Learning pathways: Levelling, scaffolding & mapping curriculum

At one mid-sized research-intensive university in Western Canada, the Bachelor of Science in Nursing (BSN) program recently underwent significant curriculum revisions (Epp et al., 2021). A constructivist approach was adopted to create opportunities for students to align knowledge, skills, and abilities (KSA) with prior learning to build a deeper understanding (Vygotsky, 1978). In congruence with constructivist theory, faculty developed several learning pathways as curriculum planning tools to strategically sequence student learning outcomes, facilitate student achievement of program learning outcomes, and improve curriculum integrity. The faculty developed a conceptual model of a learning pathway and identified several key program outcomes that would benefit from a curriculum review to ensure these concepts were adequately covered across the nursing program. Each learning pathway details curriculum mapping of the levelling and scaffolding of specific concepts and content to facilitate students in the acquisition of KSA through a progressive approach (Gazza & Hunker, 2012; Maguire, 2013). This article will profile the BSN Scholarly Writing Pathway and the BSN Psychomotor Pathway as exemplars.

Radical transformation: Embracing constructivism and pedagogy for an innovative nursing curriculum

To effectively navigate today's complex and rapidly changing health care environments, nurses require a high level of knowledge, sound psychomotor skills, diverse thinking and reasoning abilities, and a strong professional identity. The evidence showed that programs that offer students focused clinical practice experiences and offer students opportunities to 'think like a nurse' enable them to become sound practitioners. Faculty and staff at one mid-sized research-intensive university in Western Canada, engaged in an iterative process of rethinking the theoretical and pedagogical underpinnings of a BSN curriculum for educating nurses for the complexity of today's practice. Constructivist learning theory was chosen as the main underpinning of the revised curriculum. Furthermore, transformational learning theory guided the selection of several pedagogical approaches utilized throughout the program with the goal of inviting critical reflection and encouraging the development of competent, compassionate, ethical, and professional nurses. Additionally, we employed an innovative approach to clinical practicums where the process of learning is both integrated and intentional, and students are mentored to use prior knowledge in their decisions and clinical reasoning.

"I will go if I don't have to talk": Nursing students' perceptions of reflective, debriefing discussions and intent to participate

BACKGROUND/OBJECTIVES

The ability to be a reflective practitioner is recognized by nursing regulatory bodies as a component of professional competence and becoming a reflective practitioner is an essential part of learning to become a nurse. In this multi-site study, we explored undergraduate nursing students' beliefs, capacities and intentions to participate in reflective, debriefing discussions facilitated by clinical instructors. At the same time, we tested the effectiveness of a period of rest and an intervention designed to refresh and inspire them.

DESIGN

A randomized crossover design.

SAMPLE

Our analyzed sample consisted of 106 students; 87.7% were female and 65.1% were less than 20 years old.

METHOD

This study was guided by the Theory of Planned Behaviour and consisted of five steps: instrument development, recruitment, random assignment to intervention, data collection at two time points using four tools, and data analysis. One hundred and forty-one first year nursing students used a learning management system to sign up to one of 15 potential clinical groups; maximum 10 students per group. Eight groups were randomly assigned to an intervention during post-clinical discussions; seven groups participated in the usual post-clinical discussions for the same length of time. After six weeks, the groups 'crossed-over' (switched).

RESULTS

Students had a negative attitude towards routine discussions that occur after clinical practice experiences which did not significantly improve despite a period of rest and an intervention. Most did not feel in control and felt social pressure to participate. Additional results revealed that most students arrived at reflective post-clinical discussions with an underlying intent not to talk. Intent to remain silent (not participate) did not significantly improve despite a period of rest and intervention.

CONCLUSIONS

The context and timing of the routine discussions may dramatically influence students' decision-making regarding intent to participate. Reflective processes require time and routine reflective debriefing discussions could be delayed until later in the week after students have had a chance to absorb and assimilate their experiences.

Conservative Treatment of Stress Urinary Incontinence In Women: A 10-Year (2004-2013) Scoping Review of the Literature

Stress urinary incontinence is a serious threat to the well-being of women world-wide. In this scoping review of the literature, we examined the most prominent research foci between the years 2004 and 2013. In this article, conservative treat-ment is operationalized as any non-surgical or non-pharmacological treatment modalities that could be carried out by specially trained nurses, physiotherapists, or physicians to treat stress urinary incontinence in women. The two most frequently described or systematically investigated treatment options identified in our review were 1) strengthening pelvic floor muscles with pelvic floor muscle training, including biofeedback and weighted vaginal cones; and 2) the use of intravaginal support devices, such as incontinence pessaries. Other treatment modalities were also explored in the literature review, such as intraurethral devices, behavioral and lifestyle interventions, products, and alternative therapies, such as acupuncture and acupressure. However, the focus of this article is on the two most frequently described options.