Entry requirements in nursing: Results from a national survey of nurse academics on entry requirements in Australian bachelor of nursing programs

Nurse academics' self-reported insights into the teaching of undergraduate nursing numeracy: A national cross-sectional study

AIMS

The aim of this research was to explore the teaching of undergraduate nursing numeracy in tertiary education settings in Australia. Specifically, it explored and identified: (1) the most common basic numeracy concepts taught, (2) additional training and resources to support numeracy teaching, (3) who is best placed to teach numeracy and (4) the preferred methods of teaching medication calculations.

BACKGROUND

Nurse academics are required to teach nursing numeracy to undergraduate nursing students who enter university unprepared to accurately calculate medication dosages. It is important that students understand numeracy concepts as this is then applied to contextualised clinical applications. Nurse academics teach basic numeracy; however, the literature reveals that nurse academics do not consider themselves mathematics teachers and that experts in this area are better suited to teaching this skill. There are a dearth of studies about the nurse academics who conduct the teaching and this study seeks to fill that gap by exploring firsthand the nurse academics' self-reported insights into the teaching of undergraduate nursing numeracy.

DESIGN

Cross-sectional survey. The setting was Australian universities that deliver an accredited undergraduate nursing degree.

METHODS

Purposive sampling was used to recruit Australian nurse academics (n = 170), sessional or permanent who currently teach all aspects of nursing numeracy and medication calculations to undergraduate nursing students. Data were collected between Nov 2023 - Feb 2024 using an online survey platform and analysed using a descriptive content analysis.

RESULTS

Nurse academics taught basic arithmetic most commonly (92 %), yet most (90 %) had not received professional development or additional training in how to teach these concepts. To assist with numeracy teaching, resources were requested (47 %) as were the need for mathematics learning support staff (82 %). The formula method was most commonly taught (91 %), however, most participants (94 %) were willing to learn and to teach other methods of calculating medications.

CONCLUSIONS

This research suggests an evidenced-based education framework be created to support and guide nurse academics when teaching all aspects of nursing numeracy and medication calculations. Building the teaching capacity of nurse academics in this vital area will enhance student competence and contribute to patient safety.

Numeracy Teaching for Undergraduate Nursing Students: A Scoping Review

BACKGROUND

Education providers teach numeracy to undergraduate nursing students using a diverse range of approaches. Proficiency in numeracy skills is critical for patient safety; however, alarmingly, the accuracy rate of calculations by both undergraduate nurses and RNs is reported to be low.

METHOD

The literature search yielded 1,180 articles published between 1994 and 2022. The assessment of the studies was reported using the PRIMSA extension for Scoping Reviews.

RESULTS

Thirty-nine articles were included in the review. A diverse range of approaches were used to teach numeracy including learning theory, methods of calculation, learning environment, and examination aids.

CONCLUSION

This review highlights the plethora of approaches for teaching numeracy within undergraduate nursing education. Internationally, there were limited studies on the most effective teaching approaches; therefore, developing a robust evidence-based numeracy framework would be beneficial to guide non-nursing instructors in teaching undergraduate nurses. [J Nurs Educ. 2024;63(4):218-227.].

Nurse education leaders' perspectives on the teaching of numeracy to undergraduate nursing students: A qualitative research study

AIM

The aim of this study was to explore the perspectives of nurse education leaders of Australian undergraduate nursing degrees on the teaching of nursing numeracy and how the Australian Nursing & Midwifery Accreditation Standards influence curriculum development.

BACKGROUND

Nurses' numeracy skills are reportedly deficient worldwide, posing a significant threat to patient safety. This is an issue for the education of undergraduate nurses and thus for the nursing profession. The international literature reveals a heterogeneous blend of learning approaches, but it is unclear which approaches are best suited to improve the numerical calculation ability of nurses. In the Australian context, there are no accreditation standards referring to numeracy, therefore, it is important to discover how nurse education leaders' design and implement the teaching of numeracy.

DESIGN

A qualitative approach using thematic analysis was employed. The setting was Australian universities that delivered an accredited undergraduate nursing degree leading to nursing registration.

METHODS

Purposive sampling was used to recruit 17 nurse education leaders of Australian undergraduate nursing degrees. Individual, semi-structured virtual interviews were conducted between November 2022 and January 2023. Interview data were analysed using Braun and Clarke's (2006) six phases of thematic analysis.

FINDINGS

Five themes emerged from the analysis: (i) indistinct accreditation standards, (ii) teaching basic maths for clinical applications, (iii) a range of bespoke teaching approaches (iv) we're nurses, not numeracy educators and (v) assumptions about an unprepared cohort.

CONCLUSION

The leaders of undergraduate nursing degrees assumed that nursing students would have proficiency in numeracy skills on entering university. However, this was not the case, hence numeracy was an essential skill that needed to be taught to the undergraduate nursing students. Lack of direction from the accreditation council led to the existence of various curricula and an array of approaches to teaching numeracy and medication calculations, which challenged nursing academics who did not consider themselves numeracy educators. This study makes a novel contribution to knowledge, teaching and practice in undergraduate nursing numeracy curricula.

Mathematics anxiety and associated interventions in nursing: A scoping review

BACKGROUND

Mathematics proficiency is a key element in accurate medication calculation and patient safety. Education providers play an important role in preparing students for safe medication administration. However, the presence of mathematics anxiety in students may impact on relevant mathematics mastery.

OBJECTIVES

To explore what is known and reported about mathematics anxiety in nursing and the nature of interventions developed.

DESIGN

A scoping review guided by the work of Arksey and O'Malley and Joanna Briggs Institute methodology.

DATA SOURCES

CINAHL, Medline, ERIC and Proquest Nursing and Allied Health.

REVIEW METHODS

Search included primary research published between 2000 and 2021 and in English language.

RESULTS

Ten studies were included in the final review, and numerous different tools used to measure mathematics anxiety. A number of factors were found to influence mathematics anxiety and various local interventions are reported. There is a lack of consistency in research reporting on mathematics anxiety, with most being single-site studies and small in scale.

CONCLUSIONS

Overall, despite its importance, there is scant research into mathematics anxiety in nursing. There is a need for a consistent, valid and reliable tool for its measurement, as well as validated interventions to address it. Furthermore, there is a deficit in research evaluating mathematics anxiety longitudinally across the duration of an education program. There is a need for nurse education providers to work to address these important gaps and establish entry-level benchmark requirements.

Nurse Education and Mathematical Competency: Implementation of an Online, Self-Directed, Prerequisite Model

Mathematical competency in the profession of nursing has increasingly become a central focus as more nursing students appear to struggle with basic concepts of arithmetic, mental estimation, and critical reasoning. This paper highlights how one School of Nursing in Ontario, Canada implemented a Dosage Calculation Competency Test model which involved an online, self-directed, prerequisite approach to improve student mathematical competency and confidence. The purpose of this research case study was to document, through shared participant perceptions, the creation, implementation, and subsequent modifications to a Dosage Calculation Competency Test model in light of student needs and advances in online learning and assessment. The research design combined a quantitative survey of Year 1-4 nursing students, followed by a series of qualitative, semi-structured interviews with nursing students and program instructors. The study took place within a School of Nursing undergraduate program in Ontario, Canada. Forty-four participants, including students from all four years of the nursing program, completed the survey, followed by individual interviews with nine students and six faculty instructors. Survey (the open-response items) and interview data were analyzed thematically using ATLAS.ti (ATLAS.ti, Berlin, Germany). The authors recount the new DCCT model's development, implementation, and subsequent modifications and further discuss student/instructor perceptions of learning types, math confidence, and competency. The paper concludes with a series of seven key recommendations for nursing programs.

The self-regulated learner, entry characteristics and academic performance of undergraduate nursing students transitioning to University

BACKGROUND

Although the importance of fostering students self-regulated learning is well known, little is known about the relationship between student entry characteristics, particularly students from disadvantaged backgrounds, self-regulatory strategy use and academic performance. The study aim was to examine undergraduate nursing students' entry characteristics, motivational behaviours and learning strategies, and academic performance after transitioning into the first unit of an undergraduate nursing course.

DESIGN

A cross-sectional survey.

SETTING

A university in Australia.

PARTICIPANTS

First-year undergraduate nursing students.

METHODS

The Motivational Strategies for Learning Questionnaire, including demographic information, was distributed to students in the fourth week of commencing University, consent was obtained for the use of student unit grades.

RESULTS

For the 448 eligible students, n = 282 (62.9%) completed the survey. Students were categorised by age into three groups: 18 years, 19-22 years, and 23+ years. Entry characteristics, motivation and learning strategies scores and academic performance were related to the age category with the greatest difference between 18 and 23+ student groups. 23 years+ had higher scores for 11 MSLQ scales (mean difference 0.78-0.31, p < 0.05) highest grades (F = 4.694, p = 0.010). Students 23+ years had the highest motivational behaviours and learning strategies. The international students' academic grades in this study were lower than the domestic student's grades (t = -2.212, p = 0.028).

CONCLUSION

This study highlights the need to address the tensions that exist between attracting quality students, the requirement to assess their quality efficiently and allowing students from disadvantaged groups the opportunity to enter nursing undergraduate degree courses. This study contributes new knowledge to the impact students' entry characteristics have on motivational behaviours, learning strategy use and academic performance. Knowing this would allow faculty to identify students at risk of failure early in the course and offer instructional support.

Personal qualities needed by undergraduate nursing students for a successful work integrated learning (WIL) experience

BACKGROUND

International research has shown that during work integrated learning (WIL) undergraduate nursing students may experience stress, self-doubt, and coping issues, however personal qualities these students bring to their WIL journey or those needed to succeed during WIL remain unknown.

OBJECTIVE

To describe the views of students midway through their Bachelor of Nursing program regarding personal qualities they bring to and need for WIL success.

DESIGN

This article reports on a descriptive study that used an electronic questionnaire to collect the data.

SETTINGS AND PARTICIPANTS

Bachelor of nursing students (n = 421), who were studying fulltime or part time equivalent, at a regional university in Queensland Australia, were invited to complete the anonymous electronic questionnaire that was developed by the research team following an extensive review of literature. Inclusion criteria required participants to have completed at least one WIL experience and be midway through their three-year Bachelor of Nursing program.

METHODS

Data were collected during January and February 2017. The electronic questionnaire consisted of demographic, forced choice questions, and open-ended questions. This paper presents the qualitative analysis of responses to two of the open-ended questions that focused on personal strengths and work integrated learning experiences. Data were analysed using the inductive content analysis approach.

RESULTS

Six personal qualities were identified including: enthusiasm to succeed, commitment to learning, self-motivation, confidence, effective communication skills, and compassion.

CONCLUSIONS

Pre-entry screening of applicants to bachelor level nursing programs and the delivery of learning opportunities that encourages both reflection and debriefing may assist in describing personal qualities needed to succeed in WIL.

Psychometric evaluation of the 11-item English language usage scale in commencing nursing students

BACKGROUND

Globalisation has increased the number of students from culturally and linguistically diverse backgrounds enrolling in nursing programs where English is the primary medium of instruction. These students may experience challenges with English language usage and need to be identified early to ensure academic success.

OBJECTIVE

To develop and test the psychometric properties of a self-report English language usage scale (ELUS-11).

METHODS

Prospective, correlational study of commencing nursing students enrolled in a communication unit at a university in the western Sydney region of Australia. English-language usage was measured using the ELUS-11, an 11-item self-report tool with a 5-point Likert scale response format. Factorial validity was examined using exploratory and confirmatory factor analysis and logistic regression was used to compute the predictive validity of the ELUS.

RESULTS

Of the 1723 students enrolled, 1100 (64%) returned surveys with all items of the ELUS-11 completed. The mean age of respondents was 25.4 years (SD: 8.0 years), 85% were female and 67% spoke a language other than English at home. Exploratory factor analysis yielded a one-factor structure that explained 65% of the variance, with factor loadings ranging from 0.72 to 0.86; and high internal consistency (α = 0.96). The ELUS-11 was able to discriminate among different groups of students based on age, domestic/international enrolment status and language spoken at home (all p < 0.001). Logistic regression revealed the ELUS-11 had good predictive validity, with those in the high ELUS-11 group over three times more likely to obtain a pass grade in their first written assessment (Adjusted odds ratio: 3.01, 95% CI: 2.05-4.43).

CONCLUSION

The ELUS-11 is a valid and reliable measure of English-language usage, and appropriate for use in an undergraduate nursing population to identify students at risk of poor academic performance.