Role modeling in undergraduate nursing education: an integrative literature review

Contextual determinants impacting final year nursing students' emergency team communication during deteriorating patient simulations: A grounded theory study

BACKGROUND

Ability to focus on development of students' team communication and non-technical skills may be reduced in content saturated nursing curricula. Even when communication and simulation-based education is provided, students' utilisation of non-technical skills remains challenging. Although simulation is a recognised means to learn communication skills, little is known about nursing students' team communication in simulated settings.

OBJECTIVE

To understand the process by which final year undergraduate nursing students communicate in simulated team emergencies.

DESIGN

Using constructivist grounded theory, data was collected using semi-structured interviews and student observations and analysed using constant comparative analysis.

SETTING

Simulation laboratories in one university nursing school in Australia.

PARTICIPANTS

21 final year nursing students in seven teams.

METHODS

Data were gathered from interviews and video observations of final year nursing students during simulated team emergencies.

RESULTS

Interview data and observations of video-recordings revealed contextual determinants that influence communication within teams: the simulation context, the student context and the team context. Team member characteristics, such as cultural and linguistic background, life experiences, gender and age, the ability to shift from leadership to followership as well as environmental factors such as mask wearing and simulation fidelity, contributed to uncertainty in communicating that nursing team effectiveness.

CONCLUSIONS

Improvement of contextual conditions necessitates implementation of supportive strategies. These include development of educational initiatives, and further research in experiential learning as a modality for learners to experience team communication. Further, simulation context, student context and team context are important considerations. Meeting clinical communication learning needs of students allows better preparation to care for deteriorating patients as graduates.

Personality portraits, resilience, and professional identity among nursing students: a cross-sectional study

BACKGROUND

The lack of professional identity can impede the transition from nursing students to qualified nurses and exacerbate the shortage of health care professionals. Personality is important to resilience-building and professional identity development in nursing students. However, the associations among personality, resilience, and professional identity are less explored. The study aims to identify latent subtypes of personality, to evaluate the mediating role of resilience between personality and professional identity in nursing students, and to provide practical guidance for educators' subsequent interventions with nursing students' professional identity.

METHODS

1397 nursing students were recruited from Be Resilient to Nursing Career (BRNC) between October 2020 and April 2022 by cluster sampling from 4 universities in China. NEO Five-Factor Inventory, 10-item Connor-Davidson Resilience Scale, and Professional Identity Questionnaire for Undergraduate Students were administered. Analyses of latent profiles and mediations were performed.

RESULTS

Three latent personality types were identified: Over-sensitivity (35.4%), Ordinary (53.8%), and Flexibility (10.8%). Nursing role model was found to be a significant indicator of personality (Ordinary as ref, Over-sensitivity: OR = 0.73, 95% CI: 0.57-0.93, P = 0.010; Flexibility: OR = 1.85, 95% CI: 1.29-2.65, P = 0.001). The association between personality portraits and professional identity were significantly mediated by resilience (P < 0.05).

CONCLUSIONS

There exists heterogeneity in nursing students' personality. Resilience plays a significant role in mediating the relationship between personality and professional identity.

A nursing perspective on the antecedents and consequences of incivility in higher education: A scoping review

Background

Understanding antecedents and consequences of incivility across higher education is necessary to create and implement strategies that prevent and slow uncivil behaviors.

Purpose

To identify the nature, extent, and range of research related to antecedents and consequences of incivility in higher education.

Objectives

1) To identify disciplines and programs sampled in higher education incivility research, and 2) to compare antecedents and consequences examined in nursing education research with other disciplines and programs in higher education.

Design

A scoping review of the literature.

Data sources

Eight electronic databases searched in January 2023 including MEDLINE Ovid, CINAHL, ERIC, PsycINFO, Scopus, ProQuest Education Database, Education Research Complete, and ProQuest Dissertations and Theses Global.

Review methods

We included primary research articles examining antecedents or consequences of incivility in higher education. Two reviewers independently screened and determined inclusion of each study. Data extraction was completed. We employed a numerical descriptive summary to analyze the range of data and content analysis to categorize the antecedents and consequences of incivility in higher education.

Results

Database searches yielded 6678 unique articles. One hundred and nineteen studies published between 2003 and 2023 met the inclusion criteria, of which, 65 reported research in nursing education, and 54 in other programs and disciplines. A total of 91 antecedents and 50 consequences of incivility in higher education were reported. Stress (n = 12 nursing, n = 4 other programs), faculty incivility (n = 9 nursing, n = 5 other programs), and student incivility (n = 4 nursing, n = 5 other programs) were reported as antecedents of incivility in higher education. Physiological and psychological negative outcomes (n = 25 nursing, n = 12 other programs), stress (n = 6 nursing, n = 6 other programs), and faculty job satisfaction (n = 3 nursing, n = 2 other programs) were reported as consequences of incivility in higher education.

Conclusions

Supporting development of teaching practices and role modeling of civility by faculty is a crucial element to slowing the frequency of uncivil interactions between faculty and students. Specific strategies that target stress, such as, cognitive behavioral therapy, coping skills, and social support could mitigate incivility in higher education. Future research needs to examine the strength of the negative effects of incivility on physiological and psychological outcomes through advanced statistical methods, as well as the cumulative effects of uncivil behavior on these outcomes over time for both students and faculty. Application of advanced statistical methods can also support our understanding of sources of incivility as well as the accuracy of causal connections between its antecedents and consequences.

Role Modeling of Professional Behavior in Nursing Education During the COVID-19 Pandemic: A Mixed Method Study

This study aimed to examine professional behavior as role models in nursing education during the COVID-19 pandemic perceived by nursing students. This study applied a mixed-method design using a sequential explanatory approach. A total of 120 nursing students participated in the self-reported questionnaire, and 10 were involved in semistructured individual interviews. The Professional Nurse Educator Role-Model questionnaire developed by the authors was used to collect quantitative data, and four open-ended questions modified from a previous study as the guideline in qualitative data collection. Quantitative data were analyzed using descriptive quantitative analysis. Open-ended questions were analyzed using thematic analysis. Quantitatively, students reported that excellent professional behaviors as role models were prevalent in nursing education (Mean 3.61 out of 4). Four themes from qualitative findings were revealed to complement the quantitative data, including teaching by example, altruism, efficiently performing, and effective communication. In conclusion, nurses as educators and clinicians could be students' professional role models, particularly in clinical settings during the COVID-19 pandemic. It is essential for nurse educators and clinicians to actively create a culture of professional nursing care for self and others during the pandemic to be present in wholeness and provide holistic care.

Nursing students' experience of bullying and/or harassment during clinical placement

PROBLEM OR BACKGROUND

Bullying is a recognised problem in nursing. Nursing students are particularly vulnerable. Bullying and harassment of nursing students can be detrimental to both students and recipients of care.

AIM

This study aims to identify the incidence and nature of bullying and/or harassment experienced by nursing students in Sri Lanka.

METHODS

A cross-sectional survey consisting of eight demographic questions and 15 items specific to the experience of bullying and harassment was administered to nursing students online.

FINDINGS

A total of 656 students from 26 nursing education institutions in Sri Lanka participated. The majority were female with a mean age of 24.4 years. More than a quarter of respondents reported that they had experienced bullying and/or harassment while on clinical placement, with a further 16.7 % being unsure. Most bullying or harassment (55 %) occurred in hospitals with 29 % experienced in community settings. Registered nurses, including nurse managers and clinical facilitators were the most common perpetrators. Verbal abuse was the most frequent type of behaviour reported.

DISCUSSION

These findings support existing literature that indicates that bullying of nursing students is an international phenomenon. The context of this study provides clues as to how culture may influence the problem. There is a need to better understand bullying and harassment in the environments in which it occurs, in order to identify strategies that can bridge cultures and settings.

CONCLUSION

The incidence of bullying and harassment of nursing students in Sri Lanka is concerning. Further research is needed to identify and evaluate targeted strategies to help prevent negative outcomes in all nursing contexts.

Nursing students' movement toward becoming a professional caring nurse

BACKGROUND

Previous research mainly focuses on how to support nursing students in caring for the patient and on educators' views of students' development as professional caring nurses. Against this background, it is important to further investigate nursing students' perspectives on what it means to become a professional caring nurse.

RESEARCH AIM

This qualitative systematic review study aims to identify and synthesize nursing students' perceptions on the meaning of becoming a caring nurse.

RESEARCH DESIGN AND DATA SOURCES

Systematic data searches were conducted by using the electronic databases MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premiere (EBSCO), and Philosopher`s Index. In total, 13 studies met the inclusion and quality criteria. The articles were analyzed by a systematic review and a thematic synthesis according to Thomas and Harden.

ETHICAL CONSIDERATION

The study followed good ethical practice guidelines outlined in the Northern Nurses' Federation.

FINDINGS

The analysis resulted in eight descriptive themes and finally in three analytical themes: Becoming is to get in touch with one's inner ethic or ethos, Becoming is a movement between courage, understanding, and being touched, and Becoming is strengthened through caring role models and a learning culture.

CONCLUSIONS

Becoming a professional caring nurse is seen as an ongoing movement toward a deeper understanding of oneself and one's being and bearing. This movement is enabled when nursing students have a sense of self-awareness, courage to stand in their vulnerability, and reflect on their responsibility, caring attitude, and inner values and ethics. The force of becoming is that the attention is directed beyond self to care for and feel empathy for others in a caring manner. Becoming is released through a caring relationship, external confirmation, and good role models. A lack of external support in the movement can potentially prevent the students from becoming a professional caring nurse.

A Paradigm Shift for the Nursing Education Model: A Scoping Review

BACKGROUND

The Nursing Education Model (NEM) introduced a framework for education reform. This study examined the applications of NEM in education to determine whether modifications to NEM were warranted.

METHOD

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews process for scoping reviews was used. Online databases and searches identified peer-reviewed articles published from 2010-to June 2023, and 71 articles were identified that met the inclusion and exclusion criteria.

RESULTS

Six themes were derived from the findings: (1) learner-centered curricula; (2) instructional methods; (3) inclusive classrooms; (4) pedagogical creativity; (5) bridge theory-clinical divide; and (6) multiple units of analysis.

CONCLUSION

The findings support the application of the NEM to promote a paradigm shift in instructional content, methods, and evaluation of outcomes. Based on use of the model identified in the literature, future modifications to NEM may be indicated, based on continued evidence. [J Nurs Educ. 2024;63(3):141-147.].

Professional identity and preparedness for hospital practice among undergraduate nursing students: A cross-sectional study

BACKGROUND

Professional identity is a crucial characteristic that undergraduate nursing students must possess to ensure effective and safe clinical practice. It has been identified as a factor influencing nursing student retention and their intention to remain in the nursing profession. However, the influential factors that impact the development of professional identity among nursing students currently are not well known.

OBJECTIVES

To identify factors determining professional identity among undergraduate nursing students and to confirm the relationship between nursing students' professional identity and their preparedness for hospital practice.

DESIGN

A cross-sectional study.

SETTINGS

The largest public nursing college in Oman.

PARTICIPANTS

180 full-time undergraduate nursing students in their third and fourth years who had completed at least one clinical course.

METHODS

Students completed validated, self-administered paper questionnaires through convenience sampling, including professional identity and preparedness for hospital practice scales.

RESULTS

The mean total score for professional identity was 63.3 (SD = 10.5), indicating a moderate level of professional identity. The findings showed a low level of preparedness for hospital practice among nursing students, with, a mean total score of 165.8 out of 246 (SD = 30.4). We found a significant positive association between professional identity and preparedness for hospital practice (r = 0.43, p < 0.001), the number of clinical courses taken (r = 0.15, p = 0.041), enrolment in fourth-year clinical courses (H (4) = 19.9, p = 0.001), grade (H (3) = 7.8, p = 0.049) and the selection of nursing profession as the first choice (H (3) = 28.0, p = 0.05).

CONCLUSIONS

The study has implications for identifying students with lower readiness for hospital practice and providing them with the necessary training. Nursing educators should prioritize reinforcing professional identity among students who have chosen nursing as a secondary option or have a lower grade. This can be achieved by promoting a positive nursing image and fostering a supportive clinical learning environment.

Nursing students' processes of taking role models and being role models: A descriptive phenomenological study

BACKGROUND

Role models are frequently viewed as a means of motivating people to adopt new behaviors and inspiring them to establish ambitious targets. Role models play a significant role in the characters of individuals and can be effective in shaping their career choices, education, and identities. Within the nursing profession, role models are integral to nursing students' journey towards understanding the nursing role and professional responsibility. For this reason, it is very important for nursing students to identify role models that support the development of students growth and development.

OBJECTIVES

This study aimed to investigate the qualities of nurses who serve as role models for senior undergraduate nursing students in shaping their professional attitudes and behaviors, identify the motivations behind selecting these individuals as role models.

DESIGN

A descriptive phenomenological research method was used.

SETTINGS

The research was conducted at a state university nursing school.

PARTICIPANTS

The study was conducted with the participation of 16 senior nursing students.

METHODS

Data collected from one-on-one interviews. A thematic analysis was used to analyze the data.

RESULTS

Student nurses mostly took clinical nurses and lecturers as professional role models. They were most impressed by their role models' knowledge, strong communication skills, and respect for human beings. To imitate their role models, students were willing to work in the clinic to improve their communication and psychomotor abilities and engaged in research and inquiry in areas where they felt insufficient. However, they also reported that most clinical nurses were not positive role models. They avoided taking nurses as role models because they had low communication skills, did not guide the student, and did not value human beings.

CONCLUSIONS

The study's findings indicated that student nurses were primarily influenced by clinical nurses and viewed them as both positive and negative role models, and they aspired to emulate the qualities of the nurses they considered positive role models while actively avoiding behaviors and traits associated with those seen as negative role models. Clinical nurses, who are in contact with prospective nurses the most, have an important role in guiding them.

Improving cultural humility in physical therapy students: What is faculty's role?

BACKGROUND

Clinician bias contributes to health disparities; therefore, educational standards and professional expectations incorporate cultural humility. Vague standards and numerous pedagogical methods make implementing an effective and uniform curriculum challenging. Classroom and clinical faculty's attitudes and behaviors are pivotal; however, evidence on roles beyond instruction is lacking.

PURPOSE

This study explored physical therapy (PT) students' perceptions of faculty's role in improving their cultural humility.

METHODS

This study was rooted in a phenomenological approach that incorporated elements of both descriptive and interpretive phenomenology. Thirteen first-year PT students participated in one-on-one interviews which underwent reflexive thematic analysis.

RESULTS

Reflexive thematic analysis generated two hundred-ninety codes, six categories, and one overarching theme. Dissonance emerged between students' perceptions of faculty's role and the explicit and implicit curriculum.

CONCLUSION

Explicit messaging from classroom instruction and implicit messaging from clinical encounters and unspoken attitudes, values, and behaviors were disparate. Faculty role modeling, diversity, cultural awareness, and perceived comfort interacting with a diverse patient population improved students' self-confidence and cultural humility. Professional development including field experience with a cognitive apprenticeship approach, and standardized, discipline-specific cultural humility competencies may provide uniform and clear guidelines.

Nursing students learning transfer from classroom to clinical practice: An integrative review

AIM

The aim of this integrative review was to examine the theoretical, qualitative, quantitative and mixed-methods literature focused on how nursing students transfer learning from theory courses into clinical practice.

BACKGROUND

As nursing curriculum aligns with the growing body of nursing knowledge, nursing students continue to develop their knowledge base and skill sets to prepare for future nursing practice. The bulk of this preparation involves developing connections between classroom/lab knowledge and further demonstrating those connections in clinical practice. However, the extant state of evidence on undergraduate nursing students' learning transfer has not yet been synthesized.

DESIGN

This integrative review was conducted using the Whittemore and Knafl framework.

REVIEW METHODS

Eight databases were searched in June 2022: MEDLINE, APA PsycInfo, EMBASE, Web of Science, CINAHL, ERIC, Academic Search Complete and Education Research Complete. Literature was included if it focused on undergraduate nursing students who have participated in at least one clinical practicum and reported on learning transfer in clinical settings. Only English-language, peer-reviewed literature was included. Two researchers independently assessed the eligibility of articles at the title-and-abstract level and at the full-text level, followed by an assessment of methodological quality. The Joanna Briggs Institute's critical appraisal checklists were used to assess theoretical papers and literature reviews and the mixed-methods appraisal tool (MMAT) was used to appraise all studies. Reference lists of included articles were searched for additional relevant literature. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines.

RESULTS

Twenty-eight articles met our inclusion criteria and were included in this review, including 20 qualitative studies, one quantitative study, three mixed-methods studies, three theoretical articles and one integrative review. The results of this review highlighted that numerous facilitators and barriers influence nursing students' ability to transfer learning within clinical learning environments. Facilitators included having knowledgeable and supportive educators and nursing staff, using strategies to promote connections, fostering reflection and aligning theory and practice. Barriers included unclear connections between course content, incongruencies between classroom and practice, lack of nurse role models, lack of real-world applicability and unsupportive nurse educators.

CONCLUSIONS

The information generated from this integrative review provides evidence about barriers that can be mitigated and facilitators that can be leveraged to facilitate undergraduate nursing students' learning transfer into clinical practice. The findings also highlighted gaps in evidence surrounding the need to understand how nursing students transfer learning from classroom settings to clinical practice settings.

Factors triggering the progressive detachment of nurses toward the fundamental needs of patients: findings from a qualitative study

The progressive desensitization of nurses in relation to fundamental needs (FNs) has been documented in anecdotical, scientific, and policy literature with nurses spending limited time at the bedside, thus affecting the quality of care and clinical outcomes. A potential reason that has been recognized is the limited nursing staff available in the units. However, other cultural, social, and psychological factors which have not been investigated to date may have a role in triggering the phenomenon. To investigate nurses' perceptions of the reasons that progressively detach clinical nurses from the FNs of patients, was the main intent of the study. In 2020, a qualitative study based on grounded theory following the Standards for Reporting Qualitative Research guidelines was performed. Purposeful sampling was adopted, by including 22 clinical nurses designated as 'good nurses' according to the perception of nurses working in executive and academic position. All agreed to be interviewed face-to-face. The detachment of nurses from the patients' FNs has been explained by three main factors that are interconnected: namely 'Being personally and professionally convinced regarding the role of FNs', 'Being progressively detached from the FNs', and 'Being forced to be detached from FNs'. Nurses also identified a category including strategies aimed at preventing detachment and 'Rediscovering the FNs as the core of nursing'. Nurses are personally and professionally convinced about the relevance of the FNs. However, they distance themselves from the FNs due to: (a) factors mainly attributable to internal personal and professional forces, such as the emotional fatigue that daily work entails; and (b) external forces related to the work environment where nurses work. To prevent this detrimental process that may result in negative outcomes for patients and their relatives, several strategies at the individual, organizational, and educational levels should be implemented.

A complex and demanding situation - Midwifery preceptors and midwifery students' experiences of teaching and learning prevention of severe perineal trauma

BACKGROUND

Many high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described.

AIM

To describe midwifery preceptors and midwifery students' experiences' of teaching and learning how to manage the second stage of labour, with the specific aim of preventing severe perineal trauma.

METHODS

A qualitative study with focus group discussions and individual in depth-interviews with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed by qualitative content analysis.

RESULTS

"A complex and demanding situation with mutual need for feedback, reflection and safety" was the overall theme describing the conditions. Three sub-themes were identified. "Adapting to a unique situation" refers to the difficulty of teaching and learning the aspects needed to prevent severe perineal trauma, and to provide care during this stage. "Hindering and limiting circumstances" describes teaching strategies that were perceived negatively, and how midwifery students tried to adapt to the preceptors rather than the birthing women. "A trustful and communicative relationship" describes the importance of the relationship between the student and the preceptor, where communication was a central, but not obvious part.

CONCLUSION

An increased awareness among preceptors is needed to optimize teaching strategies, enabling the students to focus on learning the art of the second stage of labour; supporting the woman, preventing severe perineal trauma and ensuring the safety of the unborn baby. Future research should address how existing prevention models can include training to increase preceptors' confidence in teaching.

Caring behaviours demonstrated to nursing students in the interpersonal relation with the faculty: A cross sectional study

BACKGROUND

Nursing students need to experience caring in their educational environment in order to learn how to care for the patients.

OBJECTIVE

The present study describes the caring model demonstrated by the faculty to the nursing students through their behaviours, from the perspective of both students and faculty members.

DESIGN

A cross-sectional, descriptive, observational study was conducted.

PARTICIPANTS

The sample included 286 students and faculty members.

METHODS

The Nursing Students' Perceptions of Instructor Caring assessing tool was used to gather the data.

RESULTS

After analysing 676 questionnaires, it was revealed a moderately high level of caring perceived by the students. The most appreciated dimension was control versus flexibility, reporting a mean value of 82.29 and a confidence interval from 81.14 to 83.44, and the least valued was appreciation of life's meanings, reporting a mean value of 63.90 and a confidence interval from 62.20 to 65.60. The students' perception of the care demonstrated by the faculty was significantly lower than the care that the latter believed to transmit in all dimensions (p < 0.001).

CONCLUSIONS

The caring perceived by the student was expressed through behaviours that inspired confidence in them, promoted a climate of learning and support, helped them to recognise the meaning of life, showed them flexibility and fostered their professional autonomy. The findings of this study can help to improve nursing education by providing a view of the interpersonal relations that the students established during their training with the faculty.

Predicting stress and mental wellbeing among doctoral researchers

BACKGROUND

Although mental health in higher education is increasingly recognised as a public health issue, postgraduate research students are often overlooked. Recent studies indicate a high prevalence of mental distress in this population.

AIMS

This study assesses the experience of doctoral researchers and identifies factors influencing mental wellbeing and perceived stress.

METHODS

A cross-sectional study examined how key demographic, individual and contextual factors related to stress and mental wellbeing in a sample of 431 doctoral researchers in the United Kingdom.

RESULTS

Respondents gave positive reports about their supervisory relationship and identified feeling confidently prepared for their work. Family support, good general health, sleep and low levels of self-depreciation predicted stronger mental wellbeing and lower levels of stress. Students who were confident about their future career and felt well prepared for their studies were less stressed and those who were achievement orientated had better mental wellbeing.

CONCLUSIONS

Focused attention on exploring career options and building confidence may help reduce stress among doctoral researchers. Taking steps to tackle the imposter phenomenon may help further. These could include addressing fear of failure, improving confidence in research ability and clarifying the role of doctoral researchers within the wider academic community.

Fourth year intellectual disability student nurses' journey and future work intention: a qualitative study

BACKGROUND

The aim of this qualitative study is to explore the views and experiences of final year BSc intellectual disability nursing students' journey, future work plans and examine factors influencing their migration intentions following graduation.

METHODS

A qualitative component of a mixed methods study where a focus group interview was conducted with final year BSc intellectual disability nursing students (n = 10) from one University in Ireland in June 2019. A topic guide was utilised, and participant's were interviewed about their programme, future work plans and migration intentions. An inductive approach was utilised, and data were analysed using a pre-existing framework for initial coding and thematic development. Duffy's conceptual model of identity transformation provided a structure to analyse the data and map themes onto the conceptual framework.

RESULTS

The findings were mapped onto the five stages of Duffy's (2013) conceptual model of identity transformation: Pre-Entry; Reaffirming; Surmounting; Stabilising and Actualising. Findings indicate that further work is required to promote intellectual disability nursing and address professional esteem issues, support for education and professional development, such as providing career guidance opportunities prior to course completion, development of clinical skills within their education programme and support for the professional development of new graduates. Participant's identified uncertainty about career opportunities and saw scope for future professional development opportunities particularly in community-based work.

CONCLUSION

This study has identified that final year intellectual disability nursing students are uncertain about career options and opportunities for intellectual disability nurses in other country's. There is an urgent need for the intellectual disability nursing profession to articulate their practice and advocate for their role and contribution to the care of people with intellectual disability. This study identified a clear need for direction and information regarding intellectual disability nursing roles and career opportunities.

Mothers' hygiene experiences in confinement centres: A cohort study

Introduction

Ethnic Malaysian Chinese used to observe the 1-month postpartum confinement period at home and many families would engage a traditional postpartum carer to help care for the mother and newborn. A recent trend has been the development of confinement centres (CCs) which are private non-healthcare establishments run by staff not trained in health care. Concerns about hygiene in CCs arose after infections were reported. We describe the practice of hand hygiene observed in CCs, the availability of resources for hygiene, and the prevalence of health-related problems in CCs.

Methods

This is a cohort study of ethnic Chinese mothers intending to breastfeed their healthy infants. They were recruited post-delivery along with a comparison group who planned to spend their confinement period at home. After their 1-month confinement period, they were contacted for a structured telephone interview about their experience. To avoid any alteration in behaviour, mothers were not told at recruitment that they had to observe hygiene practices. Multiple logistic regression was used to assess the effect of place of confinement on rates of infant health problems.

Results

Of 187 mothers, 88(47%) went to 27 different CCs while 99(53%) stayed at home. Response rates for the 1-month interviews were 88%(CC) versus 97%(home). Mothers in CC group stayed in one to four-bedded rooms and 92% of them had their baby sleeping separately in a common nursery described to have up to 17 babies at a time; 74% of them spent less than six hours a day with their babies; 43% noticed that CC staff had inadequate hand hygiene practices; 66% reported no hand basins in their rooms; 30% reported no soap at hand basins; 28% reported inexperienced or inadequate staff and 4% reported baby item sharing. Among the mothers staying at home, 35% employed a traditional postpartum carer for her baby; 32% did not room-in with their babies, but only 11% spent less than 6 hours a day with their babies. Of mothers who employed traditional postpartum carers, 32% did not know if their carer washed hands after changing diapers and 18% reported that their carer did not. Health problems that were probably related to infection (HPRI) like fever and cough were similar between the groups: 14%(CC) versus 14%(home) (p = 0.86). Multiple logistic regression did not show that CCs were a factor for HPRI: aOR 1.28 (95% CI 0.36 to 4.49). Three mothers reported events that could indicate transmission of infection in CCs.

Conclusion

We found unsatisfactory hygiene practices in CCs as reported by mothers who spent their confinement period there. Although we were not able to establish any direct evidence of infection transmission but based on reports given by the mothers in this study, it is likely to be happening. Therefore, future studies, including intervention studies, are urgently needed to establish an appropriate hygiene standard in CCs as well as the best method to implement this standard. Training CC staff with hygiene knowledge so that they can be empowered to contribute to the development of these standards would be important.

Experiences of faculty and staff nurses working with nursing students during clinical placement in residential aged care facilities: a systematic review of qualitative evidence

OBJECTIVE

The objective of this review was to synthesize evidence on the experiences of faculty and staff nurses working with nursing students in clinical placement in residential aged care facilities.

INTRODUCTION

Nursing education helps prepare students to provide quality care to older adults. Nursing programs across the globe are championing the integration of content on the care of older adults into their curricula as well as recognizing the value of clinical placements that focus exclusively on this population. Staff nurses who work in residential aged care facilities often work alongside students. In this role, they can support faculty and mentor students. This review explored faculty and staff experiences of nursing student placements in such facilities.

INCLUSION CRITERIA

This review considered qualitative studies that address the experiences of faculty and staff nurses working with nursing students in residential aged care facilities. Studies published in English from 1995 onward were included.

METHODS

The literature search was conducted in CINAHL, MEDLINE, Embase, and ERIC. The search for unpublished articles included Proquest Dissertations and Theses and Google searches of the Canadian Nurses Association and American Nurses Association websites. Papers were screened by two reviewers independently against the inclusion criteria. Those meeting the criteria were appraised using the JBI critical appraisal checklist for qualitative research. Key findings from included studies were extracted using a standardized tool and classified as unequivocal, credible, or not supported. This review followed the principles of meta-aggregration in line with the JBI approach.

RESULTS

Six studies, published between 2001 and 2017, were included in the review. A total of 32 findings were extracted and aggregated into nine categories. From the nine categories, four synthesized findings were developed: i) students enhance the environment, whereby faculty and staff perceive that student presence enhances the residential aged care work and living environment, ii) effort is required by faculty and staff to make the experience work, reflecting a need for faculty and staff to accept and work with negativities, iii) residential aged care facilities provide rich learning experiences, indicating an appreciation for available learning opportunities, and iv) importance of a residential aged care-academic partnership for a collaborative approach in creating positive experiences for faculty and staff working with students in this setting.

CONCLUSION

Faculty and staff experiences highlight that residential aged care has the potential to provide students with valuable learning experiences, including how to provide comprehensive and quality nursing care to older adults. A lack of resources in residential aged care inspires faculty and staff to be creative in how they work with students. However, working with students can be challenging for faculty who lack interest and expertise in caring for older adults in this setting. Additionally, staff can become frustrated when they perceive that students do not value the learning opportunities that are available or do not appreciate the expertise required to work with older adults. Partnerships between residential aged care facilities and academic programs can ensure that faculty and staff have the support and resources required to optimize the clinical placements for students.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020168698.

Undergraduate student nurses' experiences of their community placements

BACKGROUND

Community nursing placements play an increasingly important part in the undergraduate nursing students learning experience as a greater proportion of health care delivery is set to migrate to community care settings. Therefore, nursing education programmes and health services must ensure that student nurses are exposed to high quality community placements that provide suitable learning experiences for students to acquire the skills and knowledge required for the health service of the future.

OBJECTIVES

This qualitative evidence synthesis examines undergraduate nursing students' experiences of community nursing placements from 1996 to date.

DESIGN

Qualitative Evidence Synthesis, Thematic synthesis.

DATA SOURCES

CINHAL, EMBASE, ProQuest, Medline, Embase, Scopus, Psycinfo.

REVIEW METHODS

A systematic search across electronic databases was carried out to identify all available existing evidence relevant to the search question. Data was extracted and synthesised through thematic synthesis to identify and interpret emerging themes.

RESULTS

Six qualitative studies were included in the data, from these three themes were identified. The first of these highlighted the important influence of the community nursing teams and mentor on the students' placement experience. The second theme highlights the students' professional development as a result of their community placements and finally the third theme explores the students' perceptions of the essence of caring in the community.

CONCLUSION

The community provides valuable learning experiences of nursing from an alternative perspective, enhancing professional development and understanding of the nurse patient relationship. Mentorship and inclusion in teams are key factors that influence students' experiences and this working environment is useful for teaching about holistic care that is person and family centered. Role modeling is enhanced by the pace and proximity of the mentoring relationship.

Medication administration behaviors in prelicensure nursing students: A longitudinal, cohort study

AIM

This longitudinal study identified changes in safe medication administration behaviors in a single cohort of students followed over four semesters of nursing school.

BACKGROUND

Over 40% of a nurse's shift is dedicated to the processes of medication administration, placing them in a position to interrupt costly medication errors. Yet, despite efforts to decrease medication errors, including electronic medical records, smart pumps, and standardized processes, 5% of hospitalized patients experience adverse drug events and the sequela costs billions of dollars annually. One cognitive aid first introduced in nursing school to help nurses administer medications safely is the rights method, including the foundational five (patient, medication, dose, route, and time). However, facility restrictions, complicated electronic health records, and high faculty-to-student ratios are limiting opportunities to apply these rights and develop safe medication administration competency. Although nursing faculty and clinical partners expect competency when initially licensed as professionals, graduating nursing students are not competent and new graduates feel ill prepared to deliver medications safely. Previous studies report findings on safe medication administration in different cohorts of nursing students, but none has followed the same cohort of students throughout nursing school.

DESIGN

Using a non-experimental design, the same cohort of nursing students was followed over four semesters and observed independently administering medications in simulation scenarios.

METHODS

Each semester, this cohort of students self-selected into 10-12 simulation groups. One student from each group was randomized to the role of primary nurse. Guided by the NLN/Jeffries simulation theory and the International Nursing Association for Clinical Simulation and Learning's Standards of Best Practice: Simulation^SM, students participated in four simulations that required the primary nurse to deliver medications as part of clinical care. A single investigator completed an observational checklist during the simulations on verification of the foundational five rights in these students.

RESULTS

Verification of most rights varied each semester, but students consistently did poorly verifying right dose. One hundred percent of students observed in the first semester did not verify all five rights. At the time of graduation, 80% of students observed did not verify all five rights prior to medication administration.

CONCLUSIONS

These concerning findings align with previous research showing that students are not safely administering medications in patient care settings. Educators, administrators, and healthcare systems need to ensure that students receive consistent, high-quality experiences vital to training future nurses for competency in safe medication administration.

How do hospice nurses prepare to give end-of-life care? A grounded theory study of nurses in one UK hospice

BACKGROUND

Literature for preparing hospice nurses to deliver end-of-life care is sparse.

AIM

To investigate how nurses in one UK hospice prepared to deliver end-of-life care in their role.

METHODS

A classic grounded theory approach was used to investigate the experiences of 22 registered nurses in one UK hospice, to discover how they prepared for their role. A total of 17 individual interviews and one focus group were conducted. Constant comparison of data and member checking were performed to establish validity.

FINDINGS

Findings were synthesised into five categories: the 'shared ideal', feeling good at the job, making a difference, experience/exposure to hospice work and the importance of role models. The shared ideal formed the core category, which explained how hospice nurses feel a sense of 'fit' with their work.

CONCLUSION

The feeling of a nurse feeling well-suited to the work and that there the work was a good 'fit' for them was identified as a core element to nurses' feelings of preparedness to provide end-of-life care.

Components of the nursing role as perceived by first-year nursing students

BACKGROUND

Identifying and acquiring the nursing role is key to the development of nurses' professional identity. Understanding nursing students' perceptions in this regard will enable nursing educators to choose teaching strategies that lead to positive development of their students' professional identity.

OBJECTIVES

To describe how nursing students perceive the different components of the nursing role at the beginning of the nursing degree.

DESIGN

Cross-sectional, descriptive, observational study.

PARTICIPANTS/SETTINGS

106 first-year nursing students at the University of Huelva, Spain.

METHODS

Data on social and academic variables and variables relating to the instrumental and expressive roles were collected via an adapted, pilot-tested questionnaire assessed by experts.

RESULTS

For participants, caregiving is the core of the nursing role in the clinical setting, including both technical execution and patient care aspects. They highlighted the disease prevention, health promotion, restoration, and education profiles of nurses rather than their teaching, professional, and technical profiles. They were acquainted with the concept of postgraduate professional development, but were unaware of the academic pathways leading to it. They considered nurses to be decision-makers, who are nevertheless subordinate to doctors.

CONCLUSIONS

Students did not consider nursing to be an autonomous profession, although they highlighted its decision-making capacity. They placed greater emphasis on the traditional profile of primary care nurses than on their technical profile, and were able to identify the members of the multidisciplinary healthcare team.

Nursing Student Medication Administration Performance: A Longitudinal Assessment

BACKGROUND

Nurses must be adequately prepared for safe medication administration.

PURPOSE

The specific aims of the study were to compare first- and final-semester nursing students' medication administration performance, describe graduating nursing student performance, assess the long-term effect of an Individual Simulation-Based Experience (ISBE), and determine if nursing assistant experience impacted performance.

METHODS

The study was a longitudinal, descriptive, experimental, 2-group pretest-posttest design. The Medication Administration Safety Assessment Tool was used to assess nursing student (n = 68) medication administration performance at 3 points in time: after learning the skill, after participation in an ISBE or traditional practice session, and prior to graduation.

RESULTS

Only one-third of senior nursing students accurately demonstrated medication administration. There was no significant difference between first- and last-semester performance.

CONCLUSION

Findings suggest nursing students are not prepared for safe medication administration upon graduation. The reality of practice opportunities to perform this skill throughout a nursing program should be examined.

Experiences of undergraduate nursing students with faculty incivility in nursing classrooms: A meta-aggregation of qualitative studies

Faculty-to-student incivility can have detrimental impacts on both the individual students and the nursing profession. This study synthesized the current qualitative research evidence on the experiences of undergraduate nursing students with faculty incivility in nursing classrooms. A meta-aggregation approach was applied in a systematic review of qualitative studies based on the guideline of the Joanna Briggs Institute. The analysis of 11 qualitative studies identified four synthesized findings: (1) faculty incivility included a wide range of uncivil behaviors from disruptive to threatening behaviors, (2) pedagogical incompetence, including ineffective teaching, unresponsiveness, and unfairness, was perceived as uncivil, (3) faculty incivility negatively impacted on psychological well-being and learning, and (4) adaptation efforts included seeking support from family and friends and voicing the need for an official support system. Nursing faculty members need to be aware of the malicious impacts of faculty incivility, have formal teaching preparation, and develop pedagogical competency. The students and faculty members should be empowered by establishing official support systems for students and training faculty members to be role models for civility, respectively. Faculty perspectives of their incivility to students, interventions for cultivating faculty civility, and the long-term effects of faculty incivility are suggested as areas for further research.

Nursing students' perspectives of dance movement therapy to learn relational skills: A qualitative description study

BACKGROUND

Nursing students are expected to develop communication and relational skills during their undergraduate education, and the literature on art-based methods for teaching these skills is growing. Art-based education seems to be a promising method for teaching relational skills, especially embodied and performing arts. Dance Movement Therapy has been used previously to learn relational skills, but never in undergraduate nursing students.

AIM

To describe how first-year undergraduate nursing students experienced the learning of communication and relational skills through a Dance Movement Therapy workshop.

SETTINGS & PARTICIPANTS

First-year undergraduate nursing students who completed a two-session Dance Movement Therapy workshop.

DESIGN & METHODS

This study utilised a Qualitative Description design. Data were gathered from students' reflective journals (n = 226 journals, 113 students) and analysed with a thematic analysis approach.

RESULTS

Three themes were identified: learning happens through the experience of competences, learning happens through corporeality, and learning takes time. The first theme describes how students experienced theoretical concepts through workshop games. "Learning happens through corporeality" focuses on the role of the body during Dance Movement Therapy games as a medium for learning. "Learning takes time" describes students' evolution during the workshop, both within and between sessions, and the graduality of comprehension and learning.

CONCLUSIONS

The findings of this study suggest that Dance Movement Therapy can be an applicable methodology for nursing students to learn communication and relational skills. Most of the relational skills and non-verbal communication components were explored and strengthened during the workshop. Students were also able to create links between theoretical concepts and nursing practice. Nurse educators may want to consider using Dance Movement Therapy to teach communication and relational skills.

Pedagogical foundations of cybercivility in health professions education: a scoping review

BACKGROUND

Teaching cybercivility requires thoughtful attention to curriculum development and content delivery. Theories, models, and conceptual and theoretical frameworks (hereafter "tools") provide useful foundations for integrating new knowledge and skills into existing professional practice and education. We conducted this scoping review to identify tools used for teaching cybercivility in health professions education.

METHODS

Using Arksey and O'Malley's scoping review framework, we searched six biomedical and educational databases and three grey literature databases for articles available in English published between January 1, 2000 and March 31, 2020. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), we screened and extracted relevant data, and reported the results of the search.

RESULTS

The search resulted in 2272 articles, with 8 articles included in this review after inclusion criteria were applied. Four articles (50%) were peer-reviewed journal papers while the other 4 (50%) were dissertations. Eleven unique tools were identified by this review: (1) Transpersonal Caring Theory, (2) Theory of Workplace Incivility, (3) Conceptualization of Incivility, (4) Media Ecology Theory, (5) Principlism, (6) Salmon's Five Stage Model of Online Learning, (7) Learner-Centered Educational Theory, (8) Gallant and Drinan's 4-Stage Model of Institutionalization of Academic Integrity, (9) Theory of Planned Behavior, (10) Communication Privacy Management Theory, and (11) Moral Development Theory. Based on the tools analyzed in our scoping review, we determined three features of cybercivility pedagogy to which the tools provided a guide: (1) behavioral manifestations, (2) academic integrity, and (3) digital professionalism.

CONCLUSIONS

The reviewed tools provide a pedagogical foundation and guidance for teaching various properties of cybercivility. Future studies should be expanded to include a broader literature body and non-English literature to provide the global perspective and global skills needed by a diverse population of learners.

Health TAPESTRY: Exploring the Potential of a Nursing Student Placement Within a Primary Care Intervention for Community-Dwelling Older Adults

The increasing prevalence of chronic diseases in aging places demands on primary care. Nurses are the major nonphysician primary care workforce. Baccalaureate nursing programs should expose students to primary care and older adults to support these demands and help recruit new graduates to this setting. However, many baccalaureate nursing programs focus on acute care and placements aimed at older adults are viewed negatively. To address these curriculum challenges, third-year Canadian baccalaureate nursing students were placed in an innovative primary care program—Health TAPESTRY—for community-dwelling older adults. Health TAPESTRY involves an interprofessional primary care team, trained lay volunteers conducting home visits, system navigation, and an online software application. The goal of this study was to explore third-year baccalaureate nursing students’ perceptions of this unique clinical primary care placement. This qualitative descriptive study explored students’ perceptions of this placement’s strengths, weaknesses, opportunities, threats (SWOT), and outcomes. Nursing students participated in focus groups (n = 14) or an interview (n = 1) and five completed narrative summaries following visits. Qualitative content analysis was supported by NVivo 10. Strengths of the clinical placement included training for the intervention; new insights about older adults; and experience with home visiting, interprofessional team functions, and community resources. Weaknesses included limited exposure to older adult clients, lack of role clarity, lack of registered nurse role models, and technology challenges. Opportunities included more exposure to primary care, interprofessional teams, and community resources. No threats were described. Nursing students’ clinical experiences can be enhanced through engagement in innovative primary care programs. Adequate exposure to clients, including older adults; interprofessional teams; mentoring by registered nurses or advanced practice nurse preceptors; and role clarity for students in the primary care team should be considered in supporting baccalaureate nursing students in primary care clinical placements.

Using an International Role-Modeling Pedagogy to Engage First-Year Occupational Therapy Students in Learning Professionalism

IMPORTANCE

Professionalism is a core attribute for competent occupational therapists, but teaching professionalism to students is challenging for educators.

OBJECTIVE

To investigate whether students can expand their understanding of professionalism by engaging with international role models.

DESIGN

Pretest-posttest.

SETTING

One academic institution in Hong Kong.

PARTICIPANTS

First-year students (N = 102) enrolled in an introductory occupational therapy course.

INTERVENTION

An international role-modeling pedagogy was informally embedded into a course curriculum. Students were divided into 16 groups and collaboratively interviewed eight role models (academic theory or practice model developers) to understand their inspiration and ideas about occupational therapy competence.

OUTCOMES AND MEASURES

In addition to pre- and postclass surveys, students completed individual self-reflection reports as a course assignment. A postsemester focus group was also held.

RESULTS

Sixty-three students completed the surveys, and 5 attended the focus group. The students showed significant improvements in their understanding of professionalism after the course (Wilcoxon signed rank Zs = 5.671-6.766, p < .001). Interviewing the role models enabled the students to become more aware of intrinsic aspects of professionalism. Major themes in the student focus group included gaining a better understanding of professionalism and committing to personal change. Some implementation challenges were also experienced.

CONCLUSIONS AND RELEVANCE

International experts (theory or practice model developers) can be integrated into occupational therapy curricula as role models to enhance the teaching of professionalism to students.

WHAT THIS ARTICLE ADDS

Interviewing international role models who have developed theories or practice models can enhance student learning in the area of professionalism and complement traditional approaches to clinical education.

Facilitating students' interest in older people nursing: Gerontological nurse teachers under scrutiny

Having teachers who are knowledgeable and passionate about issues related to older people is crucial in enhancing nursing students' interest in older people nursing. However, whether such commitments and abilities are present among gerontological nurse teachers is unknown. This study therefore describes how undergraduate nursing students perceive their gerontological nurse teachers' abilities to facilitate students' interest in older people nursing. This is a descriptive cross-sectional study of undergraduate nursing students (N = 331) in Finland. The data were collected electronically using the Gerontological Nurse Teacher Scale (GeNTS). Descriptive statistics were used to analyze the data. The students agreed that their teachers are knowledgeable and interested in gerontological nursing (M = 3.62, SD = 0.92) and demonstrate leadership in gerontology (M = 3.50, SD = 1.04). However, they were uncertain about how their teachers address students concerns about aging, promote gerontology careers, and the teachers' abilities in developing gerontological nursing practical training. Gerontological nursing teachers should make deliberate effort to promote gerontology careers by highlighting the incentives and possibilities for career advancement in older people nursing. Further studies are needed to find out if nursing students' perception of their gerontological nurse teachers is a predictor of students' interest in older people nursing.

Pedagogical practices that influence professional identity formation in baccalaureate nursing education: A scoping review

OBJECTIVES

The purpose of this review was to identify pedagogical practices that contribute to professional identity formation in undergraduate nursing education and to map the components of professional identity described within these practices.

DESIGN

A scoping review using a six-stage methodological framework was used to capture a range of evidence describing how professional identity has been conceptualized and integrated into nursing curriculum.

DATA SOURCES

Databases searched included: Ovid MEDLINE: Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE® Daily and Ovid MEDLINE® 1946-Present, EBSCO CINAHL (1981 to present), OVID PsycINFO (1806 to Present), ProQuest ERIC, ASSIA, and Sociological Abstracts. Additional studies were identified by scanning the reference lists of relevant articles.

REVIEW METHODS

The study team collaboratively designed the data charting table and two coauthors independently screened the studies using Covidence software. Qualitative content analysis was used to categorize learning outcomes into five components of professional identity that were associated with pedagogical practices identified in the studies.

RESULTS

A total of 114 peer-reviewed journal articles were initially charted. Articles were categorized as intervention studies (46, 40%), perspective studies (40, 35%), theoretical papers (17, 15%), or reviews (11, 10%). To ensure feasibility in collating and reporting the results, the review focused on the 46 empirical intervention studies that described associations between pedagogical practices and professional identity formation learning outcomes for students.

CONCLUSIONS

This scoping review illustrates the range of contexts in which nursing students learn, the multidimensional nature of identity formation, as well as the breadth of pedagogical practices and learning outcomes that guide course design. The results can be used to inform future curriculum planning and to identify focused research questions to extend our understanding of evidence-based teaching practices supporting professional identity formation.

Should we use preceptorships in undergraduate nursing education?

BACKGROUND

Clinical learning experiences are the cornerstone of undergraduate nursing education as they allow students to apply theory to practice and help them develop as competent practitioners who are prepared for the realities of diverse, complex, and ever-changing practice environments.

PROBLEM

The traditional clinical teaching model, where small groups of students work with educators who are on-site facilitating learning, has numerous issues and thus there have been calls for reform. This Creative Controversy focuses on one reform option, the alternative clinical teaching model of preceptorships, which has gained popularity in recent years.

APPROACH

Current evidence surrounding preceptorships in undergraduate education was examined and critiqued.

CONCLUSION

Despite their popularity, there is a lack of robust evidence surrounding preceptorships and the motivations for using this model remain questionable. Future study is needed so preceptorships are implemented according to evidence-based teaching practices and not clouded by inappropriate motivations. The author challenges readers to question their practices and work to positively contribute to the science and practice of nursing education.

Construction of professional identity in nursing students: qualitative research from the historical-cultural perspective

OBJECTIVE

to analyze the process of professional identity construction in undergraduate nursing students during their education.

METHOD

qualitative research, anchored in the Historical-Cultural framework. Twenty-three undergraduate nursing students took part. Data were collected through individual interviews, with a semi-structured script. Thematic Analysis was used to analyze the data.

RESULTS

the following four themes were obtained, "The subject in movement to become a nurse: from previous experiences to entering the courses"; "The nursing professor in the construction of the undergraduate's professional identity: a two-way mirror"; "Pedagogical relationship: instrument for constructing the student's professional identity" and "Historical-cultural conditions: space for the construction of the student's professional identity".

CONCLUSION

the construction of the students' professional identity is limited to the material conditions of existence, translating appropriation to the intrapsychic scope of elements that occur, first, in the inter-psychological space of interactions. Nursing professors can become a paradoxical mirror, with one face to be imitated and the other, which materializes meanings of a model not to be followed. This construction is also influenced by the conditions of professional practice and university education.

'Ward for the day': A case study of extended immersive ward-based simulation

BACKGROUND

Simulation is an important teaching strategy in the preparation of nursing students for professional practice. The focus of simulation has shifted from single patient encounters to multiple case studies provoking immersion in all the activities that are regularly performed on the ward. Extended immersive simulation cannot replicate completely the stresses of working on a 'real' ward, but it does provide a safe environment for students to practice the role of being a registered nurse.

OBJECTIVE

To evaluate satisfaction associated with student experiences of mentorship by industry partners, self-reflection on performance, and responses to clinical situations following an episode of extended immersive ward-based simulation.

DESIGN

Mixed methods case study.

SETTING

School of Nursing and Midwifery metropolitan Western Australian university.

PARTICIPANTS

A cohort of 278 final year students enrolled in a three-year Bachelor of Nursing program.

METHOD

Eight demonstration rooms were re-configured to resemble a mixed medical/surgical ward. Nursing students and manikins in each room simulated different patient scenarios. Students were organised in three-hour shifts in which to undertake the role of a registered nurse. Industry partners undertook shift coordinator and senior nursing roles. Surveys were distributed to students at the end of the two-day simulation. Student satisfaction was evaluated using the Satisfaction with Simulation Experience scale and content analysis of open-ended questions.

RESULTS

A total of 243 students (87.4%) responded to the survey. None of the scaled items had a mean score of below 4.5. Content analysis of 458 written responses identified three themes: simulation, role of registered nurse and learning.

CONCLUSION

Extended immersive ward-based simulation offers the opportunity for educators to mirror what happens in clinical practice. Students value the opportunity to safely experience simulated demands of working on a busy ward and learn how to meet workplace pressures in the delivery of patient care.

The Perceptions of Professional Values among Students at a Spanish Nursing School

(1) Background: This study aims to reflect student nurses' perceptions of professional values across the four training years. (2) Methods: This study was designed as a cross-sectional study; data were collected using the Nurses' Professional Values Scale-Revised, adapted by Basurto-Hoyuelos. A total of 315 student nurses participated from a Nursing Faculty in Spain representing each of the four academic years. (3) Results: Students' perceptions of professional values were significantly correlated with their academic year. Overall, students' scores were higher in the ethics dimension. The two highest scores were for Maintain patient confidentiality for years 1 and 2 (4.77 and 4.68, respectively) and Safeguard patients' right to privacy for years 3 and 4 (4.95 and 4.98, respectively). Lower scores were observed in the professional expertise dimension across all years, and corresponded to a single item Participate in peer review (3.51, 3.38, 3.98, and 3.26, respectively). (4) Conclusions: This study is relevant as it highlights how nursing students' perceptions of professional values change overtime, even during the four years of their training. The ethics dimension was the most highly regarded across all academic years. However, the professional expertise dimension requires greater attention throughout the degree as students regarded it as less important for their immediate future.

Nurse educators’ experiences with student incivility: a meta-synthesis of qualitative studies

This study aimed to synthesize the best available qualitative research evidence on nurse educators’ experiences with student incivility in undergraduate nursing classrooms. A meta-synthesis of qualitative evidence using thematic synthesis was conducted. A systematic search was performed of 12 databases for relevant literature published by March 31, 2019. Two reviewers independently conducted critical quality appraisals using the checklist for qualitative research developed by the Joanna Briggs Institute. Eleven studies that met the inclusion criteria were selected for review. From the pooled study findings, 26 descriptive themes were generated and categorized into the following 5 analytical themes: (1) factors contributing to student incivility, (2) management of student incivility, (3) impact: professional and personal damage, (4) impact: professional growth, and (5) initiatives for the future. Many nurse educators became confident in their role of providing accountability as both educators and gatekeepers and experienced professional growth. However, others experienced damage to their personal and professional life and lost their motivation to teach. Nurse educators recommended the following strategies for preventing or better managing student incivility: institutional efforts by the university, unified approaches for student incivility within a nursing program, a faculty-to-faculty network for mentoring, and better teaching and learning strategies for individual educators. These strategies would help all nurse educators experience professional growth by successfully preventing and managing student incivility.

The Role of Students with Practical Nursing Diplomas in the Process of Undergraduate Nursing Education: A Qualitative Study

Background:

Awareness of the experiences of students and educators in the educational process plays an important role in facilitating and improving this process. This study aimed to explain and investigate the experiences of nursing educators and students about the presence of students with practical nursing diplomas in the process of undergraduate education.

Materials and Methods:

In this qualitative study conducted from 2016 to 2018, which adopted a content analysis approach, 24 nursing students and educators of Lorestan University of Medical Sciences were selected using the purposive sampling method and were interviewed in depth. The data were manually recorded and analyzed using the Graneheim and Lundman method.

Results:

The three main themes of “from contrast to alignment with professional competence,” “peaceful coexistence in the educational process,” and “reflection of the perceived reality of the clinical environment,” along with six categories and 30 subcategories were extracted from the interviews.

Conclusions:

It seems that monitoring and managing undergraduate courses more thoroughly, as well as raising the awareness of educators about the positive and negative dimensions of the presence of nursing students with practical nursing diplomas in undergraduate nursing courses can make it possible to optimize and improve students’ learning process.

Exploring nursing students' use of the Fundamentals of Care framework in case-based work

AIMS AND OBJECTIVES

To explore how nursing students perceive and use the conceptual Fundamentals of Care framework in case-based work in nursing education and furthermore to describe influencing factors on perceptions and use of the framework.

BACKGROUND

The Fundamentals of Care framework has been integrated in core courses in two Schools of Nursing in Region North Denmark in response to studies reporting that nursing students and newly graduated nurses lack the knowledge, skills and competencies to meet the challenges of delivering fundamental care in clinical practice. An integration of the framework in case-based work in nursing education has not previously been studied.

DESIGN AND METHODS

The study design was focused ethnography. Data were collected using participant observations, focus group interviews and individual interviews. Four groups of four to five nursing students participating in case-based work sessions and three faculty members from two Schools of Nursing were included. The study adhered to COREQ.

RESULTS

The results show an uncertainty among the students about how to understand and use the conceptual framework in case-based work. The uncertainties derive from diversities in faculty members' perceptions and curricular planning among others. However, the framework appears to support the students' learning about what nursing is and requires.

CONCLUSIONS

The study indicates that integrating Fundamentals of Care framework in case-based work may be one way of teaching nursing students the complexities of integrated fundamental nursing care. However, there is a need to consider how to support students in articulating Fundamentals of Care, and to draw attention to the influence of role models and curricular planning.

RELEVANCE TO EDUCATIONAL PRACTICE

The study provides knowledge relevant when customising future educational interventions regarding the integration of Fundamentals of Care in nursing education and may provide valuable knowledge of evaluation strategies.

Nurses' knowledge, behaviour and compliance concerning hand hygiene in nursing homes: a cross-sectional mixed-methods study

Background

Effective hand hygiene is one of the most important measures for protecting nursing home residents from nosocomial infections. Infections with multi-resistant bacteria’s, associated with healthcare, is a known problem. The nursing home setting differs from other healthcare environments in individual and organisational factors such as knowledge, behaviour, and attitude to improve hand hygiene and it is therefore difficult to research the influential factors to improve hand hygiene. Studies have shown that increasing knowledge, behaviour and attitudes could enhance hand hygiene compliance in nursing homes. Therefore, it may be important to examine individual and organisational factors that foster improvement of these factors in hand hygiene. We aim to explore these influences of individual and organisational factors of hand hygiene in nursing home staff, with a particular focus on the function of role modelling by nursing managers.

Methods

We conducted a mixed-methods study surveying 165 nurses and interviewing 27 nursing managers from nursing homes in Germany.

Results

Most nurses and nursing managers held the knowledge of effective hand hygiene procedures. Hygiene standards and equipment were all generally available but compliance to standards also depended upon availability in the immediate work area and role modelling. Despite a general awareness of the impact of leadership on staff behaviour, not all nursing managers fully appreciated the impact of their own consistent role modelling regarding hand hygiene behaviours.

Conclusion

These results suggest that improving hand hygiene should focus on strategies that facilitate the provision of hand disinfectant materials in the immediate work area of nurses. In addition, nursing managers should be made aware of the impact of their role model function and they should implement this in daily practice.

"You can't escape it": Bullying experiences of New Zealand nursing students on clinical placement

BACKGROUND

Bullying in nursing is not a new phenomenon and nursing students are not exempt from its effects, however there is limited literature that deals directly with bullying of nursing students within the clinical environment in New Zealand. Quality clinical placements are vital to facilitate the link between theory and practice whilst working in complex healthcare settings.

AIM

The purpose of this article is to present the experiences described by nursing students regarding the nature and extent of bullying during clinical placements.

DESIGN

This study employed a cross-sectional survey design using an electronic survey in which this paper focuses on the textual data provided by nursing students from across New Zealand. Data was analysed by coding and grouping into themes.

RESULTS

There were numerous uncivil behaviours students were subject to during clinical placements. The consequences of these behaviours had physical, psychological and financial implications for students, with some suggestions that they choose to leave the nursing profession.

CONCLUSIONS

Predominantly the practice setting is clearly not nurturing enough for nursing students; a situation unlikely to change in the near future. Hence academic institutions must be proactive in developing students' ability to address incivility in these environments and to educate their own staff on how to recognise and respond to bullying in the clinical arena.

Nursing profession and nurses' contribution to nursing education as seen through students' eyes: A qualitative study

The behavior of clinical instructors, as observed by students, deeply influences their professional development. When instructors behave unprofessionally, they risk undermining the professional growth students gain from their clinical placement experience. Clinical instructors need to be aware of how their behavior can affect the students' learning process and the contributions they make to clinical nursing education. A qualitative study was performed to describe the nursing profession as perceived by students who observed their clinical instructors' behaviors during the clinical experience. In-depth interviews of nursing students were conducted until data saturation was attained. Sixteen interviews were analyzed using an inductive content analysis methodology. The nursing profession was described by the participants through five themes as follows: the helping relationship, technical role, professional growth, working group, and contradictions and conflicts. Several examples of unprofessional behaviors on the part of the clinical instructors were reported by the respondents. The nursing profession, as perceived by nursing students, does not always reflect their expectations and their ideas related to professionalism. Universities and schools of nursing should ascertain that clinical instructors are prepared to educate students. Faculty should clearly state to students what they can expect from the clinical experience, namely, preparing students to face real working environments that do not always reflect educational philosophies.

Addressing the psychosocial needs of patients: Challenges for nursing students

PURPOSE

To evaluate the ability of nursing students to determine the psychosocial needs of patients and identify the needs and problems encountered by nursing students.

DESIGN AND METHODS

This study is a mixed method research. The nursing care plans of 40 nursing students that provided care to 129 patients with chronic medical diseases were examined retrospectively. Individual interviews were also conducted with five nursing students and six academicians.

FINDINGS

It was determined that nursing students defined an average of 15.77 ± 11.55 physiological and an average of 3.05 ± 2.28 psychosocial nursing diagnoses for 129 patients. Data analysis of individual interviews revealed two main themes: (1) identifying psychosocial diagnoses: teaching difficulties and (2) identifying psychosocial diagnoses: learning difficulties.

PRACTICE IMPLICATIONS

This can facilitate the learning process of each student to include physiological and a psychosocial care focus in their nursing care through discussions and evaluation with their mentors and instructors.