Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project)

Assessing Evidence-Based Practice in Operating Room Nursing Students: A Cross-Sectional Study in the Southwest of Iran

Evidence-based practice (EBP) is a clinical decision-making process that is grounded in the utilization of the most reliable and up-to-date evidence. It involves utilizing resources and evidence to enhance patient management. The application of evidence-based decisions in patient care and education is of utmost importance in the performance of health sciences students. However, the emphasis on this concept among operating room nursing students has been lacking. Hence, the objective of this research is to assess the implementation of evidence-based practice among operating room nursing students studying in the operating room department at the Shiraz University of Medical Sciences in Iran. The study follows a descriptive, cross-sectional design, with a sample of 148 operating room nursing students selected through census sampling based on the student list. After obtaining informed consent, participants completed a demographic information form and the Rubin-Parrish evidence-based practice questionnaire. The data that were gathered underwent analysis through the utilization of SPSS version 22 software, employing descriptive statistics, T-tests, and Pearson correlation coefficient tests. The results revealed that the overall average score of evidence-based practice among the students exceeded the standard scores (172.66 ± 14.74). There was a significant association between the evidence-based practice score and prior familiarity with evidence-based practice, interest in the field of study, research experience, intention to participate in the Master's exam, and the participants' grade point average (GPA) (p < 0.05). These findings indicate that operating room nursing students displayed an average level of evidence-based practice, emphasizing the need for effective plans and strategies to improve their performance. Addressing the identified factors from this study becomes crucial in this regard.

Using evidence to identify teaching strategies to improve student competencies

BACKGROUND

Organizational assessment revealed opportunities to develop a critical mass of faculty educated about EBP and integrate competencies into practice. The faculty orientation online program did not include information about the EBP process, teaching strategies, or student competencies.

PURPOSE

The purpose of this EBP project was to investigate the best teaching strategies that foster student competencies.

IMPLEMENTATION PLAN

Based on the evidence, an online EBP module was developed including the best teaching strategies for instruction of EBP, the student competencies that must be mastered and teaching barriers that must be overcome. The results and implementation plan were presented to leaders and faculty Online Council for feedback, approval, and buy-in.

OUTCOMES

Twenty-five faculty completed the EBP online module over 1 year providing examples for teaching strategies that related EBP to clinical practice, teaching methods that engaged students and examples of assignments that promoted student competency.

IMPLICATIONS FOR PRACTICE

Using evidence to develop an EBP module for faculty orientation to online teaching provided a cost-effective way to develop a critical mass of faculty educated in EBP teaching strategies and methods that foster student competencies.

Social media as a mechanism of dissemination and knowledge translation among health professions educators: a scoping review

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes.

Purpose, Planning, and Individualization of Master of Science in Nursing Capstone Experiences: An Integrative Review

BACKGROUND

Graduate-level education programs use capstone experiences for students to demonstrate achieving essential learning and programmatic outcomes. However, a lack of standardization of these experiences and outcome measurements could result in varying competencies among students with the same degree. Employers seeking specific skills may find this problematic, and graduates may feel unprepared for new roles, which could hinder transition.

METHOD

A systematic search of nine databases was conducted to identify: (1) the essential characteristics of master in nursing capstones and (2) the assessments programs use to demonstrate achievement of program outcomes.

RESULTS

Synthesis and analysis of six sources of evidence revealed uniform agreement in purpose, planning, and individualization of experiences, yet ways of assessing student achievement of program outcomes were less clear and varied widely.

CONCLUSION

Capstone experiences should be relevant to graduate-level education and include mapping to program outcomes to ensure students' competency and readiness to transition into their new role. [J Nurs Educ. 2023;62(9):502-508.].

Educational strategies used in master's and doctoral nursing education: A scoping review

BACKGROUND

Advanced practice nurses and future nursing researchers must be adequately educated with the best available evidence. However, we know little about educational strategies and their characteristics used explicitly to educate advanced practice nurses and future researchers.

METHOD

A scoping review was used to map the latest educational strategies used in master's and doctoral nursing education between 2011 and 2021. Components of educational strategies were extracted based on the Guideline for Reporting Evidence-Based Practice Educational Interventions and Teaching and the Saskatchewan Education Department Framework of Professional Practice. The New World Kirkpatrick Model was used to categorize the associated learning outcomes. A narrative description approach was used to synthesize the findings.

RESULTS

A total of 56 studies were included. Several information was missing regarding the theoretical foundations of the educational strategies. A total of 158 educational strategies were identified. Individual work (e.g., homework) was the most popular educational strategy. Most studies assessed learning outcomes related to reactions (e.g., satisfaction) or learning (e.g., knowledge).

CONCLUSION

More studies should be done using interactive instruction or multimodal approaches, while the authors should better describe intervention components. A systematic review of effectiveness needs to be conducted to evaluate the best educational strategies in the master's and doctoral nursing education.

Self-perceived competences in evidence-based practice of clinical-teaching nurses versus clinical nurses

AIM

To compare the evidence-based practice (EBP) self-perceived competences of clinical teacher nurses (CTN) versus clinical nurses (CN) to detect areas for improvement in practical training.

METHOD

A cross-sectional study by means of a self-assessment questionnaire sent to nurses of two public hospitals of Castilla y León was performed, between February to May 2020. Variables included competences in evidence based practice (EBP) - attitude, knowledge, skills and use-, sociodemographic, job, academic, teaching relations and training in investigation methodology and/or EBP. A validated questionnaire EBP-COQ prof© of 35 questions with answers type Likert (1, very disagree-5, very agree) was used. Data analysis (descriptive and bivariate) was performed by means SPSS v.24 program.

RESULTS

171 questionnaires were answered by nurses. CN 52%, CTN 48%. There were no significant differences between both groups regarding sociodemographic variables. Mean age was 43.6 ± 9.9 and 42.9 ± 8.5 for CN and CTN, respectively. Total sample showed a mean EBP competency score of 3.54 ± 1.00 (attitudes: 4.40 ± 0.60; knowledge: 3.08 ± 0.94; skills: 3.57 ± 0.66; utilization: 3.36 ± 0.75). The CTN group obtained higher mean scores in knowledge dimension, compared with CN (P = .02) and with total sample (P = .02). There were no significant differences in other dimensions.

CONCLUSION

CTN showed better self-perceived competences scores only in the knowledge dimension compared with CN. Taking in account the level of responsibility they support in their daily practice, it would be advisable to design management strategies in order to improve attitudes, skills and utilize EBP, acting as professional role models for students and peer mentors.

Methods of teaching evidence-based practice: a systematic review

BACKGROUND

To identify the effectiveness of different teaching modalities on student evidence-based practice (EBP) competency.

METHODS

Electronic searches were conducted in MEDLINE, Cochrane central register of controlled trials, PsycINFO, CINAHL, ERIC, A + Education and AEI through to November 2021. We included randomised-controlled trials comparing EBP teaching modes on EBP knowledge, skills, attitudes or behaviour in undergraduate and post-graduate health professions education. Risk of bias was determined using the Cochrane risk of bias tool.

RESULTS

Twenty-one studies were included in the review. Overall, no single teaching modality was identified as being superior to others at significantly increasing learner competency in EBP. Changes in learner knowledge, skills, attitudes and behaviour were conflicting, with studies either reporting no change, or a moderate increase in EBP behavioural outcomes when directly compared to another intervention.

CONCLUSION

Current evidence highlights the lack of a single teaching modality that is superior than others regarding learner competency in EBP, regardless of health professions discipline or graduate status. The poor quality, heterogeneity of interventions and outcome measures limited conclusions. Further research should focus on the development of high-quality studies and use of psychometrically validated tools to further explore the impact of different EBP teaching modalities.

Evidence-based practice profiles of nurses: a transcultural study†

Objective

To compare (i) the evidence-based practice (EBP) profiles and (ii) socio-demographic characteristics of nurses in 4 selected low-middle income countries (LMICs).

Methods

A cross-sectional survey was conducted among 677 nurses from 4 hospitals in 4 countries (Afghanistan, Ghana, Iran, and Uganda).

Results

The findings revealed that there are significant differences between the 3 EBP subscales (that is, practice/use, attitude, and knowledge/skill) across the 4 countries (P < 0.05). No significant EBP differences were identified across age groups and gender in the subscales of practice, knowledge, and attitude. Practice and knowledge subscales were significantly associated with working schedules (that is, part-time and full-time) (P < 0.05). Analyses also revealed significant differences between attitude and knowledge subscales and working experience (P < 0.05).

Conclusions

Nurses in the 4 countries have moderate practice, attitude, and knowledge/skills of EBP. Nurses in LMICs require continuous professional development programs and support to enhance their practice and knowledge regarding EBP in clinical settings.

The Development of Research Skills in Nursing Postgraduate Training

The objective of this study was to understand the contribution of postgraduate training to the development of research skills, aiming at their application in clinical practice. Method: This was a qualitative, exploratory, and descriptive study conducted with eight nurses in the Local Health Unit of Baixo Alentejo, in Portugal, who had postgraduate training. The researchers conducted a group interview, or discussion group, using a semi-structured interview, which was assessed by two reviewers. The data were submitted to content analysis, and the results underwent a validation process with the participants and two reviewers. This study was approved by the institution’s ethics committee. Result: In terms of the research skills developed in nursing postgraduate education, the following indicators emerged from the participants’ discourse: understanding the research process, searching databases, developing literature reviews, assessing the quality of articles, developing research projects, communicating about science, and translating knowledge into clinical practice. Conclusion: The participants developed research skills in their nursing postgraduate training and reported developing these skills in their clinical practice.

Development and psychometric evaluation of nurses' perception towards the gap between knowledge and practice

AIM

The aim of the study was to develop a survey instrument and psychometrically evaluate nurses' perceptions of the gap between knowledge and practice. Although the nursing literature has widely documented a gap between knowledge and practice, no instrument has been developed to measure this gap.

DESIGN

Psychometric analysis was done on 513 nurses working in different positions at two large hospitals in Jeddah City.

METHODS

Cronbach's alpha was used to determine the internal consistency and reliability of the research instrument, and a panel of experts evaluated the validity of the tool's content.

RESULT

The content validity index computed from expert rankings was 0.89. Factor analysis yielded four major components: knowledge, practice, environment and learning. Cronbach's alpha indicated a high level of internal consistency and reliability for the component items. The newly developed scale will facilitate measuring nurses' perceptions of the knowledge-practice gap in clinical settings.

Defining 'research inspired teaching' and introducing a research inspired online/offline teaching (riot) framework for fostering it using a co-creation approach

BACKGROUND

There are calls to ensure that evidence-based practice is enabled for every midwife and nurse by means of education, research, leadership and access to evidence. Concurrently, there is a global call for universities to foster 'Research Inspired Teaching'. Yet such teaching must first be defined and may usefully be developed, delivered, and evaluated as part of a framework approach.

OBJECTIVE

To co-create a uniform definition of 'Research Inspired Teaching' and a framework for developing, delivering, and evaluating it.

DESIGN

A co-creation approach was taken, underpinned by the interpretive framework of communal constructivism.

SETTING

United Kingdom.

PARTICIPANTS

The sampling strategy was purposive, whereby those who had reportedly actively engaged in 'Research Inspired Teaching' were invited to participate. The resulting multidisciplinary team of co-creators (n = 14) included students, educators, and self-identified facilitators of 'Research Inspired Teaching'.

METHODS

The co-creation of outputs was facilitated by two online co-creation workshops. All creative, written, and verbal contributions made by co-creators were collected as data and used to 'co-define', 'co-design' and 'co-refine' outputs. To enhance credibility, triangulation was used throughout. A final review of results presented in this article via all co-creators concluded this process.

RESULTS

This article presents a definition of teaching, a definition of research, a founding definition of Research Inspired Teaching and a guiding framework along with 10 core principles for developing, delivering, and evaluating it.

CONCLUSIONS

These outputs may be useful for both midwifery and nursing faculties, providing common language for collaboration and inspiring further developments and research. In pursuit of excellence, further international research could usefully investigate how these outputs may further bridge the Research-Teaching Nexus in Higher Education, and partner with other universities looking to cultivate, evidence and promote their own 'Research Inspired Teaching' in practice. In this pursuit, inter-university partnerships would be welcomed.

The impact of postgraduate education in transition to practice programmes on new graduate nurses' knowledge and skills: A pre- post survey design

BACKGROUND

Research indicates that nurses perceive postgraduate education to have a positive effect on their knowledge and practice. Many jurisdictions offer/require new graduate nurses to undertake postgraduate coursework however the consequences of this are not clear.

OBJECTIVES

This research aims to determine the impact of completing a postgraduate course in clinical assessment on the capabilities of new graduate nurses.

DESIGN

A two group pre/post design with a naturally occurring intervention employing an online questionnaire was used to gather data.

SETTINGS

Two metropolitan hospitals in New Zealand delivering new graduate programmes, one inclusive of a postgraduate course and the other not.

PARTICIPANTS

Eighty five nurses completed the questionnaire on commencement of the programme and fifty-two on completion of the programme.

METHODS

An online questionnaire was administered to two new graduate cohorts, on commencement and completion of their new graduate programme.

RESULTS

Results showed significant pre/post increases for four out of five factors for those who had completed a postgraduate course compared to only one significant increase for those who had not. In addition, when comparing the scores of the two groups there was no significant differences between groups on the pre-measures. However, on post measures there were significant differences with the postgraduate group scoring higher on three of the five subscales: Knowledge for Practice, Explaining Practice and Applied Diagnostic Reasoning.

CONCLUSION

It is the author's belief that this is the first study that has attempted to quantify new graduate nurses' perceptions of their educational experience in their first year of practice and suggests that the inclusion of the postgraduate course enhanced knowledge for practice and diagnostic reasoning skills.

Design of the EBE-ST Questionnaire among Nursing Students: Multicenter Study from Eight Universities in Spain

Background: Twenty years after the degree in nursing was introduced in Spain, the subject of evidence-based nursing is still unstructured and unestablished in most faculties. Moreover, there are hardly any rigorous studies at a national level that evaluate the current state of this competence in our faculties. Understanding the starting point is essential for the curricular design to ensure that evidence-based practice is implemented among future professionals. Aim: To design and validate an evidence-based nursing competency questionnaire for fourth-year nursing students. Methods: A specific questionnaire was developed and validated (EBE-ST). A cross-sectional survey design with psychometric validation of an instrument. Participants were 304 senior year nursing students from eight universities in Spain (2020). Results: The EBE-ST questionnaire is composed of 33 items that determine eight factors. It presents adequate reliability and validity (alpha = 0.882), measuring knowledge, attitudes and the practical application of evidence-based practice. Conclusions: We have created an instrument with good psychometric properties to measure evidence-based practice competence among senior nursing students. The heterogeneity of knowledge regarding evidence-based nursing in our country suggests that further reflection is warranted on the incorporation of this topic during undergraduate training. We have designed and validated an evidence-based nursing competency questionnaire specific to nursing students.

Practice expectations for Australian graduate emergency nursing programs: A Delphi study

BACKGROUND

Practice standards in nursing provide minimum expectations to enable the provision of high quality and safe care. There are currently no practice standards for post-registration graduate emergency nursing programs in Australia, leading to variation in graduate attributes and clinical expectations on completion of their program.

OBJECTIVES

The aim of this study was to establish consensus-based practice standards for graduate emergency nursing programs in Australia.

DESIGN

Delphi approach.

PARTICIPANTS

Australian nurses who identified as an emergency nurse and currently worked, or previously worked, in an emergency care environment.

METHODS

A modified two-round Delphi method was used. The survey was divided into four sections of data collection, including demographics, graduate emergency nursing course entry requirements, graduate expectations, and clinical care capabilities. Data were analysed using descriptive statistics including calculation of content validity index (CVI).

RESULTS

There were 204 respondents in Round One and 153 respondents in Round Two. Respondents agreed that nurses wanting to undertake graduate studies in emergency nursing require prior experience in the emergency care environment and should be working a minimum of 0.5 full time equivalent (FTE) whilst completing their studies. Thirty-nine statements presented under graduate attributes achieved a CVI of >0.8. All 70 clinical care capability statements presented in Round Two achieved a CVI of >0.8.

CONCLUSION

This study generated the evidence to establish minimum practice standards for Australian graduate emergency nursing programs. The standards centre around three key areas: graduate entry requirements, graduate attributes and clinical care capabilities. The standards provide a clear guide for employers, educators and clinicians, and inform capabilities for early career emergency nurses.

Embedded researchers in Australia: Survey of profile and experience across medical, nursing and midwifery and allied health disciplines

AIMS AND OBJECTIVES

This study explores embedded researcher's age, qualifications, research environment and experience in healthcare and academic organisations in Australia and makes comparisons across three core professional disciplines of nursing and midwifery, medicine and allied health.

BACKGROUND

The embedded researcher model, where a researcher is embedded as a core member of the clinical team, offers promise to support the implementation of research evidence into practice. Currently, there is a lack of clarity about how the model has been adopted across the three largest professional disciplines in Australian health care.

DESIGN

A cross-sectional survey was designed and reported, using the STROBE Statement.

METHODS

A purposive sample of embedded researchers was invited to participate in an exploratory online survey. Embedded researchers worked, or had worked, for a minimum of 30% of their time, in a healthcare organisation doing research or building research capacity. Participant responses were extracted from the survey and imported into SPSS for analysis.

RESULTS

Perspectives of 100 Australian embedded researchers were compared across nursing and midwifery (36%, n = 37), allied health (35%, n = 36) and medicine (26%, n = 27). Professional differences are reported in respondents' qualifications and experience, employment conditions and their research cultures and environments. Comparatively, most nursing and midwifery embedded researchers were older, more clinically experienced than allied health respondents, who were more research qualified. Medical-embedded researchers are typically older, more clinically experienced and focussed on producing personally relevant clinical research. Nursing and midwifery embedded researchers reported doing clinical research within their teams, as well as research capacity building, management and clinical practice roles.

CONCLUSIONS

Embedded researchers describe different career trajectories across the three largest professional disciplines in Australian health care.

RELEVANCE TO CLINICAL PRACTICE

Embedded researchers from different professional disciplines enact their work differently. It appears that when they engage in research capacity building via a range of management and networking roles, embedded researchers contribute to their organisation's research culture and receive greater recognition for their achievements.

Teaching evidence-based practice (EBP) in nursing curricula in six European countries-A descriptive study

BACKGROUND

Teaching evidence-based practice (EBP) in nursing education varies among nurse educators and universities. Lack of nurses' knowledge and skills are among the barriers commonly associated with the limited use of EBP in practice.

OBJECTIVES

To describe the presence, characteristics and content of courses of EBP in nursing bachelor's, master's, and PhD programs in six European countries.

DESIGN

A descriptive study design was employed.

SETTINGS

The study was implemented as part of the EBP e-Toolkit Project as a strategic partnership of six European higher education institutions from six countries in the framework of the Erasmus+ Programme.

PARTICIPANTS

Census sampling (N = 225) was used. A total of 162 (72%) faculties responded from the following countries: Spain (79), Italy (44), the Czech Republic (15), Poland (12), Greece (7), and Slovenia (5).

METHODS

Three structured instruments were developed by using the consensus development panel. The research was conducted from December 2018 to March 2019. For names of subjects, a manual narrative Template Analysis was used with open descriptive coding.

RESULTS

Subjects in "EBP in Nursing or Health Care" are included in 45 (29.2%) bachelor's programs, mostly worth 180 European Credit Transfer System (ECTS) credits, 30 (28%) master's, and 6 (40%) PhD programs. In bachelor's programs, an average of 134 h are spent teaching EBP steps, followed by 127 h in master's programs and 52 h in PhD programs. EBP subjects have different focuses: clear topics in EBP, development of research knowledge, awareness of the need for evidence-based clinical work, and understanding the needs of the profession.

CONCLUSIONS

Teaching EBP is not yet sufficiently integrated into nursing curricula. For more efficient integration, guidelines on the standardization of teaching approaches and content have to be developed in all three cycles of higher education. Further research is needed on the implementation of teaching at master's and PhD levels of nursing curricula.

Effectiveness of an Evidence-Based Practice Educational Intervention among School Nurses

The evidence-based practice (EBP) approach to high-quality care is designed to improve patient outcomes. However, little research has been conducted to determine how EBP is adopted and implemented among school nurses in Taiwan. This study evaluated an EBP training program implemented among school nurses in Taiwan to determine whether and how effectively it improved their knowledge levels, attitudes, skills, and self-efficacy. A pretest-posttest research design was employed. Participants were recruited via convenience sampling from among 193 primary schools throughout Tao-Yuan and New Taipei City in Taiwan. The EBP program implemented both mobile learning technology and the flipped classroom format. The learning outcomes were evaluated before, immediately after, and at a 3-month follow-up. In this regard, the data were collected using the School Nurse Evidence-Based Practice Questionnaire. The results showed that the participant scores for the items of knowledge and self-efficacy significantly increased over the study period. Somewhat differently, scores for the skill items significantly increased from the pre-test to the immediate post-test, but significantly decreased from the immediate post-test to the final follow-up. Overall, however, the EBP program led to marked improvements in knowledge, skills, and self-efficacy. These findings can help guide the development of a creative evidence-based school nursing curriculum.

Paths taken by Brazilian Nursing for the development of terminological subsets

OBJECTIVE

to discuss the paths taken by Brazilian Nursing in the development of terminological subsets of the International Classification for Nursing Practice.

METHOD

documentary research, carried out in master's dissertations and doctoral theses, which developed terminological subsets, available at the Bank of Doctoral Theses and Master's Dissertations of the Under-graduation Personnel Improvement Coordination. The variables were analyzed were institution, year; academic level, type of health service, methodological approach, clientele, theoretical reference, validation of terms, cross mapping, modeling of new concepts, validation of statements, method used for elaboration, term collection, finalization and dissemination.

RESULTS

124 doctoral theses and master's dissertations were found, 91 were excluded and 33 were included, 23 (69.70%) of which were master's dissertations, with the highest production in 2014 (n=10; 30.30%), with emphasis on the Northeast (36.36%); the 'Primary Care' scenario, with six studies (18.18%); and the predominant clientele was cancer patients. As for the methodological characteristics, in 96% of the studies, the quantitative approach was used; in 2%, a qualitative approach; and 2% associated the quantitative and qualitative approaches. As for the type of study, 60% were methodological and 24% descriptive-exploratory, with the Horta model being the most used (36%).

CONCLUSION

the paths are successful, yet still permeated by weaknesses in the validations and potentialities to standardize the language.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.

Development and testing of an instrument (HeSoEduCo) for health and social care educators' competence in professional education

BACKGROUND

Health and social care education is highly important for preparing future professionals for their future roles in sustainable health and social care. However, previous studies have emphasized that health and social care educators' competence is complex and poorly defined. Thus, there is a clear need for a psychometrically validated instrument to enable clarification and assessment of the required skills.

OBJECTIVE

To develop and psychometrically validate an instrument (the HeSoEduCo) for assessing health and social care educators' competence in higher and professional education.

DESIGN

Cross-sectional study.

METHODS

A HeSoEduCo instrument, with items inviting 1-4 Likert scale responses, was developed, based on one systematic review and one qualitative study, then validated in terms of face, content and construct validity and internal consistency (Cronbach's alpha values). All health and social care educators based in all 21 universities of applied sciences in Finland and seven vocational colleges were subsequently invited to participate in a large-scale application of the instrument in fall 2018. In total, responses of 390 of these educators are analyzed here.

RESULTS

The face and content validity of 71 newly developed items were assessed by experts in two evaluation rounds. The final content validity showed high scores for the instrument's relevance and clarity. Confirmatory factor analysis (to test construct validity) yielded eight factors (43-items remaining), defining the following competence areas of educators: evidence-based practice, digital collaborative learning, student-centered pedagogy, collaboration & societal, leadership & management, cultural & linguistic diversity, mentoring student into professional competence development and subject & curriculum. Cronbach's alpha values for the factors ranged from 0.70 to 0.89.

CONCLUSION

The instrument can be used to obtain self-evaluations of educators' competence when assessing their general competence levels and help human resources departments and managers to identify suitable continuous education programs for their staff.

Lack of focus on nutrition and documentation in nursing homes, home care- and home nursing: the self-perceived views of the primary care workforce

Background

Malnutrition is a comprehensive challenge for the nursing home, home care- and home nursing sector. Nutritional care and the subsequent documentation are a common and multifaceted healthcare practice that requires that the healthcare professionals possess complex combinations of competencies in order to deliver high-quality care and treatment. The purpose of this study was to investigate how a varied group of healthcare professionals’ perceive their own competencies within nutrition and documentation and how organizational structures influence their daily work and the quality of care provided.

Methods

Two focus groups consisting of 14 healthcare professionals were conducted. The transcribed focus group interviews was analyzed using the qualitative content analysis approach.

Results

Six categories were identified: 1) Lack of uniform and systematic communication affect nutritional care practices 2) Experience-based knowledge among the primary workforce influences daily clinical decisions, 3) Different attitudes towards nutritional care lead to differences in the quality of care 4) Differences in organizational culture affect quality of care, 5) Lack of clear nutritional care responsibilities affect how daily care is performed and 6) Lack of clinical leadership and priorities makes nutritional care invisible.

Conclusions

The six categories revealed two explanatory themes: 1) Absent inter- and intra-professional collaboration and communication obstructs optimal clinical decision-making and 2) quality deterioration due to poorly-established nutritional care structure. Overall, the two themes explain that from the healthcare professionals’ point of view, a visible organization that allocates resources as well as prioritizing and articulating the need for daily nutritional care and documentation is a prerequisite for high-quality care and treatment. Furthermore, optimal clinical decision making among the healthcare professionals are compromised by imprecise and unclear language and terminology in the patients’ healthcare records and also a lack of clinical guidelines and standards for collaboration between different healthcare professionals working in nursing homes, home care or home nursing.

The findings of this study are beneficial to support organizations within these settings with strategies focusing on increasing nutritional care and documentation competencies among the healthcare professionals. Furthermore, the results advocate for the daily involvement and support of leaders and managers in articulating and structuring the importance of nutritional care and treatment and the subsequent documentation.

Electronic supplementary material

The online version of this article (10.1186/s12913-019-4450-1) contains supplementary material, which is available to authorized users.

Experiences of supervision during clinical education among specialised nursing students in Sweden: A cross-sectional study

BACKGROUND

The importance of the clinical learning environment in nurse education has gained increasing attention over the last decades. However, there is a lack of research on the learning environment, its significance and meaning in specialist nurse education.

OBJECTIVE

The objectives of the study were to investigate specialised nursing students' experiences of supervision during clinical practice and to compare students who were satisfied with the supervision with those who were dissatisfied with respect to a) organisation of supervision and number of preceptors, as well as time allocated by preceptors for b) supervision, c) reflection, d) discussion of intended learning outcomes, and e) assessments of students' performance by preceptors.

DESIGN

This study used a cross-sectional design.

SAMPLE AND SETTINGS

A convenience sample of specialised nursing students was derived from five Swedish universities in the years 2016 and 2017.

METHODS

Data were collected using a questionnaire. Statistical analyses and a qualitative conventional content analysis were performed.

RESULTS

While almost all specialised nursing students reported that there had been time for discussion on their performance assessment, almost half of the students reported not getting time for supervision, or time for reflections and discussions on intended learning outcomes with the preceptor. Students reporting having time allocated for supervision by preceptors were found to be more satisfied with supervision. It was described as important that the preceptor(s) acknowledged the students previous work experiences. Even though being a registered nurse, reflections and feedback were described as valuable for the students learning. Several preceptors were described as positive allowing a broader picture and different views regarding working as a specialist nurse.

CONCLUSIONS

This study indicates that supervision, in terms of discussions and reflections, of specialised nursing students is significant for learning experiences and satisfaction during clinical placement.

Does improved postgraduate capacity shift the balance of power for nurse specialists in a low-income country: A mixed methods study

AIM

To explore nurse specialists' experiences of change and influence on practice two years after graduating with a postgraduate degree.

BACKGROUND

In the absence of further study opportunities for nurses in their own country, a master's degree was introduced to train the first group of nurse specialists in Mozambique.

DESIGN

Within a hybrid evaluation framework an exploratory, sequential mixed methods design was followed.

METHODS

Qualitative data from focus group interviews with nurse specialists (N = 12) led to five thematic data sets from which survey questions were formulated for the sequential quantitative component.

FINDINGS

"Change expectations", "Ambiguous practice environments", "Feeling powerless", "Having some influence" and "Workplace support" were emergent themes from interview data. Areas of positive change occurred in research (100%) and the use of evidence (88.9%) and involvement in decision-making (77.8%). For some change did not happen as anticipated-reasons included lack of nurse mentors to support new graduates (55.6%); lesser respect compared with doctors (44.4%) and poor understanding of the value of a master's degree (44.4%). Improvements in service quality and elevating the status of nursing were areas of greatest influence (77.8%).

CONCLUSION

Several enabling and limiting factors were identified in the experiences of change and influence on practice of newly qualified nurse specialists. Tacit change with respect to the value of the degree in improving the status of nursing seems not to have affected nurse specialists' own ability and power to influence practice. Improved postgraduate capacity on its own does not empower nurses in their role as specialists.

IMPACT

The findings point to a two-tiered strategy to be developed to dismantle barriers to the empowerment and advancement of nurse specialists. The identification of designated nurse mentors is essential to induct and sustain newly graduated nurse specialists. A clear research policy should be developed that supports the conduct of relevant research and the use of evidence in specialist practice.

Undergraduate student nurses' knowledge of evidence-based practice: A short online survey

BACKGROUND

Various approaches and frameworks have been designed and tested to increase the uptake of research findings into practice. One approach is to base healthcare providers' practices on the best available research evidence rather than on expired policy or tradition. For which knowledge of evidence-based practice (EBP) principles is a prerequisite.

OBJECTIVE

The purpose of the current inquiry is to evaluate Jordanian nursing students' knowledge of EBP.

DESIGN

This study was an on-line cross-sectional survey.

SETTINGS

We targeted students in two universities in the north and one in the capital city of Amman.

PARTICIPANTS

The target population was Jordanian student nurses, and the sample consisted of 316 from the nursing schools within three government universities.

METHODS

The EBP knowledge test was used to collect data from students. It was adapted from the EBP Knowledge, Attitudes, Access & Confidence Evaluation. Ethical approval was obtained from the principal investigator's university before the questionnaire was uploaded on to the free online survey website. The link to the survey was established and shared on Facebook.

RESULTS

Just over half of the participating students were male (51.9%) and the average age was 21.6 years (SD 2.7). The mean total knowledge score as measured by the EBP knowledge test was low at 1.9 (SD 1.4) out of 10.

CONCLUSIONS

An evaluation of EBP-related content in nursing schools' curricula is needed in order to design and test the effectiveness of implementing an EBP course in improving knowledge and skills. Critical appraisal and evidence synthesis skills should be honed as they are seen to be very weak, with much room for improvement. Meanwhile, research courses could be the mainstay for a nursing faculty to introduce the EBP approach for undergraduate nurses.

Engaging Biomedical Engineering in Health Disparities Challenges

Health Disparities (HD) are community-based, biomedical challenges in need of innovative contributions from Science, Technology, Engineering and Math (STEM) fields. Surprisingly, STEM professionals demonstrate a persistent lack of HD awareness and/or engagement in both research and educational activities. This project introduced Health Disparities (HD) as technical challenges to incoming undergraduates in order to elevate engineering awareness of HD. The objective was to advance STEM-based, HD literacy and outreach to young cohorts of engineers. Engineering students were introduced to HD challenges in technical and societal contexts as part of Engineering 101 courses. Findings demonstrate that student comprehension of HD challenges increased via joint study of rising health care costs, engineering ethics and growth of biomedical-related engineering areas.