Defining soft skills in nursing:a concept analysis

Objective:To define soft skills in nursing.Methods:This is a concept analysis using the Walker and Avant approach.Multiple electronic databases in the English language including CINAHL,Science Direct,MEDLINE on EBSCOhost,and Scopus were consulted.Results:Soft skills in nursing include the intrapersonal attributes,interpersonal skills,and creativity of the nurse,which,when combined with professionalism,teamwork,and effective communication skills,improve the quality of nursing care and client satisfaction.Conclusions:Although hard and soft skills are compatible and synergetic,soft skills are to be prioritized for the success of nursing care in the healthcare industry.This concept analysis adds to the body of knowledge by identifying the attributes of soft skills in nursing and revealing that a good nurse needs more than just good grades to be successful.

Research on the Role of Guiding Students to Participate in Skills Competitions on the Development of Young Teachers in Vocational Colleges

This paper explores the role of guiding students to participate in skills competitions on the development of young teachers in vocational colleges.We investigate the impact of skills competitions on the consolidation of professional knowledge,development of innovation capabilities,improvement of hands-on abilities,and enhancement of communication skills with students.The results of this research demonstrate that skills competitions have a positive influence on the professional growth of young teachers.The consolidation of professional knowledge,development of innovation capabilities,improvement of hands-on abilities,and enhancement of communication skills collectively contribute to the effectiveness of young teachers in vocational colleges.It is recommended that vocational colleges prioritize and support the participation of young teachers in skills competitions to foster their professional development.

Analysis of Young Learners’Listening Skills

The importance of listening as one of the communication skills cannot be overstated.However,in many areas,listening is neglected.For young learners,learning to listen is even more beneficial for their future studies,therefore,listening skills should be given due importance.

Adolescent suicide risk factors and the integration of socialemotional skills in school-based prevention programs

Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.

Effect of health education based on information-motivationbehavioral skills model on patients with unilateral vestibular dysfunction

BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown.The study uses the information-motivation-behavioral skills(IMB)model for health education,effectively improve the quality of life,increase their self-confidence,reduce anxiety and depression,and effectively improve the psychological state of patients.AIM To explore the effect of health education based on the IMB model on the degree of vertigo,disability,anxiety and depression in patients with unilateral vestibular hypofunction.METHODS The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects,and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods.Among them,the control group was given routine nursing health education and guidance,and the observation group was given health education and guidance based on the IMB model.The changes in self-efficacy,anxiety and depression,and quality of life of patients with unilateral VH were compared between the two groups.RESULTS There was no significant difference in General Self-Efficacy Scale(GSES)scale scores between the two groups of patients before nursing(P>0.05),which was comparable;after nursing,the GSES scale scores of the two groups were higher than those before nursing.The nursing group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of Hospital Anxiety and Depression Scale(HADS)and anxiety and depression subscales between the two groups before nursing(P>0.05).After nursing,the HADS score,anxiety,and depression subscale scores of the two groups of patients were lower than those before nursing,and the nursing group was lower than the control group,and the difference was statistically significant(P<0.05).After nursing,the Dizziness Handicap Inventory(DHI)scale and DHI-P,DHI-E and DHI-F scores in the two groups were decreased,and the scores in the nursing group were lower than those in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Health education based on the IMB model can effectively improve patients'quality of life,increase self-efficacy of patients with unilateral vestibular hypofunction,enhance patients'confidence,enable patients to resume normal work and life as soon as possible,reduce patients'anxiety and depression,and effectively improve patients'psychological status.

The Forecast Skills and Predictability Sources of Marine Heatwaves in the NUIST-CFS1.0 Hindcasts

Using monthly observations and ensemble hindcasts of the Nanjing University of Information Science and Technology Climate Forecast System(NUIST-CFS1.0) for the period 1983–2020, this study investigates the forecast skill of marine heatwaves(MHWs) over the globe and the predictability sources of the MHWs over the tropical oceans. The MHW forecasts are demonstrated to be skillful on seasonal-annual time scales, particularly in tropical oceans. The forecast skill of the MHWs over the tropical Pacific Ocean(TPO) remains high at lead times of 1–24 months, indicating a forecast better than random chance for up to two years. The forecast skill is subject to the spring predictability barrier of El Nino-Southern Oscillation(ENSO). The forecast skills for the MHWs over the tropical Indian Ocean(TIO), tropical Atlantic Ocean(TAO), and tropical Northwest Pacific(NWP) are lower than that in the TPO. A reliable forecast at lead times of up to two years is shown over the TIO, while a shorter reliable forecast window(less than 17 months) occurs for the TAO and NWP.Additionally, the forecast skills for the TIO, TAO, and NWP are seasonally dependent. Higher skills for the TIO and TAO appear in boreal spring, while a greater skill for the NWP emerges in late summer-early autumn. Further analyses suggest that ENSO serves as a critical source of predictability for MHWs over the TIO and TAO in spring and MHWs over the NWP in summer.

Performance in the Fundamentals of Laparoscopic Surgery: Does it reflect global rating scales in the Objective Structured Assessment of Technical Skills in porcine laparoscopic surgery?

Objective:To correlate the utility of the Fundamentals of Laparoscopic Surgery(FLS)manual skills program with the Objective Structured Assessment of Technical Skills(OSATS)global rating scale in evaluating operative performance.Methods:The Asian Urological Surgery Training and Educational Group(AUSTEG)Laparoscopic Upper Tract Surgery Course implemented and validated the FLS program for its usage in laparoscopic surgical training.Delegates’basic laparoscopic skills were assessed using three different training models(peg transfer,precision cutting,and intra-corporeal suturing).They also performed live porcine laparoscopic surgery at the same workshop.Live surgery skills were assessed by blinded faculty using the OSATS rating scale.Results:From March 2016 to March 2019,a total of 81 certified urologists participated in the course,with a median of 5 years of post-residency experience.Although differences in task time did not reach statistical significance,those with more surgical experience were visibly faster at completing the peg transfer and intra-corporeal suturing FLS tasks.However,they took longer to complete the precision cutting task than participants with less experience.Overall OSATS scores correlated weakly with all three FLS tasks(peg transfer time:r=0.331,r^(2)=0.110;precision cutting time:r=0.240,r^(2)=0.058;suturing with intracorporeal knot time:r=0.451,r^(2)=0.203).Conclusion:FLS task parameters did not correlate strongly with OSATS globing rating scale performance.Although FLS task models demonstrated strong validity,it is important to assimilate the inconsistencies when benchmarking technical proficiency against real-life operative competence,as evaluated by FLS and OSATS,respectively.

Improved Scatter Search Algorithm for Multi-skilled Personnel Scheduling of Ship Block Painting

This paper focuses on the optimization method for multi-skilled painting personnel scheduling.The budget working time analysis is carried out considering the influence of operating area,difficulty of spraying area,multi-skilled workers,and worker’s efficiency,then a mathematical model is established to minimize the completion time. The constraints of task priority,paint preparation,pump management,and neighbor avoidance in the ship block painting production are considered. Based on this model,an improved scatter search(ISS)algorithm is designed,and the hybrid approximate dynamic programming(ADP)algorithm is used to improve search efficiency. In addition,the two solution combination methods of path-relinking and task sequence combination are used to enhance the search breadth and depth. The numerical experimental results show that ISS has a significant advantage in solving efficiency compared with the solver in small scale instances;Compared with the scatter search algorithm and genetic algorithm,ISS can stably improve the solution quality. Verified by the production example,ISS effectively shortens the total completion time of the production,which is suitable for scheduling problems in the actual painting production of the shipyard.

The Influence of Preschool Teachers’Social Skills on Job Burnout:A Moderated Mediation Model

Background:Teacher burnout is a serious issue in the field of education,particularly in early childhood education,where teachers face high levels of work stress and emotional labor,leading to emotional exhaustion and job burnout.However,past research has not sufficiently explored the mechanisms of social skills,empathy,and mindfulness in mitigating teacher burnout.Therefore,this study aims to investigate the relationship between preschool teachers’social skills,empathy,and mindfulness with job burnout,in order to provide theoretical basis and practical guidance for reducing teacher burnout.Methods:This research utilized a convenience sampling approach to target preschool teachers for a questionnaire survey.A total of 1109 questionnaires were collected.To ensure the quality of the data,we excluded questionnaires that were not carefully filled out in terms of lie scale questions,those with abnormal demographic variables,and outliers identified based on response time.Ultimately,901 valid questionnaires were obtained,achieving a valid response rate of 81.2%.Participants’levels of social skills,empathy,mindfulness,and job burnout were assessed using the Social Skills Scale(SKS),Empathy Scale(Measure of Empathy,ME),Mindful Attention Awareness Scale(MAAS),and the Maslach Burnout Inventory-Educators Survey(MBI-ES),respectively.Data analysis was conducted using SPSS.Results:After controlling for gender,age,teaching experience,educational level,grade taught,and location of the kindergarten,the study found:(1)There is a negative correlation between preschool teachers’social skills and the level of job burnout(r=−0.238);(2)Empathy has a dual-track effect on job burnout,where cognitive empathy negatively affects job burnout(r=−0.245),while emotional empathy has a positive effect(r=0.045);(3)Cognitive empathy partially mediates the relationship between social skills and job burnout(β=−0.124);(4)Mindfulness significantly impacts social skills,cognitive empathy,and job burnout(r=0.278;r=0.286;r=−0.539),and plays a moderating role in the mediation model(β=0.003;β=−0.023).Conclusion:These findings provide theoretical support for the development of burnout prevention and intervention strategies targeted at preschool teachers.They also point out new directions for future research and potential intervention targets,suggesting that enhancing preschool teachers’social skills and cognitive empathy,as well as increasing their mindfulness level,can help them cope with work-related stress and emotional labor,thereby alleviating job burnout.

Effect of information-motivation-behavioral skills model based perioperative nursing on pain in patients with gallstones

BACKGROUND The incidence of cholecystolithiasis is on the rise.Use of information,motivation,and behavioral skills can play a positive role in promoting changes in individual health behaviors.However,reports on the effects of information-motivationbehavioral(IMB)skills model based high-quality nursing as a perioperative nursing intervention for patients with gallstones are nonexistent.AIM To explore the application of IMB skills model based high-quality nursing in patients with gallstones.METHODS Two hundred and sixteen patients with cholecystolithiasis treated at our hospital from January 2022 to January 2023 were enrolled and divided into a control,highquality,and combined nursing groups,with 72 patients in each group.The control,high-quality,and combination groups received conventional,high-quality,and IMB skills model based perioperative nursing services,respectively.Differences in clinical indicators,stress levels,degree of pain,emotional state,and quality of life were observed,and complications and nursing satisfaction among the three groups were evaluated.RESULTS After nursing,the time to recovery of gastrointestinal function in the high-quality and combined nursing groups was significantly shorter than that of the control group,with the recovery of gastrointestinal function being the fastest in the combined nursing group(P<0.05).After nursing intervention,cortisol and norepinephrine levels in the high-quality and combined nursing groups were closer to normal than those of the control group 24 h after surgery,with the combined nursing group having the closest to normal levels(P<0.05).After 3 and 7 d of intervention,the patients’pain significantly improved,which was more prominent in the highquality and combination groups.Meanwhile,the pain score in the combination group was significantly lower than those of the control and high-quality nursing groups(P<0.05).After nursing intervention,the emotional states of all patients improved,and the scores of patients in the combination group were significantly lower than those of the control and high-quality nursing groups.The quality of life of patients in the high-quality and combined nursing groups significantly improved after nursing intervention compared to that of the control group,with the combined nursing group having the highest quality of life score.After intervention,the incidence of complications in the high-quality and combination groups was significantly lower than that of the control group(P<0.05),but the difference between the combination and high-quality nursing groups was not significant.Nursing satisfaction of patients in the high-quality and combination groups was significantly higher than that of the control group,with the nursing satisfaction being the highest in the combination group(P<0.05).CONCLUSION IMB skills model based nursing can improve surgical stress levels,degrees of pain,emotional state,quality of life,and nursing satisfaction of patients with gallstones and reduce the incidence of complications.

Analysis of the Digital Skill Gap of Agricultural Extension Personnel in South-East, Nigeria

The study analysed the digital skill gap of agricultural extension personnel on the use of digital technologies for extension services delivery in South-East, Nigeria. The specific objectives were to describe the socioeconomic characteristics of agricultural extension personnel in South-East Nigeria and identify the digital skill gaps among agricultural extension personnel in the area of study. Purposive sampling technique was used to select 364 Agricultural Extension personnel for the study. Data were collected through the use of structured questionnaire and were analysed using simple descriptive statistical tools such as percentages, mean score, and standard deviation. Findings indicated that most of the personnel were male (57.8%), within the age bracket of 38 - 47 years (62.9%), had B.Sc./HND as their highest educational qualification (74.7%), married (86.3%), and had a household size of 6 - 10 Persons (57.7%). It was further revealed that the majority (70.1%) were members of professional organization, earned a monthly income of N50,001.00 - N100,000.00 (65.7%), had a work experience of 11 - 15 years (51.1%), and owned a smartphone/ iPad/laptop (91.5%). Findings further indicated that they had moderate skill gap in Basic Computer skills (Mean = 4.32), and digital communication and collaboration skills (Mean = 4.26). Findings also showed that they had a high skill gap in digital technical skills (Mean = 2.46), digital data analysis skills (Mean = 2.09), digital content creation skills (Mean = 2.43), digital ethical skills (Mean = 2.79), multimedia production skills (Mean = 2.81), and video library management skills (Mean = 2.39). The study concluded that though there exists a high digital skill gap among agricultural extension personnel in South-East, Nigeria, their socioeconomic characteristics are capable of supporting the implementation of digital extension services in the area. The study recommended that the management of Agricultural Development Programs in South-East, Nigeria, should provide digital training for extension personnel to close the digital skill gap that currently exists among the personnel.

Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Assessing the Levels of Clinical Reasoning Skills Using Self-Assessment of Clinical Reflection and Reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.

逆向设计下的Integrated skills板块教学探索

译林版高中英语教材中的Integrated skills板块,注重听、读、说、写能力的综合训练和应用,鼓励学生在真实情境中运用语言,全面培养学生的语言运用能力。逆向设计理念强调从目标出发,反向规划教学过程。基于逆向设计理念的高中英语Integrated skills板块教学,首先确定教学目标,明确学习结果;接着细化学习任务,确定评估证据;最后关注关键要素,安排教学活动。

单元整体教学视角下的Integrated skills板块教学

Integrated skills板块起到承上启下的作用,板块编排以活动为导向,要求学生在运用听、看等理解性技能的基础上,向说和写的表达性技能过渡,最终实现听、说、读、看、写语言技能的融合发展,承担着培养学生跨文化交际能力的重要任务。在单元整体教学视角下进行Integrated skills板块教学,应基于单元教学目标,确定板块教学目标;围绕单元主题语境,设计多层次学习活动;聚焦板块内部的整体性,实现语言技能的融合。

Integrated skills板块写作教学策略——基于对教材编排的分析

Integrated skills板块以活动为主导,将语言输入与输出有机融合。通过对教材编排的分析,发现Integrated skills板块的写作任务指向解决问题,且联系生活实际。基于此,Integrated skills板块的写作教学应以解决问题为目标,以生活实际为抓手,对教材提供的话题与写作任务进行整合。

Integrated skills板块教学设计

课堂是教学的主阵地。优秀的教学设计能为教师提供经验与启示,帮助教师提高教学质量。为此,2024年,本刊开设专栏《典型课例》。在该栏目中,我们以“教学设计+点评”的形式,呈现一线教师学习、理解新课标,深化素养导向的课堂教学改革和育人方式转变的实践与思考。我们主要呈现在省级、市级课堂教学评比中获奖的教学设计,希望通过这些典型课例,引领教师关注教学细节,激发教学灵感,在实践中探索、总结和创新,不断提升教学质量。

Improvement in Patient Mobility Following Short-Term Rehabilitation in Skilled Nursing Facilities

Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.

Improvement of Activities of Daily Living (ADL) for Patients Treated in Skilled Nursing Facilities (SNFs)

Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.