Barriers and Facilitators to the Learning and Acquisition of Research Competencies among Nursing Students through Active Methodologies: A Qualitative Study Using Reflective Writing

BACKGROUND

The development of educational research, critical thinking skills, and evidence-based practice requires proposals for educational innovation. The purpose of this study was to explore the perspectives of undergraduate nursing students on the barriers and facilitators after the implementation of a novel activity within the course of research methodology, composed of three active learning strategies: (a) project-based learning; (b) small-group learning; and (c) self-directed learning.

METHODS

A qualitative exploratory study using reflective writing was conducted at the Nursing Department of the Red Cross School (Spain). Seventy-four nursing students participated in the study, enrolled in the research methodology course. Purposive sampling was used. Online reflective notes were collected from a script of open-ended questions. An inductive thematic analysis was performed.

RESULTS

The new proposals facilitated learning of the subject matter and its contents. They were useful and enabled the students to put the contents into practice. In addition, they improved the students' organization, planning, and involvement. The barriers identified were a lack of time, ambiguity, inadequate tutoring or novelty of the work, and inequity in the distribution of tasks and workloads.

CONCLUSIONS

Our findings shed light on the barriers and facilitators identified by nursing students when implementing an educational innovation proposal, using three active learning methodologies as learning tools for the subject of nursing research.

A Multicenter Study about the Population Treated in the Respiratory Triage Stations Deployed by the Red Cross during the COVID-19 Pandemic

BACKGROUND

Care demand exceeded the availability of human and material resources during the COVID-19 pandemic, which is the reason why triage was fundamental. The objective is to know the clinical and sociodemographic factors of confirmed or suspected COVID-19 cases in triage stations from different Ecuadorian provinces.

METHOD

A multicenter study with a retrospective and descriptive design. The patients included were those who accessed the Respiratory Triage stations deployed by the Ecuadorian Red Cross in eight Ecuadorian provinces during March and April 2021. Triage allows for selecting patients that need urgent treatment and favors efficacy of health resources.

RESULTS

The study population consisted of a total of 21,120 patients, of which 43.1% were men and 56.9% were women, with an age range between 0 and 98 years old. Severity of COVID-19 behaved differently according to gender, with mild symptoms predominating in women and severe or critical symptoms in men. Higher incidence of critical cases was observed in patients over 65 years old. It was observed that overweight predominated in critical, severe, and moderate cases, while the body mass index of patients with mild symptoms was within the normal range.

CONCLUSIONS

The Ecuadorian Red Cross units identified some suspected COVID-19 cases, facilitating their follow-up and isolation. Fever was the most significant early finding.

Under-graduate nursing students working during the first outbreak of the COVID-19 pandemic: A qualitative study of psychosocial effects and coping strategies

BACKGROUND

The first wave of the COVID-19 pandemic caused a shortage of health care staff, forcing the hiring of senior nursing students.

AIMS

To describe the psychosocial impact and coping strategies used by nursing students during the first outbreak of the COVID-19 pandemic and to understand the coping strategies they employed.

METHOD

A qualitative exploratory study was conducted, based on Sandelowski's proposal. Purposive sampling was carried out to recruit 18 students hired during the pandemic. The students were interviewed between 18 March and 15 June 2020. Semi-structured interviews were conducted using a digital platform. An inductive thematic analysis was performed.

FINDINGS

The students lived alone and isolated during their contract to protect their cohabitants from possible contagion. The impact of working during the pandemic leads to experiences of stress, insomnia, nightmares and anxiety. Nursing students coped with the emotional burden through mental disconnection and the support of co-workers and family members.

CONCLUSION

Psychological support and tutoring should be provided by health centres. In addition, in these special circumstances, universities should adapt the training provided.

Ethical challenges during the COVID-19 pandemic: Perspectives of nursing students

BACKGROUND

The first wave of the COVID-19 pandemic caused a shortage of qualified nurses in Spain. As a result, the government authorized the hiring of senior students.

OBJECTIVES

To explore the ethical dilemmas and ethical conflicts experienced by final-year nursing students who worked during the first outbreak of the COVID-19 pandemic in Spain.

RESEARCH DESIGN

A qualitative exploratory study was conducted using purposive sampling. Semi-structured interviews were carried out using a question guide. Interviews took place via a private video chat room platform. A thematic, inductive analysis was performed of the information gathered.

PARTICIPANTS AND RESEARCH CONTEXT

Eighteen nursing students were recruited from two universities of Madrid, aged between 18 and 65 years old, enrolled in the fourth year of nursing studies and who were hired under a relief contract for health professionals during the pandemic.

ETHICAL CONSIDERATIONS

The present study was carried out in accordance with the Declaration of Helsinki, and the study was approved by the Local Ethics Committee of Universidad Rey Juan Carlos.

RESULTS

Three specific themes emerged: (a) coping with patient triage, (b) difficulties in providing end-of-life care, and (c) coping with patient death. Nursing students participated in the process of patient selection for resource allocation and ICU bed occupancy. They were shown how to care for patients who were not admitted to the ICU, in their last moments and were faced with the difficulties of applying end-of-life care. Finally, the nursing students were confronted with the death of their patients, in overwhelming numbers and under adverse conditions.

CONCLUSIONS

These findings can help shed light on the ethical dilemmas and ethical conflicts faced by novice nursing students, incorporated into the workforce during the COVID-19 pandemic. Moreover, it was described that students may normalize the death due to the exhaustion and overwhelmed routine.

The challenges of "learning on the go": A qualitative study of final-year Spanish nursing students incorporated to work during the first Covid-19 pandemic

BACKGROUND

The first wave of the COVID-19 pandemic caused a shortage of qualified nurses in Spain. As a result, the government authorized the hiring of senior students.

OBJECTIVES

To explore the perspectives of a group of final-year nursing students who were hired on the basis of a relief contract for health professionals during the first COVID-19 outbreak, regarding their learning process and their mixed role as students and novice nurses.

DESIGN

A qualitative exploratory study was conducted.

SETTINGS

The Nursing Department of the European University of Madrid, and the Red Cross College of Nursing.

PARTICIPANTS

Eighteen nursing students were recruited, aged between 18 and 65 years old, enrolled in the fourth year of Nursing Studies and who were hired under a relief contract for health professionals during the pandemic.

METHODS

Purposive sampling was used. Semi-structured, in-depth interviews were carried out using a question guide. Interviews were conducted in a private video chat room platform. Also, a thematic, inductive analysis was performed. This study was conducted according to the Consolidated Criteria for Reporting Qualitative Research and the Standards for Reporting Qualitative Research.

RESULTS

Four specific themes emerged: a) The students' role during the relief contract; b) The learning process during the pandemic; c) Barriers to learning; and d) A unique learning opportunity. The students had an undefined mixed role, which hindered their skills and activities. Learning was self-directed, sometimes through trial and error, and through experiencing critical events. Time constraints and having to learn under pressure were experienced as difficulties for learning. Nevertheless, this was a unique professional learning opportunity. The students learned to be organized and effective, acknowledge their limitations, gain confidence, face their fears, and mature.

CONCLUSIONS

These results can help inform nurse training programs and improve the organization and incorporation of nurses in health care facilities during the COVID-19 pandemic.

Limitation of therapeutic effort experienced by intensive care nurses

Background:

Nurses who practice limitation of therapeutic effort become fully involved in emotionally charged situations, which can affect them significantly on an emotional and professional level.

Objectives:

To describe the experience of intensive care nurses practicing limitation of therapeutic effort.

Method:

A qualitative, phenomenological study was performed within the intensive care units of the Madrid Hospitals Health Service. Purposeful and snowball sampling methods were used, and data collection methods included semi-structured and unstructured interviews, researcher field notes, and participants’ personal letters. The Giorgi proposal for data analysis was used on the data.

Ethical considerations:

This study was approved by the Ethical Research Committee of the relevant hospital and by the Ethics Committee of the Rey Juan Carlos University and was guided by the ethical principles of voluntary enrollment, anonymity, privacy, and confidentiality.

Results:

In total, 22 nurses participated and 3 themes were identified regarding the nurses’ experiences when faced with limitation of therapeutic effort: (a) experiencing relief, (b) accepting the medical decision, and (c) implementing limitation of therapeutic effort.

Conclusion:

Nurses felt that, although they were burdened with the responsibility of implementing limitation of therapeutic effort, they were being left out of the final decision-making process regarding the same.