B, Dow boldt and D, Tamlyn riority of experien tially based learning to didactic approaches, here was less emphasis on role playing, journal writing, and clinical experience. Self -directed activities were more commonly reported by nursing programs, especially in the United Kingdom, where they were used by all of the programs that responded Sixteen or more topics were reported as being addressed many of which were similar to those identified as being im por tant for health education studen ts in an american study by tandy and Sexton (1985). Despite recent criticisms of the Kubler-Ross stage model of grieving, her theoretical model was identified as being used by the majority of programs. Theory-based instruc tion was not strongly evident in U.K. medical programs. Some authors have indicated that health profession programs do not incorporate theory as a foundation for the design of death edu cation programs, and th is has been identified as a significant prob lem (Durlak Riesenberg, 1991) Evaluation of cognitive learning was generally achieved through tests, Papers, discussion of clinical practice, and case stud ies, Affective ch assessed through class discu ssions and observations in the clinical area. Only selected nursing programs attempted to measure changes in attitude toward death and dying or death anxiety The findings identified eight priority for futur lu m planning that provide direction for curriculum de velopment Affective issues such as attitudes to ward death and dying and death anxiety were seen as the greatest priority for nursing pro grams. Canadian nursing programs ranked as their second prior ity the provision of focused clinical experiences. This finding i consistent with the finding that a structured clinical experience with dying individuals and their family members was provided in few programs. The addition or refocusing of theoretical approaches was the third priority identified by Canadian nursing programs and the second priority for U. K nursing programs Medical programs gave limited responses to this question, mak ing it difficult to provide any meaningful interpretation of these data here are several conclusions that can be drawn from this sur- vey of Canadian and U.K. nursing and medical programs. Manyrio rity o f e x p e rie n tially bas e d le ar n in g to d id ac tic ap p ro ach e s, th e r e was le ss e m p h asis o n r o l e p la yin g , jo u r n al writin g , an d c lin ical e xp e rie n ce . Se lf-d ire cte d ac tivitie s we re m o re co m m o n ly r e p o rte d b y n u rsin g p r o g r am s, e sp e c ia ll y in th e Un it e d Kin g d o m , wh e r e th e y we r e u s e d b y al l o f th e p r o g r am s th a t re sp o n d e d . Six te e n o r m o re to p ic s we re r e p o rte d a s b e in g ad d re ss e d , m an y o f wh ich we r e sim ilar to th o se id e n tifie d as be in g im p o r￾tan t fo r h e alth e du catio n stu de n ts in an Am e rican stud y by Tan dy an d Se xto n ( 1985) . De sp ite re ce n t criticism s o f th e Ku ble r-Ro ss stag e m o d e l o f g rie vin g , h e r th e o re tic al m o d e l was id e n tifie d as b e in g u se d b y th e m ajo rity o f p ro g ram s. Th e o r y-b as e d in str u c - tio n was n o t stro n g ly e vid e n t in U.K. m e d ic a l p ro g r am s. So m e au th o rs h ave in d ic ate d th at h e alth p ro fe ssio n p r o g ram s d o n o t in co rp o rate th e o r y as a fo u n d atio n fo r th e d e sign o f d e ath e d u - cation pro gram s, an d th is h as be e n ide n ti® ed as a sign i® can t p rob￾le m ( Durlak & Rie se n be rg , 1991) . Eva lu a tio n o f c o g n itive le ar n in g was g e n e rally ach ie ve d th ro ugh te sts, p ap e rs, d iscussion of clin ical practice , an d case stud￾ie s. Affec tive ch an ge s we re asse sse d th ro ugh class d iscu ssio n s an d o bse r vatio n s in th e clin ical are a. On ly se le cte d n u rsin g p rog ram s atte m p te d to m e asure ch an g e s in attitu d e toward de ath an d d yin g o r d e ath an xie ty. Th e ® n d in g s id e n ti® e d e igh t prio rity are as for fu ture cu rricu￾lu m p lan n in g th at p rovide d ire ctio n fo r cu rriculu m d e ve lo pm en t. Af f e c tive issu e s su ch as attitu d e s to ward d e ath an d d yin g an d d e ath an xie ty we re se e n as th e g re ate st p rio rity fo r n u rsin g p ro - g ram s. Can ad ian n ursin g p ro g ram s ran k e d as th e ir se co n d p rio r￾ity th e p ro visio n o f f o cu s e d c lin ic al e x p e rie n c e s. Th is fin d in g is co n siste n t with th e fin d in g th at a stru ctu re d clin ical e x p e rie n c e with d yin g in d ividu als an d th e ir fam ily m e m be rs was p ro vide d in f ew p ro g ram s. Th e ad d itio n o r re f o cu sin g o f th e o re tic al app ro ach e s was th e th ird priority id e n ti® e d by Can ad ian n ursin g p r o g r am s an d th e se co n d p rio rity f o r U.K. n u rsin g p ro g ram s. Me d ic al p ro g ram s g ave lim ite d re sp o n se s to th is q u e stio n , m ak - in g it d ifficu lt to p ro vid e an y m e an in g fu l in te rp re tatio n o f th e se d ata.Th e re are seve ral con clusion s th at can be drawn fro m th is sur- ve y o f Can ad ian an d U.K. n u rsin g an d m e d ic al p ro g ram s. Man y 186 B . D o w n e-W am bold t a n d D . Ta m lyn