appear in the table of contents. This page provides a formal opportunity to thank family, friends, and faculty members who have been helpful and supportive. The acknowledgements page is only included in the final dissertation and is not part of the proposal. If this page is not to be included, delete the heading, the body text, and the page break below. Table of Contents List of Tables. xi List of Figures. xii Chapter 1: Introduction to the Study. 1 Introduction. 1 Background of the Study. 6 Problem Statement 7 Purpose of the Study. 10 Research Questions and/or Hypotheses. 11 Advancing Scientific Knowledge and Significance of the Study. 14 Rationale for Methodology. 15 Nature of the Research Design for the Study. 17 Definition of Terms. 19 Assumptions, Limitations, Delimitations. 21 Assumptions. 21 Limitations and delimitations. 22 Summary and Organization of the Remainder of the Study. 23 Chapter 2: Literature Review.. 26 Introduction to the Chapter and Background to the Problem.. 26 Identification of the Gap. 28 Theoretical Foundations and/or Conceptual Framework. 30 Review of the Literature. 32 Methodology and instrumentation/data sources/research materials. 36 Summary. 39 Chapter 3: Methodology. 42 Introduction. 42 Statement of the Problem.. 43 Research Questions and/or Hypotheses. 44 Research Methodology. 45 Research Design. 47 Population and Sample Selection. 48 Quantitative sample size. 49 Qualitative sample size. 50 Research Materials, Instrumentation OR Sources of Data. 54 Trustworthiness (for Qualitative Studies) 58 Credibility. 59 Transferability. 60 Dependability. 60 Confirmability. 61 Validity (for Quantitative Studies) 61 Reliability (for Quantitative Studies) 63 Data Collection and Management 64 Data Analysis Procedures. 66 Ethical Considerations. 69 Limitations and Delimitations. 72 Summary. 73 Chapter 4: Data Analysis and Results. 75 Introduction. 75 Descriptive Findings. 76 Data Analysis Procedures. 80 Results. 82 Summary. 90 Chapter 5: Summary, Conclusions, and Recommendations. 93 Introduction and Summary of Study. 93 Summary of Findings and Conclusion. 94 Implications. 97 Theoretical implications. 97 Practical implications. 98 Future implications. 98 Strengths and weaknesses of the study. 98 Recommendations. 99 Recommendations for future research. 99 Recommendations for future practice. 100 References. . 103 Appendix A. Site Authorization Letter(s) 108 Appendix B. IRB Approval Letter 109 Appendix C. Informed Consent 110 Appendix D. Copy of Instruments and Permissions Letters to Use the Instruments. 111 Appendix E. Power Analyses for Sample Size Calculation (Quantitative Only) 112 Appendix F. Additional Appendices. 113 List of TablesTable 1. Correct Formatting for a Multiple Line Table Title is Single Spacing and Should Look Like this Example 78Table 2. Equality of Emotional Intelligence Mean Scores by Gender .. 84Table 3. The Servant Leader .. 86 Note: Single space multiple-line table titles; double space between entries per example above. The List of Tables and List of Figures (styled as Table of Figures) have been formatted as such in this template. Update the List of Tables in the following manner: [Right click à Update Field à Update Entire Table], and the table title and subtitle will show up with the in-text formatting. After you update your List of Tables, you will need to manually remove the italics from each of your table titles per the example above. List of FiguresFigure 1. IRB alert . 70Figure 2. Correlation for SAT composite score and time spent on Facebook 87 Note: single-space multiple line figure titles; double-space between entries per example in List of Tables on previous page. Use sentence case for figure titles. After you update your List of Figures, you will need to manually remove the italics per the example above. Chapter 1: Introduction to the Study IntroductionThis section describes what the researcher will investigate, including the research questions, hypotheses, and basic research design. The introduction develops the significance of the study by describing how the study is new or different from other studies, how it addresses something that is not already known or has not been studied before, or how it extends prior research on the topic in some way. This section should also briefly describe the basic nature of the study and provide an overview of the contents of Chapter 1.The GCU Dissertation Template provides the structure for the GCU dissertation. The template provides important narrative, instructions, and requirements in each chapter and section. Learners must read the narrative in each section to fully understand what is required and also review the section criteria table which provides exact details on how the section will be scored. As the learner writes each section, s/he should delete the narrative and Help comments, but leave the criterion table, after each section, as this is how the committee members will evaluate the learners work. Additionally, when inserting their own narrative into the template, leaners should never remove the headings , as these are already formatted, or styled. Removing the headings will cause the text to have to be reformatted, that is, you will need to reapply the style. Styles are a feature in Word that defines what the text looks like on the page. For example, the style Heading 1, used for Chapter headings and the List of Tables title, the List of Figures title, the References title, and the Appendices title, has set up to conform to APA: bold, double spaced, keep with next, Times New Roman 12. In addition, the automatic TOC reads these styles so that the headings show up in the TOC and exactly match those in the text.The navigation pane in Word shows the first and second level headings that will appear in the Table of Contents. To access the navigation pane, click on Home in a Word document>View Pane. Learners should consult their course e-books for additional guidance on constructing the various sections of the template (e.g., Grand Canyon University, 2015, 2016, 2017a, 2017b).Learners should keep in mind that they will write Chapters 1 through 3 as the dissertation proposal. However, there are changes that typically need to be made in these chapters to enrich the content or to improve the readability as the final dissertation manuscript is written. Often, after data analysis is complete, the first three chapters will need revisions to reflect a more in-depth understanding of the topic and to ensure consistency. Engaging in scholarly writing, understanding the criterion rubrics, and focusing on continuous improvement will help facilitate timely progression.To ensure the quality of both the proposal and final dissertation and reduce the time for AQR reviews, writing needs to reflect doctoral level, scholarly-writing standards from the very first draft . Each section within the proposal or dissertation should be well organized and easy for the reader to follow. Each paragraph should be short, clear, and focused. A paragraph should (1) be three to eight sentences in length, (2) focus on one point, topic, or argument, (3) include a topic sentence the defines the focus for the paragraph, and (4) include a transition sentence to the next paragraph. Include one space after each period. There should be no grammatical, punctuation, sentence structure, or APA formatting errors. Verb tense is an important consideration for Chapters 1 through 3. For the proposal, the researcher uses future tense (e.g., The purpose of this proposed study is to ), whereas in the dissertation, the chapters are revised to reflect past tense (e.g., The purpose of this study was to ). Taking the time to ensure high-quality, scholarly writing for each draft will save learners time in all the steps of the development and review phases of the dissertation process.As a doctoral researcher, it is the learners responsibility to ensure the clarity, quality, and correctness of their writing and APA formatting. The DC Network provides various resources to help learners improve their writing. Grand Canyon University also offers writing tutoring services through the Center for Learning Advancement on writing basics; however, the writing tutors do not provide any level of dissertation editing. The chair and committee members are not obligated to edit documents. Additionally, the AQR reviewers will not edit the proposal or dissertation. If learners do not have outstanding writing skills, they may need to identify a writing coach, editor, and/or other resource to help with writing and editing. Poorly-written proposals and dissertations will be immediately suspended in the various levels of review if submitted with grammatical, structural, and/or form-and-formatting errors.The quality of a dissertation is evaluated on the quality of writing and based on the criteria that GCU has established for each section of the dissertation. The criteria describe what must be addressed in each section within each chapter. As learners develop a section, first read the section description. Then, review each criterion contained in the table below the description. Learners use both the overall description and criteria as they write each section. Address each listed criterion in a way that it is clear to the chair and committee members. Learners should be able to point out where each criterion is met in each section.Prior to submitting a draft of the proposal or dissertation or a single chapter to the chair or committee members, learners should assess the degree to which each criterion has been met. Use the criteria table at the end of each section to complete this self-assessment. The following scores reflect the readiness of the document: 0 = Item Not Present or Unacceptable. Substantial Revisions Are Required. 1 = Item is Present. Does Not Meet Expectations. Revisions are Required. 2 = Item is Acceptable. Meets Expectations. 3 = Item is Exemplary. No Revisions Required. Sometimes the chair and committee members will score the work between numbers, such as a 1.5 or 2.5. The important thing to remember is that a minimum score of 2 is required on each criterion on the prospectus, proposal and dissertation before one can move to the next step. A good guideline to remember is that learners are not finished with the dissertation until the dean signs the cover page. Learners need to continuously and objectively self-evaluate the quality of writing and content for each section within the proposal or dissertation. Learners will score their work using the learner column in the criteria tables as evidence that they have critically evaluated their own work. When learners have completed a realistic, comprehensive self-evaluation of their work, then they may submit the document to the chair for review. Rating work as all 3s will indicate that the learner has not done this. The chair will also review and score each section of the proposal and dissertation and will determine when it is ready for full committee review. Keep in mind the committee review process will likely require several editorial/revisions rounds, so plan for multiple revision cycles as learners develop their dissertation completion plan and project timeline. Notice the tables that certain columns have an X in the scoring box. As mentioned above, the chair will score all five chapters, the abstract and the reference list; the methodologist is only required to score Chapters 1, 3, and 4 and the abstract; the content expert is only required to score Chapters 1, 2, and 5 and the abstract. The chair and committee members will assess each criterion in their required chapters when they return the document with feedback.Once the document has been fully scored and approved by the chair and committee, and is approved for Level 2 or 5 review, the chair will submit one copy of the proposal or dissertation document with the fully scored assessment tables and one copy of the document with the assessment tables removed for AQR review. Refer to the Dissertation Milestone Guide for descriptions of levels of review and submission process. Criterion *(Score = 0, 1, 2, or 3) Learner Score Chair Score Methodologist Score Content Expert Score Introduction This section provides a brief overview of the research focus or problem, explains why this study is worth conducting, and discusses how this study will be completed. (Minimum three to four paragraphs or approximately one page) Dissertation topic is introduced and value of conducting the study is discussed. Discussion provides an overview of what is contained in the chapter. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. *Score each requirement listed in the criteria table using the following scale: 0 = Item Not Present or Unacceptable. Substantial Revisions are Required.1 = Item is Present. Does Not Meet Expectations. Revisions are Required.2 = Item is Acceptable. Meets Expectations. Some Revisions May be Suggested or Required.3 = Item Exceeds Expectations. No Revisions are Required. Reviewer Comments: Background of the StudyThe background section of Chapter 1 describes the recent history of the problem under study. It provides a summary of results from the prior empirical research on the topic. First, the learner identifies the need for the study, referred to as a gap, which the dissertation study will address. Strategies learners can use to identify a need or gap include: Using results from prior studies. Using recommendations for further study. Using societal problems documented in the literature. Using broad areas of research in current empirical articles. Using needs identified in three to five research studies (primarily from the last three years. Next, the learner builds an argument or justification for the current study by presenting a series of logical arguments, each supported with citations from the literature. This need, called a gap, developed from the literature, is the basis for creating the problem statement. A local need is appropriate for a study. However, the learner needs to situate the need or problem by discussing how it is applicable beyond the local setting and contributes to societal and/or professional needs. The problem statement is developed based on the need or gap defined in the Background to the Study section. Criterion *(Score = 0, 1, 2, or 3) Learner Score Chair Score Methodologist Score Content Expert Score Background of the Study Minimum two to three paragraphs or approximately one page The background section of Chapter 1 provides a brief history of the problem.Provides a summary of results from the prior empirical research on the topic. Using results, societal needs, recommendations for further study, or needs identified in three to five research studies (primarily from the last three years), the learner identifies the stated need, called a gap.Builds a justification for the current study, using a logical set of arguments supported by citations. The problem is discussed as applicable beyond the local setting and contributes to societal and/or professional needs. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. *Score each requirement listed in the criteria table using the following scale: 0 = Item Not Present or Unacceptable. Substantial Revisions are Required.1 = Item is Present. Does Not Meet Expectations. Revisions are Required.2 = Item is Acceptable. Meets Expectations. Some Revisions May be Suggested or Required.3 = Item Exceeds Expectations. No Revisions are Required. Reviewer Comments: Problem StatementResearch problems are socially constructed, meaning that a problem may not be considered one until society recognizes it as a problem. For example, spousal abuse was recognized as a problem after women earned more rights. Research problems are not determined only by how much one knows about it, but by the need to investigate phenomena that affect people in order to improve their lives (Krysik & Flynn, 2013).The Problem Statement section begins with a declarative statement of the problem under study, such as It is not known if and to what degree/extent or It is not known how/why Other examples are: It is not known _____. Absent from the literature is______. While the literature indicates ____________, it is not known in (school/district/organization/community) if __________. This section then describes general population affected by the problem along with the importance, scope or opportunity for the problem and the importance of addressing the problem. Questions to consider when writing the problem include: What is the need in the world or gap in the literature that this problem statement addresses? What is the real issue that is affecting society, students, organizations? At what frequency is the problem occurring? What is the extent of human suffering that the problem produces? Why has the problem received lack of attention in the past? What does the literature and research say about the problem that can and should be addressed at this time? What are the negative outcomes that this issue is addressing? This section ends with a description of the unit of analysis, which is the phenomenon, individuals, group or organization under study. Specifically, at the conceptual level, the unit of analysis is the entity/thing (social organization, community, group, individual, social artifacts, policies/principles, or phenomenon) that the researcher wants to be able to say something about. It is the main focus of the study. The unit of analysis is that which the researcher is studying. At the implementation level, the unit of analysis gets determined and defined by the research question/problem statement. Criterion * (Score = 0, 1, 2, or 3) Learner Score Chair Score Methodologist Score Content Expert Score States the specific problem proposed for research with a clear declarative statement.Discusses the problem statement in relation to the gap or need in the world, considering such issues as: real issues affecting society, students, or organizations; the frequency that the problem occurs; the extent of human suffering the problem produces, the perceived lack of attention in the past; the discussion of the problem in the literature and research about what should be addressed vis à vis the problem; the negative outcomes the issue addresses. Describes the general population affected by the problem. The general population refers to all individuals that could be affected by the study problem.Example: All older adults in the US who are 65 yrs. or older. The target population is a more specific sub-population of interest from the general population, such as low income older adults (? 65 yrs.) in AZ. Thus, the sample is derived from the target population, not from the general one. Describes the unit of analysis, which is the phenomenon, individuals, group or organization under study. Discusses the importance, scope, or opportunity for the problem and the importance of addressing the problem. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. *Score each requirement listed in the criteria table using the following scale: 0 = Item Not Present or Unacceptable. Substantial Revisions are Required.1 = Item is Present. Does Not Meet Expectations. Revisions are Required.2 = Item is Acceptable. Meets Expectations. Some Revisions May be Suggested or Required.3 = Item Exceeds Expectations. No Revisions are Required. Reviewer Comments: Purpose of the StudyThe Purpose of the Study section of Chapter 1 provides a reflection of the problem statement and identifies how the study will be accomplished. It explains how the proposed study will contribute to the field. The section begins with a declarative statement, The purpose of this study is . Included in this statement are also the research design, target population, variables (quantitative) or phenomena (qualitative) to be studied, and the geographic location. Further, the section clearly defines the variables, relationship of variables, or comparison of groups for quantitative studies. For qualitative studies, this section describes the nature of the phenomenon/a to be explored. Keep in mind that the purpose of the study is restated in other chapters of the dissertation and should be worded exactly as presented in this section of Chapter 1. Criterion *(Score = 0, 1, 2, or 3) Learner Score Chair Score Methodologist Score Content Expert Score PURPOSE OF THE STUDY Minimum two to three paragraphs Begins with one sentence that identifies the research methodology and design, target population, variables (quantitative) or phenomena (qualitative) to be studied and geographic location.This can be presented as a declarative statement: The purpose of this study is . that identifies the research methodology and design, population, variables (quantitative) or phenomena (qualitative) to be studied and geographic location. Describes the target population and geographic location. Quantitative Studies : Defines the variables and relationship of variables. Qualitative Studies : Describes the nature of the phenomena to be explored. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. *Score each requirement listed in the criteria table using the following scale: 0 = Item Not Present or Unacceptable. Substantial Revisions are Required.1 = Item is Present. Does Not Meet Expectations. Revisions are Required.2 = Item is Acceptable. Meets Expectations. Some Revisions May be Suggested or Required.3 = Item Exceeds Expectations. No Revisions are Required. Reviewer Comments: Research Questions and/or HypothesesThis section narrows the focus of the study and specifies the research questions to address the problem statement. Based on the research questions, it describes the variables or groups and their hypothesized relationship for a quantitative study or the phenomena under investigation for a qualitative study. The research questions and hypotheses should be derived from, and are directly aligned with, the problem statement and theoretical foundation (theory(s) or model(s). The Research Questions and/or Hypotheses section of Chapter 1 will be presented again in Chapter 3 to provide clear continuity for the reader and to help frame data analysis in Chapter 4.If the study is qualitative, state the research questions the study will answer, and describe the phenomenon to be studied. Qualitative studies will typically have one overarching research question with three or more subquestions. If the study is quantitative or mixed methods, state the research questions the study will answer, identify the variables, and state the hypotheses (predictive statements) using the format appropriate for the specific design. For quantitative studies, the research questions align with the purpose statem
Discussion: Managing Quality and Risk
Discussion: Managing Quality and Risk ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Managing Quality and Risk Assignment Content Managing quality often means addressing small issues so that they do not escalate into risks for the organization. This weeks learning activities addressed some of the organizational challenges nursing leaders are likely to face. Discussion: Managing Quality and Risk Select one of the topics from this weeks learning activities: Discussion: Managing Quality and Risk Mitigating bullying and lateral violence Managing conflict Using power to influence Improving communication Valuing diversity Develop a plan to carry out your selected topic as a nurse leader on your floor. Consider: Available resources: time, budget, space, industry collateral, personnel. Discussion: Managing Quality and Risk Employee engagement Change management principles Team dynamics Create a presentation to show your CNO how you plan to address the topic. You Have Two (2) Format Options: Format your assignment as one of the following: 7- to 10-slide presentation. Provided detailed speaker notes. Cite the source of the information on for all speaker notes (each speaker note should have a a citation). Format the title slide and the reference(s) slides using APA format. Or 450-word executive summary using UOPX approved format (see tools section below). Provide references to support your work. Format reference section using APA format. reading_chapters.docx incivility_bullying_and_workplace_violence__ana_position_statement.pdf wk_3_nur_451___gra Chapter 9 Cultural Diversity in Health Care This chapter focuses on the importance of cultural considerations for patients and staff. Although it does not address comprehensive details about any specific culture, it does provide guidelines for actively incorporating cultural aspects into the roles of leading and managing. Diverse workforces are discussed, as well as how to capitalize on their diverse traits and how to support differences to work more efficiently. The chapter presents concepts and principles of transculturalism, describes techniques for managing a culturally diverse workforce, emphasizes the importance of respecting different lifestyles, and discusses the effects of diversity on staff performance. Scenarios and exercises to promote an appreciation of cultural richness are also included. Discussion: Managing Quality and Risk Learning Outcomes Describe common characteristics of any culture. Evaluate the use of concepts and principles of acculturation, culture, cultural diversity, and cultural sensitivity in leading and managing situations. Analyze differences between cross-cultural, transcultural, multicultural, and intracultural concepts and cultural marginality. Evaluate individual and societal factors involved with cultural diversity. Value the contributions a diverse workforce can make to the care of people. Discussion: Managing Quality and Risk Key Terms acculturation cross-culturalism cultural competence cultural diversity cultural imposition cultural marginality cultural sensitivity culture ethnicity ethnocentrism multiculturalism transculturalism Introduction Culture influences leadership from two perspectives. One is the way in which we meet patient needs; the other is the way in which we work together in a diverse workforce. Effective leaders can shape the culture of their organization to be accepting of persons from all races, ethnicities, religions, ages, lifestyles, and genders. These interactions of acceptance should involve a minimum of misunderstandings. Multicultural phenomena are cogent for each person, place, and time. Connerley and Pedersen (2005) provided 10 examples for leading from a complicated culture-centered perspective. For example, 3. Explain the action of employees from their own cultural perspective; 6. Reflect culturally appropriate feelings in specific and accurate feedback (p. 29). Therefore culture-centered leadership provides organizational leaders, such as nurse managers and effective team members, the opportunity to influence cultural differences and similarities among their unit staff. Concepts and Principles What is culture? Does it exhibit certain characteristics? What is cultural diversity, and what do we think of when we refer to cultural sensitivity? Are culture and ethnicity the same? Various authors have different views. Cultural background stems from ones ethnic background, socio-economic status, and family rituals, to name three key factors. Ethnicity, according to The Merriam-Webster Dictionary (Merriam-Webster Inc., 2013), is defined as related to groups of people who are classified according to common racial, tribal, national, religious, linguistic, or cultural backgrounds. This description differs from what is commonly used to identify racial groups. This broader definition encourages people to think about how diverse the populations in the United States are. Inherent characteristics of culture are often identified with the following four factors: 1.Culture develops over time and is responsive to its members and their familial and social environments. 2.A cultures members learn it and share it. 3.Culture is essential for survival and acceptance. 4.Culture changes with difficulty. For the nurse leader or manager, the characteristics of ethnicity and culture are important to keep in mind because the underlying thread in all of them is that staffs and patients culture and ethnicity have been with them their entire lives. All people view their cultural background as normal; the diversity challenge is for others to view it as normal also and to assimilate it into the existing workforce. Cultural diversity is the term currently used to describe a vast range of cultural differences among individuals or groups, whereas cultural sensitivity describes the affective behaviors in individualsthe capacity to feel, convey, or react to ideas, habits, customs, or traditions unique to a group of people. Spector (2009) addressed three themes involved with acculturation. (1) Socialization refers to growing up within a culture and taking on the characteristics of that group. All of us are socialized to some culture. (2) Acculturation refers to adapting to a particular culture. An example of this might be what a particular society calls a particular food or how healthcare organizations are changing to blame-free environments to encourage safety disclosures. The overall process of acculturation into a new society is extremely difficult. America has a core culture and numerous subcultures. For example, think how differently people in rural American regions dress from those in urban centers, or how a city looks on Saturday night versus Sunday morning. In other words, subcultures expand on how the core culture might be described. (3) Assimilation refers to the change that occurs when nurses move from another country to the United States, or from one part of the country to another. They face different social and nursing practices, and individuals now define themselves as members of the dominant culture. An example of this might be when nurses no longer say they are from their country of origin. They say they are from where they live and practice. Providing care for a person or people from a culture other than ones own is a dynamic and complex experience. The experience according to Spence (2004) might involve prejudice, paradox and possibility (p. 140). Spence used prejudice as conditions that enabled or constrained interpretation based on ones values, attitudes, and actions. By talking with people outside their circle of familiarity, nurses can enhance their understanding of personally held prejudices. Prejudices enable us to make sense of the situations in which we find ourselves, yet they also constrain understanding and limit the capacity to come to new or different ways of understanding. It is this contradiction that makes prejudice paradoxical (Spence, 2004, p. 163). Paradox, although it may seem incongruent with prejudice, describes the dynamic interplay of tensions between individuals or groups. We have the responsibility to acknowledge the possibility of tension as a potential for new and different understandings derived from our communication and interpretation. Possibility therefore presumes a condition for openness with a person from another culture (Spence, 2004). Discussion: Managing Quality and Risk Cultural marginality is defined as situations and feelings of passive betweenness when people exist between two different cultures and do not yet perceive themselves as centrally belonging to either one (Choi, 2001, p. 193). This betweenness is a time when managers might perceive disinterest in cultural considerations. This situation might actually reflect cognitive processing of information that isnt yet reflected in effective behaviors. Ethnocentrism refers to the belief that ones own ways are the best, most superior, or preferred ways to act, believe, or behave (Leininger, 2002b, p. 50), whereas cultural imposition is defined as the tendency of an individual or group to impose their values, beliefs, and practices on another culture for varied reasons (Leininger, 2002b, p. 51). Such practices constitute a major concern in nursing and a largely unrecognized problem as a result of cultural ignorance, blindness, ethnocentric tendencies, biases, racism or other factors (Leininger, 2002b, p. 51). Providing quality of life and human care is difficult to accomplish if the nurse does not have knowledge of the recipients culture as it relates to care. Leininger believed that culture reflects shared values, beliefs, ideas, and meanings that are learned and that guide human thoughts, decisions, and actions. Cultures have manifest (readily recognized) and implicit (covert and ideal) rules of behavior and expectations. Human cultures have material items or symbols such as artifacts, objects, dress, and actions that have special meaning in a culture (Leininger, 2002b, p. 48). Leininger (2002b) stated that her views of cultural care are a synthesized construct that is the foundational basis to understanding and helping people of different cultures in transcultural nursing practices (p. 48). (See the Theory Box on p. 157.) Accordingly, quality of life must be addressed from an emic (insider) cultural viewpoint and compared with an etic (outsider) professionals perspective. By comparing these two viewpoints, more meaningful nursing practice interventions will evolve. This comparative analysis will require nurses to include global views in their cultural studies that consider the social and environmental context of different cultures. Discussion: Managing Quality and Risk Theory How do leaders, managers, or followers take all of the expanding information on the diversity of healthcare beliefs and practices and give it some organizing structure to provide culturally competent and culturally sensitive care to patients or clients? Purnell and Paulanka (2008), Campinha-Bacote (1999, 2002), Giger and Davidhizar (2002), and Leininger (2002a) provided an overview of each of their theoretical models to guide healthcare providers for delivering culturally competent and culturally sensitive care in the workplace. Purnell and Paulankas (2008) Model for Cultural Competence provides an organizing framework. The model uses a circle with the outer zone representing global society, the second zone representing community, the third zone representing family, and the inner zone representing the person. The interior of the circle is divided into 12 pie-shaped wedges delineating cultural domains and their concepts (e.g., workplace issues, family roles and organization, spirituality, and healthcare practices). The innermost center circle is black, representing unknown phenomena. Cultural consciousness is expressed in behaviors from unconsciously incompetentconsciously incompetentconsciously competent to unconsciously competent (p. 10). The usefulness of this model is derived from its concise structure, applicability to any setting, and wide range of experiences that can foster inductive and deductive thinking when assessing cultural domains. Purnell (2009) described the dominant cultural characteristics of selected ethnocultural groups and a guide for assessing their beliefs and practices. The Purnell Model for Cultural Competence serves as an organizing framework for providing cultural care, which is based on 20 major assumptions. Campinha-Bacotes (1999, 2002) culturally competent model of care identifies five constructs: (1) awareness, (2) knowledge, (3) skill, (4) encounters, and (5) desire. She defined cultural competence as the process in which the healthcare provider continuously strives to achieve the ability to effectively work within the cultural context of a client (individual, family, or community) (Campinha-Bacote, 1999, p. 203). Cultural awareness is the self-examination and in-depth exploration of ones own cultural and professional background. It involves the recognition of ones bias, prejudices, and assumptions about the individuals who are different (Campinha-Bacote, 2002). Ones world view can be considered a paradigm or way of viewing the world and phenomena in it (Campinha-Bacote, 1999, p. 204). Cultural knowledge is the process of seeking and obtaining a sound educational foundation about diverse cultural and ethnic groups. Obtaining cultural information about the patients health-related beliefs and values will help explain how he or she interprets his or her illness and how it guides his or her thinking, doing, and being (Campinha-Bacote, 2002). The skill of conducting a cultural assessment is learned while assessing ones values, beliefs, and practices to provide culturally competent services. The process of cultural encounters encourages direct engagement in cross-cultural interactions with individuals from other cultures. This process allows the person to validate, negate, or modify his or her existing cultural knowledge. It provides culturally specific knowledge bases from which the individual can develop culturally relevant interventions. Cultural desire requires the intrinsic qualities of motivation and genuine caring of the healthcare provider to want to engage in becoming culturally competent (Campinha-Bacote, 1999). The Giger and Davidhizar Transcultural Assessment Model identified phenomena to assess provision of care for patients who are of different cultures (2002). Their model includes six cultural phenomena: communication, time, space, social organization, environmental control, and biological variations. Each one is described based on several premises (e.g., culture is a patterned behavioral response that develops over time; is shaped by values, beliefs, norms, and practices; guides our thinking, doing, and being; and implies a dynamic, ever-changing, active or passive process). Leiningers (2002a) central purpose in her theory of transcultural nursing care is to discover and explain diverse and universal culturally based care factors influencing the health, well-being, illness, or death of individuals or groups (p. 190). She uses her classic Sunrise Model to identify the multifaceted theory and provides five enablers beneficial to teasing out vague ideas, two of which are The Observation, Participation, and Reflection Enabler and the Researchers Domain of Inquiry. Nurses can use Leiningers model to provide culturally congruent, safe, and meaningful care to patients or clients of diverse or similar cultures. See the following Theory Box. National and Global Directives The American Nurses Association (ANA) has a long and vital history related to ethics, human rights, and numerous efforts to eliminate discriminatory practices against nurses as well as patients. The ANA Code of Ethics for Nurses with Interpretive Statements, Provision 8, states, The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs (2008, p. 23). This provision helps the nurse recognize that health care must be provided to culturally diverse populations in the United States and on all continents of the world. Although a nurse may be inclined to impose his or her own cultural values on others, whether patients or staff, avoiding this imposition affirms the respect and sensitivity for the values and healthcare practices associated with different cultures. This provision is reinforced by the ANA position statement (2010), The Nurses Role in Ethics and Human Rights: Protecting and Promoting Individual Worth, Dignity, and Human Rights in Practice Settings. The value of human rights is placed in the forefront for nurses whose specific actions are to promote and protect the human rights of every individual in all practice care environments. Similar statements are made with an international emphasis and a specialty emphasis. The ICN Code of Ethics for Nurses (2012) states: The nurse ensures that the individual receives accurate, sufficient and timely information in a culturally appropriate manner on which to base consent to care and related treatment. The nurse shares with society the responsibility for initiating and supporting action to meet the health and social needs of the public, in particular those of vulnerable populations. The nurse demonstrates professional values such as respectfulness, responsiveness, compassion, trustworthiness and integrity. (p. 3) Nurse educators, as a specialty example, are expected to recognize multicultural, gender, and experiential influences on teaching and learning; identify individual learning styles and unique learning needs of international, adult, multicultural, educationally disadvantaged, physically challenged, at-risk, and second degree learners; and ensure that the curriculum reflects institutional philosophy and mission, current nursing and health care trends, and community and societal needs so as to prepare graduates for practice in a complex, dynamic, multicultural health care environment. (National League for Nursing, 2005, pp. 1, 2, 4) These examples illustrate a global concern for cultural sensitivity. Although the emphasis has been on recipients of care, the same attentiveness is needed in the workforce. Patients are aware of how they are treated; and they also see how staff interact with each other. Special Issues Health disparities between majority and ethnic minority populations are not new issues and continue to be problematic because they exist for multiple and complex reasons. Causes of disparities in health care include poor education, health behaviors of the minority group, inadequate financial resources, and environmental factors. Disparities in health care that relate to quality of care include provider/patient relationships, actual access to care, treatment regimens that necessarily reflect current evidence, provider bias and discrimination, mistrust of the healthcare system, and refusal of treatment (Baldwin, 2003). Health disparities in ethnic and racial groups are observed in cardiovascular disease, which has a 40% higher incidence in U.S. blacks than in U.S. whites; cancer, which has a 30% higher death rate for all cancers in U.S. blacks than in U.S. whites; and diabetes in Hispanics, who are twice as likely to die from this disease than non-Hispanic whites. Native Americans have a life expectancy that is less than the national average, whereas Asians and Pacific Islanders are considered among the healthiest population groups. However, within the Asian and Pacific Islander population, health outcomes are more diverse. Solutions to health and healthcare disparities among ethnic and racial populations must be accomplished through research to improve care. Consider how these disparities in disease and in healthcare services might affect the healthcare providers in the workplace in relationship to their ethnic or racial group. It is necessary to increase healthcare providers knowledge of such disparities so that they can more effectively manage and treat diseases related to ethnic and racial minorities, which increasingly might include themselves. The healthcare system in the United States has consistently focused on individuals and their health problems, but it has failed to recognize the cultural differences, beliefs, symbolisms, and interpretations of illness of some people as a group. As health care moves toward provision of care for populations, culture can have an even greater influence on approaches to care. Commonly, patients for whom healthcare practitioners provide care are newcomers to health care in the United States. Similarly, new staff are commonly neither acculturated nor assimilated into the cultural values of the dominant culture. Currently, accessibility to health care in the United States is linked to specific social strata. This challenges nurse leaders, managers, and followers who strive for worth, recognition, and individuality for patients and staff regardless of their ascribed economic and social standing. Beginning nurse leaders, managers, and followers may sense that the knowledge they bring to their job lacks real-life experiences that provide the springboard to address staff and patient needs. In reality, although lack of experience may be slightly hampering, it is by no means an obstacle to addressing individualized attention to staff and patients. The key is that if the nurse manager and staff respect people and their needs, economic and social standings become moot points. This challenge will intensify as the implications of the Patient Protection and Affordable Care Act of 2010 unfold. If nothing else happens, the diversity of insured patients will increase. Language Translating a message in one language to another language to ensure equivalence includes maintaining the same meaning of the word or concept. Equivalency is accomplished through interpretation, which extends beyond word-for-word translation to explain the meaning of concepts. When providing care to a language diverse patient, the nurse must realize that the process of translation of illness/disease conditions and treatment is complex and requires certain tasks. Two important tasks are (a) transferring data from the source language to the target language and (b) maintaining or establishing cross-cultural semantic equivalence (International Council of Nurses, 2008, p. 5). The current practice seems to be one of using interpreters rather than translators when speaking with nonEnglish-speaking patients and clients. Why? Purnell and Paulanka (2008) advocate that trained healthcare providers as interpreters can decode words and provide the right meaning of the message. However, the authors also suggest being aware that interpreters might affect the reporting of symptoms, using their own ideas or omitting information. It is important to allow time for translation and interpretation and to clarify information as needed. Promotion of culturally competent care with a translator has legal implications in the United States. The legal foundation for language access lies in Title VI of the 1964 Civil Rights Act, which states: No person in the United States, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefit of, or be subjected to discrimination under any program or activity receiving federal financial assistance (Chen, Youdelman, Brooks, 2007, p. 362). The federal government has interpreted and treated language as a proxy for national origin, and language assistance should be pursued. These activities supported by the Civil Rights Act include access to health care. Additionally, once a healthcare provider accepts any federal funds (e.g., Medicaid payments), the provider is responsible for providing language access to all the providers patients. Meaning of Diversity in the Organization Leading and managing cultural diversity in an organization means managing personal thinking and helping others to think in new ways. According to Noone (2008), nursing leaders need a workforce that can provide culturally competent care. In addition, nursings goal is to create a workforce that reflects the population it serves. This diversity can occur across roles, including advanced practice registered nurses, managers, and chief nurse executives. Managing issues that involve culturewhether institutional, ethnic, gender, religious, or any other kindrequires patience, persistence, and much understanding. One way to promote this understanding is through shared stories that have symbolic power. Staff who know what is valuable to patients and to themselves can act accordingly and derive satisfaction from work. Having a clear mission, goals, rewards, and acknowledgment of efforts leads to greater productivity from a culturally diverse staff who aspire to unity and uniqueness. (The following Research Perspective illustrates this point in providing end-of-life care.) When assessing staff diversity, the nurse leader or manager can ask these two questions: What is the cultural representation of the workforce? What kind of team-building activities are needed to create a cohesive workforce for effective healthcare delivery? Discussion: Managing Quality and Risk Cultural Relevance in the Workplace Although the literature has addressed multicultural needs of patients, it is sparse in identifying effective methods for nurse managers to use when dealing with multicultural staff. Differences in education and culture can impede patient care, and uncomfortable situations may emerge from such differences. For example, staff members may be reluctant to admit language problems that hamper their written communication. They may also be reluctant to admit their lack of understanding when interpreting directions. Psychosocial skills may be problematic as well, because non-Westernized countries encourage emotional restraint. Staff may have difficulty addressing issues that relate to private family matters. Non-Asian nurses may have difficulty accepting the intensified family involvement of Asian cultures. The lack of assertiveness and the subservient physician-nurse relationships of some cultures are other issues that provide challenges for nurse managers. Unit-oriented workshops arranged by the nurse manager to address effective assertive techniques and family involvement as it relates to cultural differences are two ways of assisting staff with cultural work situations. Respecting cultural diversity in the team fosters cooperation and supports sound decision making. Nurse leaders and managers who ascribe to a positive view of culture and its characteristics effectively acknowledge cultural diversity among patients and staff. This includes providing culturally sensitive care to patients while simultaneously balancing a culturally diverse staff. For example, cultural diversity might mean being sensitive to or being able to embrace the emotions of a large multicultural group comprising staff and patients. Unless we understand the differences, we cannot come together and make decisions that are in the best interest of the patient. Transculturalism sometimes has been considered in a narrow sense as a comparison of health beliefs and practices of people from different countries or geographic regions. However, culture can be construed more broadly to include differences in health beliefs and practices by gender, race, ethnicity, economic status, sexual preference, age, and disability or physical challenge. Thus, when concepts of transcultural care are discussed, we should consider differences in health beliefs and practices not only between and among countries but also between genders and among, for example, races, ethnic groups, and different economic strata. This requires us to consider multiple factors about all individuals. The range of attitudes toward culturally diverse groups can be viewed along a continuum of intensity (Lenburg et al., 1995, p. 4) from hate to contempt to tolerance to respect and ending with celebration/affirmation. Managers need to be aware of this continuum so that they can apply strategies appropriately to the workforcefor example, contempt versus affirmation. These responses are equally reflected in employee groups. Variables that may influence the nurses response may include how the illness is perceived by the culture and the cultural competency of the healthcare provider. If the nurses culture is different from the patients, whose cultural perspective dominates? It might not be possible to adapt care totally to the patients perspective. However, knowing that a difference exists allows for a mutual conversation related to the rationale for care. Similarly if a workplace dispute occurs, trying to see the other view can create new insights into a situation. To make cultural competence relevant to clinical practice, Engebretson, Mahoney, and Carlson (2008) linked a cultural competency continuum, in which they identified the levels of competence, to values in health care. They cited the levels as cultural destructiveness, cultural incapacity, cultural blindness, cultural pre-competence and proficiency that would be complementary to patient care. The clinically relevant continuum included behaviors of maleficence, incompetence, standardization, and outcomes focused (positive health outcomes). A model was developed that integrated the cultural competence continuum with the clinically relevant continuum and the components of evidence-based care; namely, best research practice, clinical expertise, and patients values and circumstances. Discussion: Managing Quality and Risk Their goal was to suggest how to make cultural concerns relevant to clinical practitioners at the level of the patient-provider encounter. To understand, value, and use diversity, nurse managers need to approach every staff person as an individual. This same strategy works for all of us. Although staff of different cultural groups may be diverse in appearance, values, beliefs, communication patterns, and mannerisms, they have many things in common. Staff members want to be accepted by others and to succeed in their jobs. With fairness and respect, nurse managers should openly support the competencies and contributions of staff members from all cultural groups with a goal of achieving quality patient care. Nurse managers hold the key to allowing the full potential of each person on the staff. Body movements, eye contacts, gestures, verbal tone, and physical closeness when communicating are all part of a persons culture. For the nurse manager, understanding these cultural behaviors is critical in accomplishing effective communication within the diverse workforce population. As if language differences arent challenging enough, add on the slang, idioms, and fads inherent to U.S. culture. It is no surprise that culturally sensitive communications is difficult to achieve. Nurses need to ensure that ineffective communication among staff, with patients, and with others does not lead to misunderstandings and eventual alienation. Failure to address cultural diversity leads to negative effects on performance and staff interactions. Nurse managers can find many ways to address this issue. For example, in relation to performance, a nurse manager can make sure messages about patient care are received. This might be accomplished by sitting down with a nurse and analyzing a situation to ensure that understanding has occurred. In addition, the nurse manager might use a communication notebook that allows the nurse to slowly digest information by writing down communication areas that may be unclear. For effective staff interaction, the nurse manager also can make a special effort to pair mentors and mentees who have different ethnic backgrounds and encourage staff to learn another language, one prominent among the population served. Even a word a day approach could alter a teams ability to interact with patients. Individual and Societal Factors Nurse managers must work with staff to foster respect of different lifestyles. To do this, nurse managers need to accept three key principles: multiculturalism, which refers to maintaining several different cultures; cross-culturalism, which means mediating between/among cultures; and transculturalism, which denotes bridging significant differences in cultural practices. Each of those principles operates in t
Discussion: Sociology Hypothesis Testing
Discussion: Sociology Hypothesis Testing ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Sociology Hypothesis Testing 1. Hypothesis testing: how to form hypotheses (null and alternative); what is the meaning of reject the null or fail to reject the null; how to compare the p-value to the significant level (suchlike alpha = 0.05), and what a smaller p-value means. Discussion: Sociology Hypothesis Testing 2. How to interpret the one-sample t-test results: what are Ho and Ha; the standard for determining statistical significance, i.e., t statistic and p-value; what are the steps for the one-sample t test; what a normal distribution looks like. 3. How to interpret the one-way ANOVA results: what are Ho and Ha; the standard for determining statistical significance, i.e., F statistic and p-value; what an F distribution looks like. 4. How to interpret the simple linear regression results: what are Ho and Ha; the standard for determining statistical significance, i.e., t statistic and p-value of the slope; what is the slope and what it means; what is the R-square (not R, it is R-square!) and what it means; what are independent variables and dependent variable, and what their relationships are; how would you plot the relationship between a dependent variable and an independent variable; from a given independent variable, how would you predict the value of a dependent variable. 5. How to interpret the multiple regression results: how to interpret the slope of an independent variable (i.e., the impact of this independent variable, holding other independent variables constance). Discussion: Sociology Hypothesis Testing _midterm_review.docx Form: 20 questions in total. 10 multiple choice or filling the blanks; 10 short responses, related to the statistical tables provided (suchlike those tables in HW assignments). Key points are summarized below: Level of measurement: understand what are continuous and discrete variables, and examples of different types (discrete, continuous, and the 4 types below) Hypothesis testing: how to form hypotheses (null and alternative); what is the meaning of reject the null or fail to reject the null; how to compare the p-value to the significant level (suchlike alpha = 0.05), and what a smaller p-value means. How to interpret the one-sample t-test results: what are Ho and Ha; the standard for determining statistical significance, i.e., t statistic and p-value; what are the steps for the one-sample t test; what a normal distribution looks like. How to interpret the one-way ANOVA results: what are Ho and Ha; the standard for determining statistical significance, i.e., F statistic and p-value; what an F distribution looks like. How to interpret the simple linear regression results: what are Ho and Ha; the standard for determining statistical significance, i.e., t statistic and p-value of the slope; what is the slope and what it means; what is the R-square (not R, it is R-square!) and what it means; what are independent variables and dependent variable, and what their relationships are; how would you plot the relationship between a dependent variable and an independent variable; from a given independent variable, how would you predict the value of a dependent variable. How to interpret the multiple regression results: how to interpret the slope of an in dependent variable (i.e., the impact of this independent variable, holding other independent variables constance). Discussion: Sociology Hypothesis Testing Understand how to use SPSS or Stata to produce all of the tables that you have had to handle so far. Homework 1: Tables used: Homework 2: Tables used: Homework 3: Tables used: Be familiar with the variables housed in the GSS dataset. Limited because it doesnt have a lot of the best kind of variables, but the variables still work. Limitations: level of measurement / going to be a lot of times you have to overlook the problems HAPMAR (happiness in marriage), RINCOME (income), PAPRES10 (fathers prestige score) `How are they coded? HAPMAR ? 1 = very happy, 2 = pretty happy, 3 = not too happy, 8 = dont know, 9 = no answer, 0 = Not applicable RINCOME ? 1 = Lt $1000, 2 = $1000 $2999, [ ], 12 = $25000 or more, 13 = Refused, 98 = Dont know, 99 = No answer, 0 = applicable PAPRES ? For the 3 different papres variables on GSS, there are no labels associated with the codes Levels of measurement? HAPMAR nominal RINCOME ordinal PAPRES interval Be able to distinguish among various levels of measurement for variables. Nominal Data cannot be ordered nor can it be used in calculations Republican, democrat, green, libertarian Not useful in calculations Data is qualitative, cant be used in a meaningful way such as means and standard deviations. Discussion: Sociology Hypothesis Testing Ordinal Data that can be ordered, differences cannot be measured Small 8oz, medium 12oz, large 32oz Cities ranked 1-10, but differences between the cities dont make sense/ cant know how much better life is in city 1 vs city 2 Also shouldnt be used in calculations Interval Data with a definite ordering but not starting point; the differences can be measured, but there is no such thing as a ratio Not only classifies and orders the measurements, but it also specifies that the distances between each interval on the scale are equivalent along the scale from low interval to high interval Can be ordered and differences between the data make sense Data at this level does not have a starting point 0 degrees doesnt mean absence of temperature think temperature: 10?+10?=20? but 20? is not twice as hot as 10?. We can see this when we convert to Farenheit; 10?= 50?, but 20?= 68?. Ratio Data Data with a starting point that can be ordered; the differences have meaning and ratios can be calculated All features of interval data plus absolute zero Phrases such as four times as likely are actually meaningful Is defined as a quantitative data, having the same properties as interval data, with an equal and definitive ratio between each data and absolute zero being treated as a point of origin Tell us about the order, the exact value in between units Height, weight, duration Both descriptive and inferential statistics can be applied Discussion: Sociology Hypothesis Testing Your highest level, your most sophisticated Axis of whatever you are measuring There can be no negative numeric value in ratio data Amount of money in your pocket right now Understand the difference between continuous and discrete variables. Discrete data Very discrete spaces in between values / not going to have values in between whole numbers Certain number of values; positive, whole numbers (like number of people) Continuous data Fractional size spaces in between Capturing every moment of the process / any value between a given range Height, weight, etc. Not restricted to separate values Occupies any value over a continuous data value Age Why is it important to know #4 and #5 in performing statistical procedures. Not all variable types can have statistical procedures performed on them Affects what type of analytical techniques can be used on the data and what conclusions can be drawn Important to understand that they are just 2 different types of data which will explain the relationship of the data & create a better understanding for analysis Important because you always want to know the level of measurement before you start analysis you want to choose the right way of doing analysis What do we mean by inference? Inference: causal Something caused/influenced another thing A caused by B Concerned primarily with understanding the quality of parameter estimates How sure are we that estimated xbar is near true population mean µ Reliability of statistical relationships, typically on the basis of random sampling Would you need to perform any work regarding inference with population data? No, inferential statistics allows you to make inferences about the population based on sample data. No inferences would need to be made if you had population data. What is the purpose of hypothesis testing, and on what kind of data? Hypothesis testing is the primary mechanism for making decisions based on observed sample statistics We want to know if theres any relationship causal or correlated Related to the conclusion we can get/ pre-score and post-score see if theres a difference Must be done with continuous sample data The alpha level tells you that youre operating at the possibility of being wrong Working cautiously and understanding limitations What are the important components of hypothesis testing? What are the essential elements? Read all the elements to understand what its about. Discussion: Sociology Hypothesis Testing Know sampling statistic derive from own data Critical value get off curve Compare critical value to the point you derive from your data Based on the level of significance, you draw a conclusion Theres a lot of components you have to have a dataset, have to construct your own hypothesis, find mean & variance to construct analysis Null & alternative hypotheses Test statistic Sampling statistic Critical value Probability values and statistical significance Conclusions of hypothesis testing What are the steps in performing a hypothesis test? Specify the null hypothesis and alternative hypothesis assumptions / givens Random sampling, known parameters, levels of measurement, known statistics Set the significance level (alpha value) Calculate the test statistic and corresponding p-value Drawing a conclusion Be able to draw a curve and label that curve appropriately for a hypothesis test. Plot number line below curve and be able to do the math Make sure math matches curve If its a two tailed test make sure you break it up into two sides F is always one tail Question about greater than or equal to its a one-sided test What alternative is there to a curve? You can walk through the equation without drawing a curve Ex: calculate p-value and compare that to the critical value You perform the test and afterwards and tell people how to determine if thats significant or not How do tests of proportion differ from tests of means? A test of proportions seeks to find a statistically significant difference between the proportions of two groups. A test of means seeks to find a statistically significant difference between the means of two groups. What is a sampling distribution and how is it derived? A sampling distribution is a probability distribution of a statistic obtained through a large number of samples drawn from a specific population It tells us which outcomes we should expect for some sample statistics (mean, standard deviation, correlation, etc Discussion: Sociology Hypothesis Testing Represents the distribution of the point estimates based on samples of a fixed size from a certain population. It is useful to think of a particular point estimate as being drawn from such distribution. Understanding the concept of a sampling distribution is central to understanding statistical inference. Example below: unimodal and approximately symmetric. Centered exactly at true population mean µ=3.90. Sample means should tend to fall around population mean. What are sampling distributions used for? Knowledge of sampling distribution & making inferences about the overall population What is a significance level? How is it interpreted? (significance level = a) Probability of error / doing our best to get as close as we can. Restricting to 5%, 1%, etc. The significance level, also denoted as alpha or a is the probability of rejecting the null hypothesis when it is true. For example, a significance level of .05 indicates a 5% risk of concluding that a difference exists when there is no actual difference (95% confidence interval to evaluate hypothesis test). With this example, we will make an error whenever the point estimate is at least 1.96 standard errors away from population parameter (about 5% of the time, 2.5% on each tail) Can you set your level of significance anywhere? Yes you can youre essentially making an assumption at the beginning of your statistical experiment so you can adjust it to whatever you want Lower the alpha(significance level), more confident Coming in with an alpha of .01 one would most likely assume that findings would be somewhat significant What do we mean by a significant finding? Differences that are being studied are real and not due to chance What are the basic things you need to perform a hypothesis test? Parameter & Statistic parameter: summary description of a fixed characteristic or measure of the target population. Denotes the true value that would be obtained if a census rather than a sample were undertaken Mean (µ), Variance ( o 2), standard deviation ( o ), proportion (p) Statistic: summary description of a characteristic or measure of the sample. The sample statistic is used as an estimate of the population parameter Sample mean (xbar), sample variance (S^2), sample standard deviation (S), sample proportion (pbar) Sampling Distribution: probability distribution of a statistic obtained through a large number of samples drawn from a specific population Standard Error: similar to standard deviation both are measures of spread. The higher the number, the more spread out your data is. Standard error uses statistics (sample data) and standard deviation uses parameters (population data) Tells you how far your sample statistic (such as sample mean) deviates from the actual population mean. Larger your sample size, the smaller the SE/closer your sample mean is to the actual population mean. Null hypothesis: a statement in which no difference or effect is expected Alternate hypothesis: a statement that some difference or effect is expected.Discussion: Sociology Hypothesis Testing Descriptive statistics Brief descriptive coefficients that summarize a given data set, which can be either a representation of the entire or a sample of a population/ summarizes or describes characteristics of a data set Broken down into measures of central tendency (mean, median, mode) and measures of variability (spread standard deviation, variance, minimum and maximum variables, skewness) What do you run on the computer at the very start of a hypothesis test? (Varies with type of test) Run a frequency distribution to make sure your levels of measurement match the procedures you want to do What is a test statistic and how many test statistics have we worked with so far? Test statistic measures how close the sample has come to the null hypothesis. Its observed value changes randomly from one random sample to a different sample. A test statistic contains information about the data that is relevant for deciding whether to reject the null hypothesis or not Hypothesis test Test Statistic Z-Test Z-Statistic t-test t-statistic ANOVA F-statistic Chi-square tests Chi-square statistic What is a frequency distribution and a cross tabulation and how do you interpret them? Frequency distribution: shows you how common values are within the variable We can get an idea about whether something is a continuous or categorical variable/ snapshot view of the characteristics of a data set allows you to see how scores are distributed across the whole set of scores (spread evenly, skew, etc.) SPSS steps: click on analyze > descriptive statistics > frequencies Move the variable of interest into the right-hand column Click on the chart button, select histograms, and press continue and OK to generate distribution table Cross tabulations: shows where the variables have something in common, seen at the intersec tion of the row and the column summarize the association between two categorical variables joint frequency distribution of cases based on two or more categorical variables SPSS steps: analyze > descriptive statistics > select cross tabulation Here you will see Rows and Columns. You can select one or more than one variable in each of these boxes, depending on what you have to compare, then click on OK. For percentages analyze > descriptive statistics > crosstabs > cells > under percentage, select all 3 options Can you determine the level of measurement from a frequency distribution? Yes, the independent variable of a frequency distribution should indicate its level of measurement which is typically categorical What is the purpose of an analysis of variance? Is it relevant for data that comes in proportions? Discussion: Sociology Hypothesis Testing ANOVA uses a single hypothesis test to check whether the means across many groups are equal: H0: The mean outcome is the same across all groups. In statistical notation, µ1 = µ2 = = µk where µi represents the mean of the outcome for observations in category i. HA: At least one mean is different. Generally we must check three conditions on the data before performing ANOVA: the observations are independent within and across groups, the data within each group are nearly normal, and the variability across the groups is about equal How do you calculate Eta 2 from ANOVA and how do you interpret it? (from the reading) A measure in ANOVA that tells you how much variance is in between each variable Is a measure in ANOVA (h^2) proportion of the total variance that is attributed to an effect. It is calculated as the ratio of the effect variance (SSeffect) to the total variance (SStotal) We will be given value and just need to interpret it on test Example: Total SS: 62.29, Anxiety SS: 4.08 > 4.08/62.29 = 6.6% 6% of variance is associated with anxiety What kind of data is needed for an analysis of variance? Dependent variable must be a continuous (interval or ratio) level of measurement Independent variable must be a categorical (nominal or ordinal variable) Two way ANOVA has 2 independent variables Females may have higher IQ scores compared to males, but this difference could be greater or less in European countries compared to North American countries ANOVA assumes: data is normally distributed, homogeneity of variance (variance among groups should be approx. equal), observations independent of each other How does ANOVA work with both means and variances? Inferences about means are made by analyzing variance What is the equation for ANOVA? F = MST/MSE where F = Anova coefficient, MST = mean sum of squares due to treatment, MSE = mean sum of squares due to error MST = SST/p-1 SST = ?n(x-xbar)^2 where SST = sum of squares due to treatment, p = total number of populations, n = total number of samples in a population MSE = SSE/N-p SSE = ?(n-1)S^2 Where SSE = sum of squares due to error, S = standard deviation of samples, and N = total number of observations F=MSbetween/MSwithin What kind of conclusion are we looking to draw from an ANOVA procedure? What is ALL that we can report? We are looking to see if the means between groups are statistically equal to one another, which is all we can report. P-value and Eta^2 What are we able to conclude from linear regression that we have not been able to conclude with other procedures? Based on what? The growth of dependent variable due to changing (can be positive or negative) of 1 unit of independent variable. Which group is significantly different from the others (coding each group as one binary independent variable). What level of variable measurement is ideal for regression? Why? Continuous variable Any time youre working with means, you want to be working with ratios because you want to be able to have continuous data with an absolute zero Why are certain levels of measurement problematic? TA doesnt think they are problematic, but for some variables getting the mean doesnt make sense If not continuous, maybe its not normally distributed.Discussion: Sociology Hypothesis Testing OTHER NOTES / READING NOTES Descriptive statistics: uses the data to provide descriptions of the population, either through numerical calculations or graphs or tables Inferential statistics: makes inferences and predictions about a population based on a sample of data taken from the population in question ANOVA Analysis of variance using a test statistic F/ uses single hypothesis test to check whether the means across many groups are equal Null: mean outcome is the same across all groups; Alternate: at least one mean is different Interval or ratio level data 3 conditions before performing ANOVA: the observations are independent within and across groups The data within each group are nearly normal The variability across the groups is about equal Example: consider a stats department that runs three lectures of an introductory stats course. We might like to determine whether there are statistically significant differences in first exam scores in these three classes (A,B, and C). Describe appropriate hypotheses to determine whether there are any differences between the 3 classes. H0= Average score is identical in all lectures, any observed difference is due to chance. HA: average score varies by class Mean square between groups( MSG) : Simultaneously consider many groups, and evaluate whether their sample means differ more than we would expect from natural variation Mean square between groups is quite useless so we compute a pooled variance estimate mean square error (MSE). MSE has an associated degrees of freedom value dfE= n k It is helpful to think of MSE as a measure of variability within the groups. When the null hypothesis is true, any differences among the sample means are only due to chance and the MSG and MSE should be about equal. As a test statistic for ANOVA, we examine the fraction of MSG and MSE F = MSG/MSE The MSG represents a measure of the between-group variability, and MSE measures the variability within each of the groups ANOVA on SPSS One-way: Analyze > Compare means > One way ANOVA Dependent list: variable whose means will be compared between the samples Factor: the independent variable: categories will define which samples will be compared F test When to use F-test: F: represents a standardized ratio of variability in the sample means relative to the variability within groups. If null is true, F follows an F distribution. The upper tail of the F distribution is used to represent the p-value We can use the F statistic to evaluate the hypotheses in what is called an F test. A p-value can be computed from the F statistic using an F distribution, which has two associated parameters df1 and df2 The larger the observed variability in the sample means (MSG) relative to the within-group observations (MSE), the larger F will be and the strongest evidence against the null hypothesis. Because larger values of F represent stronger evidence against the null hypothesis, we use the upper tail of the distribution to compute a p-value.Discussion: Sociology Hypothesis Testing P-value is how significant your findings are Used to determine statistical significance in a hypothesis test; evaluate how well the sample data support the devils advocate argument that the null hypothesis is true. Measures how compatible your data are with the null hypothesis. The result you find from your z or t score after doing test Lower the better more likely that you can reject your null For F> tail is where significant values are Alpha is what you set beforehand to see if p-value is going to be below it a= 1 confidence interval µ= population mean, xbar = sample mean Variance Trying to see how close together a data set is T test (steps and components) When to do T-Test: On SPSS: Analyze > Compare means > Independent Samples T Test Test variables: the dependent variable(s)/ continuous variable whose means will be compared between the two groups Grouping variable: independent variable/categories of the independent variable will define which samples will be compared in the t test Steps using calculator/walk through procedure: Discussion: Sociology Hypothesis Testing Z tests (steps and components) When to do Z-test Population is always a z test The formula for calculating a z -score is z =(x-?)/?, where ? is the population mean and ? is the population standard deviation (note: if you dont know the population standard deviation or the sample size is below 6, you should use a t-score instead of a z -score). Giving frequency table and understanding how its coded What does the table/number represent What kind of data is that Happiness of marriage: categorical One-tailed test (steps and components) A statistical hypothesis test in which the critical area of a distribution is one-sided so that it is either greater than or less than a certain value, but not both. If sample being tested falls into the one sided critical area, the alternative hypothesis will be accepted instead of the null Two-tailed test (steps and components) Method in which the critical area of a distribution is two-sided and tests whether a sample is greater than or less than a certain range of values. If sample being tested falls into either of the critical areas, the alternative hypothesis is accepted instead of the null. Review Session/OH notes Know how to read the curve and table for a Z, T, and F test Probability, different parameters, different testing, etc. Dont need to know all equations but do need to know really straightforward equations e. F test = means squared/ another means squared Sum of squared/sum of squared Know what all of these mean Know how sampling distributions work Know something about z, t, f scores/ what they mean Z-tests are statistical calculations that can be used to compare population means to a samples A z-score is a measure of position that indicates the number of standard deviations a data value lies from the mean. Positive if above mean, negative if below. T-tests are calculations used to test a hypothesis, most useful when we need to determine if there is a statistically significant difference between two independent sample groups Comparing two related samples Population is infinite and normal, population variance is unknown and estimated from sample, mean is known, sample observations are random and independent, sample size is small, null may be one sided or two sided F-test is used to test the equality of two populations/ if data conforms to a regression model which is acquired through least square analysis/ determines whether any of the independent variables is having a linear relationship with the dependent variable A statistical test which determines the equality of the variances of the two normal datasets How much proportion of the variation is being contributed by this effect > n^2=SSeffect/SStotal Might encounter a situation where we have so many groups, might not be a huge impact because of so many groups Hypothesis test with slope y=B0+B1X1 Testing if slope is significant (B1) Discussion: Sociology Hypothesis Testing Null hypothesis: B1=0 Sociology 113 Cumulative Final Exam Study Guide All the knowledge you need included below. Understand how to use SPSS or Stata to produce all of the tables that you have had to handle so far. Frequency Distribution, Cross tabulation, ANOVA Output, Two-Sample T-Test Frequency Distribution Analyze ? Descriptive Statistics ? Frequency Distribution Used in order to summarize categorical variables Cross Tabulation Analyze ? Descriptive Statistics ? Cross Tabulation Used in order to expose relationships between two separate variables ANOVA Output Analyze ? Compare Means ? One-Way ANOVA output Independent variable goes under factor Dependent variable goes under dependent list Discussion: Sociology Hypothesis Testing Post Hoc test at significance level 0.05 If P is = or < 0.05, then reject the null. If above, then fail to reject. Two-Sample T-Test Analyze ? Compare Means ? Independent Samples T-Test Input Test variable and grouping variable If sig (2-tailed) is below 0.05, reject the null hypothesis Be familiar with the variables housed in the GSS dataset. Be familiar particularly with the variables used in the homework happiness in marriage (HAPMAR), respondents income (RINCOME), fathers prestige score (PAPRES10) How are they coded? [a] Levels of measurement? HAPMAR nominal [b] [c] [d] RINCOME ordinal PAPRES interval Be able to distinguish among various levels of measurement for variables. Nominal name only; labels with no numerical significance cannot perform statistical procedures Ordinal ordered levels or ranks; differences between each is unknown cannot perform statistical procedures Interval numeric scales in which we know both the order and the exact differences between the values, like temperature can perform some statistical analysis, but the problem is that they dont have a true zero (0 does not mean the absence of value; it is actually another number used on the scale, like 0? or 0?, there is no absence of temperature) which means we cannot calculate ratios think temperature: 10?+10?=20? but 20? is not twice as hot as 10?. We can see this when we convert to Farenheit; 10?= 50?, but 20?= 68?. Ratio tell us about the order, the exact value between units, and they also have an absolute zero, like height, weight, durationDiscussion: Sociology Hypothesis Testing both descriptive and inferential statistics can be applied Understand the difference between continuous and discrete variables. [e] discrete variables refer to those that have a certain number of values; positive, whole numbers (like number of people) Whole values continuous variables refer to t hose that can take any value between a given range (like height, weight, etc) Any values like fractions of values Why is it important to know #4 and #5 in performing statistical procedures. it is important to know the level of measurement because not all variable types can have statistical procedures performed on them (see #3) You can do means test on ratio data, but not on nominal data What do we mean by inference? statistical inference is the theory, methods, and practice of forming judgments about the parameters of a population and the reliability of statistical relationships, typically on the basis of random sampling causal inference is finding the causal relationship between variables Would you need to perform any work regarding inference with population data? no, inferential statistics allows you to make inferences about the population based on sample data. no inferences would need to be made if you have the population data What is the purpose of hypothesis testing, and on what kind of data? hypothesis testing is the primary mechanism for making decisions based on statistical analysis in order to make inferences about population parameters based on observed sample statistics is there a causal relationship? must be done on continuous sample data What are the important components of hypothesis testing? What are the essential elements? the null and alternative hypotheses test statistic Discussion: Sociology Hypothesis Testing sampling statistic critical value (aka significance aka alpha value) probability values and statistical significance conclusions of hypothesis testing get data set 2. find variable 3. construct hypothesis 4. construct analysis. What are the steps in performing a hypothesis test? hypothesis: null and alternative assumptions/givens: random sampling, normal population distribution, level of measurement, known parameters/known statistics sampling distribution test statistic: use appropriate sampling distribution to calculate value for test statistic level of significance, the critical va
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