WHATS THE BIG ISSUECREATING STANDARDS-BASED CURRICULUM.docx

WHAT'S THE BIG ISSUE?
CREATING STANDARDS-BASED CURRICULUM
Glenn R. Hider
A student in my methods class
recently presented an engaging lesson
to his classmates. He asked about a
technology used in sporting events
using video camera images. The sys-
tem, made by Ques Tec, uses a series
of cameras, computers, and sophisti-
cated tracking technologies to create
computer-generated virtual replays in a
number of venues including tennis, golf,
and baseball. The students quickly rec-
ognized applications: tennis balls barely
hitting the white line, slow motion
analysis of golf swings, and pitches

entering the strike zone of batters.
The discussion continued with the
baseball application: How could the
technology actually help the game?
Suggestions included: batters scouting
the pitchers for their tendencies; pitch-
ers scouting batters for their tenden-
cies; pitchers scouting umpires for their
tendencies in calling strikes; and the
league using the results to help
umpires improve. Ultimately, the dis-
cussion settled on whether or not
umpires should be replaced outright by
the new technology. A lively debate
presented issues from several points of
view. I knew right away this would be
a great topic for a recently finished cur-
riculum entitled Technological Issues.

Technological Issues is one of a series
of standards-based curricula being
developed through the Center for the
Advancement of Teaching Technology
and Science (CATTS). The curriculum,
which should be available to CATTS
Consortium members this fall, has been
developed by this author over the past
year and a half. Surprisingly, it seems
T What is necessary is a re-wiring of that
part of your hrain that controls curriculum
development.
that many issues, such as the one that
surfaced in my class, appear to be an
excellent fit within this curriculum.
Given a topic as broad and far-reaching
as technological issues, how then do
you begin to develop a curriculum that

is standards-based, relevant but not
dating itself, and that can please the
many consortium constituents? This
indeed was a challenge, and one that I
would like to share with the readers.
The simplest approach is to look at this
curriculum development as a system:
inputs (guiding principles), processes
(how to develop standards-based cur-
riculum), output (the curriculum), and
feedback (what the reviewers reacted
to). Knowing there are readers who will
T
i
examine this from different perspec-
tives. Figure 1 shows the system
model and what each section refers to
(feel free to skip to the section that

most affects you).
Inputs
Obviously, for standards-based
curriculum, we need to start with the
standards. This is easy to say, but a bit
more difficult to put into practice.
Fortunately, we have national stan-
dards that have been developed
through ITEA with the collaboration of
other nationally recognized organiza-
tions (NSF, NASA, AAAS, NAE).
Standards for Technological Literacy
{ITEA, 2000/2002) provides the starting
Inputs:
Guiding Principles
Processes:
Developing Standards-
Based Curriculum
Output:
What s in the
Curriculum

Feedback:
What did the Reviewers
Say, Adjustments?
Figure 1. Curriculum Development System
30 December/January 2006 • THE TECHNOLOGY TEACHEH
point But whicfi standards and bench-
marks should be included, and how
many should the curriculum include?
The first step in the process was to
identify organizing principles. In other
words, what are the major ideas that a
technologically literate person should
be able to articulate? A discussion of
ttiis process was presented by Barry
Burke in the May/June 2005 issue of
The Technology Teacher (Burke, 2005),
and has been identified by ITEA as the
Engineering byDesign" model. This

process resulted in the identification of
course content organizers. The next
step involved the use of experts to
identify which standards/bencfimarks
represented each of the organizing
principles. The final result is a series of
courses, which, taken as a whole in
the high school sequence, will ensure
that all standards are covered. Not all
standards are covered in any one
course, and some standards may be in
more than one course, but all standards
are addressed within the collection
of courses.
The next detail was to identify specific
benchmarks for each course curricu-
lum, and the intensity of their use.
Should they be covered in detail and

drive the lesson, covered with some
detail, or merely be supportive?
Additionally, standards and bench-
marks for mathematics and science
were also identified for each curriculum
by content specialists. Once this matrix
was completed, and a title was identi-
fied based on the organizing principles,
an author was sought to develop the
curriculum. With a little coaxing, this is
the point at which I entered into the
system.
Process
With a large collection of
standards/benchmarks from three
disciplines, and a succinct title.
Technological Issues, how does one
start to develop a standards-based cur-

riculum? The natural tendency of some-
one who has been developing
curriculum for years was to start witfi
the activities to meet the standards.
T However, as Burke (2005) exposes,that would result in a
standards-
reflected rather than standards-based
curriculum.
What is necessary is a rewiring of that
part of your brain that controls curricu-
lum development. Here's a good analo-
gy: Many of us trained in industrial arts
years ago were "wired" to use three-
view drawings in our approach to
design. We are able to see a device in
each of the three views. Along came
parametric modeling, or 3-D visualiza-
tion. Young students today pick up this
approach to design quite quickly; it is

close to how the brain visualizes
devices. However, those of us wired
for the three-view approach require a
rewiring to begin to use this new
design paradigm. The same is true for
curriculum development.
The first step in this new process was
a detailed examination of the standards
recommended for this course. With the
concept of issues in the background, a
brainstormed list of potential topics,
T
i
links, concepts, impacts, specific prob-
lems, and other technological experi-
ences was generated. This list was
massaged, rearranged, and generally
bantered about for a while. The goal at

this juncture was to determine the ulti-
mate experiences we want students to
leave with following their exposure to
tfiis course, based on these specific
standards. In other words, what were
the Big Ideas we wanted students to
leave with and be able to apply to
future situations?
The process for developing standards-
based curriculum is shown in Figure 2
(a more detailed explanation can be
found in Planning Learning, ITEA 2005}.
It is important to note that this is not a
linear process. I didn't discover this
until after I went through the process
and started to reflect upon it. My analo-
gy of the process is to the design
process: a circular process whereby, if

need be, you can revisit earlier steps
based on knowledge gained later in the
process. Some examples may help
shed light on this process.
Identify
Standards and
Benchmarks
Technology
Science
Mathematical
Organize
Content into
Important "Big
ideas"
Develop
Activities that
Support the
Units and
H Lessons
Development
Assessment of
Big Ideas and
Standards

Develop Units
and Specific
Lessons
Figure 2. Curriculum Development Process
T
THE TECHNOLOGY TEACHER • December/January 2006 31
The organization of content into the big
ideas was one area that had to be re-
visited over several iterations. It
required continuous questioning: Were
the big ideas representative of the stan-
dards? Were the big ideas inclusive
enough to welcome all of the ideas
brainstormed around the course con-
cept of technological issues? And,
were the big ideas representative of
the course concept as envisioned by
the consortium members? It sbould be
T
i
noted that system feedback (from con-
sortium members) was used at various
stages in the development process
(see Figure 1).
Another area that required some re-

examination was tbe initial selection of
standards, or specific benchmarks.
Some strongly suggested benchmarks
(ones that should drive the lessons)
appeared initially out of place within
the organization I had developed. Other
T benchmarks, though not identified asimportant to this course,
I felt were
major ones that fit my big ideas. For
example, I was charged with including
the following benchmark (STL-5 I):
"With the aid of technology, various
aspects of the environment can be
monitored to provide information for
decision making." Although this is
more specific than my Big Idea for
that unit would include, I did add a
lesson that addresses that standard
Unit
1.
2.
3.
4.
5.
Big Ideas
Recognition - The selection,
application, and consequences of
all technology create various

types of issues, which may affect
individuals, groups and/or
society as a whole.
Sources - Technological issues
can result from the technology
itself, how or where it is
transferred, or how it interacts
with the limitations of the
environment or ecosystem.
Examinine - Examining whv
and what humans design,
including the constraints and
limitations, and how the designs
interact with society and the
environment, helps us create
designs and solve problems with
fewer technological issues.
Addressing ~ Developine
solutions to address human
needs or wants, requires certain
practices, policies, and
protections to minimize
technological issues.
Predicting- A variety of lools
and processes are available to
predict outcomes of designs or
problem solutions in advance,
thus limiting negative
Supporting Ideas
A. Historical examples of technological issues help us

better understand current and future issues as they
arise.
B. Recognizing and addressing technological issues
requires a multidisciplinary approach.
C. Technology and society affect each other.
0. All technologies have alternatives, each with their
own benefits and risks.
A. Growth of human population and economic systems
create technological issues.
B. Transferring technology can create cultural as well as
C. Engineering design otkn creates unforeseen failures.
D. The earth has limited energy and material resources
as well as a limited ability to recycle wastes.
A. Needs assessment for design include safety and
quality of life.
B. Design criteria and constraints should use ergonomic
principles.
C. Ethics and product liability are important to reduce
D. Environmental assessments and monitoring should be
done in advance to limit technological issues.
A. Appropriate technology is a design methodology that
incorporates the technology, the user, and the

location.
B. Careful selection of materials and processes,
including recycling and green products, limits
C. Policies and regulations can govern designs and
problem solutions to limit technological issues.
D. Acquiring, applying, and protecting technical
knowledge reduces technological issues.
A. Design analysis tools can be used to select a design or
solution with the least amount of technological
issues.
B. Modeling, gaming, and simulations can be used to
examine systems before they are fully developed.
C. Technology assessment tools are used to research
possible negative impacts prior to the selection and
use of a variety of technologies.
D. Forecasting and other futurology techniques can be
used to minimize possible technological issues in
advance.
Figure 3. Curriculum Units and Big Ideas.
32 December/January 2006 • THE TECHNOLOGY TEACHER
specificallv. In another case, the bench-
mark (S71-3 G) was pertinent to a Big

Idea, which stated: "Technology trans-
fer occurs when a new user applies an
existing innovation developed for one
purpose in a different function," which
must be done thoughtfully to avoid
causing issues. Interestingly enough,
additional technological concepts were
explored that are not even in the
standards, but perhaps should be.
One example is the examination of
engineering design failures, an impor-
tant learning tool for many engineering-
based programs.
Additionally, input was provided from
consortium members from over a
dozen different states, each with their
unique requirements and desires. Tfie
initial design of the curriculum, based

on consortium requests, was a curricu-
lum that could be used as a stand-
alone course, or Integrated into existing
courses. That original curriculum
evolved through several iterations into
the current stand-alone, full-year, high
school level course, with a variety of
compromises to meet the consortium
needs. The resulting curriculum is
described in the next section.
Output
Technological Issues is a standards-
based (rather than standards-reflected),
full-year high school curriculum. The
technology, mathematics, and science
standards and benchmarks identified
for this curriculum are included in a
matrix in the appendix of the docu-

ment. They were the building blocks
that were used to develop a curriculum
centered on the topic of technological
issues, as discussed in the last section.
Topics, links, concepts, impacts, spe-
cific problems, and other technological
experiences that addressed the identi-
fied standards were molded into five
units. The five units represent five Big
Ideas, or major concepts all students
should be able to understand and
apply. The goal is to help students
become technologically literate; stu-
T dents should be able to understand andapply these big ideas
not only in the
course, but in future situations they
encounter.
The five units and corresponding Big
Ideas are shown in Figure 3. Units one

through three progress from recognition
of issues and identifying sources to
examining some current issues. Unit
four allows students to tackle techno-
logical problems that are aimed at
avoiding the creation of issues. Finally,
unit five allows students to use tools of
predicting (and hopefully avoiding)
technological issues with future tech-
nologies.
Each Big Idea is then broken down into
supporting ideas. Each of the support-
ing ideas represents a lesson organizer
(20 lessons total). The technology stan-
dards are listed for each lesson, and
mathematics and science standards
are tied to the lesson objectives. The
lessons provide background information

for the teacher and student, sugges-
tions for teaching the unit, assessment
tools, a listing of resources, and stu-
dent assignment/activity handouts.
Lesson titles are shown in Figure 4.
Another important part of each lesson
is Additional Extension Activities, which
allow students to explore additional
topics/activities and provide sugges-
tions for teachers to use students'
work to help promote their program
and link their solutions to the communi-
ty. For example. Lesson 4-2, which has
the class developing a model city using
themes of recycling and green prod-
ucts, can be presented to local or
regional planning groups in the
community.

One important output for this type of
curriculum development is the types of
lessons that occur. The
assignments/activities may not look
like your traditional technology course.
Students are engaged in research and
presentations for most of the activities.
They are involved in examining some
designs, suggesting and modeling
design changes, and developing.
T prototyping, and packaging otherdesigns. They are asked
extensively to
relate technology to their other sub-
jects and to real-world problems. They
are challenged to take a critical look at
the application of technology and, in
one case, even debate a current issue.
The last unit encourages them to apply
predictive tools to examine how tech-

nology may be applied in the future
without creating major issues.
The output, or product, of this curricu-
lum development may appear different
than what is currently taught in a tech-
nology program. Every day I continue
to see issues in the news that could be
addressed in this course. Hopefully,
this guide will help teachers present
the standards and big ideas in active,
real-world programs. As teachers gain
experience with this course, they will
be able to add additional activities to
suit their needs. This was the case at a
workshop for teachers in the Baltimore
area this summer, where additional
activities were created for each unit
based on their experience and expert-

ise. I believe this enrichment will help
reduce the main negative feedback to
this course, as discussed in the next
section.
Feedback
Consortium members were involved in
feedback to the curriculum throughout
the process. This began with an early
proposal of how my outline and big
ideas would meet the intended stan-
dards for this course. Originally, the
consortium members requested a flexi-
ble type of curriculum, one that could
be used as a stand-alone course, or
able to be integrated into existing tech-
nology courses. The resulting curricu-
lum is intended as a full-year,
stand-alone technology high school

course (although parts of it could be
integrated into existing courses).
The current version of the curriculum
was reviewed by consortium members
in various regions of the country. Many
of their concerns were addressed in
the most recent editing period. For
T
Lesson Number and Title
Ovet^'iew of the Course
Unit I - Lesson One: Introduction to Technological
Issues Using an Historical Case Study
Unit I - Lesson Two: Relatitig Technological Issues
to Other Subject Areas
Unit f - Lesson Three: Examining a Technology and
its Adoption
Unit I - Lesson Four: Technology Alternatives:
Benefits and Risks
Unit II - Lesson One: Examining Exponential
Growth
Unit II - Lesson Two: Evaluating Technology
Transfer

Unit II - Lesson Three: Issues From Engineering
Design Failures
Unit II - Lesson Four: Examining Earth's Limited
Resources
Unit III - Lesson One: Design and Technology for
Quality of Life
Unit III - Lesson Two: Criteria for Safe and
Ergonomic Design
Unit III - Lesson Three: Design Ethics and Product
Liability
Unit III - Lesson Four: Modeling Monitoring
Technology
Unit IV- Lesson One: Appropriate Technology
Design
Unit IV - Lesson Two; Model City Design Based on
Recycling and Green Products
Unit IV- Lesson Three: Debating Current
Technologies and Their Issues
Unit IV- Lesson Four: Protecting Technology
Unit V- Lesson One: Weighing and Prioritizing
Design Trade-OtTs
Unit V- Lesson Two: Using Models, Simulations,
and Games
Unit V- Lesson Three: Applying Technology
Assessment Tools
Unit V- Lesson Four: Applying
Forecasting/Futurology Tools
Review, Quizzes, Tests
School Functions/Make-up Time
Total
Corresponding
Assignment Number
Lesson 1-1

Lesson 1-2
Lesson 1-3
Lesson 1-4
Lesson 2-1
Lesson 2-2
Lesson 2-3
Lesson 2-4
Lesson 3-1
Lesson 3-2
Lesson 3-3
Lesson 3-4
Lesson 4-1
Lesson 4-2
Lesson 4-3
Lesson 4-4
Lesson 5-1
Lesson 5-2
Lesson 5-3
Lesson 5-4

Hours of
Instruction
2
4
4
4
4
4
6
4
6
6
4
4
6
12
12
6
6

4
6
4
6
4
2
120 hours*
*120 hours equates to 180 days (full year course) at 40 minutes
per period
Figure 4. Course Lessons and Corresponding Assignments
(Activities)
34 December/Janijary 2006 • THE TECHNOLOGY TEACHER
example, the mathematics and science
standards are referenced more clearly
in each lesson, and additional ques-
tions were added to the pre/post test
questions—questions that are more
open-ended in nature and more directly
assess students' mastery of the

standards/benchmarks.
Two feedback issues, however, are still
not resolved. First is the issue of
"hands-on" activities. It was apparent
from the start that a standards-based
course entitled Technological Issues
would be difficult to develop that
matches our current activity-driven cur-
riculum. Believe me, it was difficult.
However, I would argue that research-
Ing, examining, and presenting on tech-
nological issues is an alternative
method of hands-on (just doesn't have
the traditional smoke and chips}.
The second issue is related to the
first—how will teachers in the field
react to the curriculum? This remains
to be seen. I believe if teachers are

given introductory instruction on the
delivery of this course, and gain experi-
ence adapting it to their class and stu-
dents, it will be a rewarding experience
for both. It should be apparent for the
reader to see many things that are not
currently in this curriculum that easily
could be incorporated. That is truly the
goal of technological literacy—applying
knowledge and skills to new and future
situations.
Last Remarks
Getting back to the issues presented in
my introduction: Should umpires be
replaced by a proven, more reliable
technology? Obviously this scenario
has already happened in other work sit-
uations, displacing many jobs (and cre-

ating others). As with most
technological issues, there are not sim-
ple yes or no decisions to be made.
This may be a new concept for both
students and teachers. Examining and
avoiding issues can be a complex and
challenging activity.
T Hopefully, the reader now has a betterunderstanding of the
product—a cur-
riculum entitled Tecbnological Issues.
Equally important, the reader should
now have an appreciation for and
understanding of the process required
to develop standards-based curriculum.
As a profession, I believe we are on the
forefront for this type of curriculum
development, and as such, are in
uncharted waters. Thus, I would wel-
come any critique to the process or the

product, as would the CATTS consor-
tium members.
References
Burke, B. (2005, May/June). Why CAnS
needs space! The Technology Teacher.
64-3.(21-26). Reston, VA: ITEA
International Technology Education
Association (ITEA). (2000/2002).
Standards for technological literacy:
Content for the study of techr^oiogy.
Reston, VA: Author.
International Technology Education
Association (ITEA). (2005). Planning
learning: Developing technology
curricula. Reston, VA: Author.
Glenn R. Hider,
Ed.D., is a profes-
sor in the
Department of
Applied Engineering
and Tecbnology at
California University
of Pennsylvania.
He can be reacbed at [email protected]

T
California University
of Pennsylvania
One Tenure-Track Faculty Position
in Technology Education; effec-
tive August 2006. The successful
applicant will teach undergraduate
Technology Education courses in
physical: information, and biotech
systems and graduate courses.
Other responsibilities could include;
supervising student teachers, advising
students and student clubs, assist-
ing with program accreditation and
curriculum development, improving
and maintaining facilities, serving
on committees, recruiting students,
continuing scholarship, and develop-
ing relationships with constituents.
Qualifications include strong
academic and teaching experience

in Technology Education. Master's
required; doctorate preferred, with
at least one degree in Technology
Education/Industrial Arts required.
To be considered, applicants must sub-
mit hardcopy of all the following before
an on-campus interview is considered:
• Comprehensive curriculum vitae
• Official transcripts from all colleges
and universities attended
• Application letter highlighting the
qualifications, teaching interests,
teaching philosophy, and plans for
continuing scholarship
• Contact information for three profes-
sional references that have current
knowledge of the applicant's abilities
as a teacher and scholar
Initial Review of applicants
begins November 30, 2005.
Ca! U is M/FA//D/AA/EEO
Dr. Daniel E. Engstrom:
[email protected]

Phone: 724-938-4381
For more information visit
www.cup.edu/employment
N4325 Nursing Research
Submit by the due date and time listed in your syllabus.
Overview
This assignment will allow you to create an evidence-based
practice project that includes the development of a PICO
question and follows the initial steps of the Iowa Model. You
will share your findings using an APA formatted paper.
Submitting your assignment
· Save this document to your desktop as a Word document.
· Open the document from your desktop and review the
assignment instructions and grading rubric.
· Create a separate Word document for your paper.
· Return to Blackboard and upload your paper and your nursing
research article that was approved by your coach in Module 2 to
the assignment submission link in Module Four. Please note:if
you forget to upload your nursing quantitative research article,
a 5 point penalty will be applied to your paper.
Grading Rubric
Use this rubric to guide your work the assignment. Points are
awarded for each section based on content and clarity of

expression.
Accomplished
(Maximum points awarded)
Proficient
(Points awarded based on content)
Needs Improvement
(Minimum points awarded)
Initial PICO question completed / nursing research article
selected.
Research article is a quantitative article, nursing focused, and is
5 years or less from current publication date.
Please note: if you forget to upload your nursing quantitative
research article, a 5 point penalty will be applied to your paper
5 – 4 points
Research article is a quantitative article that is nursing focused
but is greater than 5 years old.
3 - 2 points
Research article is not nursing focused or is a qualitative
article, systematic review, meta-synthesis, meta-analysis, meta-
summary, integrative review, clinical information article or
“how-to” article.
No article uploaded.
0 points
Opening Paragraph
(Paragraph #1)
Introduction statement(s) present.

PICO question with all elements present.
Statement of importance with two facts such as costs,
morbidity, mortality, safety. Include related statistics with
citation and is 5 years or less from current publication date.
10 – 9 points
No introduction statement(s).
PICO statement is incomplete.
Statement of importance incomplete or missing.
Citation is incomplete or missing.
8 – 3 points
No introduction statement(s).
PICO statement grossly incomplete or missing.
Statement of importance missing.
No citation
2 - 0 points
Summary paragraph for your nursing quantitative research
article.
(Paragraph #2)
Three facts clearly identified from quantitative nursing research
article and is 5 years or less from current publication date.
A least two of the facts include information from the Results
and / or Discussion sections.
Facts clearly tied to PICO question.

Facts connected to your nursing practice.
10 - 9 points
Less than three facts clearly identified from quantitative nursing
research article.
Only one fact includes results or discussion sections.
Facts not clearly tied to PICO question.
Facts not clearly connected to your nursing practice.
8 - 3 points
No facts clearly identified from the article.
No facts from the results or discussion sections
No attempt to connect facts from the article back to the PICO
question.
No attempt to connect facts from the article back to your
nursing practice.
2 - 0 points
Reliability paragraph for your nursing quantitative research
article.
(Paragraph #3)
Definition of reliability offered with citation.
Discussion of reliability clearly connected to data collection or
measurement methods with examples from the student’s
research article.
Type of reliability is identified and named.
Hint: This information is covered in Chapter 10. Use Table 10-1
in your textbook to identify the type of reliability of the
measurement instrument / tool.
10 - 9 points

Vague or no definition of reliability.
Minimal reference to data collection or measurement methods in
discussion of reliability with no reference to specific
information from the student’s article.
Type of reliability is not clearly identified / named.
8 - 3 points
Vague statements about reliability made with no discussion of
data collection or measurement methods offered.
Type of reliability is not identified / named.
2 - 0 points
Validity paragraph for your nursing quantitative research
article.
(Paragraph #4)
Definition of validity offered with citation.
Discussion of validity clearly connected to data collection, or
measurement methods with examples from the student’s
research article.
Type of validity is identified and named.
Hint: This information is covered in Chapter 10. Use Table 10-1
in your textbook to identify the type of validity of the
measurement instrument / tool.
10 - 9 points
Vague or no definition of validity.
Minimal reference to data collection, or measurement methods
in discussion of validity with no reference to specific
information from the student’s article.
Type of validity is not clearly identified / named.

8 - 3 points
Vague statements about validity made with no discussion of
data collection or measurement methods offered.
Type of validity is not identified / named.
2 - 0 points
Two additional strengths or weaknesses from your nursing
quantitative research article.
(Paragraph #5)
Two strengths or two weaknesses or one strength and one
weakness are specifically identified from your nursing
quantitative research article.
The student choices for strengths / weaknesses must focus on
the methods used by the authors for sampling, measurement
methods used (ex. a questionnaire), or how the data was
collected (data collection) with examples from the student’s
research article.
10 - 9 points
Only one strength / or weakness explained well with second
strength / weakness only identified.
Strengths / weaknesses not based on sample, measurement
methods, or data collection.
8 - 3 points
Strength / weaknesses identified are not based on these three
critique skills.
No strengths / weaknesses identified.
2 - 0 points
Clinical practice guideline summary.

(Paragraph #6)
Name of the clinical practice guideline and specific website
identified. Guideline is the most recent version or published
within the past five years.
Three facts clearly identified that were found within the
guideline and relate to the practice of a BSN.
10 - 9 points
Name of the clinical practice guideline or website not clearly
identified.
Fewer than three facts clearly identified that were found within
the guideline or facts not specifically related to the practice of
the nurse.
Facts vaguely tied to PICO question.
Facts vaguely connected to your nursing practice.
8 - 3 points
Name of the clinical practice guideline or website not stated.
No clearly identified facts from the guideline.
Facts not tied to PICO question or nursing practice.
2 - 0 points
“Fourth resource” summary.
(Paragraph #7)
Three facts clearly identified from the fourth resource which is
5 years or less from current publication date.

10 - 9 points
Less than three facts clearly identified from the fourth resource.
Facts not clearly tied to PICO question.
Facts not clearly connected your nursing practice.
8 - 3 points
No facts clearly identified from the fourth resource.
No attempt to connect facts from the fourth resource back to the
PICO question.
No attempt to connect facts from the fourth resource back to
your nursing practice.
2 - 0 points
Closing Paragraph(s)
(Paragraph #8 and #9, if needed)
PICO question is restated.
A summary of what was learned (from all sources) is present.
Recommendations for practice are offered.
10 - 9 points
Missing one or more of the following elements:
PICO question.
A summary of what was learned.
Recommendations for practice.
8 - 3 points
No PICO question.

Poor or no attempt to summarize information from the
resources.
No / vague recommendations for practice are offered.
2 - 0 points
APA Style and Formatting
APA formatting for this paper will follow the guidelines for
general formatting, in text-citations, margins, headings (if
desired) alignment and line spacing, font type and size,
paragraph indentation, page headers, and the reference page as
explained in the 2nd edition of APA the Easy Way or the 6th
edition of the APA Manual.
Helpful Hints:
· Do not use 1st person in a formal paper.
· Do not use direct quotes, instead summarize and paraphrase
what you are reading. Multiple quotes (more than two) will
receive multiple point deductions.
· Please do not forget to use the approved CONHI cover page.
The first time an APA error is discovered, it will be pointed out
to you and a point will be deducted from your paper. Maximum
number of points deducted for APA errors: 15 points
Instructions for Completing Your Assignment
· Step one:Using the topic you chose for Module 2 Searching
for a Quantitative Nursing article, identify a nursing clinical
practice question that you would like to explore.
· Step two: Complete the readings from Module Four. Use the
readings from Module Four to put your nursing clinical practice
question into a PICO format.
· Step three: Search for a nursing quantitative research article

(or two) that relates to your PICO question using Academic
Search Complete, CINHAL, Pubmed, Google Scholar, or any
other database that contains nursing research articles. Please
note: you may be able to use the article that you submitted in
Module Two to meet this requirement.
· The article you will find must meet the following mandatory
requirements:
· It must be based on the topic list attached here.
· It must be from a nursing research journal or have a nurse as
an author.
· It must be no more than 5 years old from the current
publication year.
· It must include implications and / or interventions that are
applicable to nursing practice.
· It may not be a qualitative article, systematic review, meta-
synthesis, meta-analysis, meta-summary, integrative review or a
retrospective / quality improvement study. For more information
on how to recognize these types of article see Grove, Gray, and
Burns (2015) pp. 22-24.
· It may not be a clinical information article or “how-to” article.
· Step four: If you have questions about your PICO question
formatting or the nursing quantitative research article that you
found, post them to the Q & A discussion board for feedback
from your peers.
· Self-check: if you choose the wrong type of nursing
quantitative research article for your paper (the one that you
will be using to write paragraph 2, 3, 4, & 5) the best grade you
could make is a 55. Yikes!!! Please make sure that you have
selected a nursing quantitative research article that meets the
criteria for this assignment and ask for help if you are not sure.

Please note: you may be able to use the article that you
submitted in Module Two to meet this requirement.
· Step Five: Collecting More Evidence (Do the research)
· Find a resource published within the past 5 years that provides
you with at least two facts (ex. costs, morbidity, mortality,
safety, or other related statistics) for why your clinical problem
is important (provide statistics). (The internet is a great place
to get this information…just don’t forget to cite this
information and add it to your reference page).
· Find a clinical practice guideline at
http://www.guideline.gov/browse/by-topic.aspx that relates to
your question. It must have information that relates to the role
of the nurse. Guideline is the most recent version or published
within the past five years. (It is true that guidelines are not
always updated within 5 years so you will need to discuss this.)
· Find a clinical “how-to” article, a nursing professional
practice website, a systematic literature review, a meta-analysis,
or a manufacturer’s website published within the past 5 years
that relates to your practice question.
· Hint: Did you notice that you will be finding a total of four
different sources of information for your PICO question? To
re-cap, these four sources are:
· Statistics you are reporting in paragraph one.
· Nursing quantitative research article for paragraphs 2, 3, 4,
and 5.
· Clinical Practice Guideline (paragraph 6)
· A source of your choosing (paragraph 7)
· Step Six: Write up your findings in APA format and submit
them to Blackboard by the due date and time listed in your
syllabus. Here’s how to write up your findings:
· Start with a UTA CONHI approved cover page.

· Paragraph #1: This is your opening paragraph. Start with an
introduction statement. What is your PICO question? Describe
why was it important (share the dollars, morbidity / mortality,
statistics, safety stats you found with citation)?
· Paragraph #2: What did your nursing quantitative research
article add to your knowledge on this topic? Share at least three
facts (two must be from the Results or Discussion sections) that
you found within the article in this paragraph that is relevant to
your PICO question and your practice as a nurse.
· Paragraph #3: Define reliability as it is used in your textbook.
Critique the reliability of the nursing quantitative research
article you used. Go back to what you learned in your article
critique about measurement methods and data collection in
Module 3 to make sure you are being thorough in your
assessment. Use Table 10-1 in your textbook to identify the type
of reliability for your measurement instrument / tool. Be
specific, so that your instructor, if reading the article, can find
them too.
· Paragraph #4: Define validity as it is used in your textbook.
Critique the validity of the nursing quantitative research article
you used. Go back to what you learned in your article critique
about measurement methods, and data collection to make sure
you are being thorough in your assessment. Use Table 10-1 in
your textbook to identify the type of validity for your
measurement instrument / tool. Be specific, so that your
instructor, if reading the article, can find them too.
· Paragraph #5: Using the skills you have learned in your
critique of a research article, describe two strengths or two
weaknesses (or one strength and one weakness) that you found
as you read this article. Go back to what you learned in your
article critique about sampling methods, measurement methods
(ex. questionnaires), and data collection (how did they collect

the data to make sure you are being thorough in your
assessment. Be specific, so that your instructor, if reading the
article, can find them too. Do not re-state the limitations
provided by the authors of your study unless they have to do
with the study’s sampling, measurement methods, or data
collection. Do not discuss the descriptive or inferential
statistics used by the authors as a strength or weakness of the
study, as this is not related to with the study’s sampling,
measurement methods, or data collection.
· Paragraph #6: What is the name and website of the clinical
practice guideline that you found? Share at least three facts
that you found within the guideline that is relevant to the PICO
question and your practice as a BSN nurse and cite the guideline
appropriately.
· Paragraph #7: Identify the fourth resource you found (clinical
“how-to” article, a nursing professional practice website, a
systematic literature review, a meta-analysis, or a
manufacturer’s website) that relates to your practice question.
Share at least three facts that you found within this source that
is relevant to the PICO question and your practice as a nurse,
and cite appropriately.
· Paragraph #8 (and #9 if needed): re-state your PICO question
and briefly summarize what you have learned through your
search. What would you recommend, if anything, as a change in
practice for nurses? Why? Remember, this is your closing
paragraph(s).
· Note to students about writing up your findings:
· This is a formal APA paper. Look at the Rubric for more APA
information for this paper.
· Don’t forget to use your APA resources that were reviewed in
Module Two!

· Don’t forget to use the Module Four discussion board for
additional questions about your paper.
· Turn your paper (as a word document) and article (in pdf
format) that you used for paragraphs 2, 3, 4, & 5 in to the
assignment submission link in Module Four at the due date and
time listed in your syllabus.
· Possible points for this assignment: 100 points
Module 4: Evidence Based Practice Project: Finding the
Evidence
PAGE
©2017 UTA School of Nursing
Page 1 of 7
PICO(T) Worksheet
First, identify each element of your PICO on the line below,
then take a look at the templates below to help you formulate a
PICO(T) question.
P: Population/disease ( i.e. age, gender, ethnicity, with a certain
disorder)
P:
_____________________________________________________

_______________
I: Intervention or Variable of Interest (exposure to a disease,
risk behavior, prognostic factor) Note: Not every question will
have an intervention (as in a meaning question – see below).
I:
_____________________________________________________
_______________
C: Comparison: (could be a placebo or "business as usual" as in
no disease, absence of risk factor). Note: This is not used in a
meaning question – see below.
C:
_____________________________________________________
_______________
O: Outcome: (risk of disease, accuracy of a diagnosis, rate of
occurrence of adverse outcome)
O:
_____________________________________________________
_______________
T: Time: The time it takes to demonstrate an outcome (e.g. the
time it takes for the intervention to achieve an outcome or how
long participants are observed). This is an optional “add-on” for
a PICO question.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
For PICO questions about a nursing intervention/therapy:
In _______(P), what is the effect of _______(I) on ______(O)
compared with _______(C) within ________ (T)?
For PICO etiology questions:
Are ____ (P) who have _______ (I) at ___

(increased/decreased) risk for/of_______ (O) compared with
______ (P) with/without ______ (C) over _____ (T)?
For PICO questions involving prevention:
For ________ (P) does the use of ______ (I) reduce the future
risk of ________ (O) compared with _________ (C)?
For PICO questions that predict:
Does __________ (I) influence ________ (O) in patients who
have _______ (P) over ______ (T)?
For PICO questions that want to know more about the meaning
of…..
How do ________ (P) diagnosed with _______ (I) perceive
______ (O) during _____ (T)?
Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-
based practice in nursing & healthcare. New York: Lippincott
Williams & Wilkins.
HEALTH POLICY AND SYSTEMS
Factors That Influence the Development of Compassion Fatigue,
Burnout, and Compassion Satisfaction in Emergency
Department
Nurses
Stacie Hunsaker, MSN, CPEN, CEN1, Hsiu-Chin Chen, PhD,
RN, EdD2, Dale Maughan, PhD, RN3,
& Sondra Heaston, MS, NP-C, CEN, CNE4
1 Iota Iota, Assistant Teaching Professor, Brigham Young
University College of Nursing, Provo, UT, USA

2 Professor, Department of Nursing, Utah Valley University,
Orem, UT, USA
3 Chair, Department of Nursing, Utah Valley University, Orem,
UT, USA
4 Iota Iota, Associate Teaching Professor, Brigham Young
University College of Nursing, Provo, UT, USA
Key words
Compassion fatigue, compassion satisfaction,
burnout, emergency nurses
Correspondence
Ms. Stacie Hunsaker, Assistant Teaching
Professor, Brigham Young University College
of Nursing, Provo, UT 84602. E-mail:
[email protected]
Accepted: October 20, 2014
doi: 10.1111/jnu.12122
Abstract
Purpose: The purpose of this study was twofold: (a) to
determine the preva-
lence of compassion satisfaction, compassion fatigue, and
burnout in emer-
gency department nurses throughout the United States and (b) to
examine
which demographic and work-related components affect the
development

of compassion satisfaction, compassion fatigue, and burnout in
this nursing
specialty.
Design and Methods: This was a nonexperimental, descriptive,
and pre-
dictive study using a self-administered survey. Survey packets
including a
demographic questionnaire and the Professional Quality of Life
Scale version
5 (ProQOL 5) were mailed to 1,000 selected emergency nurses
throughout
the United States. The ProQOL 5 scale was used to measure the
prevalence of
compassion satisfaction, compassion fatigue, and burnout
among emergency
department nurses. Multiple regression using stepwise solution
was employed
to determine which variables of demographics and work-related
characteris-
tics predicted the prevalence of compassion satisfaction,
compassion fatigue,
and burnout. The α level was set at .05 for statistical
significance.
Findings: The results revealed overall low to average levels of
compassion
fatigue and burnout and generally average to high levels of
compassion satis-
faction among this group of emergency department nurses. The
low level of
manager support was a significant predictor of higher levels of
burnout and
compassion fatigue among emergency department nurses, while
a high level
of manager support contributed to a higher level of compassion
satisfaction.
Conclusions: The results may serve to help distinguish elements

in emer-
gency department nurses’ work and life that are related to
compassion satis-
faction and may identify factors associated with higher levels of
compassion
fatigue and burnout.
Clinical Relevance: Improving recognition and awareness of
compassion
satisfaction, compassion fatigue, and burnout among emergency
department
nurses may prevent emotional exhaustion and help identify
interventions that
will help nurses remain empathetic and compassionate
professionals.
The profession of emergency nursing is physically and
emotionally demanding. Complex patient loads, long
shifts, demanding physicians, a fast-paced environ-
ment, and working in an emotionally and physically
challenging area can cause stress for emergency de-
partment (ED) nurses (Healy & Tyrrell, 2011; Hooper,
Craig, Janvrin, Wetsel, & Reimels, 2010; Von Rueden
et al., 2010). Compassion fatigue (CF) and burnout are
186 Journal of Nursing Scholarship, 2015; 47:2, 186–194.
C⃝ 2015 Sigma Theta Tau International
Hunsaker et al. Compassion Fatigue, Satisfaction, and Burnout
conditions that can become overwhelming burdens on
nurses and can cause physical, mental, and emotional
health difficulties (Potter, 2006). CF is a negative conse-
quence of working with traumatized individuals (Figley,

1995). Moreover, CF has been described as emotional,
physical, and spiritual exhaustion from witnessing and
absorbing the problems and suffering of others (Peery,
2010; Sabo, 2011). Equally as troubling is burnout,
which differs from CF in that it is associated with feelings
of hopelessness and apathy and creates an inability to
perform one’s job duties effectively (Stamm, 2010).
Burnout manifests similarly to CF, but is not typically
linked to empathy. Instead, it is a gradual worsening
of feelings of frustration with career responsibilities
(Maslach, Jackson, & Leiter, 1996). Both CF and burnout
may cause a nurse to become ineffective, depressed,
apathetic, and detached (Boyle, 2011). Long-term results
of both CF and burnout include low morale in the
workplace, absenteeism, nurse turnover, and apathy
(Jones & Gates, 2007; Portnoy, 2011). All of these
consequences have a negative impact on patient care.
Moreover, high levels of nurse burnout are linked to
patient dissatisfaction (Vahey, Aiken, Sloane, Clarke, &
Vargas, 2004). Consequently, it is imperative that CF and
burnout be recognized and addressed. By studying the
impact of CF and burnout on ED nurses, researchers may
bring to the attention of managers, healthcare leaders,
and nurses themselves the reality of this phenomenon
and aid in the comprehension of its negative influence.
Additionally, the complexity of patient care is climbing,
resources are decreasing, and insurance reimbursement
is being linked to patient satisfaction (Medicare, 2013).
It is more important now, perhaps more than at any
other time in health care, to understand the prevalence
and predictors of CF and burnout, but also compassion
satisfaction (CS), in ED nurses. By understanding factors
that influence both positive and negative aspects of
nurses’ work, perhaps levels of awareness will be raised
and nurses may maintain caring relationships and posi-

tive attitudes. Moreover, few studies were conducted to
explore factors that influence the prevalence of CF and
burnout on ED nurses (Dominguez-Gomez & Rutledge,
2009; Hooper et al., 2010). Thus, the purpose of this
study was to determine the prevalence of CS, CF, and
burnout in ED nurses throughout the United States
and to determine which demographic and work-related
components affect the development of CS, CF, and
burnout in this nursing specialty.
Based on the purpose of the study, the research ques-
tions were: (a) What is the prevalence of CS, CF, and
burnout among ED nurses? (b) What demographic char-
acteristics such as age and gender are associated with the
prevalence of CS, CF, and burnout among ED nurses?
(c) What work-related characteristics such as educational
level, years in nursing, shift length, years worked in the
ED, hours worked per week, and having adequate man-
ager support are significantly associated with the preva-
lence of CS, CF, and burnout among ED nurses? And
(d) To what extent do the variables of demographics
and work-related characteristics predict the prevalence
of developing CS, CF, and burnout among ED nurses,
respectively?
Literature Review
The term compassion fatigue was first introduced by
Joinson in 1992. She described CF as nurses losing their
ability to nurture. CF has been defined as the negative
consequences of working with a significant number of
traumatized individuals in combination with a strong,
personal, empathic orientation. Figley (1995), a noted
early researcher on CF, commented that those who are
in a caring profession have an enormous capacity for

feeling and expressing empathy and tend to be more at
risk for CF. Humans, by nature, are wired for empathy,
and therefore, caregiving can take a toll both emotionally
and physically (Flarity, 2011).The stress resulting from
helping a traumatized or suffering person may result in
CF, which develops as a self-protection measure (Figley,
1995).
While CF is caused by empathy, burnout is associ-
ated with environmental factors such as high patient
acuity, overcrowding, and problems with administration
(Flarity, Gentry, & Mesnikoff, 2013). Burnout is a con-
dition often associated with feelings of hopelessness and
inability to perform job duties effectively (Stamm, 2010).
Burnout and CF are often linked and closely mimic
one another. CF is often described as a type of burnout
(Portnoy, 2011). A principal difference between burnout
and CF is that burnout typically exhibits a gradual
onset while CF may occur suddenly. Although measur-
ing negative aspects of a nurse’s job is important, it is
equally valuable to determine what makes a nurse feel
happy. CS is the positive aspect of helping others. It is the
satisfaction achieved with one’s work by helping others
and being able to do one’s job well (Stamm, 2010). Many
nurses chose their profession specifically to help others.
CF and burnout may have severe professional conse-
quences in addition to affecting a nurse’s personal well-
being. CF and burnout affect nurse retention, patient
safety, and patient satisfaction (Burtson & Stichler, 2010;
Potter et al., 2010). Hospitals are expected not only to
provide positive outcomes for patients, but make them
happy while providing quality care. A relatively new per-
formance measure for hospitals is patient satisfaction.
Journal of Nursing Scholarship, 2015; 47:2, 186–194. 187

Compassion Fatigue, Satisfaction, and Burnout Hunsaker et al.
Since 2007, the passage of health reform legislation has
increased focus on the importance of the patient experi-
ence (McHugh, Kutney-Lee, Cimiotti, Sloane, & Aiken,
2011). Therefore, Medicare reimbursements to hospitals
are now partially based on patient satisfaction measure-
ments. Thirty percent of the incentive payments provided
by Medicare to hospitals is based on approval scores of
satisfaction (Medicare, 2013).
Nurses who are experiencing CF and burnout are too
exhausted to provide levels of care that help patients
feel satisfied (Boyle, 2011; McHugh et al., 2011). As
aforementioned, CS is the positive aspect of helping oth-
ers (Stamm, 2010). Many nurses choose this profession
because they experience fulfillment in helping others.
Thus, understanding the factors that contribute to CF
and burnout may help ED nurses maintain their ability
to experience work fulfillment and contribute to patient
satisfaction.
Empirical Studies Related to the Study Problem
The need to identify the level of CF in ED nurses
was clear throughout the literature review. The conclu-
sions in most research reviewed portrayed high levels
of CF in healthcare workers and indicated the need for
further research regarding CF and burnout among ED
nurses. To the researchers’ knowledge, there have been
only two quantitative studies precisely targeting CF in
ED nurses (Dominguez-Gomez & Rutledge, 2009; Hooper

et al., 2010). Both studies had a limitation of a small sam-
ple size and studied CF in ED nurses in two specific ge-
ographical locations: a hospital in the Southeast United
States, and three hospitals in California, respectively.
Hooper et al. (2010) compared levels of CS, CF, and
burnout among ED, intensive care unit, oncology, and
nephrology nurses. The Professional Quality of Life
(ProQOL) scale was used to examine a difference in
the level of CF and burnout in nurses working in these
different specialty units. Although this exploratory,
cross-sectional study did not show a significantly statis-
tical difference in CF levels of the nurses among those
specialty units, it did attest that ED nurses were at risk for
less CS compared to the other types of nurses. This study
also revealed a greater risk for burnout in ED nurses and
a greater risk for CF in oncology nurses.
Dominguez-Gomez and Rutledge’s (2009) study fo-
cused on measuring the level of CF in ED nurses us-
ing the Secondary Traumatic Stress tool. It was the first
quantitative exploration of CF in ED nurses. The find-
ings of the study demonstrated high levels of CF among
the ED nurse respondents. High levels of CF in nurses
may affect patient care and contribute to burnout. The
study suggested further research aims at increasing the
awareness of this phenomenon, as well as a recommen-
dation for managers and organizations to be more aware
of the problems of CF and burnout and to support nurses,
and, when appropriate, urge them to seek counseling
(Dominguez-Gomez & Rutledge, 2009).
Understandably, EDs are often considered to be a
stressful work environment. Multiple studies have re-
vealed that workplace violence, death or resuscitations of

patients, caring for trauma victims, and stressful events
that occur frequently in this setting contribute to in-
creased stress in ED workers (Healy & Tyrrell, 2011; Von
Rueden et al., 2010). ED nurses must deal with unpre-
dictable events, which may include death, violence, and
overcrowding. However, little evidence has emerged to
identify factors that are associated with ED nurses’ de-
mographics and work-related characteristics contributing
to their CF, CS, and burnout levels. Identifying factors
that may predict CF and burnout, as well as recognizing
factors that improve satisfaction at work, may be useful
in retaining ED nurses and developing strategies to sup-
port them to provide excellent care without compromis-
ing their own health and happiness.
Conceptual Framework
A number of theoretical frameworks were applied to
guide studies related to CS, CF, and burnout, such as
Maslow’s theory of hierarchy of needs and Watson’s the-
ory of human caring (Burtson & Stichler, 2010). A most
significant theoretical model developed by Figley (2002)
was the stress-process framework. This model was de-
veloped based on factors that contribute to CF. Figley
discovered that CF develops as a result of a caregiver’s
exposure to his or her patients’ experiences joined with
his or her natural empathy. Later on, Stamm (2010) ap-
plied the CS-CF model to the development of the Pro-
QOL scale. The CS-CF model illustrates a theoretical path
analysis of positive outcomes (CS) and negative outcomes
(CF) of helping those who have experienced traumatic
stress.
Based on Stamm’s (2010) theoretical path analysis di-
agram, a conceptual framework related to CS, CF, and
burnout among ED nurses was developed to guide this

study. The researchers believe that individual and orga-
nizational characteristics may contribute to and have an
influence on the development of CS, CF, and burnout.
Several variables were identified according to literature
reviews. The demographic independent variables were
age and gender. The work-related independent variables
were level of education, years in profession, hours of
work per week, length of shift, years as an ED nurse, and
manager support. The dependent variables included CS,
CF, and burnout.
Methods
Sample and Population
This cross-sectional study used a nonexperimental,
descriptive, and predictive design. The target population
for this study was registered nurses (RNs) who worked in
EDs throughout the United States. The inclusion criteria
for participation were: (a) work at least 8 hr per week in
the ED, (b) interact directly with ED patients at least 8 hr
per week, and (c) have at least 1 year of experience in the
ED. The rationale for including a minimum of at least 1
year of experience in the ED and working at least 8 hr per
week was the consideration of having experience and ex-
posure frequently enough to traumatic events that con-
tribute to the development of CF and burnout. According
to a list of ED nurse members with mailing addresses
throughout the United States provided by the Emergency

Nurses Association (ENA), a purposive sampling was
used to recruit the total 1,000 ED nurses in this study.
Data Collection Procedure
Approval from the institutional review board of the
university was obtained prior to any data collection.
The survey packet, including a letter of explanation, an
informed consent letter, a copy of the demographic ques-
tionnaire, and a copy of the ProQOL version 5 (ProQOL
5) scale, was mailed to each potential participant. The
participants returned the surveys to the researchers in
a provided self-addressed stamped envelope. In order
to maximize the response rate, two follow-up postcard
reminders were sent to all 1,000 potential participants
at 2-week and 6-week intervals, respectively, from
the original survey mailing date. The researchers took
every precaution possible to protect the anonymity and
privacy of the individuals. The survey was answered
anonymously and kept confidential in reporting the
results of the study by removing identifying information.
To protect confidentiality, all data were numerically
coded and accessible only by the researchers.
Instrumentation
The survey used in this study included the ProQOL 5
scale and a set of demographic questions developed by
the researchers. The demographic questions included in-
formation about the ED nurses’ education level, years
in nursing profession, typical shift length, age, etc. The
ProQOL is a 30-item self-report survey that includes
three subscales: CS, CF, and burnout (Figley & Stamm,
1996). Testing for convergent and discriminant validity
have demonstrated that each scale measures different
constructs (Stamm, 2010). Each subscale is distinct, and

the results of each subscale cannot be combined to give
a single significant score. Stamm (2010) reported psy-
chometric properties with an α reliability ranging from
.84 to .90 on the three subscales. The interscale correla-
tions showed 2% shared variance (r = −.23; co-σ = 5%;
N = 1,187) with CF and 5% shared variance (r = −0.14;
co-σ = 2%; N = 1,187) with burnout. Each subscale has
10 question items and uses a 5-point Likert scale scoring
from 1 = never to 5 = very often (Stamm, 2010). Stamm
(2010) has previously established the construct validity
and reliability of the ProQOL. The scores of the ProQOL
for each subscale were totaled using Stamm’s validated
levels: a CS score of 22 or less denotes low levels of CS, a
score of 23–41 indicates average levels, and 42 and above
suggests high levels of CS. For CF and burnout, a score
of 22 or less indicates low levels, 23–41 indicates average
levels, and a score of 42 and higher reveals high levels of
CF and burnout.
The ProQOL tool was first developed in 1995 and has
been used, revised, and updated over time. The ProQOL
5 was used to examine the prevalence of CS, CF, and
burnout among ED nurses in this study. Cronbach’s α co-
efficients of internal consistency reliability of the ProQOL
5 for this study were .96 for the total scale, .92 for the CS
subscale, .79 for the CF subscale, and .82 for the burnout
subscale.
Data Analysis
All of the data were entered into and analyzed by the
Statistical Package for the Social Science (SPSS) for Win-
dows, version 21.0 (SPSS Inc., Chicago, IL, USA). Item
means, standard deviations, medians, and percentages of
the descriptive statistics were computed for the level of

CS, CF, and burnout. A series of Pearson r correlation,
t test, and one-way analysis of variance (ANOVA) were
used to examine the associations between demograph-
ics, work-related characteristics, and the level of CS, CF,
and burnout. The α level was set at .05 for statistical
significance.
Multiple regression was employed to determine which
variables of demographics and work-related character-
istics contributed to the variation of the level of CS,
CF, and burnout. Using seven selected independent
variables to run a multiple regression, this study needed
a minimum sample size of 153 subjects to achieve 95%
power and a medium effect size (.15) at α = .05.
Results
Demographic Characteristics
Of the 1,000 surveys mailed to ED nurses nation-
wide, 284 were returned, representing a 28% response
rate. Because six participants worked fewer than 8 hr
per week, their results were removed from data analysis,
leaving the total sample number at 278. The participants
of the study were primarily women (n = 243, 87.4%),
White (n = 248, 89.2%), and married (n = 190, 68.3%).
The mean age was 44 years (SD = 11.47; range = 24–74
years). Years working as a nurse ranged from 1 to 48 (M =

17.58; SD = 12.67). The mean length of years working in
the ED was 13.01 (SD = 9.89; range = 1–40). The partici-
pants’ educational background varied from diploma (n =
86, 30.9%) to MSN/doctoral degree (n = 55, 19.8%),
with the largest number holding a bachelor’s degree
(n = 137, 49.3%). Most of the participants worked
12-hr shifts (n = 213, 77.2%).
Prevalence of CS, CF, and Burnout
Research question 1 was “What is the prevalence of CS,
CF, and burnout among ED nurses?” Descriptive statistics
were used to calculate means, standard deviations, and
percentages for CS, CF, and burnout. The mean scores for
the level of CS, CF, and burnout among ED nurses were
39.77 (SD = 6.32), 21.57 (SD = 5.44), and 23.66 (SD =
5.87), respectively. According to Stamm’s (2010) inter-
pretation, 56.8% of the ED nurses fell into the average
level of CS (score of 23–41), 65.9% of the ED nurses were
in the low level of CF (score of 22 or less), and 54.1% of
the ED nurses were in the average level of burnout (score
of 23–41).
Associations Between Demographics, CS, CF,
and Burnout
Research question 2 was “What demographic charac-
teristics such as age and gender are associated with the
prevalence of CS, CF, and burnout among ED nurses?”
The Pearson r correlation and t test were used to ex-
amine the prevalence of CS, CF, and burnout related to
the demographic variables of age and gender. The results
showed that the older the nurse was at the time of taking
the survey, the higher the level of CS (r = .260, p = .001).
The younger the nurse was at the time of taking the sur-

vey, the higher the burnout score (r = −.191, p = .002)
and the CF score (r = −.134, p = .027). While compar-
ing the difference in the level of CS, CF, and burnout be-
tween male and female nurses, no statistical significance
was found.
Associations Between Work-Related
Characteristics, CS, CF, and Burnout
The Pearson r correlation, t test, and one-way ANOVA
were used to answer research question 3, “What
work-related characteristics such as educational level,
years in nursing, shift length, years worked in the ED,
hours worked per week, and having adequate manager
support are significantly associated with the prevalence
of CS, CF, and burnout among ED nurses?” Scheffe post-
hoc comparisons were used to compare if significant dif-
ferences were found in the groups. It was discovered that
the CS level among nurses who held graduate and doctor-
ate degrees was higher than among nurses with diploma
or ADN and BSN degrees (F = 5.48, p = .005). More-
over, those who had master’s or doctorate degrees had
significantly lower burnout levels than did nurses who
held the other degrees (F = 4.92, p = .008). No signifi-
cant differences in CF between educational backgrounds
were identified in this study.
The relationship between years as a nurse, years as
a nurse working in the ED, average hours worked per
week, and level of CS, CF, and burnout was computed us-
ing Pearson’s bivariate correlations, respectively. The re-
sult indicated that the more years a nurse has practiced,
the higher the level of CS (r = .269, p = .001) and the
lower the level of burnout (r = −.182, p = .003). There

was no statistically significant relationship between years
that a nurse has practiced and CF level. Additionally, the
more years that nurses worked in the ED, the higher the
level of CS (r = .264, p = .001) and the lower the level
of burnout (r = −.183, p = .003) they had. There was no
significant relationship between years a nurse worked in
the ED and level of CF. Also, no significant relationships
between average hours that ED nurses worked per week
and level of CS, CF, and burnout were identified.
While comparing the difference in the level of CS, CF,
and burnout between length of shifts and the support of
managers, respectively, t tests were computed to find that
nurses who worked 8- to 10-hr shifts had a higher level
of CS (t = 2.47, p = .014) and a lower level of burnout
(t = −3.34, p = .001) than did nurses who worked
12-hr and “other” shifts, respectively. No significant dif-
ference in CF was found between nurses who worked 8-
to 10-hr shifts and those who worked 12-hr and other
shifts. Regarding the support received from the manager,
nurses who perceived receiving support from the man-
ager had a higher level of CS (t = 3.99, p = .001) and a
lower level of CF (t = −2.89, p = .005) and burnout (t =
−5.64, p = .001).
Factors for Predicting the Level of CS, CF, and
Burnout
In order to identify which significant variables
of demographics and work-related characteristics
can predict the level of CS, CF, and burnout, multiple
regression was employed for research question 4. Seven
significant variables of demographics and work-related

Table 1. Summary of Multiple Regression for Predicting the
Compassion Satisfaction, Compassion Fatigue, and Burnout in
Emergency Department
nurses (N =237)
Dependent variable/ Adjusted R Standardized
Blocka variable entered R2 square change F coefficient β t
Compassion satisfaction
1 Age .040 .044 .239 3.90∗ ∗
2 Manager support .122 .085 17.36∗ ∗ .292 4.77∗ ∗
Compassion fatigue
1 Age .006 .011 −.126 −1.96
2 Manager support .055 .053 7.76∗ ∗ −.230 −3.59∗ ∗
Burnout
1 Age .013 .017 −.166 −2.74∗
2 Manager support .148 .138 21.26∗ ∗ −.373 −6.15∗ ∗
a Stepwise solution was used.
∗
p< .05; ∗ ∗ p < .01.

characteristics identified from research questions 2 and
3 were entered into the regression equation using the
stepwise solution. As shown in Table 1, age (β = .239,
p < .01) and manager support (β = .292, p < .01) signif-
icantly and positively predicted the level of CS, whereas
only manager support (β = −.230, p < .01) significantly
and negatively predicted the level of CF. In addition, age
(β = −.166, p < .05) and manager support (β = −.373,
p < .01) significantly and negatively predicted the level
of burnout. Apparently, manager support was the major
predictor contributing to the level of CS (8.5%, adjusted
R2 = .122, F = 17.36, p < .01), CF (5.3%, adjusted R2 =
.055, F = 7.76, p < .01), and burnout (13.8%, adjusted
R2 = .148, F = 21.26, p < .01).
Discussion
Level of CS, CF, and Burnout
In this study, the results indicated a low to average
level of CF and burnout among ED nurses, which is
not consistent with the results of the two previous stud-
ies (Dominguez-Gomez & Rutledge, 2009; Hooper et al.,
2010) related to ED nurses who perceived significantly
higher levels of these two negative aspects. Due to this
study’s participants being members of the ED professional
organization, perhaps they were more involved and in-
vested in their careers than the non-ENA counterparts.
Compassion satisfaction occurs when the care provider
feels a sense of connection with his or her patients and
feels a sense of achievement in his or her work (Stamm
et al., 2010). The positive aspect of caring for others and
providing support for those in need may outweigh the
difficulties of the job. Although the CS level among ED
nurses was average in this study, the possible reason

might be that this group’s nurses were more senior and
encompassed a more confident outlook of CS toward the
positive aspects of nursing. Low levels of CS are a known
factor in nursing turnover in the ED (Sawatzky & Enns,
2012). Not only should the nursing profession pursue
the likely causes of CF, but it must further investigate the
factors that contribute to CS in ED nurses.
Demographic-Related Characteristics and CS,
CF, and Burnout
CF is less prevalent with increasing age and working
experience (Hill & Stephens, 2003). Correspondingly, this
current study demonstrated that older nurses had higher
CS scores, as well as lower CF and burnout levels. Specific
challenges are present for new, younger nurses. Not only
are they inexperienced and challenged to learn new in-
formation daily, but they must also maintain their stride
in a busy work environment where speed and skill are
critical. The ED leadership and experienced senior nurses
must provide a supportive and collaborative environment
for newer nurses. Perhaps a formal mentoring program
would be helpful to pair a new ED nurse with a more
established nurse.
Work-Related Characteristics and CS, CF, and
Burnout
Crucial factors that surfaced in this study as significant
elements in ED nurses who exhibited higher CS levels
and lower burnout levels included increased years in the
profession, more years in the ED, a higher level of edu-
cational background, shorter shift length, and adequate

manager support at work. The above-mentioned findings
are consistent with previous research in which the influ-
ence of a positive work environment and more working
experience leads to more satisfied nurses (Friedrich,
Prasun, Henderson, & Taft, 2011; Hoar, 2011; Li, Early,
Mahrer, Klaristenfeld, & Gold, 2014; Torangeau, Cum-
mings, Cranley, Ferron, & Harvey, 2010). The more
attentive and involved ED managers are, the higher
the CS scores of their nurses. Healthy, happy work
environments that include manager support, shared
decision making, and recognizing nurses’ contributions
to practice are precisely associated with increased nurse
retention, reduced staff turnover, and increased job
satisfaction (American Organization of Nurse Executives,
2003; Leiter & Laschinger, 2006).
Factors for Predicting the Level of CS, CF, and
Burnout
This study identified specific demographic and work-
related characteristics that influence a nurse’s level of
happiness and satisfaction, as well as CF and burnout at
work. A critical modifiable feature related to predict the
level of CS, CF, and burnout was manager support. While
influences such as age are not changeable, the nursing
leaders might acknowledge that younger nurses may be
at risk for developing burnout and CF at work.

A key concern is that EDs are becoming increasingly
busier and more stressful. Between 1997 and 2007, total
annual visits to U.S. EDs increased from an estimated 94.9
million to an estimated 116.8 million (Tang, Stein, Hsia,
Maselli, & Gonzales, 2010). According to the Agency for
Healthcare Research and Quality, ED visits in the United
States are outpacing the growth of the general popula-
tion. In 2011, there were more than 131 million total ED
visits in the United States (Weiss, Wier, Stocks, & Blan-
chard, 2014). Certainly, these statistics are going to make
an ED nurse’s job more challenging. The prevalence of
CF and burnout will most likely continue to grow unless
further strategies and solutions are made available to de-
crease the severity. Compassion fatigue and burnout may
have severe professional consequences, such as affecting
the ability to care for others (Boyle, 2011; Sabo, 2011;
Wisniewski, 2011) and affecting nurse retention, patient
safety, and patient satisfaction (Burtson & Stichler, 2010;
Hooper et al., 2010; Potter et al., 2010).
A positive, supportive manager is more likely to have
nurses who have high levels of CS, as well as lower
levels of burnout. Nurse leaders must become cognizant
of nurses who are at higher risk for CF and burnout
and have a positive relationship with them in order
to appropriately counsel and communicate with them.
These leaders are crucial in the successful development
of strong, positive, professional practice environments
(Laposa, Alden, & Fullerton, 2003). By building a sup-
portive environment, perhaps the early recognition of
CF and burnout in ED nurses and providing adequate
manager support may aid in the retention of knowledge-
able, caring, experienced nurses.

Limitations and Recommendations
One limitation of this study was a small sample size
with a low response rate. To reach more subjects, a
mailed survey was utilized. However, out of 1,000 sur-
veys mailed to ENA members, only 284 were returned.
A disadvantage of a mailed survey is that prospective
subjects may not feel the topic is pertinent to them and
they may not participate. Another shortcoming of send-
ing the survey to ENA members is that the results may
not be generalizable to all ED nurses. Not all ED nurses
belong to this professional organization; involvement and
membership is voluntary. A second limitation is that the
prevalence of CS, CF, and burnout was measured at a
single point in time, and it is possible that an individ-
ual’s assessment of his or her perceptions changes over
time due to individual work-related conditions (Stamm,
2010). Moreover, ED nurses’ perceptions of CS, CF,
and burnout are subjective, and their perceptions may
be affected by variables that were not examined in
this study.
Further research could lead to the development of pro-
grams that help ED nurses manage the strain of caring for
difficult patients. Additional exploration may be directed
toward examining coping strategies that may prevent the
development of CF and burnout. Future research con-
centrating on a more detailed view of the finding that
older and more experienced nurses had higher levels of
CS would be very beneficial for the nursing profession. It
may be possible that more experienced nurses could be
the key in assisting newer, younger nurses to find strate-
gies that can improve their quality of life at work and
perhaps prevent burnout and CF.
Conclusions

Overall results of this study revealed average to low
levels of CF and burnout and average to high levels of CS
among this group of ED nurses. Demographic and work-
related characteristics, such as age, educational back-
ground, and years as a nurse, influenced the prevalence
of CS, CF, and burnout among ED nurses. A key predic-
tor, manager support, predicted the CS, CF, and burnout
in this study. An increased awareness of CF and burnout
may aid in improved ED nurse job satisfaction, and there-
fore, increased quality patient care. It is imperative that
the nursing profession address support, strategies, and so-
lutions that may facilitate a higher level of work satisfac-
tion among ED nurses.
Clinical Resources
Professional quality of life information, including
compassion fatigue/burnout;
Professional Quality of Life Scale self-test: www.
proqol.org
Information for caregivers: www.compassion-
fatigue.org
Information and articles for post-traumatic
stress syndrome survivors and their caregivers:
www.giftfromwithin.org
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Stock Epinephrine 1
Running head: STOCK EPINEPHRINE AUTO-INJECTORS IN
SCHOOLS
Stock Epinephrine Auto-Injectors in Schools
Fantastic RN-BSN Student
The University of Texas Arlington
College of Nursing and Health Innovation
In partial fulfillment of the requirements of
N4325 Nursing Research
Regina Urban, MSN, RN-BC, CCRN

February 13, 2015
2
STOCK EPINEPHRINE AUTO-INJECTORS IN SCHOOLS
Stock Epinephrine Auto-Injectors in Schools
With the increasing rise in food allergies that can be
potentially life threatening, it is
becoming extremely important that schools be prepared to
handle such emergency situations.
Among school age children, 1 in 25 students has a food allergy
and 30-50% of those allergies
will induce an anaphylaxis emergency (Zacharski, DeSisto,
Pontius, Sheets, & Richesin, 2012).
What is scary is that these are statistics of children with known
food allergies. However, it is
estimated that 25% of students that have an anaphylactic
reaction had previously no known
allergies (Zacharski et al., 2012). In dealing with anaphylactic
emergencies, it is the schools
responsibility to plan and be prepared to handle situations. The
school nurse takes the lead in
managing student’ s health needs, educating school staff, and
providing a safe learning

environment for students (Zacharski et al., 2012). So, does the
presence of stock epinephrine
auto injectors in schools reduce the complications school age
students experience in the event of
an anaphylactic emergency?
In a research study, California school nurses were surveyed to
determine “ experience
with life-threatening anaphylaxis, implementation of allowable
stock epinephrine auto-injector
programs, and barriers to program implementation” (Morris,
Baker, Belot, & Edwards, 2011, pp.
471-472). Some interesting facts that the article presented
included that 73% of the school
nurses reported that they had student with known allergies in
their schools with 52% of those
nurses having students that can self-carry their epinephrine
auto-injectors (Morris et al., 2011).
Additionally, 30% of the school nurses surveyed had at one time
used another student’ s
prescribed rescue medication for the use on another student
during an emergency (Morris et al.,
2011). Lastly, 72% of the school nurses reported that there
were students in their schools that

had known allergies or previous use of epinephrine who had
parents that did not supply the
3
school with the proper medication to treat their child’ s allergic
reaction (Morris et al., 2011).
Epinephrine auto-injects if stocked in schools could allow
school nurses to use them in case a
student happened not to be carrying theirs or if a student with
an unknown allergy had a reaction
and especially if parents did not provide proper medication in
case of a reaction. In all of these
situations the school nurse’ s immediate recognition and
administration of epinephrine could
prevent deaths or serious injury to students (Morris et al.,
2011).
Reliability deals with the consistency in measurement methods
within a study (Grove,
Gray, & Burns, 2015). In critiquing the reliability of the Morris
et al. (2011) article, they used a
41 question survey that looked at the “ attitude, knowledge, and
preparation of schools for
anaphylaxis” (Morris et al., 2011, p. 473). The survey was

developed specifically by these
authors so that their research questions could be answered. The
pilot study was done to ensure
the ease of administering the survey and found no difficulties
(Morris et al., 2011). “ Cronbach’ s
alpha was .93 indicating strong internal reliability” (Morris et
al., 2011, p. 473). The surveys
were collected anonymously in two ways either online through
email or in person at the 2007
CSNO state conference both using OnSurvey (Morris et al.,
2011). So the Morris et al. (2011)
article was reliable in both its data collection and measurement
methods.
Validity deals with determining “ how well the instrument
reflects the abstract concept
being examined” (Grove et al., 2015, p. 290). In critiquing the
validity of the Morris et al,
(2011) article, a cross-sectional, descriptive design was used to
conduct their study. The study
looked to “ examine existing trends of care, highlights areas of
concern, and identifies topics what
would benefit from further study” as it related to the care and
treatment of anaphylaxis (Morris,
et al., 2011, p. 472). For the 41 question survey the authors

created, they had a panel of experts
4
review each question to determine content validity (Morris et
al., 2011). So the Morris et al.
(2011) showed validity in its research design and measurement
methods.
In looking at the Morris et al. (2011) article there were
weaknesses and strengths that
stood out in their study. A weakness within the study was the
authors conducted their study
using a convenience sample of only California certified school
nurses (Morris et al., 2011). In
using the convenience sampling method to obtain their
population, it limits the author’ s ability to
control for biases (Grove et al., 2015). A strength within the
study was the authors ability to
create a survey that had a Cronbach’ s alpha of .93, especially
since this was the first time this
survey had been used in a study besides their pilot study
(Morris et al., 2011). Having a
Cronbach’ s alpha so close to 1.0 means there was strong
internal consistency and less random

error among their survey meaning it would have strong
reliability (Grove et al., 2015).
In the Voluntary Guidelines for Managing Food Allergies in
Schools and Early Care and
Education Centers on the Center for Disease Control website it
emphasized the importance of
the school nurse being able to recognize how children might
describe their symptoms if they are
having an allergic reaction. Children might say things itch, feel
funny, there are bugs crawling in
their mouth or ears, or even that is in the back of their throat (“
Centers for Disease Control and
Prevention” , 2013). Having the school nurse be able to
identify symptoms alone is not enough
having access in schools to the recommended treatment for
anaphylaxis (which is epinephrine)
can help to increase a student’ s ability to survive an allergic
reaction and recover quickly
(“ Centers for Disease Control and Prevention” , 2013). The
school nurse needs to be able to
identify students with allergies and create emergency actions
plans for them, provide training for
school personal, make sure epinephrine auto-injectors are easily
accessible in case of emergency,

5
and create an environment that is safe for all students (“ Centers
for Disease Control and
Prevention” , 2013).
As food allergies are on the rise among children, being
prepared to handle emergencies in
schools is becoming increasingly important. It is estimated that
it could cost a school $100 to
stock two epinephrine auto-injectors yearly as they would need
to be replaced due to expiration
if not used (Gregory, 2012). School nurses and school staff
should not hesitate to administer
epinephrine because of its side effects or liability if something
goes wrong. “ Epinephrine’ s side
effects such as anxiety and palpitation, are not harmful for the
average, healthy child” (Gregory,
2012, p.224). As long as a school nurse or staff member is
acting in good faith when
administering the epinephrine auto-injector they should not be
held liable for civil damages
(Gregory, 2012). Lastly, the article stressed “ stock epinephrine

laws nationwide will enable
school nurses to treat anaphylactic emergencies promptly, and
could potentially save lives”
(Gregory, 2012, p.225). So with the presence of stock
epinephrine auto injectors in schools the
complications during an anaphylactic emergency could be
prevented.
In conclusion, does the presence of stock epinephrine auto
injectors in schools reduce the
complications school age students experience in the event of an
anaphylactic emergency? With
proper training of school nurses/staff and stocking of
epinephrine auto-injectors in schools,
allergic reaction emergencies students experience at school can
be treated immediately and
potentially save lives (Gregory, 2012). A recommendation that
could be made for school nurses
would be the ability to receive more specialized training in
recognizing and treating anaphylactic
reactions in the school setting. This would be beneficial to
school nurses because early
recognition and treatment of anaphylactic reactions can help
prevent deaths (Morris et al., 2011).

6
References
Centers for Disease Control and Prevention. (2013). Voluntary
Guidelines for Managing Food
Allergies in Schools and Early Care and Education Programs.
Retrieved from
http://www.cdc.gov/HealthyYouth/foodallergies/pdf/13_243135
_A_Food_Allergy
_Web_508.pdf
Gregory, N. (2012). The case for stock epinephrine in schools.
NASN School Nurse, 27(4), 222-
225. doi: 10.1177/1942602X12449057
Grove, S.K., Gray, J.R., & Burns, N. (2015). Understanding
nursing research: Building an
evidence-based practice (6th ed.). St. Louis, MO: Elsevier
Saunders.
Morris, P., Baker, D., Belot, C., & Edwards, A. (2011).
Preparedness for students and staff with
anaphylaxis. Journal of School Health, 81(8), 471-476.
Retrieved http://onlinelibrary

.wiley.com/journal/10.1111/(ISSN)1746-1561
Zacharski, S., DeSisto, M., Pontius, D., Sheets, J., & Richesin,
C. (2012). Allergy/Anaphylaxis
Management in the School Setting. National Association of
School Nurses. Retrieved
from
http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports
/NASNPosition
StatementsFullView/tabid/462/ArticleId/9/Allergy-Anaphylaxis-
Management-in-the-
School-Setting-Revised-June-2012
Philosophy of Education
First published Mon Jun 2, 2008; substantive revision Thu Aug
15, 2013
All human societies, past and present, have had a vested interest
in education; and some wits have claimed that teaching (at its
best an educational activity) is the second oldest profession.
While not all societies channel sufficient resources into support
for educational activities and institutions, all at the very least
acknowledge their centrality—and for good reasons. For one
thing, it is obvious that children are born illiterate and
innumerate, and ignorant of the norms and cultural
achievements of the community or society into which they have
been thrust; but with the help of professional teachers and the
dedicated amateurs in their families and immediate environs
(and with the aid, too, of educational resources made available
through the media and nowadays the internet), within a few
years they can read, write, calculate, and act (at least often) in

culturally-appropriate ways. Some learn these skills with more
facility than others, and so education also serves as a social-
sorting mechanism and undoubtedly has enormous impact on the
economic fate of the individual. Put more abstractly, at its best
education equips individuals with the skills and substantive
knowledge that allows them to define and to pursue their own
goals, and also allows them to participate in the life of their
community as full-fledged, autonomous citizens.
But this is to cast matters in very individualistic terms, and it is
fruitful also to take a societal perspective, where the picture
changes somewhat. It emerges that in pluralistic societies such
as the Western democracies there are some groups that do not
wholeheartedly support the development of autonomous
individuals, for such folk can weaken a group from within by
thinking for themselves and challenging communal norms and
beliefs; from the point of view of groups whose survival is thus
threatened, formal, state-provided education is not necessarily a
good thing. But in other ways even these groups depend for
their continuing survival on educational processes, as do the
larger societies and nation-states of which they are part; for as
John Dewey put it in the opening chapter of his classic work
Democracy and Education (1916), in its broadest sense
education is the means of the “social continuity of life” (Dewey
1916, 3). Dewey pointed out that the “primary ineluctable facts
of the birth and death of each one of the constituent members in
a social group” make education a necessity, for despite this
biological inevitability “the life of the group goes on” (Dewey,
3). The great social importance of education is underscored,
too, by the fact that when a society is shaken by a crisis, this
often is taken as a sign of educational breakdown; education,
and educators, become scapegoats.
It is not surprising that such an important social domain has
attracted the attention of philosophers for thousands of years,
especially as there are complex issues aplenty that have great

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