The families in these focus groups used the elders' life stories to frame their decisions for care. Providers working in primary care settings who work with families in making care decisions for cognitively impaired elderly patients may find narrative ethics more pertinent than principle-based ethics in understanding families' perspectives and priorities, while also recognizing their decision-making transition from using the principle of autonomy to that of beneficence.

Used as a reflective practicum, contextual learning can be a model of clinical learning in nursing education that develops the contextual, reflective nature of critical thinking.

Rural respondents tended to express confidence in natural forces; death was seen as neutral or beneficent. Resistance to the approach of death was more characteristic of urban respondents, some of whom insisted upon aggressive medical care in advanced dementia.

The RPI stimulated double loop learning that changed paediatric critical care nurses' attitudes about family, enhanced their communication and ability to build trusting relationships with families and brought about a new appreciation of the uniqueness of family stress. There was a new integration of family care into the nurses' practice as a result of the intervention.

Nursing educators need to continue to explore ways that new pedagogies such as narrative pedagogy and reflective practice inform and extend students' thinking in classroom and clinical situations. The goal of instruction becomes creating an opportunity for learning that integrates content knowledge with knowledge of the context. Educational methodologies that incorporate the use of context in a reflective, dialogical approach over time hold much promise in developing a dynamic process of thinking in practice. Contextual learning is a reflective learning intervention that offers new possibilities for nurse educators to prepare nurses to think critically in practice. In this expository paper the design and instructional methodology of contextual learning is discussed, beginning with a brief overview of the nature of critical thinking and the use of narrative as major underpinnings in the development of this intervention. Examples of how the intervention was implemented with novice nurses in practice is provided. Finally, reflections on how the intervention could be refined for nursing students is offered.

Specific techniques of role modelling and reflective practice are suggested as effective approaches to teach family sensitive care in clinical settings where families are part of the care environment.

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Although many women suffer from fecal incontinence (FI), little is known about their day-to-day experiences. The aims of this phenomenological study were to understand the experience of women living with FI from their perspective and to elicit women's self-care and management strategies for FI. Ten women participated in audiotaped, unstructured interviews that were transcribed into a written text. The text was analyzed using Van Manen's approach for deriving themes. The findings display the women's experience of lived time, lived space, lived relationships, and lived body and the essential theme of "controlling the body out of control." The findings demonstrate that FI is a problem that affects women in all dimensions of their lifeworld experience and describes the continual attention and self-management FI requires.