Development of a master of science, nursing and interprofessional leadership program: AACN essentials in action

BACKGROUND

Leadership acumen, interprofessional relationships, and knowledge of healthcare operations are essential proficiencies for nurses to navigate the dynamic and complex healthcare landscape. The American Association of Colleges of Nursing (AACN) re-envisioned the academic nursing standards, The Essentials: Core Competencies for Professional Nursing Education (Essentials), to guide curricular development in preparing nurses with the aptitude to meet these challenges.

PURPOSE

The purpose of this project was to develop an innovative Master of Science nursing program to address the challenges facing the RN workforce.

METHODS

A relationship-based framework and the Analysis, Design, Development, Implementation and Evaluation (ADDIE) model were used to guide the development of the program using the Essentials to inform curricular design.

RESULTS

A Nursing and Interprofessional Leadership Master of Science program was designed comprising seven core courses with two tracks, Bachelor of Nursing and Post Graduate Option.

LIMITATION

The program was created during the COVID-19 pandemic, which may have influenced the data used for the program's design.

CONCLUSION

Healthcare complexities are requiring nursing education to evaluate curricula for advanced knowledge and skills. A Nursing and Interprofessional Leadership Master of Science degree program guided by the Essentials was developed to meet this challenge.

Exploring the status and critical issues in mixed methods research in doctoral nursing education in the Philippines

BACKGROUND

Mixed methods research (MMR) can be a pathway for doctoral nursing students to create innovative and noble contributions for the advancement of nursing theory, practice, and education. Several issues and challenges must be identified to successfully train, mentor, and support doctoral nursing students in conducting MMR.

AIM

The study aimed to explore the status and critical issues in conducting, mentoring, and training MMR in doctoral nursing programs in the Philippines.

METHODS

A descriptive qualitative study was conducted by performing semi-structured online interviews with 10 purposively selected participants who were faculty and educators with doctoral degrees, involved in teaching and mentoring MMR among doctoral nursing students in the last 10 years. Data were analyzed using Braun and Clarke's thematic analysis.

FINDINGS

Four key themes emerged, namely, (1) perceptions on the use of MMR, (2) facilitators to use MMR, (3) barriers to the use of MMR, and (4) recommendations to promote the use of MMR focused on the student, faculty, and educational institution levels.

CONCLUSION

Providing educational, institutional, and research support for doctoral nursing students and faculty could flourish the use of MMR in doctoral nursing programs with deeper meaning and reasoning.

Effect of a transcultural nursing course on improving the cultural competency of nursing graduate students in Korea: a before-andafter study

PURPOSE

This study aimed to evaluate the impact of a transcultural nursing course on enhancing the cultural competency of graduate nursing students in Korea. We hypothesized that participants’ cultural competency would significantly improve in areas such as communication, biocultural ecology and family, dietary habits, death rituals, spirituality, equity, and empowerment and intermediation after completing the course. Furthermore, we assessed the participants’ overall satisfaction with the course.

METHODS

A before-and-after study was conducted with graduate nursing students at Hallym University, Chuncheon, Korea, from March to June 2023. A transcultural nursing course was developed based on Giger & Haddad’s transcultural nursing model and Purnell’s theoretical model of cultural competence. Data was collected using a cultural competence scale for registered nurses developed by Kim and his colleagues. A total of 18 students participated, and the paired t-test was employed to compare pre-and post-intervention scores.

RESULTS

The study revealed significant improvements in all 7 categories of cultural nursing competence (P<0.01). Specifically, the mean differences in scores (pre–post) ranged from 0.74 to 1.09 across the categories. Additionally, participants expressed high satisfaction with the course, with an average score of 4.72 out of a maximum of 5.0.

CONCLUSION

The transcultural nursing course effectively enhanced the cultural competency of graduate nursing students. Such courses are imperative to ensure quality care for the increasing multicultural population in Korea.

Introduction to digital health course

Digital health is health care delivery that connects and empowers people and populations to manage health and wellness through technology. This mode of health care delivery has increased exponentially since the COVID-19 pandemic with most hospitals and health systems offering digital health services. The American Association of Colleges of Nursing (AACN) published The Essentials: Core Competencies for Professional Nursing Education which digital health education helps to partially meet four of these competencies. It is imperative graduate nursing education prepare future advanced practice registered nurses for practice in the evolving health care field. The purpose of this article is to share how to implement a graduate level digital health course for advanced practice registered nursing students.

Developing Family Nurse Practitioner Student Competencies: A Two-Part Mental Health-Focused Telehealth Education Activity

Telehealth is becoming a vital option for increasing access to health care. Family Nurse Practitioners (FNPs) are often the primary providers for rural and disadvantaged populations. They may be the first to encounter patients experiencing depression and other psychiatric problems. This article describes a two-part simulated telehealth education initiative to build FNP student competencies in the use of telehealth technology to interview clients with depressive symptoms. In Part 1, students completed didactic modules that introduced them to telehealth concepts. In Part 2, they participated in a simulated telehealth encounter with a standardized patient experiencing depression. Preparation included a review of care of patients with depression and focused content on telehealth etiquette. After the encounter, they received feedback from the standardized patient, debriefed with faculty, and documented their simulated telehealth visit. The activity was evaluated through post-education surveys and a one-time focus group. Students were overwhelmingly positive regarding the relevance of the educational activity to their graduate preparation and future practice. Many shared suggestions for refinement of the activity. Integration into the current curriculum and use of existing resources increased the feasibility, cost-effectiveness, and potential for long-term sustainability of the educational initiative.

Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies

BACKGROUND

The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts.

OBJECTIVE

The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course.

DESIGN/METHODS

Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting.

CONCLUSION

Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.

Influences on advance practice nursing education to prescribe medications for opioid use disorder

BACKGROUND

Opioid misuse is a major public health concern in the United States. Opioid agonist medications are evidence-based treatments for opioid use disorders (OUD) that can be prescribed by advance practice registered nurses (APRNs) with prescriptive authority and appropriate training.

PURPOSE

Article examines factors influencing preparation to provide medications for opioid use disorder (MOUD) in APRN education.

METHODS

Data from semi-structured interviews addressing the role of education in preparing APRNs to provide MOUD were grouped into key themes using thematic analysis. Data were collected in a mixed methods study in four states with high opioid overdose deaths whose main findings were previously published.

FINDINGS

Two overarching themes emerged: "addressing attitudes" and "curriculum change." Sub-themes include affective barriers to providing OUD treatment; motivation to respond to the OUD crisis; and attitude change through experience with MOUD.

DISCUSSION AND CONCLUSION

APRNs can play a key role in reducing the harms caused by OUD. Attention to attitudinal issues, such as stigma, toward people using opioids is important in educating APRNs about providing MOUD.

Characteristics of faculty mentoring in the Robert Wood Johnson Foundation Future of Nursing Scholars Program

BACKGROUND

To address the need for faculty scientists, Robert Wood Johnson Foundation (RWJF) provided support for an accelerated PhD program: Future of Nursing Scholars (FNS).

PURPOSE

To describe the experience of faculty mentoring PhD students in the RWJF FNS program pursuing a 3-year accelerated PhD degree, including faculty members' support activities for students, time commitment, student productivity in manuscript dissemination, and challenges and opportunities for supporting students.

METHODS

Surveys were sent to faculty mentors of FNS to understand mentoring activities, strategies used, and mentee productivity.

FINDINGS

Of 93 faculty mentors, they reported most FNS students (n = 61, 65.6%) completed a manuscript format dissertation. FNS students required academic/dissertation mentoring, with frequent emotional support and positive reinforcement.

DISCUSSION AND CONCLUSION

Mentors reported providing more frequent mentoring and spent more time mentoring FNS students than with other PhD students. Alignment of the student's research to that of the faculty mentor was identified as valuable.

PhD student perspectives on maintaining and formalizing peer mentorship during the COVID-19 pandemic

Mentorship is important for doctoral education and development. Students in Doctor of Philosophy (PhD) in Nursing programs traditionally receive formal mentorship from more experienced faculty mentors, creating a top-down, mentor-mentee relationship. Peer mentorship, characterized by a mentor-mentee relationship between peers in similar career stages, provides unique opportunities for career development and socialization. The emergence of the COVID-19 pandemic limited in-person interactions and introduced new, complex challenges to peer mentorship. The authors, current and recently graduated PhD in Nursing students, were forced to create new ways of connecting with peers and sought to explore how other PhD in Nursing students experienced and maintained peer mentorship in their respective programs during the pandemic. In this article, the authors share their personal experiences with peer mentorship during the pandemic, their process of creating a formal peer mentor model, and findings from a national, cross-sectional survey on COVID-related, peer mentorship experiences among PhD in Nursing students from other academic institutions. Most respondents were able to maintain peer mentorship throughout the pandemic, however, less than half reported receiving faculty support to do so. Recommendations for PhD in Nursing program administrators are provided, based on the experiences of the authors and survey results from PhD in Nursing students across the United States.

Flipping the classroom: An innovative approach to graduate nursing education

Nurse educators must be prepared to adopt innovative, evidence-based teaching approaches that, like the flipped learning method, improve student learning outcomes and better prepare the nursing workforce of the future. The purpose of this paper is to provide a comprehensive plan and resources for faculty to transition a graduate nursing course from traditional lecture-based teaching to flipped learning. The flipped learning approach was fully implemented with 24 graduate nursing students in a primary care family nurse practitioner course. The process of transitioning from traditional lecture-based teaching to flipped learning is presented, including a detailed explanation of how flipped learning class sessions were facilitated. Nurse practitioner students who participated in the flipped learning course found that this method fostered engagement with the course content and improved students' confidence in their ability to apply knowledge and skills in clinical practice. The flipped learning method has the potential to increase active learning and student engagement, integration of classroom and clinical knowledge, and application of knowledge from the classroom to nursing practice.

An innovative approach for graduate nursing student achievement of leadership, quality, and safety competencies

The COVID-19 pandemic abruptly disrupted nursing education, forcing schools of nursing to move from in-person to online classes while clinical sites suspended rotations. These changes jeopardized graduate nursing degree completion for Registered Nurses (RNs) at a time when they were urgently needed to practice. The aim of this initiative was to develop proficiency of Master of Science in Nursing (MSN) leadership competencies in the absence of in-person clinical experiences and ensure timely program completion. To meet this aim, an interactive virtual clinical experience was rapidly designed. A team of expert faculty integrated a blend of perspectives from academia and practice to develop an unfolding case study across the health care continuum based on the real-world trajectory of the pandemic. This innovative interactive virtual clinical resulted in achievement of the aim. The faculty closely monitored progressive development of student proficiency in leadership, quality, and safety competencies as the teams effectively navigated the rigorous demands of the healthcare system within a complex scenario. Students reported satisfaction with the interactive clinical experience and gained increased confidence in leadership, quality, and safety competencies.

St. Luke's International University and University of North Carolina at Chapel Hill collaboration project to develop the first DNP program in Japan

We report an international collaborative project to develop the first Doctor of Nursing Practice (DNP) program in Japan. We described the development and implementation of the first DNP program at the St. Luke's International University in Tokyo and the collaboration with the University of North Carolina at Chapel Hill in the United States. Faculty perceptions in both parties gradually evolved from the traditional perspective of international collaboration to the transitional and the beginning of the holistic partnership perspectives. The collaboration resulted in an innovative DNP program that directly addressed the gap between nursing education programs and Japan's clinical needs. The collaborative project cultivated a holistic international partnership. Rather than reporting a manual for international collaboration, we present our reflections and outcomes as narratives that others could use to achieve a holistic global partnership.

The "seeing place": Teaching nurse practitioners about cultural difference through dramatization

BACKGROUND

The use of dramatization in health professional education is one method to teach students about implicit bias and cultural difference, yet it has not been widely studied among graduate students of nursing.

OBJECTIVES

The purpose of this article is to present a qualitative analysis of data regarding doctoral nursing students' responses to a new dramatic exercise as part of a funded project to facilitate cultural learning in a diversity-enhanced nursing curriculum.

DESIGN

We employed a cross-sectional posttest design with qualitative data collection and hermeneutic analysis. Setting and.

PARTICIPANTS

Subjects were students from two cohorts in a Doctor of Nursing Practice program at a large metropolitan university in the Midwestern United States (n = 136).

METHODS

Following a dramatic exercise facilitated by a local theatre group, students debriefed and provided feedback via paper-based surveys collected by their instructor. The research team reviewed and analyzed student feedback with an eye toward new learning or insights around cultural difference.

RESULTS

Students rated the dramatic exercise highly. Their written feedback provided for a deeper exploration of how they internalized messages about cultural difference. These experiences were thematized in the following way: (a) Awareness is facilitated through integrating nonverbal (kinesthetic) and verbal encounters, (b) Hesitancy to participate in unfamiliar activities creates tension, and (c) Safety is a foundational aspect of learning sensitive issues.

CONCLUSION

Dramatization of culturally sensitive scenarios for advanced practice nurses can lead to new understanding. Educators who understand the need for thoughtful introduction of dramatization experiences can better prepare nurses for interaction in cross-cultural clinical environments.

Reflection on actions: Identifying facilitators of and barriers to using physical assessment in clinical practice

Current research suggests that nursing students do not apply all sets of physical assessment skills (PAS) learned in their nursing education. The aim of this study was to evaluate third-year nursing students' process of clinical judgment using PAS in clinical rotation. Specific focus was on how the process of clinical judgment affected when the nursing students performed physical assessment, and which types of knowledge were implied in their practice. Ten nursing students performed PAS independently while in clinical rotation; these performances were audiotaped and observed. Shortly after, individual semi-structured stimulated recall interviews (SRI) took place. Regardless of the nursing students' stated level of PAS utilization, self-efficacy or scientific knowledge, clinical judgment was primarily based on contextual factors and personal prerequisites. This study contributes to in-depth knowledge about how nursing students perform physical assessment, how they describe their clinical judgment process and their strategies towards systematically and confidently using PAS. We conclude the paper with pedagogical strategies and learning activities that can facilitate reflection-in-action and reflection-on-action.

The relationship between the undergraduate clinical learning environment and work readiness in new graduate nurses: A pre-post survey study

BACKGROUND

Due to projected nurse shortages, it is necessary that undergraduate programs optimise work readiness outcomes in new graduate nurses. Research that quantitatively evaluates characteristics of clinical nursing programs that predict increased work readiness is required.

OBJECTIVES

To explore the relationship between the undergraduate clinical learning environment and nurse perceptions of work readiness prior to and following, commencement as a new graduate nurse.

DESIGN

A pre-post follow-up study. Undergraduates were surveyed at the end of their Bachelor's degree (baseline) and at 8-10 weeks after commencement as a graduate nurse (Time 1).

SETTING

A multi-site, metropolitan private hospital in Victoria, Australia.

PARTICIPANTS

Nursing graduates who completed a university fellowship program (n = 26), or were undertaking their graduate year and had completed placement blocks within (n = 18) or outside (n = 31) the healthcare organisation.

METHODS

Participants self-completed the Clinical Learning Environment Inventory (CLEI) and Work Readiness Scale for Graduate Nurses (WRS-GN) at baseline and Time 1. Multiple regression analyses were performed.

RESULTS

CLEI scores significantly predicted work readiness outcomes (all p-values<.05), accounting for 16-36% and 17-28% of the variance of WRS-GN scores at baseline and Time 1, respectively. After adjusting for clustering due to clinical placement groups, CLEI Individualisation (p = .023) and Valuing Nurses Work (p = .01) predicted improved Time 1 WRS-GN Organisational Acumen. CLEI Innovative and Adaptive Culture scores predicted poorer Time 1 Organisational Acumen (p = .001).

CONCLUSIONS

Learning environments that offered high levels of individualised attention and valued nurses' work appeared to facilitate post-graduation engagement and identification with nursing practice. However, highly innovative and adaptive education may detract from optimal work readiness. Findings revealed that while important, the clinical learning environment only accounted for a small-to-moderate degree of nursing graduates' work readiness. To facilitate robust evidence-based improvement of clinical nursing education, future research should attempt to empirically establish the value of additional facilitators of work readiness.

Passion and ability: Mentoring in a Doctorate of Nursing Practice programme

This basic qualitative study sought to understand the experiences of Doctorate of Nursing Practice (DNP) graduates with mentorship during their DNP project completion. Fourteen participants were recruited for telephonic, semi-structured interviews. Accessibility and availability of the mentor represents the dominant theme. Additional themes represented aspects of the mentor role related to the work involved in executing the project and the mentor's personal and professional attributes that promoted the professional socialisation of the graduates to the DNP role.

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

This study used a cross-sectional design.

SAMPLE AND SETTINGS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Advanced Practice Nursing student knowledge in obesity management: A mixed methods research study

BACKGROUND

Obesity, the most prevalent chronic disease affecting multiple systems, is associated with increased mortality and a decreased life expectancy.

OBJECTIVES

The purpose of this study was to identify Advanced Practice Nursing (APN) students' confidence of obesity management as well as satisfaction of APN curriculum on and curricular recommendations regarding obesity management.

DESIGN

Modified convergent mixed-methods design.

SETTING

A university-based college of nursing in the Deep South.

PARTICIPANTS

Graduate APN Students.

METHODS

An exploratory mixed methods online survey was administered to APN students. The survey included demographics; confidence in obesity management; knowledge of pharmacological treatment; self-reported height and weight; experiences and challenges related to obesity management; and suggestions of curricular content changes for the treatment of obesity that would increase student expertise and confidence.

RESULTS

Ninety-nine surveys were completed by 94 female and five male APN students aged 26 to 61 years. The majority (70.7%) were white with BMIs ranging from 19.57 to 51.37 (x̅=27.81). Areas where students were least comfortable were prescribing anti-obesity medications and accurately billing for obesity management. Fourteen percent of APN students reported feeling that their graduate nursing education program did not prepare them well in obesity management, 25.3% reported feeling slightly well prepared, 32% reported feeling moderately well prepared, and 27.8% reported feeling very well or extremely well prepared. Qualitative responses accentuated insecurity in areas such as initiating a discussion on obesity management with patients who have obesity.

CONCLUSIONS

Overall, APN students requested that their curriculum incorporate more instruction on how to begin the discussion of weight loss and provide clear evidence-based guidelines that include diet, exercise, and medication options. An efficient way to affect the management and treatment of obesity is to ensure that the next generation of providers is thoroughly prepared to implement the best evidence-based obesity management for patients.

Mentoring in research-focused doctoral nursing programs and student perceptions of career readiness in the United States

BACKGROUND

Research-focused doctorate nursing programs are expanding and seek to double the number of doctoral-prepared nurses by 2020. There is little empirical evidence of the contributions of mentoring to doctoral nursing students' readiness for their desired careers.

PURPOSE

This study assessed characteristics and practices of nursing PhD students, the mentoring practices of their advisors, and the likelihood of self-reported career readiness.

DESIGN

A nationwide descriptive, cross-sectional study of PhD students in the United States was conducted using an electronic survey platform. A sample of 380 PhD students representing 64 schools was surveyed from January to July 2016.

METHODS

Descriptive statistics and ordered logistic regression were used to describe the sample and determine likelihood of career readiness by three readiness levels.

FINDINGS

Results revealed greater likelihood of career readiness for students that: (1) perceived their proficiency in key scholarly skills as high, (2) were older, (3) worked a larger number of hours per week, (4) had more responsibilities outside of school, (5) had both advising and mentoring support, (6) had a co-advisor, and (7) attended a private university.

CONCLUSION

Enrollment targets should be based on a faculty-to-doctoral student ratio that optimizes advising and mentoring and schools should provide mentoring guidelines and training for faculty.

A Process for Teaching Research Methods in a Virtual Environment

Translating and integrating scholarship into practice is a difficult concept for students to embrace through a passive education model. Therefore, innovative teaching strategies were integrated into a translational science course for online graduate nursing students. The purpose of this project was to increase understanding of the research process and stimulate interest in translating nursing evidence into practice. The result was an effective educational strategy for teaching and learning about the research process in a virtual environment.

Bringing us back to our creative senses: Fostering creativity in graduate-level nursing education: A literary review

OBJECTIVES

The purpose of this paper is to explore empirical findings of five studies related to graduate-level nurse educators' and nursing students' perceptions about the roles of creativity and creative problem-solving in traditional and innovative pedagogies, and examines conceptual differences in the value of creativity from teacher and student viewpoints.

DATA SOURCES

Five peer-reviewed scholarly articles; professional nursing organizations; conceptual frameworks of noted scholars specializing in creativity and creative problem-solving; business-related sources; primary and secondary sources of esteemed nurse scholars.

REVIEW METHODS

Quantitative and qualitative studies were examined that used a variety of methodologies, including surveys, focus groups, 1:1 interviews, and convenience sampling of both nursing and non-nursing college students and faculty.

RESULTS

Innovative teaching strategies supported student creativity and creative problem-solving development. Teacher personality traits and teaching styles receptive to students' needs led to greater student success in creative development. Adequate time allocation and perceived usefulness of creativity and creative problem-solving by graduate-level nurse educators must be reflected in classroom activities and course design.

CONCLUSIONS

Findings indicated conservative teaching norms, evident in graduate nursing education today, should be revised to promote creativity and creative problem-solving development in graduate-level nursing students for best practice outcomes.