Exploring how reflective practice training affects nurse interns' critical thinking disposition and communication skills

From awareness to action: investigating the impact of big-five teamwork model awareness on rationing of nursing care and patient-centered care

BACKGROUND

Nurses are the cornerstone of healthcare delivery, playing a pivotal role in ensuring safe, high-quality, and patient-centered care. However, the significant demands on their time and resources often lead to the rationing or omission of essential nursing care activities, undermining patient outcomes. As frontline caregivers, nurses' ability to collaborate effectively within teams is critical to overcoming these challenges. The Big Five Teamwork Model, which emphasizes trust, communication, and leadership, offers a transformative approach to strengthening teamwork and addressing barriers to comprehensive nursing care.

AIM

This study aimed to assess the impact of the Big Five Teamwork Awareness Sessions (Big 5TWAS) on the rationing of nursing care and patient-centered care.

METHODS

A quasi-experimental pre-post-test design was conducted in critical care units at an Egyptian university hospital. A convenience sample of 60 nurses and 31 admitted patients participated in the study. Big 5TWAS interventions were implemented for nurses, and study variables were measured using nursing teamwork surveys, the Rationing of Nursing Care Observational Checklist (RONCO), and patient-centered care questionnaires before and after the intervention. Data were analyzed using descriptive and inferential statistics.

RESULTS

The Big 5 Teamwork Awareness Sessions (Big 5TWAS) demonstrated a significant impact on the study variables. Post-sessions, there was a significant decrease in rationing of nursing care scores and significant increases in nursing teamwork and patient-centered care scores (p ≤ 0.001). In addition to the significant correlation values, regression analysis revealed that overall teamwork accounted for approximately 22% of the variance in rationing of nursing care (R² = 0.224, p = 0.015), with trust as the significant predictor. Furthermore, teamwork explained approximately 80% of the variance in patient-centered care (R² = 0.801, p < 0.001), with trust, backup, and team leadership emerging as significant predictors.

CONCLUSION AND RECOMMENDATIONS

The study underscores the critical role of teamwork in reducing the rationing of nursing care and enhancing patient-centered care in critical care units. The Big 5TWAS was effective in fostering improved team dynamics, trust, and leadership, which translated into better care delivery. These findings highlight the need for ongoing inter-professional training and teamwork-enhancing strategies led by nurse managers to sustain and amplify these improvements. By focusing on teamwork, healthcare institutions can ensure high-quality patient outcomes and minimize missed nursing care practices.

Effect of feedback-integrated reflection, on deep learning of undergraduate medical students in a clinical setting

BACKGROUND

Reflection fosters self-regulated learning by enabling learners to critically evaluate their performance, identify gaps, and make plans to improve. Feedback, in turn, provides external insights that complement reflection, helping learners recognize their strengths and weaknesses, adjust their learning strategies, and enhance clinical reasoning and decision-making skills. However, reflection alone may not produce the desirable effects unless coupled with feedback. This study aimed to investigate the impact of feedback integrated reflection on meaningful learning and higher order MCQ score among under-grade medical students.

OBJECTIVE

To evaluate the impact of feedback-integrated reflection versus reflection alone on higher-order MCQ scores among undergraduate medical students in a gynecology clinical setting.

METHODS

A randomized controlled trial was conducted with 68 final-year medical students randomly assigned to a study group (feedback-integrated reflection) and a control group (reflection alone). Both groups completed a pre-test, followed by six daily teaching sessions on gynecology topics. Participants engaged in written reflections after each session, and the study group additionally received individualized feedback. Independent sample t-tests were used to compare pre and post-test scores between the groups, while paired t-tests assessed within-group improvements.

RESULTS

Pre-test scores were comparable between the study group (11.68 ± 2.60, 38.93%) and the control group (11.29 ± 2.38, 37.15%; P = 0.52). Post-test scores showed a significant improvement in the study group (20.88 ± 2.98, 69.32%) compared to the control group (15.29 ± 2.66, 51.00%; P = 0.0001). The percentage gain in learning was 35.43% for the control group (reflection alone) and 78.77% for the study group (feedback-integrated reflection). The normalized learning gain (NLG) was calculated to compare the effectiveness of the intervention (feedback-integrated reflection) with that of the control (reflection alone). The study group demonstrated a mean normalized learning gain of 69.07%, compared to 29.18% in the control group. The net learning gain, calculated as the difference in normalized learning gains between the study and control groups, was found to be 39.89%.

CONCLUSION

The findings highlight the effectiveness of feedback-integrated reflection versus reflection alone in fostering deeper learning by improving higher-order MCQ scores in a gynecologic setting in the undergraduate medical education.

TRIAL REGISTRATION

This trial was registered retrospectively on 27th July 2024. Trial registration no is CTU/07/2024/010/RMU.

Category Characteristics and Influencing Factors of Research Competence Among Chinese Specialty Nurses: A Latent Profile Analysis

AIM

This study uses latent profile analysis to explore the latent characteristics of research competence among speciality nurses and its influencing factors.

DESIGN

This study is a cross-sectional study.

METHODS

From January to February 2024, 813 speciality nurses were recruited from five tertiary hospitals in Henan Province, China, using a convenience sampling method. Participants completed an online questionnaire, which included a scientific research ability self-evaluation rating scale of nursing staff and a reflective practice questionnaire. Conducted latent profile analysis of the research competence characteristics of speciality nurses and identified the influencing factors of their latent profiles through univariate analysis and multiple logistic regression. Data were analysed using Mplus version 8.3 and SPSS version 26.0.

RESULTS

A total of 792 speciality nurses were enrolled, with a valid response rate of 97.42%. We identified three latent categories of research competence among speciality nurses: an uneven research competence group (30.93%), a high research competence group (19.07%), and a moderate research competence group (50.0%). Multiple logistic regressions indicated that single speciality nurses were more likely to belong to the moderate research competence group (OR = 2.04, p = 0.003); speciality nurses with a college diploma were more likely to belong to the uneven research competence group (OR = 0.04, p = 0.005); specialty nurses who are permanent staff were more likely to belong to the high research competence group (OR = 1.946, p = 0.031); reflective practice was an important factor affecting the research competence of speciality nurses (OR = 0.985-1.015, p < 0.05).

CONCLUSIONS

The majority of speciality nurses were classified into the moderate research competence group. Nursing managers should focus on enhancing the research awareness of speciality nurses and strengthening research training for those with lower educational backgrounds. Additionally, it is recommended to establish incentive mechanisms for nurses participating in research to enhance their research enthusiasm and foster their reflective practice skills throughout the research process.

IMPACT

The latent characteristics and influencing factors of research competence among different categories of speciality nurses provide valuable evidence for developing individualised intervention strategies.

NO PATIENT OR PUBLIC CONTRIBUTIONS

This study aims to explore the factors related to the research competence of speciality nurses. There were no contributions from patients or the public.

Developmental trajectories of professional preparedness among senior nursing students during clinical placement: A longitudinal study

BACKGROUND

Newly graduated nurses' lack of professional competence is associated with inadequate preparation during their clinical placement as nursing students. Clinical placement is a critical stage in the development of nursing students' professional preparedness. However, research on the trajectory of nursing students' professional preparedness during clinical placement has not yielded findings with the same specificity.

OBJECTIVES

The aim of this study is to estimate differences in professional preparedness levels at different clinical placement stages, to identify distinct patterns of professional preparedness trajectories during clinical placement, and to evaluate predictors of these trajectory group memberships.

DESIGN

A quantitative longitudinal study.

SETTINGS

Participants were recruited on a voluntary basis using convenience sampling at a tertiary hospital in Nanning, China.

PARTICIPANTS

224 senior nursing students were initially invited to participate in the study. A total of 178 nursing students successfully completed the follow-up assessments at baseline, as well as at 1 month, 4 months, and 8 months into their clinical placement.

METHODS

Participants completed four online surveys, during which their professional preparedness level was measured using the Perceived Professional Preparedness questionnaire for senior nursing students. Professional preparedness scores at different time points were compared using one-way repeated measures ANOVA and latent growth model. Group-based trajectory model was applied to identify professional preparedness trajectories. Multiple logistic regression was adopted to determine the predictors of trajectory group memberships.

RESULTS

The entire sample of Senior nursing students experienced a significant increase in professional preparedness during clinical placement. The best-fitting group-based trajectory model delineated three distinct trajectories: low-slowly increase trajectory (27.53 % of sample), moderate-rapidly increase trajectory (47.19 % of sample) and a high-stably increase trajectory (25.28 % of sample). Male, good and excellent academic performance, and very high degree of professional interest are the predictors of the moderate-rapidly increase trajectory. While male, good and excellent academic performance, high and very high degree of professional interest and participating in medical-related part-time employment are the predictors of the high-stable increase trajectory.

CONCLUSIONS

Senior nursing students exhibit different levels of professional preparedness throughout their clinical placement. Simultaneously, three different trajectories were identified among the sample of nursing students. Therefore, in future research, greater attention should be directed towards the professional preparedness levels of nursing students with different trajectories, and early identification and targeted interventions should be prioritized.

Exploring the effectiveness of the Career Guidance and Counseling Program on the perceived readiness for the job market: a lived experience among nursing students

Background

The current workforce demands that nursing graduates possess the necessary skills and knowledge to perform in complex clinical and professional environments. Career guidance can potentially improve students' job readiness by increasing their confidence in career pursuits, simplifying career decisions, and helping them address decision-making challenges.

Methods

This phenomenological study aimed to explore nursing students and interns' perspectives on the effectiveness of the Career Guidance and Counseling Program (CGCP) and its impact on their readiness for the job market through their lived experiences while participating in the program. Data were collected through in-depth semi-structured interviews with a purposive sample of 28 Saudi university students and continued until data saturation was reached. Thematic analysis was used for the data analysis.

Results

Seven themes emerged: personal experiences with the CGCP, the program's importance, effectiveness, benefits, strengths, and weaknesses, and recommendations for improvement. Overall, participants expressed gratitude for the CGCP and believed that it would positively impact their future career success. They also felt that the program provided them opportunities to share ideas, information, and concerns, thereby improving their career decision-making and adaptability.

Conclusion

The results show that CGCP positively affected participants' lives by providing support, guidance, and resources for informed career decision-making, developing essential career-related skills, and navigating career transitions. These findings have practical implications for nursing colleges implementing similar programs for better integration into the curriculum and for the continuity of such vital programs to help students. Future studies should explore this topic in different colleges and specialties.

Digital proficiency: assessing knowledge, attitudes, and skills in digital transformation, health literacy, and artificial intelligence among university nursing students

BACKGROUND

Implementing digital transformation and artificial intelligence (AI) in education and practice necessitates understanding nursing students' attitudes and behaviors as end-users toward current and future digital and AI applications.

PURPOSE

This study aimed to assess the perceived knowledge, attitudes, and skills of nursing students regarding digital transformation, as well as their digital health literacy (DHL) and attitudes toward AI. Furthermore, we investigated the potential correlations among these variables.

METHODS

A descriptive correlational design was employed in a Saudi nursing college utilizing a convenience sample of 266 nursing students. A structured questionnaire consisting of six sections was used, covering personal information, knowledge, skills and attitudes toward digital transformation, digital skills, DHL, and attitudes toward AI. Descriptive statistics and Pearson correlation were employed for data analysis.

RESULTS

Nursing students exhibited good knowledge of and positive attitudes toward digital transformation services. They possessed strong digital skills, and their DHL and positive attitude toward AI were commendable. Overall, the findings indicated significant positive correlations between knowledge of digital transformation services and all the digital variables measured (p = < 0.05). Senior students reported greater digital knowledge and a positive attitude toward AI.

CONCLUSION

The study recommends an innovative undergraduate curriculum that integrates opportunities for hands-on experience with digital healthcare technologies to enhance their digital literacy and skills.

Implementation of an Enculturation Toolkit for New Nurses During Unit Onboarding

OBJECTIVE

This quality improvement project targeted an enculturation gap among new nurses by assembling and piloting an Enculturation Toolkit.

BACKGROUND

Enculturation of new nurses contributes to engagement, performance, sense of belonging, and retention. During the COVID-19 pandemic, orientation was shortened, virtual, and asynchronous, creating a gap in enculturation.

METHODS

New nurses and their preceptors were surveyed at baseline, 2 to 3 months, and 4 to 5 months to measure engagement and enculturation using the Meaning and Joy in Work Questionnaire (MJWQ) and questions about the history and values of the organization.

RESULTS

Initial MJWQ responses were high and sustained throughout the study period. Participants demonstrated increased knowledge of the organization's mission statement and logo. New nurses rated the toolkit activities favorably, with an average score of 4.6 out of 5.

CONCLUSIONS

An Enculturation Toolkit was effective in improving knowledge about the organization and sustaining engagement and belonging.

Further development of the reflective practice questionnaire

Background

This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction.

Methods

A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire.

Results

Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.

Investigating Quality of Life, Academic Resilience, and Influential Factors in Nursing Education: A Mixed-Methods Study among Nursing Students

Introduction

Investigating the correlation between quality of life (QoL) and academic resilience (AR) and understanding their influencing factors is crucial for adequately preparing nursing students to navigate the challenges in their future professional careers.

Objectives

This research aims to investigate the relationship between QoL and AR among nursing students. Additionally, to explore factors influencing these variables from the students' perspectives.

Methods

A mixed-methods design, incorporating both quantitative and qualitative data, was conducted at a Saudi nursing college. The quantitative data were collected through a cross-sectional design, with a convenience sample of 190 students completing the Brunnsviken Brief Quality of Life Scale (BBQ) and the Academic Resilience Scale (ARS-30). Simultaneously, qualitative data were collected using open-ended questions to gain insights into the factors influencing their QoL and AR, as well as the role of nursing education. The analysis involved inferential statistics and content analysis.

Results

The study revealed that Saudi nursing students reported a moderate level of both QoL and AR. A significant positive correlation indicates that AR explains around 34.0% of the variation in QoL (p < 0.005). The qualitative data identified various supportive and barrier factors impacting the QoL and AR of nursing students, and students reflected on the significant role of nursing educators and academic advising.

Conclusion

The findings hold implications for interventions such as establishing supportive educational environments, enhancing academic advising, implementing resilience-building and wellness programs, peer support initiatives, and encouraging social engagement-all essential strategies to bolster nursing students' overall well-being, QoL, and AR.

Medical students' reflective capacity and its role in their critical thinking disposition

BACKGROUND

Developing reflective capacity and critical thinking is one of the prerequisites of education in health professions, especially medicine. This study aimed to determine the reflective capacity of medical students and its role in their critical thinking disposition.

METHODS

In this cross-sectional descriptive research, conducted in 2022, a total of 240 medical intern students were selected using the convenient sampling method. Data were collected using a reflective capacity questionnaire and critical thinking disposition questionnaire and analyzed with descriptive and inferential statistics using SPSS20.

RESULTS

The mean reflective capacity was 4.53 ± 0.50, and mean critical thinking disposition was 127.52 ± 10.85. Among the dimensions of reflection, "active self-appraisal (SA)" and "reflective with others (RO)" had the highest and lowest means, respectively. The dimensions of critical thinking disposition with the highest and lowest means were related to innovation and intellectual maturity, respectively. Reflective capacity and its dimensions were found to have a direct and statistically significant relationship with critical thinking disposition and its dimensions. Regression analysis results showed that reflective capacity accounts for 28% of students' critical thinking disposition.

CONCLUSION

The relationship between students' reflective capacity and their critical thinking disposition has rendered reflection as one of the necessary components of medical education. Thus, determining the learning activities by considering the reflection process and models will be very effective in creating and strengthening critical thinking disposition.