Global standards for professional nursing education: The time is now

Exploring the Skills Prioritised in the Assessment of Students Pursuing Adult Nursing, Post-COVID: A Qualitative Analysis

AIM

To explore comments made by registered nurse practice assessors during the clinical assessment of students pursuing adult nursing.

BACKGROUND

Student nurses are entering a workforce that has changed professional and educational nursing practice systems due to the COVID-19 pandemic. Limited placement learning during lockdowns reduced opportunities for students to practise clinical skills in person. However, the current state of practice assessment for students pursuing adult nursing, particularly post-COVID, has yet to be explored.

DESIGN

Qualitative content analysis.

METHODS

Data were collected from the online assessment documentation of second-year BSc students pursuing adult nursing. A qualitative content analysis was performed to analyse comments made by qualified adult nurses who are positioned as clinical practice assessors for students pursuing adult nursing. COREQ reporting guidelines were followed.

RESULTS

Two main themes were identified: (1) task-focussed competencies and (2) relational aspects of care. Task-focussed competencies included 'technically complex physical health skills' with an emphasis on specialist clinical interventions and procedures. Relational aspects of care included values-based attributes such as compassion and empathy. However, relational aspects of care were noted less frequently. Comments related to communication skills and values-based care were less diverse than those relating to technical tasks and the language used was perfunctory.

CONCLUSION

Adult nursing assessments emphasise technical, task-focused competencies, with less attention given to relational skills like compassion and communication. To address this gap, nursing education must better integrate relational and technical competencies, enhancing patient care and supporting nurses' mental health and wellbeing for a more holistic post-pandemic nursing practice.

IMPLICATIONS FOR PRACTICE

Results suggest an increased focus on the development of relational skills is needed for students pursuing adult nursing.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The Impact of Nursing Resources on Chronic Wound Management: A Cross-Sectional Analysis

AIM

Evaluate the relationship between hospital nursing resources and outcomes among patients with chronic wounds.

DESIGN

Cross-sectional observational.

METHODS

Hospital-level predictors included the nurse work environment, proportion of Bachelor of Science (BSN)-prepared nurses, and skill mix (i.e., registered nurses [RN] as proportion of nursing personnel). Outcomes included in-hospital and 30-day mortality, discharging to a higher level of care and length of stay. Individual-level nurse data were aggregated to create hospital-level measures of nursing resources. We utilised multi-level modelling with nurses nested within hospitals and outcomes at the patient level.

DATA

Three datasets from 2021: RN4CAST-New York/Illinois survey, Medicare Provider Analysis and Review claims and American Hospital Association Annual Survey.

RESULTS

The sample included 34,113 patients with chronic wounds in 215 hospitals in New York and Illinois. In adjusted models, a 1 standard deviation improvement in the work environment was associated with 12% lower odds of in-hospital mortality, 8% lower odds of discharging to a higher level of care and a shorter length of stay by a factor of 0.96. A 10% increase in BSN composition was associated with 8% reduced odds of in-hospital mortality and 6% reduced odds of 30-day mortality. A 10% increase in skill mix was associated with 12% lower odds of in-hospital mortality and a shorter length of stay by a factor of 0.91.

CONCLUSION

Improved nursing resources are associated with better outcomes among patients with chronic wounds.

IMPLICATIONS

Nurses manage the care of patients with chronic wounds; thus, hospital investment in nursing resources is imperative for good outcomes.

IMPACT

Modifiable hospital nursing resources are associated with outcomes among patients with chronic wounds, a complex population.

REPORTING

STROBE.

Development needs for mental health nurse training in sub-saharan africa: A scoping review of international trends in nurse education and proficiencies to identify capacity-building goals in low- and middle-income countries

AIM

This scoping review aimed to evaluate existing international competencies, proficiencies and future trends for mental health nursing to assist capacity-building in sub-Saharan Africa.

BACKGROUND

Mental health nurses have a large role in meeting mental health needs in low- and middle-income countries. Improving mental health training curricula is important to achieving universal health coverage. This review of trends in international mental health nurse education aims to identify training needs in sub-Saharan Africa.

DESIGN

We used the Joanna Briggs Protocol for scoping reviews.

METHOD

A systematic search used three electronic databases and websites were searched for grey literature from global organizations, national nursing councils and regulators and personal contacts used where data were hard to obtain. Data extraction focused on education standards, curricula contents, proficiencies and global health/nursing development. Pragmatic analysis entailed critical examination of findings relevant to a priori study objectives.

RESULTS

31 documents were included: 9 for global health systems and workforce development, 22 for international nurse curricula and nursing proficiencies. We found agreement on need for improved nurse education and provision globally, but little focus on mental health nursing. Sub-Saharan African countries are developing mental health training in integrated competence-based programmes but some high-income countries were heavily behavioural and directive.

CONCLUSION

Generic standards and curricula development may assist in task-shifting, but post-basic mental health specialism may make expertise less accessible in low resource settings. We caution against following high-income country trends until foundations in mental health are established.

Deep learning approach in undergraduate nursing students and their relationship with learning outcomes: A latent profile analysis

BACKGROUND

Deep learning approach plays a pivotal role in nursing education, equipping students with the critical thinking skills and knowledge necessary to address complex clinical challenges. However, nursing students exhibit diverse approaches to deep learning, affected by individual characteristics, academic environments and teaching methods.

OBJECTIVE

This study aims to identify latent profiles of deep learning approach among undergraduate nursing students and analyze the factors influencing these profiles and their association with learning outcomes.

DESIGN

A descriptive cross-sectional survey.

METHODS

A total of 891 undergraduate nursing students from two medical universities in China participated in this study between May and July 2024. Data were collected using the Deep Learning Scale and the Learning Outcomes Scale. Latent profile analysis was employed to identify deep learning profiles. One-way analysis of variance and multinomial logistic regression were used to explore influencing factors of different profiles. The Bolck-Croon-Hagenaars (BCH) method was applied to examine differences in learning outcomes across profiles.

RESULTS

Four latent profiles of deep learning were identified: "Comprehensive Deep Learners" (27.0 %), "Ability-Oriented Learners" (25.4 %), "Attitude-Driven Learners" (21.7 %) and "Surface Coping Learners" (25.8 %). Gender, grade, preference for the nursing major and participation in flipped classrooms were significant factors influencing profile membership (p < 0.05). "Comprehensive Deep Learners" had the highest learning outcome scores, while "Surface Coping Learners" scored the lowest.

CONCLUSIONS

Significant heterogeneity exists in deep learning approach among undergraduate nursing students. "Comprehensive Deep Learners" achieved the highest learning outcomes. Nursing education should adopt tailored interventions based on the characteristics of different deep learning profiles to improve students' learning outcomes and comprehensive competencies.

Work-related stress of nurses in Poland and Lithuania: countries under the influence of war circumstances in Ukraine

BACKGROUND

Nursing is a challenging profession, often associated with high levels of work-related stress. Recent geopolitical events, such as the conflict in Ukraine, may further exacerbate stress among healthcare workers in neighbouring regions. Understanding stress levels among nurses is crucial for enhancing patient care and improving the well-being of medical staff.

OBJECTIVE

This study aims to assess work-related stress among nurses in Poland and Lithuania, taking into account the potential impact of regional geopolitical factors.

METHODOLOGY

This cross-sectional study was conducted among 482 Polish and 380 Lithuanian nurses. The online survey was performed using the standardized Expanded Nursing Stress Scale (ENSS). To compare quantitative variables between groups, the Mann-Whitney and the Kruskal-Wallis test (with Dunn's post-hoc test) were used. The significance level was set at 0.05, and effect sizes were calculated using Pearson's correlation coefficient (r) and eta-squared (η²).

RESULTS

The overall stress level (ENSS total score), as well as scores across all analyzed subscales, were significantly higher among Lithuanian nurses (mean = 168.44, SD = 38.56), compared to Polish nurses (mean = 144.13, SD = 34.15), with a statistically significant difference (p < 0.001). In Lithuania, significant factors influencing stress levels included age (p = 0.049) and place of work (p = 0.026), while in Poland, gender (p = 0.034), seniority (p = 0.002), education (p = 0.01), shift work (p = 0.004), and workload (p = 0.001) were notable factors.

CONCLUSIONS

Increased stress among nurses in both countries impacts their well-being and patient care quality, highlighting the need for targeted psychological support and better working conditions.

IMPLICATIONS FOR NURSING

Nurses play a critical role in healthcare, and mitigating stress through workplace improvements can enhance both their well-being and the quality of care they provide, especially during geopolitical crises. Implementing stress management programs and providing mental health resources are crucial steps to support nurses in high-stress environments.

Evaluation of long-term care insurance pilot city policies in China: a cross-sectional study

Background

The acceleration of China's aging process makes examining policy experiences from LTCI pilot cities highly significant for advancing the LTCI system in China and other emerging nations.

Methods

Policy documents were gathered using Citespace 6.3.R1, with primary data sources obtained from official government websites. A comparative study of LTCI policies in pilot cities was conducted, focusing on policy support, participation scope, financing channels, benefit provision, care conditions, and management structures to evaluate the programs' logic.

Results

Pilot cities have developed distinct approaches in the LTCI development process. However, issues persist, including a singular financing channel, misalignment between benefit provision supply and demand, substandard care quality, and the need for improved management effectiveness.

Discussion

Establishing a sustainable LTCI system requires implementing an independent financing mechanism and a standardized financial model, developing an efficient LTCI service supply framework, strengthening LTCI oversight and administration, and fostering the commercial insurance market.

Exploring Influential Factors Shaping Nursing as a Profession and Science in Healthcare System-A Systematic Literature Review

Introduction: Nursing faces numerous challenges amidst broader socio-political transitions in many countries. Despite efforts to establish formal nursing education and legislative frameworks, the profession's status remains relatively low within some healthcare systems. This study aims to examine the factors influencing nursing professionalism and provide insights into strategies for its enhancement. Aim: The study seeks to summarize the existing literature on nursing professionalism, assess methodological quality, and derive recommendations for future research. Through a systematic review, the study explores various factors shaping nursing professionalism, including communication skills, resilience, education, and cultural perceptions. Methods: A systematic search was conducted across multiple electronic databases from 2014 to 2024 to identify relevant studies on nursing professionalism. The search strategy encompassed elements of professionalism, nursing, and exclusion criteria. Selected studies underwent methodological quality assessment using the Critical Appraisal Skills Programme Qualitative Checklist. Results: The review identified 421 records, yielding 72 eligible studies after screening and eliminating duplicates. Fourteen studies met the inclusion criteria, revealing a complex framework of factors influencing nursing professionalism. The key determinants include communication skills, resilience, education, and cultural perceptions. Studies emphasized the importance of effective communication, resilience in crisis management, quality education, and understanding psychological and cultural influences on professionalism. Conclusions: Nursing professionalism is influenced by multifaceted factors, including communication skills, resilience, education, and cultural perceptions. Recognizing these factors is vital for promoting high-quality nursing practice and ensuring patient safety. Addressing these elements can inform targeted interventions to enhance nursing professionalism and support nurses in delivering optimal healthcare. This study underscores the importance of investing in nursing education, fostering resilience, and considering cultural nuances to cultivate a culture of excellence and professionalism within healthcare systems.

Understanding of and attitudes towards nursing education reform at medical colleges in Kyrgyzstan: A mixed-method study

AIM

To determine teachers' understanding of and attitudes towards nursing education reform at four medical colleges in Kyrgyzstan.

BACKGROUND

The quality of nursing education at undergraduate and postgraduate levels has a major impact on patient outcomes and the development of nursing as a profession and a science.

INTRODUCTION

Lower middle-income countries have sought to advance their nursing education by adopting the experiences of high-income countries.

METHODS

A mixed-method cross-sectional study design was used. The STROBE combined checklist was followed. A cohort of all faculty members at four colleges were included (N = 150). The questionnaire consisted of 10 groups of questions and statements. Both quantitative and qualitative data were collected.

FINDINGS

A total of 56.4% of respondents were familiar with the European approach to nurse education; 73.3% of respondents with a nursing education reported being familiar with the European approach, compared to 40.7% of respondents with a medical education. Qualitative written comments yielded 57 superscripts of codes, 14 subcategories, 5 categories and 2 themes as drivers and barriers of reform.

DISCUSSION

The survey revealed weak support for the nursing education reform. Respondents do not envisage nurse education being offered at all three levels of higher education (bachelor's, master's, and PhD), and even fewer recognise nurses as leaders of healthcare institutions.

IMPLICATION FOR NURSING

Teachers in nursing programmes should mostly be nurses with academic careers.

IMPLICATION FOR HEALTH POLICY

Nursing is still not recognised as an extremely important health profession that needs to be developed. This misunderstanding and negative attitude towards the role of nurses in the health care system are evident in both the quantitative and qualitative parts of the study.

Exploring the Utilisation of Internationally Qualified Nurses' Specialty Skills: Analysis of Recruiting Managers' View Points

AIM

This study examines the factors influencing the use of specialty skills among internationally qualified nurses in Australia from the recruitment managers' perspective. It specifically addresses the research question: How can the specialty skills of IQNs be effectively transferred to the healthcare systems of developed countries following immigration?

RESEARCH DESIGN

A semi-structured interview.

METHOD

Eight nurse managers directly involved in internationally qualified nurse recruitment participated in semi-structured interviews. The interview questions were formulated based on the outcomes of a preceding mixed-methods study.

DATA SOURCES

Between January and March 2023, eight recruiting managers responsible for internationally qualified nurse recruitment were interviewed. The collected data was analysed using thematic analysis.

RESULTS

Recruitment managers identified three key themes regarding transferring internationally qualified nurses' specialty skills to the Australian health system. 'Right Person, Right Opportunity' stresses the importance of matching nurses with appropriate roles. 'Barriers to Skill Alignment' highlights challenges such as credential recognition and integration issues. 'Advancing Opportunities' outlines strategies like workforce planning and tailored training to overcome these obstacles.

CONCLUSION

The findings emphasise the importance of strategic workforce planning, robust centralised assessment mechanisms and tailored training programmes for recruiting managers to support internationally qualified nurses' specialty skill utilisation.

IMPACT

This study extends to policymakers, healthcare organisations and nurses, guiding the development of strategies for safe nursing service delivery and optimising patient care. The emphasis on managerial needs highlights a pathway for creating a more efficient and supportive environment for internationally qualified nurses in the healthcare sector.

PATIENT OR PUBLIC CONTRIBUTION

This paper benefited from the insights shared by eight recruiting managers involved in hiring internationally qualified nurses, who contributed their valuable experiences and opinions.

Development and validation of the pain management competency scale for nurses and a nationwide survey of Chinese nurses

BACKGROUND

Nurses' competency in pain management is essential for effectively alleviating patients' acute pain, controlling chronic pain, and promoting patient recovery. However, reliable tools for evaluating these competencies across different clinical specialties and healthcare settings are lacking. This study aimed to develop and validate a Pain Management Competency Scale for Nurses (PMCSN) and to assess the pain management competencies of nurses in China through a nationwide survey.

METHODS

An item pool and a draft scale were developed through literature reviews, semi-structured interviews, and expert panel discussions. This was followed by refinement of the scale via Delphi expert consultations and a pilot test. To validate the scale, 342 nurses were conveniently sampled from six hospitals in Eastern and Central China. The validation process included item analysis, internal consistency reliability assessment, test-retest reliability (with 40 nurses retaking the questionnaire after a 14-day interval), content validity (evaluated by six experts using a 4-point Likert scale), and structural validity (assessed through exploratory and confirmatory factor analyses). The validated scale was then applied in a survey of 1,500 nurses from 15 hospitals across Eastern, Central, and Western China. Statistical analyses included descriptive statistics, analysis of variance (ANOVA), and t-tests.

RESULTS

The PMCSN comprised six primary dimensions-Pain Assessment and Monitoring, Pharmacological Pain Management, Non-Pharmacological Pain Management, Management of Analgesic Adverse Effects, Patient/Family Education, and Professional Development-and includes 52 tertiary items. The PMCSN scores ranged from 6 to 120, calculated by summing the standardized scores across the six dimensions, with higher scores indicating greater competency in pain management. The scale's Cronbach's α was 0.974 (dimension-specific values ranging from 0.863 to 0.935) and a test-retest reliability of 0.871. The content validity index (CVI) of the scale was 0.965. Exploratory factor analysis (EFA) showed that the six-factor model explained 67.50% of the variance. Confirmatory factor analysis (CFA) indicated good model fit, with average variance extracted (AVE) values ranging from 0.659 to 0.811 and composite reliability (CR) between 0.909 and 0.973, confirming good convergent validity. The square roots of the AVE values exceeded the inter-factor correlations, indicating good discriminant validity. In the nationwide survey, the average PMCSN score among 1,500 nurses was 101.27 ± 20.97. Nurses with higher education levels scored higher (F = 14.173, p < 0.01), as did those working in Eastern regions (F = 24.632, p < 0.01) and tertiary hospitals (T = -5.476, p < 0.01).

CONCLUSIONS

The PMCSN is a valid and reliable tool for assessing nurses' pain management competencies. It provides a standardized approach for evaluation and guides targeted interventions to improve competency. Regional and hospital-level disparities highlight the need for enhanced training in underdeveloped areas and collaboration between hospitals to promote balanced healthcare resources.

Nursing postgraduates' innovative behaviour, influencing factors and educational requirements: a national cross-sectional study

BACKGROUND

Innovative behaviours are important for nursing postgraduates who are a significant reserve for future nursing career, thinking critically, utilizing technologies and solving complex problems. In nursing undergraduates' education, innovative behaviour is closely linked with the development of professional identity. However, there are limited studies exploring innovative behaviours, influencing factors and educational requirements of nursing postgraduates.

AIM

To investigate nursing postgraduates' innovative behaviour, influencing factors, and the correlation between innovative behaviour and professional identity. Moreover, exploring nursing postgraduates' requirements for innovational education.

METHODS

A national descriptive cross-sectional study was conducted among postgraduate students in Chinese nursing schools between October and November 2022. A general information questionnaire, The Nurses' Innovative Behaviour Scale, the Professional Identity Questionnaire for Nurse Student, and a multiple-choice question about students' innovation education requirements were collected. The independent-sample t-test, one-way analysis of variance (ANOVA), multiple linear regression, and Pearson's correlation analyses were conducted.

RESULTS

This study recruited 426 nursing postgraduates from 44 nursing schools across China. The mean score of innovative behaviour of nursing postgraduates was 38.96 ± 4.90 (min-max 10-50). Nursing postgraduates' professional identity was positively correlated with innovative behaviour (r = 0.436, P < 0.01). Participants who read scientific literature frequently, had a high level of professional identity, and grew up in urban areas had high levels of innovative behaviour (adjusted R2 = 0.244, P < 0.001).

CONCLUSIONS

It was determined that the level of innovative behaviour is associated with their professional identity and the frequence of reading scientific literature in nursing postgraduates. It is imperative for educators to foster an environment that encourages postgraduate nursing students to engage with a wider array of scholarly literature and elevates postgraduate nursing students' professional identity. Furthermore, the dissemination of advanced knowledge and the adoption of diverse pedagogical approaches are likely to meet the innovative demands of nursing postgraduates.

Comparable achievement of workplace performance of student and graduate nurses: A quantitative cohort evaluation

AIM

This study explored the achievement of workplace capabilities synonymous with nursing practice. It investigated progressive development of workplace performance, against requisite standards of practice, of corresponding cohorts of student nurses during their final year placement and registered nurses during their graduate year, in south-eastern Queensland, Australia.

BACKGROUND

A capable nursing workforce is vital for the provision of safe, quality health care. Internationally, the literature discusses the breadth of capacities required for the practice of nursing. A perennial challenge is comprehensive pre-registration education that ensures new graduate nurses meet standards for practice to provide comprehensive care.

METHODS

A quantitative evaluation design was used to assess the progressive development of workplace performance of both student nurses across their final year placement (n = 214) and graduate nurses in their first nine months (n = 197). Capabilities of both cohorts were assessed using the Australian Nursing Standards Assessment Tool (ANSAT), based on Australian registered nurses' standards for practice that has demonstrated utility and validity for both students and graduates.

RESULTS

A total of 642 student assessments and 409 graduate nurse assessments were used for analysis. Findings revealed congruence in weaknesses in workplace performance for both students and graduates. Students and graduates consistently rated lowest in capabilities pertaining to high cognitive tasks that involved analysing data and modifying plans. Of interest, completing comprehensive, systematic assessments was stronger in students than in graduates.

CONCLUSION

This is the first comparable quantitative study exploring the progressive development of students and graduate nurses' workplace performance aligned to nursing practice standards. Questions of limitations throughout educational learning experiences during industry placement are raised in these findings. Furthermore, it is proposed that educational approaches be organised to address areas identified as weakest on graduation as these are most evident in initial employment. This research explicates a largely undefined area of nursing practice that can inform undergraduate learning priorities.

Embedding cultural safety in nursing education: A scoping review of strategies and approaches

INTRODUCTION

Post-secondary institutions can no longer ignore calls to action. Nursing programs are responsible for addressing racism and discrimination by integrating cultural safety into baccalaureate nursing curricula. This scoping review of peer-reviewed literature will reveal how cultural safety is integrated into nursing education across North American post-secondary institutions.

MATERIALS AND METHODS

57 records met the criteria for this scoping review between the dates of January 2016 to July 2024. The database search was conducted from November 7, 2021, to November 9, 2021, and then updated on September 17, 2024, to include articles up to and including July 2024, yielding 3444 total search results (1448 from Medline; 1996 from CINAHL). Results were manually screened, and duplicates found were removed.

RESULTS

The articles were analyzed thematically to identify strategies for integrating cultural safety into undergraduate nursing education. Four main themes were identified: experiential, theoretical, analytical, and multimodal learning.

CONCLUSION

This scoping review highlights nurse educators' role in fostering cultural safety and the importance of considering multiple strategies in curricular development. Strategies include practice experiences, simulations, storytelling, and case-based learning. To provide safe nursing care, education must be inclusive and responsive to people of all races, genders, abilities, and sexual orientations. By applying the concept of cultural safety to nursing education, students are required to acknowledge bias and address issues of power, colonialism, racism, and discrimination that exist in healthcare. These findings provide a foundation for future, more focused research. Further studies could expand on this work by evaluating the effectiveness of specific pedagogical strategies and exploring ways to better support nurse educators in promoting culturally safe learning environments.

[Initial training of nurses in nephrology care: a literature review]

Chronic kidney disease is a worldwide public health problem. Nephrology nursing is an effective intervention in the management of this disease. However, nurses can only develop the skills related to this care after receiving specialized initial education. This article explains the initial nursing education in specialized nephrology care in selected countries.

Evaluation of the relationship between adversity quotient, professional identity, and perceived humanistic care of head nurses in Master's Degrees in nursings

Background

High-level nursing talents play an important role in solving nursing scientific problems and leading nursing innovation, so the construction of high-level nursing talents has become a necessary guarantee for the health strategy in the new era. Managers have high expectations for master's degree in nursing, hoping that they will develop in all aspects of research, teaching, and professionalism, etc. However, the high expectations of managers have led to unclear job orientation, high clinical and scientific research pressure, and low recognition of nurses' sense of professional value from the outside world, which have led to the lowering of master's degree of professional identity and the tendency to leave the profession, which is not conducive to the stabilization of the nursing workforce.

Purpose

To explore the influence of adversity quotient, perceived humanistic care of nurse leaders on professional identity of nursing masters, and to clarify the relationship model between the three.

Methods

A convenience sampling method was used to conduct an online questionnaire survey on 160 master's degree nursing students in Ningbo and Shanghai from July to September 2022 using the general information questionnaire, adversity quotient, career identity and perceived humanistic care of nurse leaders scale.

Results

Adversity quotient, occupational identity and perceived humanistic care of nurse leaders were all at a moderate level. Adversity quotient (r = 0.430, P < 0.01), perceived humanistic care of nurse leaders (r = 0.443, P < 0.01) and occupational identity were positively correlated, and perceived humanistic care of nurse leaders could affect occupational identity through the mediating effect of adversity quotient, with the mediating effect accounting for 31.8%.

Conclusion

Nursing managers should create a good organizational atmosphere, build a training system for adversity quotient courses, conduct regular assessment and humanistic care to improve the ability of nursing masters to face adversity and enhance the awareness of their own professional values.

How Does the Proportion of Child-Specific Content of Pre-Registration Nursing Programmes in Higher Education Institutions Impact Upon Newly Qualified Registered Nurses' Perceptions of Preparedness to Care for Children, Young People, and Their Families? A Narrative Review Protocol

This paper presents a narrative review protocol to explore how the proportion of child-specific content of pre-registration programmes in universities impact upon newly qualified nurses' perceptions of preparedness to care for children, young people (CYP), and their families. The preparation and education to become a nurse who cares for children and young people differs from country to country. Providers of pre-registration nurse education offer routes into nursing from diploma to degree and in some countries post-graduate routes. The United Kingdom offers pre-registration programmes leading to qualifying as a children's nurse whereas programmes in countries such as the USA and Canada lead to a professional registration as a registered nurse with postgraduate study to specialize in areas such as pediatrics. The role of pre-registration nursing programmes is to facilitate preparedness for practice. Preparation for practice can include theoretical teaching and practice learning through simulation and face-to-face experience with countries requiring different numbers of practice hours to be completed. Although practice hours are central to nursing education, there is limited evidence on the impact and portion of child-specific content, including clinical learning in preparation of newly qualified nurses to care for CYP and their families. A preliminary search of Prospero, CINAHL, Medline and Cochrane Database indicates that there are no current or in progress reviews identified. The Population of interest, Exposure of interest, and Outcome framework were used to define the research question and inform the eligibility criteria. The review will consider different research designs if related to the research question. The search strategy will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for systematic reviews. Two independent reviewers will be involved in the screening progress to determine the final studies for inclusion. Eligible studies will be assessed for methodological quality using the Joanna Briggs Institute critical appraisal tools. Extraction of study characteristics and data related to the research question will be extracted into a predefined table. Data synthesis will be conducted using a descriptive analytical approach to summarize extracted data.

Deep learning and its associated factors among Chinese nursing undergraduates: A cross-sectional study

BACKGROUND

Adequate professional preparation of nursing undergraduates is conducive to developing health care careers. Deep learning is important for enhancing nursing competencies and the overall quality of students. However, limited research has been conducted to explore deep learning and its associated factors for students in higher nursing education.

OBJECTIVE

To describe the level of deep learning and explore its associated factors among Chinese nursing undergraduates.

DESIGN

A cross-sectional study.

SETTING

This study was conducted at a medical university in Anhui Province, China.

PARTICIPANTS

Convenience sampling was used to survey 271 nursing undergraduates between July and September 2023.

METHODS

The survey included questions about general information, deep learning, and critical thinking disposition. Nonparametric tests were used to distinguish the intergroup differences. Correlations were evaluated using Spearman's rank correlation analysis. Hierarchical multiple regression analysis was performed to determine the influencing factors.

RESULTS

The deep learning score of the nursing undergraduates was 3.82 (3.56, 4.00). Hierarchical multiple regression analysis revealed that gender (β = 0.10, P = 0.044), experience as a student leader (β = 0.10, P = 0.049), and critical thinking disposition (β = 0.60, P = 0.000) significantly impacted deep learning. All the variables explained 41.1 % of the total mean score variance for deep learning.

CONCLUSION

Chinese nursing undergraduates showed upper-middle levels of deep learning. Gender, experience as a student leader, and critical thinking disposition were significantly associated factors of deep learning. Nursing educators should provide targeted interventions for deep learning to facilitate the professional competencies of these students.

The Healthcare Workforce Shortage of Nurses and Physicians: Practice, Theory, Evidence, and Ways Forward

The healthcare sector is ubiquitously plagued by workforce shortages in economies around the globe. The fragility of this structural shortage becomes apparent when external shocks, such as the COVID-19 pandemic, exacerbate the lack of workers in clinical practice. In this article, we summarize current trends in healthcare workforce development across the globe, review theoretical concepts of workforce shortages, and discuss policies to address them. In practice, developed countries often address workforce shortages with targeted migration policies. However, targeted workforce migration policies only intensify workforce shortages in low-and middle-income countries. Theoretical macroeconomic models suggest that supply shortages may result from too low wages, supply lagging behind demand, and social perception. Changes in the wage rate cannot sufficiently increase the supply of health professionals as scholars find inelastic wages for physicians and nurses. Nonpecuniary factors such as working conditions, job satisfaction, and intrinsic motivation are at least equally important as financial incentives. In conclusion, increased wages can only be part of a heterogeneous policy plan to address shortages. Migration and retirement levels of health professionals can temporarily mitigate workforce shortages but rarely change the underlying systemic issues. Increasing the number of places available in medical and nursing schools while also improving, both, financial and nonfinancial incentives for employees are long-term structural policy options.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: A scoping review

BACKGROUND

Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP.

AIMS

The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs.

METHODS

The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis.

RESULTS

Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal.

LINKING EVIDENCE TO ACTION

Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.

Policy suggestions for improving nursing education in a low- and middle-income country: A modified Delphi study

BACKGROUND

Health policy critically influences a national healthcare system and nurse's roles, working conditions, and professional development opportunities, especially in low- and middle-income countries.

PURPOSE

To explore and prioritize the major challenges and solution, and establish policy directions for improving nursing education in the Kyrgyz Republic.

METHODS

The key stakeholders of nursing practice, education, policymaking, and regulation were involved in this modified Delphi study. Following two rounds of exploring priority issues and potential strategies, the participants of the final round assembled for consensual discussions on the establishment of policy directions.

DISCUSSION

Innovations in nursing education systems, building educational capacity, and ensuring educational outcomes were suggested and agreed upon for the sequential improvement of nursing education. Timely enactment of these policies will enable the Kyrgyz Republic to mitigate nursing shortages, improve the quality of healthcare services, and enhance overall public health outcomes.

CONCLUSION

The policy suggestions derived from this study, including the improvement of nursing education quality and the assurance of nurses' competencies, have great potential for improving quality healthcare practice and sustaining an effective healthcare system.

Reject the "Practice Readiness Myth": Ask if systems are ready for nursing graduates instead

The nursing profession is engaged in robust national dialogue on how to implement competency-based education. This dialogue often conflates the concept of "competency-based education" with nursing "competence" or "practice readiness." Our aim is to discuss the potential harms of conflating "competency-based education" with "competence" or "practice readiness." This commentary explores the possible risks of issue conflation. Risks include (a) suggesting that nurses who have successfully obtained licensure are not "competent" or "ready to practice," and (b) de-emphasizing the importance of safe and sustainable work environments for new graduate nurses. We discuss the need to separate conversations about "competency-based education" and "practice readiness"; the need to increase the clarity and specificity of discourse surrounding competency-based education; and the need for strategic alignment across academia and practice.

Nursing postgraduates learning experience of professional curriculum in China: A qualitative study

AIM

This study adopted the qualitative research method, aiming to explore the learning experience of nursing graduate professional curricula in China from the perspective of students and provided a basis for the continuous improvement of nursing graduate training.

DESIGN

A qualitative study.

METHODS

A purposive sampling method was employed to conduct semi-structured in-depth interviews with 14 nursing master's students enrolled in professional curricula from September 03, 2021, to December 8, 2022. The Colaizzi seven-step analysis method was utilized for data analysis, summarization and extraction.

RESULTS

Four themes emerged from the study findings: (i) The study of professional curricula is the cornerstone of scientific research work, but it is relatively boring; (ii) The teaching methods and assessment methods of postgraduate education need to be diversified; (iii) The postgraduate education needs to increase the study time of specialized courses and highlight the specialty characteristics; (iv) the study of professional curricula can enhance the comprehensive ability of postgraduate students.

CONCLUSION

The study of professional curricula for post-graduate nursing students plays an important role in the development of post-graduate research and can statistically significant improve their comprehensive ability, but there are some problems such as boring courses, single teaching assessment methods and insufficient time. In the future teaching reform, it is necessary to highlight the specialty characteristics of nursing scientific research, optimize curriculum education and improve students' scientific research knowledge and thinking.

PATIENT AND PUBLIC CONTRIBUTIONS

We thank all participants for their valuable input throughout the study.

Cultural Considerations in the Formal Process of Simulation Curriculum Adaptation: A Scoping Review

SUMMARY STATEMENT

Transborder curriculum partnerships in health professions education have been increasing in numbers in recent years. These partnerships present unique challenges when transferring curricula from one context to another. It has been noted that cultural differences between institutions, faculty, staff, and learners can have profound effects on collaboration. Given the significant need for context and fidelity (especially relative to cultural considerations) in healthcare simulation education, there are gaps that need to be addressed in the transfer of these curricula. A scoping literature review was conducted examining recently published articles with relevance to simulation curriculum design or adaptation in transborder contexts to determine to what extent cultural elements are considered in the design and adaptation of simulation-based education in transborder curriculum partnerships. This review resulted in 19 studies requiring full-text review. Studies represented every region of the world with both near and distant proximity of partnering parties. From the reviewed studies, 8 categories related to curriculum adaptation were identified. These categories, when compared with the themes present in Campinha-Bacote's model of cultural competency, showed complete overlap with the 5 themes of the model plus an additional theme complementary to the model. This scoping review demonstrates that cultural considerations clearly play a role in the adaptation of simulation curricula in transborder healthcare curricular partnerships, but further research is needed to further define the exact nature of that relationship.

Male nursing students' experiences of their clinical internships: A qualitative study

Background

Nursing has traditionally been a predominantly female profession; however, there has been a gradual increase in the proportion of male nursing students in recent years. Male nursing students may encounter distinct challenges within clinical settings, potentially impacting their physical and mental well-being.

Aim

This study aims to explore the clinical internship experiences of male nursing students and provide them with adequate support for their successful adaptation to clinical roles.

Methods

This study used a descriptive design and qualitative approach. The participants were enrolled using a convenience sampling method. Data were collected using individual face-to-face semi-structured interviews.

Results

Male nursing students' experiences of their clinical internships were described through the following themes: (1) dynamics of working as a nurse, (2) not just a male nursing student, (3) gender-based stereotypes, (4) balance between forte and failing, (5) difficulties and challenges when working in hospitals, and (6) lessons learned and knowledge needs.

Conclusions

Our research findings have significantly enhanced our comprehension of male nursing students' experiences and offered valuable recommendations for both nursing education and clinical practice. Simultaneously, these results provide essential information support for nursing educators and hospital administrators.

Usability of Standards for Scaffolding in a Health Sciences Programme: A feasibility Study

BACKGROUND

Standards contribute to comprehensive and programmatic implementation of educational strategies, such as scaffolding. Although the development of educational standards follows a rigorous consensus approach, they are socially constructed and could result in varied interpretations by users. Reports of varied implementation of standards in health professions education underscore the need to test the developed standards for scaffolding in health sciences programmes. Usability entails determining whether a product like standards works as intended under the expected conditions and contexts. This study aimed to describe the usability of standards for scaffolding in a health sciences programme through a pilot study.

METHODS

A multi-method design employing user and expert-based usability evaluation techniques sought to describe the usability of the standards for scaffolding in a three-year pre-registration nursing programme. The user sample of nurse educators drawn from the programme, conducted a self-assessment on scaffolding practices in the programme using a developed standards checklist. For the expert sample, three-panel members with an understanding of the discipline and programme context were purposively sampled. These panelists studied the users' self-assessment reports before completing an author-generated heuristics checklist to support or refute any of the standards. Descriptive statistics, comparative and content analysis were applied to analyse data from users' interviews and expert's completed heuristics checklist, determining the standards' usability, and identifying the usability flaws or strengths.

RESULTS

The users had three or more years of teaching experience in the competency-based curriculum for nursing. The experts shared an average of 16 years of experience in teaching in higher education, and seven years of experience in quality assurance and programme accreditation. The four standards had a usability score of above average (68%). Seven usability strengths and four usability flaws were identified. Usability flaws related to misinterpretation of some criteria statements and terminologies, multiple meanings, and users' challenges in generating evidence for some criteria.

CONCLUSIONS

The pilot study revealed the context-based 'truth' regarding the fidelity of a health sciences programme evaluation on scaffolding, as well as identifying the ideal contextual conditions in which the standards for scaffolding health sciences programmes would work best. The identified usability flaws highlighted the need for further revisions of the standards. Future research on the feasibility of the standards in other health sciences programmes and contexts is recommended.

A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study

AIM

The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice.

DESIGN

A mixed methods cognitive task analysis with a convergent triangulation design.

METHOD

Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions.

RESULTS

The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic.

REPORTING METHOD

The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist.

PATIENT OR PUBLIC CONTRIBUTION

Patients and public were not involved in this research.

Racial and ethnic disparities in ED use among older adults with asthma and primary care nurse practitioner work environments

Background

Nurse practitioners (NPs) increasingly deliver primary care in the United States. Yet, poor working conditions strain NP care. We examined whether racial/ethnic health disparities in ED visits among older adults with asthma are moderated by primary care NP work environments.

Methods

Survey data on NP work environments in six states were collected from 1,244 NPs in 2018-2019. 2018 Medicare claims data from 46,658 patients with asthma was merged with survey data to assess the associations of all-cause and ambulatory care sensitive conditions (ACSC) ED visits with NP work environment and race/ethnicity using logistic regression.

Results

NP work environment moderated the association of race (Black patients versus White patients) with all-cause (odds ratio [OR]: 0.91; p-value = 0.045) and ACSC (OR: 0.90; p-value = 0.033) ED visits.

Conclusions

Disparities in ED visits between Black and White patients with asthma decrease when these patients receive care in care clinics with favorable NP work environments.

Nurses retrospective view on nursing education: A repeated cross-sectional study over three decades

Background

As the healthcare landscape undergoes transformative shifts due to factors like ageing demographics, technological innovations, rapid global dissemination of infectious diseases, and imperatives for accessible, cost-effective care, a pressing need emerges for the contemporisation of nursing education. Notably, there is a paucity of research delving into nurses' introspective evaluations of their educational experiences after their immersion in professional settings.

Objective

This study aimed to examine nurses' evaluations of their educational background over 30 years and identify relationships between their assessments and their demographic.

Design

The study embraced a recurrent cross-sectional survey methodology, encompassing three distinct quantitative cross-sectional evaluations conducted in the years 1999, 2009, and 2021.

Context/participants

The cohort for this inquiry consisted of nurses stationed in Estonian general hospitals and inpatient departments of developmental plan institutions, each with at least one year of professional experience. Cumulatively, 832 nurses were engaged across three sequential evaluations: Study I (n = 463), Study II (n = 198), and Study III (n = 171).

Methods

Data procurement was executed via a structured survey, with subsequent analytical procedures encompassing descriptive and correlational methodologies.

Results

A discernible augmentation in the educational calibre of nurses was observed with each successive evaluation. This escalation concomitated enhanced positive assessments in areas like evidence-informed education, skill development, and autonomous operational capabilities. Yet, a critical appraisal persisted concerning their competencies in navigating complex patient interactions and addressing socio-religious dilemmas.

Conclusions

The merit of this investigation lies in its illumination of nursing education's evolution, as perceived retrospectively by nurses who have operationalized their academic learnings in real-world scenarios. Their vantage point, inherently informed by practice, uniquely positions them to earmark avenues of refinement. This exploration paves the way for enrichments in nursing education, spotlighting the imperative of equipping nurses to adeptly manage intricate situations.

Professionalism in pre-licensure nursing education: Core values, didactic coursework and clinical training

AIM

To discuss professionalism for pre-licensure nursing students and identify recommendations for inclusion in core values, didactic coursework and clinical training.

BACKGROUND

Professionalism is part of the nursing identity that encompasses integrity and honesty. This concept has been difficult to translate into formal education in nursing programs and clinical practice.

DESIGN

A discursive paper.

DATA SOURCES

A search of national literature without date restrictions in PubMed, CINAHL, Google Scholar and frameworks for nursing education. We explored principles of professionalism in nursing education and practice.

DISCUSSION

Evidence-based literature supports the integration of core values of altruism, autonomy, human dignity, integrity, honesty and social justice into didactic curricula, and clinical training. Principles of professionalism can be incorporated intentionally in nursing education to maintain patient safety and trust.

CONCLUSION

The principles of professionalism, related to core values of the nursing profession, are abundantly described in the literature. However, these principles represent core values that have not been formally conceptualized. With the changing landscape of healthcare, there is a need for deliberate, measurable integration of professionalism into pre-licensure education.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public involvement in the design or drafting of this discursive paper.

Nursing students experienced academic emotions during education - a longitudinal descriptive study from a nursing bachelor's program in Sweden

AIM

To explore nursing students' academic emotions during ongoing learning activities focusing on perceived challenge and competence.

BACKGROUND

Emotions plays an important part in learning. Positive emotions can be beneficial while negative emotions can be detrimental to educational outcomes. Optimal experiences are situations when learners simultaneously experience sufficient challenge and competence. Since various learning activities are performed in different learning environments during the nursing program, it is of interest to investigate students' ongoing emotions in the occurring contexts.

DESIGN

A longitudinal descriptive study.

METHODS

By using the Contextual Activity Sampling System, data was collected every third week on a three-year nursing program. From August 2015 to January 2020, a total of 2, 947 questionnaires were answered by 158 students. Experiences of positive and negative academic emotions were calculated for the entire program. Optimal experience was calculated for courses where high discrepancy between positive and negative experiences were identified.

RESULTS

Students self-reported academic emotions varied over time and in relation to learning activities. High ratings of negative emotions were reported during clinical practice in all semesters except the final. Students' positive academic emotions and optimal experience in clinical practice increased after having deepened their academic knowledge.

CONCLUSION

Nursing students had an increased positive experience when they themselves practice a learning activity and it appeared that they benefit from academic preparation prior to entering internship. Nursing students need an academic competence to develop their skills during training in the clinical reality. Increased collaboration between academia and clinic would be beneficial for students' clinical development.

Trends, Future Directions, and Questions for Preparing Successful Nurse Faculty

BACKGROUND

Many nurse educators enter the faculty role with little academic teaching experience. Although there is evidence that providing clear expectations and targeted training on teaching and learning is beneficial for new faculty members, inconsistencies and content gaps in orientation programs and prerequisite knowledge for nurse educators still pose challenges to faculty success.

METHOD

This article reviews the current state of preparation for nurse educators, describes new knowledge and skills nurse educators need to prepare nursing students for practice, and suggests approaches to continuous growth and professional development.

RESULTS

In addition to knowledge of foundational teaching concepts, nurse educators need advanced knowledge of technology, global health, and climate change. Today's learners are diverse and require equity-focused teaching and pedagogy responsive to individual learner characteristics and backgrounds.

CONCLUSION

Ensuring nurse educators are prepared to deliver a high-quality education program requires up-to-date professional development, a comprehensive orientation, and ongoing faculty support. [J Nurs Educ. 2023;62(12):661-667.].

Self-efficacy in the context of nursing education and transition to practice as a registered practitioner: A systematic review

AIM

The aim of this systematic review is to identify, describe and synthesize evidence from experimental studies conducted to measure and conceptualize self-efficacy within the context of nursing education and the transition of nursing students to practice as a registered practitioners.

DESIGN

Systematic review.

METHODS

Papers were screened by four independent reviewers, and data were extracted using a standardized data extraction tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance and checklists were used to guide this review.

RESULTS

The review included 47 studies, using a quasi-experimental pre-test-post-test design (n = 39) and randomized control trials (n = 8). Various teaching and learning interventions were used to enhance self-efficacy; however, there is no definitive conclusion to be drawn regarding the most effective educational interventions. Various instruments were used in the studies to measure self-efficacy. 10 of these were related to general self-efficacy, while 37 instruments measured self-efficacy in the context of specific skills.

Web-based standardized patient simulation for taking anamnesis: an approach in nursing education during the pandemic

BACKGROUND

To address the challenges in nursing education brought about by the pandemic, this study aimed to evaluate the use of a web-based standardized patient practice in the development of nursing students' anamnesis taking skills and their views about its application.

METHOD

We conducted a descriptive intervention study with 39 s-year nursing students. The students completed anamnesis using the standardized patient practice in line with a scenario with real standardized patients in a web-based environment with audio and video.

RESULTS

The total scores of students' anamnesis skills were low. The agreement between the total scores, scores obtained from the health patterns, and each item in the control list was statistically significant (p < 0.05).

CONCLUSION

Web-based standardized patient practice is an alternative for clinical practice facilitating the gaining of competencies in making holistic nursing diagnoses under conditions that limit face-to-face interactions, such as pandemics.

Experience in developing innovative practical ability for Master of Nursing Specialist degree program in China: A qualitative descriptive study of postgraduates

BACKGROUND

Nursing talent training should be adjusted in accordance with policies and regulations, the priority areas of health care, the development of nursing disciplines, and changes in nurses' roles. Experience from nursing education stakeholders indicates that postgraduate education faces numerous challenges. Thus, it is necessary to discuss postgraduates' experience in cultivating innovative practical ability.

OBJECTIVES

To analyze the experiences of nursing specialist postgraduates in cultivating innovative practical ability to provide a reference for further improvement of the Master of Nursing Specialist program.

DESIGN

A qualitative study.

SETTING

A university and its three affiliated tertiary hospitals in H city, China.

PARTICIPANTS AND METHODS

Individual, semi-structured interviews were conducted face-to-face with 12 postgraduates currently in clinical practice and six postgraduate nurses within two years of graduation between April and June 2022. All interviews were audio-recorded and transcribed verbatim, and the data were analyzed using the Colaizzi method.

RESULTS

Three key themes emerged: (1) the cognition of innovative practical ability; (2) the experience of cultivating innovative practical ability at school; and (3) the experience of cultivating innovative practical ability in the hospital.

CONCLUSIONS

With a full understanding of the training experience of postgraduates' innovative practical ability, policymakers and training units can clarify the shortcomings of the training model, make targeted improvements, and work together to build a more scientific and complete MNS training model. Our findings have the potential to inform faculty structure, catalyze curriculum reform, optimize clinical practice to facilitate the development of Master of Nursing Specialist programs, improve the quality of care, and promote patient recovery.

Learning needs of nursing postgraduates in Southwest China based on Hutchinson's learning needs theory: a qualitative research

BACKGROUND

The process of education is mutual. The learning needs of students need to be paid attention to and can affect the learning outcome. In order to make nursing postgraduates' curriculum better, meet the learning needs of students, and help to achieve the learning objectives of students, this study based on Hutchinson's learning needs theory, aims to collect the learning experience of nursing graduates, as well as the gap between learning needs and target needs, and explore the benefits and barriers of nursing graduates in the curriculum learning. It may provide beneficial reference for further optimizing teaching content and improving teaching methods.

METHODS

This study was designed as a qualitative research. Purposive sampling was used to recruit 17 nursing postgraduates in the only two universities in Chongqing, Southwest China, 2021. Semi-structured, in-depth individual interviews were conducted to explore how they subjectively experience the benefits and demands of the professional curriculum. Data was analyzed using Colaizzi's seven-step analysis.

RESULTS

Three main themes "clear learning cognition and goals," "positive learning attitude," and "the gap between learning goals and actual needs" were identified from the original data. Respectively, Subthemes concerning the first theme included "improve scientific research capabilities, enlighten thinking and broaden your horizons, and learn new knowledge and new skills." Subthemes of the second theme were "improve abilities in practice and actively seek diversification of course content and format." Subthemes of the third theme included "the course has a certain depth and breadth, but the course study does not meet the needs of scientific research, the course contents are theoretical, not knowing how to use the research method in certain conditions."

CONCLUSIONS

The learning needs of nursing postgraduates in Southwest China could be divided into two parts: benefits and barriers, among which the benefits were participants had clear learning goals and positive learning attitudes. When curriculum could not meet their needs, they actively sought methods (e.g., networks or off-campus resources) to close the gap between those needs and their goals. Follow-up educators should focus on learning needs and build curricula by optimizing the contents and methods of existing teaching resources.

Standards for evaluating the quality of undergraduate nursing e-learning programme in low- and middle-income countries: a modified Delphi study

BACKGROUND

The lack of standards for evaluating the quality of undergraduate nursing programmes hampers the evaluation of e-learning programmes in low- and middle-income countries. Fragmented approaches to evaluation coupled with a lack of uniform criteria have been a major deterrent to the growth of e-learning. Adopting standards from high-income countries has contextual challenges in low- and middle-income countries (LMICs). Holistic approaches coupled with uniform standards provide information to stakeholders hence the quality of the programmes is measurable. The e-learning situation in low-and middle-income countries provided an impetus to develop and validate these standards.

DESIGN

A modified Delphi technique.

REVIEW METHODS

Fourteen experts with experience and expertise in e-learning and regulation of undergraduate nursing from fourteen countries from LMICs participated in three rounds of the modified Delphi process. A pre-described set of standards was shared electronically for independent and blinded ratings. An 80% threshold was set for consensus decisions. The standards were modified based on experts' comments, and two subsequent rounds were used to refine the standards and criteria.

RESULTS

At the end of round one, the expert consensus was to keep 67, modify 39 and remove three criteria. At the end of the second round, the consensus was to modify 38 and remove one criteria. In the third round, experts agreed that the standards were feasible, usable, and practical in LMICs. A total of six broad standards with 104 criteria were developed.

CONCLUSION

The Technological bloom permeating all spheres of society, including education is an essential component in the development of e-learning programmes. E-learning in nursing education requires critical evaluation to ensure quality in undergraduate nursing programmes. The intricacies of the Low and middle-income context were taken into consideration in developing the standards to offer sustainable evaluation of the quality of e-learning in LMICs, and local solutions to local problems.

The relationship between self-regulated learning, mindful agency, and psychological resilience in Chinese master of nursing specialists: A cross-sectional study

Background

Self-regulated learning helps to improve academic performance and is an important strategy for the sustainable development of Master of Nursing Specialists. Consequently, it is relevant to identify the factors that affect self-regulated learning and analyze the correlation between them.

Objective

This study examined the status quo of self-regulated learning, the relationship between self-regulated learning, mindful agency, and psychological resilience, and explored whether mindful agency and psychological resilience influence self-regulation learning.

Methods

Chinese Master of Nursing Specialists were recruited to participate in an online survey from March to November 2022. Self-regulated learning, mindful agency, and psychological resilience were measured using three questionnaires, including the Self-Regulated Learning Scale for Clinical Nursing Practice Scale (SRLS-CNP), the Mindful Agency Scale, and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). The data were processed and analyzed using SPSS26.0. The statistical methods included descriptive statistics, Pearson’s correlation analyses, and multiple linear regression.

Results

Self-regulated learning of Chinese Master of Nursing Specialists was medium level (59.24 ± 9.33 scores). Mindful agency and psychological resilience were positively correlated with self-regulated learning (p &lt; 0.01) and important predictors of self-regulated learning of Master of Nursing Specialists, explaining 44.6% of the variation.

Conclusion

Mindful agency and psychological resilience affected the self-regulated learning level of Master of Nursing Specialists in clinical practice. These results will enable clinical educators to pay more attention to the personal psychological factors of Master of Nursing Specialists to improve their self-regulated learning ability through mindful agency and psychological resilience.

Uniformity along the way: A scoping review on characteristics of nurse education programs worldwide

BACKGROUND

The changing demands on healthcare require continuous development and education in the nursing profession. Homogeneity in nursing qualifications reduces educational inconsistencies between and within countries. However, despite various initiatives, modifying nurse education remains challenging because different countries have their own legislations, structures, motivations, and policies.

OBJECTIVES

To summarize the characteristics of nurse education programs around the globe and analyze the similarities and differences between them.

DESIGN AND METHODS

A scoping review was performed to identify different characteristics of nurse education programs in Organization for Economic Co-operation and Development (OECD) countries. Records published between January 2016 and July 2021 were searched in the PubMed, Cinahl, and ERIC databases. The reference lists of all included articles were also searched manually for relevant studies. Articles were eligible if they described nurse education in one or more of the selected countries with a focus on nursing degrees (both undergraduate and postgraduate programs), nursing titles, program duration, study load hours, or practice hours. Data were independently extracted using a predefined extraction sheet. We asked the respective nursing associations for confirmation and to provide any additional information.

RESULTS

After searching 9769 records, 117 were included in the synthesis. The included records described characteristics of undergraduate nursing educational programs (n = 50), postgraduate programs (n = 30), or both (n = 37). In total, 86 undergraduate and 82 postgraduate programs were described, with a great variety in degrees, nursing titles, study load hours, and practice hours.

CONCLUSIONS

This study demonstrates that there is still considerable variation in nurse education programs between countries. These diverse educational pathways lead to different nursing titles and internationally standardized definitions of nursing roles have not been established. This makes it difficult to understand the healthcare role of nurses. Hence, efforts are needed to increase the quality and uniformity of nurse education around the world.

Clinical learning opportunity in public academic hospitals: A concept analysis

Background

Clinical learning opportunities (CLO) are vital educational encounters occurring in various clinical areas to provide the student nurses with clinical knowledge and experiences to develop their competencies for professional practice. However, CLO is a broad concept with varied characteristics that allow ambiguity, limiting its understanding and use. Its ambiguous nature leads to uncertainties and poor development of the required clinical attributes of successful theory to practice integration, higher-order thinking skills (HOTS) and clinical competencies.

Aim

The aim of the study was to explore and describe the conceptual meaning of CLO, have a clear understanding and insight into the concept and identify the antecedents and consequences for pragmatic purposes.

Setting

The study took place in a public academic hospital in Gauteng.

Methods

The eight steps of concept analysis by Walker and Avant were followed. Multiple data sources not limited to nursing were explored and critically analysed for the definitions, characteristics, nature and uses of CLO from different fields of study.

Results

The defining attributes of CLO were identified, namely the context, antecedents, processes, consequences and outcomes. The context within which CLO occurs was dynamic, multidimensional, real-life healthcare settings; antecedents included planning of clinical placement, provision of learning outcomes and consideration of the cognitive level of the students. Engagement and active participation in collaborative, problem-based learning activities, community-based research and the use of emerging technologies were the processes identified. The outcomes were autonomous, confident, competent professional nurses with critical thinking, clinical reasoning, judgement, critical decision making and problem-solving skills.

Conclusion

A theoretical and operational definition of CLO was developed. The findings and results of concept analysis identified and specified the defining attributes of clinical learning opportunity. The findings can assist nurse educators, Clinical Education and Teaching Unit (CETU) personnel and operational managers to enhance CLO for student nurses to achieve their clinical learning goals and outcomes. The evaluation tools that may be adopted to assess the acquired clinical skills were also identified.

Contribution

An increase in the existing body of knowledge in nursing education, considering that enhancing the CLO exposes students to various clinical experiences contributing to their development of clinical competencies to solve complex problems. The strategies to enhance the CLO will be developed, which may also provide vital information for policy development. Conceptualisation of the findings to nursing practice and quality patient care will be integrated into relevant literature.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to identify and map the evidence reporting the knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries.

INTRODUCTION

Evidence-based practice aims to improve health care quality, safety, and health system efficiency. Numerous research studies have explored nurses' engagement in evidence-based practice in high-income countries. Developing nations have recently joined the evidence-based practice movement, and primary research about nurses' engagement with it are emerging.

INCLUSION CRITERIA

The scoping review will include primary studies (quantitative, qualitative, and mixed methods) and gray literature addressing knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses. Participants will include registered nurses working in low- and middle-income countries. Studies conducted in all health care settings, including acute and community settings, in low- and middle-income countries will be included.

METHODS

We will search MEDLINE, Embase, CINAHL, Scopus, ERIC, JBI Evidence-based Practice Database, Cochrane Library, LILACS, and AIM. Gray literature will be sourced from ProQuest Dissertations and Theses Global and Google Scholar for primary studies. Studies published in the English language will be included, with no limit on publication date. Titles, abstracts, and full-text articles will be assessed against the inclusion criteria by 2 independent reviewers. The extracted data will be analyzed quantitatively using frequencies and counts. Textual data from qualitative studies will be analyzed using descriptive content analysis. Results of the data analysis will be presented using graphs, tables, and a narrative format.

SCOPING REVIEW REGISTRATION

Open Science Framework ( https://osf.io/hau5y ).

Practice readiness of new graduate nurses and factors influencing practice readiness: A scoping review of reviews

BACKGROUND

For many years there has been concern that new graduate nurses may not have been adequately prepared for the workplace, often framed in terms of whether they are work ready or practice ready and able to deal with the 'reality shock' of transitioning from student to clinician. This has prompted significant research to investigate the practice readiness of new graduate nurses.

OBJECTIVES

Identify what is known about the practice readiness of new graduate nurses upon commencement of employment, how practice readiness changes over their first year of employment and explore the factors which influence practice readiness.

DESIGN

Scoping review of existing reviews guided by the framework developed by Arksey and O'Malley, with search results based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement.

METHODS

MEDLINE, CINAHL, PsycINFO, Scopus and Web of Science were searched to identify literature reviews synthesising evidence about new graduate nurses, work readiness, practice readiness, competency and transition to practice. New graduate nurses were defined as nurses who were working in any clinical setting as a nurse within their first year of employment after graduation. Database searching was supplemented with snowball searching and limited to English language papers published between 2011 and 2020. Full-text copies of included reviews were imported into an NVivo (Version 12) database to facilitate analysis and synthesis of findings.

RESULTS

Forty-five reviews were included. The findings indicate that transition is influenced by a wide range of intrapersonal, interpersonal and organisational factors, many of which are beyond the control of new graduate nurses. The findings also suggest that, overall, there are no major concerns about the practice readiness of new graduate nurses consistently supported by strong evidence. However, there is evidence to suggest that they 'lack confidence' during the first few months of employment.

CONCLUSIONS

The 'receptivity' of the clinical environment to new graduate nurses appears to be a critical influence on their experience of transitioning from student to clinician and can also influence their readiness for the role of a registered nurse. Rather than focusing on the question of whether new graduate nurses are adequately prepared for the workplace, it may be time to shift the question to whether the workplace is ready to support new graduate nurses. The findings suggest two research priorities for advancing our understanding of workplace support for new graduate nurses.

Erasmus Staff Mobility in the Building of a European Network: The Case of a Central European University

Globalization now applies to almost all aspects of life, and it also applies to the world of science. Internationalisation and interdisciplinarity are fundamental determinants of modern research and education. The foremost factor of functioning in the international world of science is the mobility of students and scientists. Considering this context, the objective of this study was to analyse the staff mobility for teaching under the Erasmus+ programme at the Wrocław University of Environmental and Life Sciences (UPWr). The research took into account the mobility of staff for teaching (STA) within the period of the academic years from 2009/2010 to 2020/2021. The methodological approach applied in this study is based on the concept of mobility network analysis and mobility flows. The geo-visualization was prepared with the use of a spider diagram. Using this approach, the connections between spatial locations and domains of scientific activity were analysed. The results show that the mobility flow at UPWr rose significantly after the authorities of the university decided to increase the funding for STA, and eventually was slowed down by the outbreak of the COVID-19 pandemic. Moreover, the findings in the geographical aspect show that there were two main regions of destination, which were the Iberian Peninsula and the closest neighbouring countries, where the predominant institutions could be observed. The most mobile group of teachers were the ones representing environment sciences. The STA flow is not reflected in the students’ mobility flow. COVID-19 has enhanced the virtual component of learning, resulting in the strengthening of the blended mobility model.

Bibliometric analysis of the Doctor of Nursing Practice dissertations in the ProQuest Dissertations and Theses database

AIMS

To examine the distributed characteristics and explore the research themes of Doctor of Nursing Practice (DNP) dissertations during the past two decades.

DESIGN

A descriptive statistical and visualization bibliometric analysis was conducted.

METHODS

Doctor of Nursing Practice dissertations submitted between January 2005 and June 2021 were collected from the ProQuest Dissertations and Theses database. A descriptive statistical analysis was conducted to calculate the distribution of the DNP dissertations by granting institution and the published year of publications. The VOSviewer 1.6.13 was used to explore the bibliometric networks and research priorities of the DNP dissertations.

RESULTS

A total of 4989 DNP dissertations from 90 universities were included in this study, all from the United States. The number of DNP dissertations showed an upward trend, with steady growth from 2005 to 2014 and rapid growth after 2015. The DNP studies focused on five areas: health care management in clinical nursing, advanced practice in nursing education and health education, public health problems, mental health care for adolescents and nurses and the older people care and long-term care.

CONCLUSION

Parallel to the numerical increase in DNP dissertations is a steady expansion in the range of research topics and scopes, which is aligned with specific specializations of the DNP. Many are interdisciplinary and employ techniques imported from the fields of public health, psychology and social sciences, resulting in nursing educators and practitioners continually broaden their subject perspectives.

IMPACT

Knowing where, when and why DNP research trends developed will help nursing educators to further develop DNP education and optimize DNP programs in the future, such as paying more attention to the nursing practice. Moreover, this study will inspire DNP students and researchers to expand their subject perspectives and broaden the research scope to solve nursing practice problems based on interdisciplinary theories and methods.