The impact of prior care experience on nursing students' compassionate values and behaviours: A mixed methods study

BACKGROUND

Compassion is critical to the provision of high-quality healthcare and is foregrounded internationally as an issue of contemporary concern. Paid care experience prior to nurse training has been suggested as a potential means of improving compassion, which has been characterised by the values and behaviours of care, compassion, competence, communication, courage, and commitment. There is however a dearth of evidence to support the effectiveness of prior care experience as a means of improving compassion in nursing.

OBJECTIVE

To explore the impact of paid prior care experience on the values and behaviours of pre-registration nursing students indicated as characterising compassionate care.

DESIGN

Longitudinal mixed methods design employing a modified concurrent triangulation strategy, comprising two work packages. Work package 1 was qualitative, and work package 2 adopted a concurrent embedded strategy with a dominant quantitative component. Research is reported in accordance with the Good Reporting of a Mixed Methods Study framework.

SETTING(S)

Three United Kingdom universities.

PARTICIPANTS

Pre-registration nursing students attending one of three universities, and individuals who had previously participated in a Health Education England paid prior care experience pilot. Participant numbers at time point 1 were questionnaires n = 220, telephone interviews n = 10, and focus groups n = 8.

METHODS

Work package 1 consisted of longitudinal semi-structured telephone interviews. Work package 2 comprised validated online questionnaires measuring emotional intelligence, compassion satisfaction and fatigue, resilience, psychological empowerment, and career commitment (as proxies of compassionate values and behaviours), and focus groups. Qualitative data were thematically analysed. Quantitative data were analysed via Analysis of Variance in SPSS v 26.

RESULTS

Qualitative findings suggest that prior care experience has both positive and negative effects on students' compassionate values and behaviours, however positive effects do not extend to qualification. No statistically significant differences were found in any of the quantitative outcome measures between participants with and without paid prior care experience. A statistically significant increase in compassion fatigue was identified in both groups of participants post-qualification. Paid prior care experience did not prevent participants from experiencing reality shock on becoming a student or on qualification.

CONCLUSIONS

There is insufficient evidence of longitudinal beneficial impact to recommend paid prior care experience as an effective intervention to foster nursing students' compassionate values and behaviours. These findings do not support mandating a period of paid care experience as a prerequisite for entry into nurse education.

REGISTRATION

N/A. Tweetable abstract Insufficient evidence of longitudinal beneficial impact to recommend prior care experience as an effective intervention to foster nursing student compassion @PriorCareExp @Sarah_F_R.

The influence of intensive clinical skills 'bootcamps' on nursing students' perceptions of ability to provide acute care: A mixed methods study

OBJECTIVES

To examine the influence of an intensive clinical skill bootcamp on students' perceptions to provide care in acute situations.

SETTING

Evidence indicates that the recognition and response to patient change can be a challenge in nursing practice and especially so for undergraduate students (Goldsworthy et al., 2022). Additionally, the impact of the pandemic interrupted the preparation of undergraduate nursing students across the world. It is suggested that intensive clinical skills practice can enhance clinical skills, confidence and time management (Hinton and Chirgwin, 2010). However, little is known about the value of these intensive programs on the perceived ability of nursing students to provide care in acute situations.

METHODS

An embedded mixed methods design was employed with a quasi-experimental repeated pre-post design using the Perception to Care in Acute Situations scale (Sterner et al., 2020) and qualitative focus groups. The intervention comprised 4 h of technical skills simulation and 2 h of immersive simulation. Data were analysed using descriptive and inferential statistics and inductive thematic analysis.

RESULTS

From 130 final year nursing student who participated in the bootcamp, 73 responses to the survey were obtained. Fifty-four responses from students before the simulation activities and 19 responses after. Significant changes in student perceptions of their abilities to provide care in acute situations were noted. Three focus groups were conducted with four themes recognised in the qualitative data including interrupted preparation; factors that influence learning; role modelling; and making connections.

CONCLUSION

The pandemic interrupted student preparation for clinical placement. Intensive clinical skills bootcamps develop student perceived confidence by providing feedback and opportunities for reflection to make connections. Opportunities for student reflection on their current competence supports developing realistic insights into perceived capabilities.

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.

Impact of a teaching strategy to promote evidence-based practice on nursing students' knowledge and confidence in simulated clinical intervention choices

BACKGROUND

Nurses self-efficacy, confidence and their competency for evidence-based practice have a relevant impact in the quality of care provided to patients. However, the implementation of evidence-based practice continues to be limited to date and the relationship between these elements has not been thoroughly understood. Thus, the aim of this study was to analyze the impact on confidence levels of a teaching strategy to promote evidence incorporation into clinical decisions made by student nurses in hypothetical scenarios. Besides, students' satisfaction with the new teaching strategy was assessed.

METHODS

The teaching strategy was asynchronous, on-line and based on multiple-choice questionnaires related to decision making on an intensive care unit patient. Confidence levels were assessed by introducing the scoring tool confidence-based marking. Changes between pre- and post-tests in correct answers, confidence levels and expected-observed ranges of accuracy at each level of certainty were analyzed through non-parametric McNemar's sign tests for paired-samples differences. To assess students' satisfaction with the teaching strategy, a mixed-methods approach was followed. Descriptive statistical methods and Qualitative Content Analysis were followed respectively in order to analyze students' satisfaction.

RESULTS

A total of 165 students completed the assignment, 101 answered the satisfaction survey and 7 participated in the interviews. Statistically significant better scoring and higher confidence levels were found in the post-intervention. Statistically significant differences in expected-observed ranges of accuracy were found for the three levels of certainty. Students were highly satisfied with the proposed task. In the qualitative analysis one category was elaborated which illustrated the students' perceived added value of this new assignment.

CONCLUSIONS

On-line teaching strategies based on clinical scenarios that focus on evidence-based decision-making have the potential to increase the confidence of nursing students. Additionally, interventions designed by teams incorporating clinical nurses, university librarians and academic nurses have the potential to bridge the evidence-practice gap in nursing education.

Nursing students' rights in clinical practice in South Korea: a hybrid concept-analysis study

PURPOSE

This study aimed to derive a conceptual definition and attributes for nursing students' rights in clinical practice in South Korea.

METHODS

This concept-analysis study was conducted at a nursing school in South Korea. The participants were recruited using purposive sampling. The inclusion criteria were being a fourth-year nursing student and having two or more semesters of practical experience. The hybrid model used in this study had three stages. First, 12 studies were reviewed during the theoretical stage. Second, 10 in-depth interviews were conducted during the fieldwork stage. Third, in the analytical stage, the concept of nursing students' rights related to clinical practice was defined and the attributes were derived.

RESULTS

The analysis established five attributes of nursing students' rights: the right to learn, the right to be protected from infections and accidents, the right to be cared for and supported, the right to be respected, and the right to be recognized as a member of a nursing team. A key theme that emerged from this study was having the right to learn in a safe and supportive environment.

CONCLUSION

It is necessary to develop a measurement tool based on the above five attributes and to verify its effectiveness.

Identifying engagement and associated factors in nursing students: An exploratory study

BACKGROUND

Burnout and engagement in health students surpass work life. Although levels of burnout in Nursing students are high, academic engagement is an understudied topic in Nursing, which has shown benefits. The aims were to know the level of engagement of Nursing students and to identify factors that prompt higher levels of engagement.

METHODS

An exploratory study was conducted during 2019 in three Universities in Spain. The UWES-S-17 questionnaire was used.

RESULTS

The sample consisted of 808 Nursing students. An average level of engagement was found. Engagement differed significantly by gender and age, with females and older students showing greater attitudes. Participants in the second year showed lower scores in the willingness to dedicate effort and persistence than those in the first and third year (p < 0.05).

CONCLUSIONS

The identification of the level of engagement and factors involved are an opportunity to probe into this approach by reinforcing positive attitudes in Nursing students. These findings show the need to seek strategies through specific educational interventions and policies. Engagement should be upheld throughout the degree and once they enter the job market to ensure the well-being during academic and future work life, a high-quality nursing care and patient safety.

Development of a virtual reality program in South Korea for the measurement of vital signs in children: a methodological study

PURPOSE

We developed a virtual reality (VR) program for use in pediatric nursing practicums to help nursing students learn to measure vital signs in children.

METHODS

The analysis, design, development, implementation, and evaluation model was employed between July 2021 and December 2021 at a university in South Korea. In the analysis phase, in-depth interviews were conducted with four nursing students, two nursing school graduates, and four experts. The topic and contents of the VR program were settled in the design phase. The VR program was developed and subsequently used and evaluated by 20 nursing students and four experts.

RESULTS

The contents of the VR program for pediatric nursing practicums included the measurement of vital signs in a newborn baby and a young child, as well as an evaluation system. The mean score for the nursing students' satisfaction with practice was 4.02 out of 5 points. The mean scores for overall satisfaction with the VR program were 4.15 and 4.79 out of 5 points for nursing students and experts, respectively.

CONCLUSION

The VR program developed in this study allows nursing students to practice measuring vital signs in children, thus improving the students' clinical performance in pediatric nursing.

The impact of learning styles on attitudes to interprofessional learning among nursing students: a longitudinal mixed methods study

BACKGROUND

A functional interprofessional teamwork improves collaborative patient-centred care. Participation in interprofessional education promotes cooperation after graduation. Individuals tend to use different approaches to learning depending on their individual preferences. The purpose of this study was to explore nursing students' experiences of professional development with a focus on the relationship between attitudes to interprofessional learning and learning styles.

METHODS

A longitudinal parallel mixed-methods design. The study was carried out at a Swedish three-year nursing program from August 2015 to January 2020. On enrolment, thirty-four students self-assessed their attitudes to interprofessional learning according to the Readiness for Interprofessional Learning Scale, and their learning style according to Kolbs' Learning Style Inventory. In the final semester the students participated in an interview focusing on their experiences and perceptions of teamwork and they self-assessed their attitudes to interprofessional learning again.

RESULTS

Our findings indicated that 64.7% had a predominantly concrete learning style and 35.3% had a predominantly reflective learning style. No significant relationship with internal consistency reliability was identified among the participants between attitudes to interprofessional learning and learning styles. The content analysis resulted in four main categories: Amazing when it's functional; Deepened insight of care; Increased quality of care; Understanding own profession which were summarized in the theme: Well-functioning teams improve patients' outcome and working environment.

CONCLUSION

The students' attitudes to interprofessional learning were positive and it was considered as an opportunity to participate in interprofessional cooperation during internship. Transformative learning is a useful strategy in fostering interprofessional relationships due to the interdependence of various professions in interprofessional teams. When students are guided to use reflection to develop new perspectives and meaning structures, they acquire emotional and rational skills beneficial for interprofessional cooperation.

Evaluation of interprofessional student teams in the emergency department: opportunities and challenges

BACKGROUND

Interprofessional education opportunities are commonly university-based and require further development during clinical practice. Many clinical contexts offer the potential for meaningful learning of both collaborative and discipline-specific practice. The emergency department (ED) demands efficient teamwork, so presents a logical location for interprofessional learning.

METHODS

An interprofessional clinical placement program was implemented with the aim to enhance students' capacity and self-efficacy for collaborative practice. Fifty-five medical and nursing students participated as interdisciplinary pairs in a two-week clinical placement in the ED. Students' perceptions of the learning environment were measured pre- and post-placement with the Self-efficacy for Interprofessional Experiential Learning Scale and the Interprofessional Clinical Placement Learning Inventory was completed post-placement. Non-parametric tests were used to establish change differences.

RESULTS

The Placement Learning Inventory revealed positive outcomes; the majority (16/19) agreed/agreed strongly that the placement provided sufficient learning opportunities, was interesting, and made them feel as if they belonged and most (14/19) reported they achieved the discipline specific learning objectives set by the university. Self-efficacy improved significantly (p = 0.017), showing promise for future use of the placement model Challenges were identified in the organisation and supervision of students. In the absence of additional dedicated student supervision, this model of interprofessional student pairs in the ED was challenging.

CONCLUSIONS

Interprofessional clinical placements in ED are an effective clinical learning approach for final year undergraduate medicine and nursing students. Recommendations for improvements for students' clinical supervision are proposed for the placement model.

Factors which influence the effectiveness of clinical supervision for student nurses in Sri Lanka: A qualitative research study

BACKGROUND

Clinical placements are an essential part of student nurse education, but their effectiveness is influenced by the type and availability of supervision and existing resources. In Sri Lanka, the specific socio-political context in which nursing, and nurse education, operate may also be important.

OBJECTIVES

To examine the impact of socio-political factors on Sri Lankan nurses' supervisory practices and student nurses' experiences of clinical supervision.

DESIGN

Qualitative descriptive.

SETTINGS

Four teaching hospitals and four educational establishments in Colombo district, Sri Lanka.

PARTICIPANTS

217 student nurses in years 2-4 of their programmes. 205 qualified nurses (clinical and academic) with a minimum of two years' supervisory experience.

METHODS

Written responses to three open questions, followed by reflexive thematic analysis with inductive, semantic coding.

RESULTS

Two themes were identified: 1. Personal and professional development 2. Tensions and conflicts. Sociocultural norms and governance structures, which limited nurses' professional recognition and self-determination, negatively affected clinical supervision.

CONCLUSIONS

The sociocultural changes necessary to raise the professional status of Sri Lankan nurses will take time to occur. Approval of a mentorship education programme for supervisors, recognition of their role and greater support for students are important first steps in this process.

Breast Cancer Awareness Based on Health Information Literacy and Influential Factors among Female Nursing Students in China

This investigation aimed to study breast cancer awareness based on health information literacy and influential factors of breast cancer awareness among female nursing students in Changchun city in China. A four-part self-report questionnaire including the participants' general demographic characteristics, the participants' specialized characteristics concerning breast cancer screening, the Chinese version of the Breast Cancer Awareness Measurement (C-BCAM), and the Chinese version of the Health Information Literacy Self-rating Scale (HILSS) was designed to investigate breast cancer awareness and health information literacy and influential factors of breast cancer awareness among 205 female nursing students in Year 1-Year 3 using convenience sampling. The data were analyzed with SPSS 26.0 using descriptive statistics, nonparametric tests, and multiple regression analysis. The nursing students had an average level of HIL (median = 101.00, (93.00, 107.00)) and a good level of breast cancer awareness (median = 82.00, (76.00, 88.00)). A significant positive correlation was found between the HILSS and total C-BCAM score (r = 0.439, P < 0.01). Multivariate logistic regression analysis demonstrated that grades (P < 0.001), training in BSE (P = 0.025), and intention of undergoing breast cancer screening (P = 0.028) were three predictive factors for breast cancer awareness among female nursing students. The female nursing students' HIL was at an average level, and breast cancer awareness was at a good level. Health information literacy and breast cancer awareness among female nursing students in Changchun were significantly positively correlation, as demonstrated by this survey. Therefore, nursing education has the responsibility to improve female nursing students' awareness of breast cancer at different grades and to cultivate health information literacy. More training in BSE is needed. Greater efforts may be needed to develop targeted nursing education to strengthen female nursing students' awareness of breast cancer and HIL.

Nursing students' perceptions of online learning and its impact on knowledge level

BACKGROUND

Online learning in nursing education has been demonstrated to exert positive effects on knowledge, skills, learning attitudes, and confidence in performance. However, a noteworthy caveat has been that such benefits could vary depending on the content of pedagogical materials.

AIM

To examine the impact of online-tutorials in place of face-to-face tutorials on knowledge level and understand the perspectives of learners who experience online-tutorials.

METHODS

This study adopted a mixed method experiential design in which the perspectives of learners who experience online-tutorials are embedded within the trial. Two cohort of nursing students enrolled for the module on Psychology for Nurses were recruited to evaluate the impact of online-tutorials compared to face-to-face tutorials in terms of knowledge level. Apart from the dissimilar mode of delivery, both cohorts experienced the same teaching structure, content, and assessments. Examination results from these two cohorts were compared upon completion of the course. For the online group, additional one-to-one interviews were conducted to further understand the impacts exerted by online learning on the level of knowledge among them.

RESULTS

There was a significant difference between the knowledge level of the two cohorts. Responses elicited during the interviews revealed five themes: lack of motivation; limited teamwork; missed learning opportunities; decreased interactions; and differences between online and face-to-face learning.

CONCLUSION

Online-tutorials may be a feasible pedagogical approach but the motivation to learn, teamwork and quality of discussion may be compromised due to the lack of socialization and interactions between students and tutors.

Using an educational mobile application to teach students to take vital signs

BACKGROUND

The utilization of smartphone applications in educational settings, specifically in the field of nursing, has grown increasingly popular. To date, there have been few, if any, smartphone applications dedicated specifically to the teaching of vital signs. The Clinic Vitals app was designed to be an acceptable substitute for in-person vital signs instruction.

OBJECTIVES

The objective of this study was to show the utility of the Clinic Vitals app as a pedagogical tool in comparison to in-person nursing educational instruction.

DESIGN

A crossover design was employed within collegiate nursing educational sessions to determine if Clinic Vitals was an equivalent alternative to traditional vital sign teaching methods.

PARTICIPANTS

Participants were first-year nursing students from six different lab sessions within the same undergraduate university.

METHODS

Students with little to no vital sign experience were given instruction via the Clinic Vitals mobile application or traditional learning. After the learning session, students were given skills assessments. After one week, students were given the opposite method of instruction followed by skills assessments.

RESULTS

Results showed that no significant difference was found between the two groups based on skills assessments. Mobile application and in-person instruction teaching methods produced a similar level of competency in students learning to take vital signs.

CONCLUSIONS

The utility of being able to access the application's videos and instructional articles at any time and anywhere that there is an internet connection would make the app particularly useful. The present study provides evidence that the Clinic Vitals mobile application can be a reliable substitute for in-person vital signs instruction. Recent educational advances have demonstrated that online videos, simulations, and mobile applications can be effective resources for nursing educators. There is potential for further study of the uses of educational mobile applications, including Clinic Vitals, for nursing education.

Educational needs for practicing neonatal intensive care among Korean nursing students

PURPOSE

This study was conducted to investigate the educational needs for practicing neonatal intensive care among Korean nursing students.

METHODS

An explorative, sequential, mixed-methods design was used. Qualitative content analysis was conducted of in-depth interviews of six nursing students, five clinical practice faculty members, and five nurses in the neonatal intensive care unit. The results of a survey of 174 nursing students were analyzed quantitatively.

RESULTS

Nursing students, clinical practice faculty members, and nurses wanted opportunities for direct nursing practice and education in school during neonatal intensive care practice. In terms of specific educational content, nursing students expressed the highest observation-related educational needs for communication with medical team members, and they expressed the highest practice-related educational needs for operating medical equipment used for neonatal intensive care. The nursing students' needs with regard to the method of practice education were highest for orientation from the head nurses.

CONCLUSION

Communication and operating medical equipment were found to be areas with high educational needs for practicing neonatal intensive care among Korean nursing students. Further research is needed to develop an educational framework and setting for practicing neonatal intensive care that would meet their needs.

Exploring Theatre of the Oppressed and Forum Theatre as pedagogies in nursing education

BACKGROUND

Concepts such as racism, oppression and social justice are critical curricular inclusions in nursing education. However, traditional approaches to nursing education often fail to produce the desired reflection and change amongst students. There is an urgent need to develop nursing educators that can step outside the rigidity of the curricular status quo and engage students with pedagogies that support critical reflection, analysis and action. Participatory, experiential and interactive theatrical methods rooted in critical pedagogy, such as Theatre of the Oppressed (TO) and Forum Theatre (FT) may prove more effective at engendering reflection, analysis and action.

OBJECTIVES

The study explores health care providers' (including nurses, nurse educators and allied health professionals) and nursing students' experiences, reflections and usefulness of TO and FT as nursing pedagogies.

DESIGN

Influenced by Freire's Pedagogy of the Oppressed and Boal's Theatre of the Oppressed, this study was conducted on a Western Canadian university campus. Two groups participated: one that included health care providers (HCP) (n = 8) and the second that included an audience of nursing educators and students (n = 7). HCPs participated in a two-day TO workshop, while nursing students participated as audience members in the FT performance. The data were drawn from sharing circles and group discussions and were analyzed using thematic analysis.

RESULTS

The findings from HCPs revealed that TO represents an opportunity for reflection and growth; strengthening relationships; and practicing vulnerability. Given that students only participated as audience members, they described practical applications for using TO and FT as pedagogies in nursing education including in simulation and in theory-based courses.

CONCLUSION

This study demonstrates that TO and FT can play an important role in supporting HCPs' development as critical educators through embodied and reflective practice and that nursing students endorse the application of TO and FT in a broad range of learning contexts.

The mediating effect of academic engagement between psychological capital and academic burnout among nursing students during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

Almost all universities have been forced to close and change to online teaching during the COVID-19 pandemic, which has been a big challenge for students. There is little knowledge about the academic burnout among nursing students in these difficult circumstances, especially in traditional Chinese medicine universities, and the relationship between the burnout and their psychological capital and academic engagement.

OBJECTIVE

The aim is to describe academic burnout and clarify the relationships between academic burnout, academic engagement, and psychological capital among nursing students in traditional Chinese medicine universities.

DESIGN

This is a cross-sectional, descriptive study.

SETTING

The study sampled a four-year undergraduate traditional Chinese medicine university in Jian, Shandong Province, China.

PARTICIPANTS

A convenience sampling method was used to select 733 nursing students from April to June 2020.

METHODS

The Academic Burnout Scale, the Positive Psychological Capital Scale, and the Academic Engagement Scale were used for data collection, in addition to social-demographic data. Path analysis was used to clarify the relationships among academic burnout, academic engagement and psychological capital.

RESULTS

Of all the study participants, 39.29% had a certain degree of academic burnout. Academic engagement and psychological capital were negatively correlated with academic burnout among nursing students in traditional Chinese medicine university. Psychological capital was positively correlated with academic engagement.

CONCLUSION

Nursing students had a certain degree of academic burnout. Academic engagement played a partial mediated role in the relationship between psychological capital and academic burnout.

Compassion fatigue, presenteeism, Adverse Childhood Experiences (ACES), and resiliency levels of Doctor of Nursing Practice (DNP) students

BACKGROUND

Doctor of Nursing Practice (DNP) students often experience challenges that can cause poor academic performance and attrition. Known threats to nurses' professional quality of life and patient care include compassion fatigue and presenteeism; it is not known how these phenomena carry over from prior nursing experience to DNP students' academic experiences and subsequent NP practice. Adverse Childhood Experiences (ACEs) can also threaten nursing students' coping ability and overall wellbeing. Building resilience can combat the negative effects related to professional quality of life and traumatic experiences and promote nursing student success.

OBJECTIVES

Measure compassion fatigue, presenteeism, ACEs, and resiliency in DNP students.

DESIGN

A cross-sectional survey was conducted with three cohorts of DNP students.

SETTING

A DNP program at a large public American University.

PARTICIPANTS

DNP students (n = 118) from four NP specialty tracks: Family, Pediatric, Psychiatric Mental Health, and Adult-Gerontology Acute Care.

METHODS

Online surveys were sent to three cohorts of DNP students: one group before beginning the program and two groups, one year apart, before starting clinical rotations in the program. Surveys included measures for compassion fatigue, presenteeism, ACEs, and resiliency.

RESULTS

The demographics of this study sample was similar to other published DNP student samples. The students reported moderate levels of compassion fatigue, presenteeism, and resiliency. ACE scores ranged from 0 to 8 out of 10, and 50% reported at least one ACE.

CONCLUSIONS

Survey results from three DNP student cohorts indicate that many are pursuing advanced practice nursing education with a history of traumatic childhood events, demands of balancing work and school, and moderate resiliency levels. Many have symptoms of negative professional quality of life and presenteeism that could inhibit their job satisfaction and quality of care as an NP. Promoting DNP students' resiliency may improve their ability to thrive amidst academic and professional challenges.

Effectiveness of virtual reality training in improving knowledge among nursing students: A systematic review, meta-analysis and meta-regression

OBJECTIVES

We aimed to (1) evaluate the effectiveness of virtual reality (VR) training in improving knowledge among nursing students and (2) identify the essential features of training.

DESIGN

This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

DATA SOURCES

Randomised controlled trials (RCTs) were obtained from PubMed, EMBASE, Cochrane Library, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest and Scopus databases from inception up until 15 October 2019.

REVIEW METHODS

Meta-analysis and random-effects meta-regression was performed using the Comprehensive Meta-analysis 3.0 software. The overall effect was measured using Hedges' g and determined using Z-statistics at the significance level of p < 0.05. Heterogeneity was assessed using χ² and I² statistics. The risk of bias tool and the Grading of the Recommendation, Assessment, Development and Evaluation (GRADE) system were employed to assess individual and overall quality of evidence, respectively.

RESULTS

Among the 1993 records identified, 14 trials were included. Meta-analysis demonstrated a significant improvement in knowledge, with a small-to-medium effect (g = 0.47) in the VR group compared to the control group (Z = 2.66, p = 0.01). Subgroup analyses highlighted that VR training was more efficacious in delivering procedural knowledge to undergraduate nursing students when conducted in multiple, self-guided, short sessions within 30 min and by using low-moderate level of immersion. Meta-regression did not detect significant covariates that influenced knowledge scores.

CONCLUSIONS

Virtual reality may be a viable teaching strategy to improve knowledge acquisition, but it is presently suitable for supplementing conventional teaching methods. Nonetheless, VR could complement current pedagogy to address challenges associated with decreased clinical placement opportunities. Larger, well-designed RCTs are required to strengthen the evidence about the effectiveness of VR training.

Fresno test to measure evidence-based practice knowledge and skills for Portuguese undergraduate nursing students: A translation and adaptation study

BACKGROUND

The Fresno Test was originally identified as an instrument to assess evidence-based practice knowledge and skills through cognitive testing and performance assessment in medical students. Further studies have been recommended to establish the measurement properties of the Fresno Test in different learner populations.

OBJECTIVES

To perform a cross-cultural adaptation of the Fresno Test for Portuguese undergraduate nursing students and to analyze the interrater reliability.

DESIGN

Cross-cultural adaptation study with interrater reliability assessment carried out in two phases during 2017-2018.

SETTINGS

One of the main nursing schools, Portugal.

PARTICIPANTS

Fourth year undergraduate nursing students.

METHODS

The study was performed in two phases, firstly the cross-cultural adaptation (performed in five stages) and secondly the analysis of interrater reliability.

RESULTS

Stages I, II, III and IV of the cross-cultural adaptation proceeded smoothly and the expert panel produced and agreed upon the pre-final version of Adapted Fresno Test. In stage V (the pre-test stage), students reported a general understanding of the items, but they reported a lack of knowledge to answer the test. An expert panel subsequently agreed that modifications were needed to ensure the test was within the student's competency level and to decrease risk of assessment bias. For phase II, 50 complete questionnaires were randomly selected to be rated by three independent nurses using the modified rubric to score the test. The overall interrater reliability was 0.826 with a range from 0.271 to 1.000 for each item.

CONCLUSIONS

The Adapted Fresno Test presented in this paper is the first instrument translated for European Portuguese and adapted specially for undergraduate nursing students. Despite good interrater reliability, further validation studies with more robust samples are suggested to definitively establish psychometric properties beyond the interrater reliability.

Effective instructional design template for virtual simulations in nursing education

BACKGROUND

Virtual-reality simulation (VRS) is an innovative teaching method in nursing education. However, information regarding the educational elements that should be included in the associated instructional design, and the technology necessary for its optimal implementation, is limited.

OBJECTIVES

To develop an effective template for VRS-based nursing education, and to evaluate its usability.

DESIGN

A methodological study.

SETTING

Multimedia room in university.

PARTICIPANTS

Sixteen undergraduate nursing students.

METHODS

First, we developed a template, which was validated by content experts. The template was then modified based on the experts' feedback, and was then applied in three VRS scenarios.

RESULTS

The developed template consisted of educational elements, virtual elements, and scenario outlines. The educational elements were learning target, learning objectives, instructional design, course flow, feedback strategies, follow-up and evaluation, debriefing structures, and human resources. The virtual elements were virtual framework, degree of virtuality, and virtual resources. The scenario outline included scenario target, learning objectives, evaluation, course flow, associated knowledge and skill, setting, scenario background, protocols, nursing intervention, algorithm and storyboard, documentation forms, mechanical supports, scenario characters, accessory items, and debriefing components. Three VRS scenarios were developed using this template. Students in focus group interviews described their learning experience.

CONCLUSIONS

The template can help educators administer effective VRS-based nursing education; however, the technical level of the platform used should be considered.

Blended learning versus face-to-face learning in an undergraduate nursing health assessment course: A quasi-experimental study

BACKGROUND

Blended learning, which integrates face-to-face and online instruction, is increasingly being adopted. A gap remains in the literature related to blended learning, self-efficacy, knowledge and perceptions in undergraduate nursing.

OBJECTIVES

To investigate outcomes of self-efficacy, knowledge and perceptions related to the implementation of a newly blended course.

DESIGN

This was a quasi-experimental pre-post test design.

SETTING

This study was conducted at an undergraduate university in Alberta, Canada.

PARTICIPANTS

A total of 217 second-year undergraduate nursing students participated and 187 participants completed all study components.

METHODS

A convenience sampling method was used. Data were collected at the start and end of the semesters. Data were analyzed using descriptive and inferential statistics using R(3.4.3) and R-Studio(1.1.423).

RESULTS

There were no significant differences in self-efficacy scores between groups or in the pre-post surveys (p > 0.100) over time. There was no significant difference in knowledge between the blended online and face-to-face groups (p > 0.100). For students in the blended course, perceptions of the online learning environment were positive.

CONCLUSION

Blended learning has the potential to foster innovative and flexible learning opportunities. This study supports continued use and evaluation of blended learning as a pedagogical approach.

Changes of ego identity and psychosocial maturity in nursing students: A longitudinal study

BACKGROUND

Nursing students who have achieved ego identity are able to develop their careers to become professional nurses. To care for patients in a clinical context, nursing students need to be psychologically and socially mature. Attainment of ego identity and maturity is a key developmental task during students' time at university as they prepare to become professional nurses.

OBJECTIVES

This study was conducted to examine changes of ego identity and psychosocial maturity in nursing students.

DESIGN AND SETTING

A longitudinal study design was employed between June 2016 and June 2019 at a university in a metropolis in South Korea.

PARTICIPANTS

The participants were 102 nursing students who responded to surveys on at least two occasions. Seventy-six nursing students completed questionnaires on four occasions (in 2016, 2017, 2018, and 2019).

METHODS

Data were collected through self-report questionnaires composed of items assessing ego identity, psychosocial maturity, and demographic characteristics. Participants returned questionnaires every June from 2016 to 2019. The data were analyzed using descriptive statistics, the kappa statistic, repeated-measures analysis of variance, and one-way analysis of variance.

RESULTS

In terms of ego identity status, 17.1% of nursing students progressed to a more advanced status, 5.3% of them regressed to a less developed status, 57.9% of students had a fluctuating status, and 19.7% of them had a status that remained stable. Overall, psychosocial maturity in nursing students increased over time. Psychosocial maturity was higher among students in the achievement and moratorium statuses than among those in other statuses.

CONCLUSIONS

These findings indicate that ego identity status fluctuated during students' time at nursing school, while psychosocial maturity simultaneously improved. Nursing students who explored their options also became psychologically and socially mature.

Supporting Australian clinical learners in a collaborative clusters education model: a mixed methods study

Background

Nursing student numbers have risen in response to projected registered nurse shortfalls, increasing numbers of new graduates requiring transitional support and pressure on clinical placements. A Collaborative Clusters Education Model, in which Entry to Practice facilitators coach ward-based registered nurses to support students’ and new graduates’ learning, may address placement capacity. The research aim was to evaluate the acceptability of the Collaborative Clusters Education Model to stakeholders by examining their perceptions of the facilitators and barriers to the model in its implementation.

Methods

A convergent mixed methods evaluation approach was adopted. The study took place in a large Australian health service in south-east Queensland. Participants included Bachelor of Nursing students, Entry to Practice facilitators, ward-based registered nurses, academics and new graduates. A mixed methods design was used. Elements included an online survey of nursing students, and interviews with new graduates, Entry to Practice facilitators, ward-based registered nurses, and academics. Descriptive statistics were calculated on quantitative data. Thematic analysis was conducted on qualitative data.

Results

Participants included 134 (of 990) nursing students (response rate 13.5%), five new graduates, seven Entry to Practice facilitators, four registered nurses, and three nurse academics. Students rated facilitators’ effectiveness highly (4.43/5 ± 0.75), although this finding is tempered by a low response rate (13.5%). For learners, the model provided access to learning experiences, although preferences for sources of support differed between students and new graduates, and further clarification of responsibilities was required. For other stakeholders, three themes emerged: students’ and new graduates’ integration into the workplace can promote learning; tensions arise in new ways to approach performance assessment; and aligning expectations requires high levels of communication.

Conclusions

This evaluation found that acceptability was good but at risk from limited clarity around roles and responsibilities. Further research into this model is recommended.

Nursing student perceptions of pharmacology education and safe medication administration: A qualitative research study

PURPOSE

This research study was performed to elicit student nurses' perceptions of the impact of pharmacology in education on safe medication administration.

OBJECTIVES

The purpose of this study was to describe student perceptions of the relationship between pharmacology education and safe clinical practice. Nurse educators will gain insights into students' perceptions of the significance of pharmacology in baccalaureate curricula.

BACKGROUND

A lack of adequate pharmacological knowledge in nursing has been shown to lead to increased medication errors. Safe administration of medication has been identified as a major area for focus in improving health care.

DESIGN

This study was an analysis of qualitative data collected as part of a larger study. Students provided narrative, open-ended responses describing how pharmacology education impacted safe medication administration.

PARTICIPANTS

The sample consisted of 28 RN-BSN students and 71 traditional BSN students.

SETTING

The research was conducted at a college in the Northeastern United States. Data was collected from students enrolled in the traditional baccalaureate and nontraditional RN-BSN hybrid programs.

METHODS

In the full study, students completed a brief survey instrument, which included both quantitative and open-ended items. The qualitative data presented in this article was analyzed using conventional content analysis.

RESULTS

Students described the impact of pharmacology education as either having a positive or negative effect on safe medication administration. The majority of students described a positive effect. Positive responses were characterized into the following themes: Knowing how medications work, Improving the nursing process, and Building a foundation of clinical knowledge. Negative responses were more heavily endorsed by RN-BSN students. The negative responses were substantiated by one theme: Inability to transfer from didactic to clinical practice.

CONCLUSIONS

The findings of this study are significant to education as nursing schools struggle to develop curriculum to prepare students for safe medication practice in today's fast-paced and demanding healthcare environment.

Relationships among nursing student palliative care knowledge, experience, self-awareness, and performance: An end-of-life simulation study

BACKGROUND

Palliative care education and experience are needed for student competence in delivering high-quality palliative nursing care. Simulation has been linked to acquired clinical competency among pre-licensure students. A known literature gap is measurement of students' performance during end-of-life simulations.

OBJECTIVES

The aim of this study was to determine relationships among previous palliative care nursing experience, knowledge, self-awareness, and performance in nursing students during an end-of-life simulation.

DESIGN/SETTING/PARTICIPANTS

A quasi-experimental pretest/posttest design was used to assess these variables with a convenience sample of 75 senior nursing students during an end-of-life simulation at a Midwest Jesuit university.

METHODS

Self-awareness was measured with the Frommelt Attitudes Toward Care of the Dying, Form B. The Palliative Care Quiz for Nursing measured participants' knowledge. Participants' performance during the simulation was measured using a modified version of the Creighton Competency Evaluation Instrument®. Palliative care nursing self-awareness and knowledge were assessed before and after the simulation. Previous end-of-life care experience was assessed with a single demographic question at pretest only.

RESULTS

The sample was highly experienced in end-of-life care (93.3% reporting experience pre-simulation). Although pretest self-awareness (M = 124.5; ±1.3) and knowledge (M = 57.1%; ±2.2) were higher in students with two or more types of end-of-life experience (n = 42), there were no significant differences (p > .10) in these outcomes by groups pre- or post-simulation. Self-awareness (M = 130.1; ±1.2), knowledge (M = 80.5%; ±2.6), and performance (M = 94.1%; IQR 87.5 to 100) scores were high for student participants (n = 36) post-simulation, with moderate correlations found between some scores (r_pb < -0.40 or 0.40).

CONCLUSIONS

Findings support self-awareness and knowledge as antecedents of high quality palliative nursing care. Students demonstrated increased post-simulation knowledge, self-awareness, and quality performance of palliative nursing care regardless of previous end-of-life experience. End-of-life simulation is supported as an education method for increasing palliative care nursing competence and assessing student performance of palliative care nursing interventions.

Undergraduate nursing students' experiences and attitudes towards working with patients with opioid use disorder in the clinical setting: A qualitative content analysis

BACKGROUND

With the US facing an opioid epidemic, undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Yet, nursing curriculums have not adapted to meet this need. Previous research indicates students are exposed to negative messages that might influence their views about patients with opioid use disorder.

OBJECTIVES

The purpose of this study was to examine nursing students' experiences encountering patients with opioid use disorder in the clinical setting, their attitudes about their encounters, and their perceptions of their educational preparedness to care for this population.

METHOD

Purposive sampling was used to identify participants. Semi-structured interviews were conducted until saturation. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes.

PARTICIPANTS

Eleven senior nursing students from a public university in New England participated.

RESULTS

Analysis revealed six themes, including: navigating ethical dilemmas, gaining comfort with time and experience, avoiding the "elephant in the room," learning from real-world scenarios, witnessing discriminatory care, and recognizing bias and stigma.

CONCLUSIONS

Students were most likely to experience bias and internal conflict in maternity clinical rotations. Education should include practical communication strategies to reduce avoidance behaviors among nursing students as well as techniques to manage difficult situations and reduce moral distress. Nurses must be mindful of their power to influence students and should model non-judgmental language and behavior. Students ultimately expressed a desire to provide informed and empathetic care.

Exploring the paradox: A cross-sectional study of academic dishonesty among Australian nursing students

BACKGROUND

Universities' responsibility to ensure academic integrity is frustrated by software and communication tools that facilitate content reuse coupled with a growing international essay writing economy. A wide range of behaviours constitute academic dishonesty and while a complex phenomenon to examine, existing evidence suggests that there is sufficient proliferation (both in volume and variety) of these behaviours among Australian university students to warrant concern. This proliferation presents faculty and staff with new challenges in ensuring academic integrity.

OBJECTIVES

This paper reports findings of a nationwide cross-sectional survey of 361 students enrolled in an Australian nursing degree program and describes the extent of academic dishonesty among those surveyed.

DESIGN

An online survey adapted from previous work was used to collect data on academic dishonesty, professional dishonesty and social desirability bias. Analysis of this data enabled identification of the prevalence of dishonesty, relationships between individual characteristics and dishonest behaviours, associations between academic and professional dishonesty, and the impact of deterrents to such behaviour.

RESULTS

Plagiarism was the most frequently reported form of academic misconduct. Most participants indicated that threat of severe punishment and signing of verification statements would deter undesirable academic behaviour. Despite this, a relatively high proportion of students reported engaging in at least one form of academic misconduct, the likelihood of which was higher among younger age groups. Of concern was that a correlation was found between academic and professional misconduct, the most common being the recording of inaccurate or fabricated vital signs and breaching client privacy.

CONCLUSION

In health professional education, there is a tendency to assume that the nobility of these disciplines would result in a lower incidence of cheating behaviours. The findings of this study support existing literature that refutes this assumption. This study found troubling rates of academic and professional misconduct among the surveyed population.

Cultural adaptation and validation of the Lasater Clinical Judgment Rubric in nursing students in Spain

BACKGROUND

The clinical judgment and decision-making abilities of nurses can influence many health outcomes, hence the importance of addressing these qualities in university studies. In this respect, clinical simulation is a commonly employed teaching method. The evaluation of simulation activities requires standardised instruments, such as the Lasater Clinical Judgment Rubric, which is widely used for this purpose, although a culturally adapted and validated version in Spain is not available.

AIMS

To obtain a Spanish culturally adapted and validated version of the rubric for undergraduate students of nursing.

DESIGN, PARTICIPANTS AND SETTING

Cultural adaptation and psychometric validation study carried out with undergraduate nursing students in the simulation laboratories at the University of Málaga (Spain).

METHODS

A process of translation/back-translation and cultural adaptation was carried out in accordance with international standards. The rubric was empirically evaluated in standardised scenarios with high and medium-fidelity simulators. Each student took part in two different simulation sessions, led by two instructors. In each simulation, the data were collected by two independent observers.

RESULTS

152 observations were obtained from 76 students. The interobserver reliability was high, with an intraclass correlation coefficient of 0.93 (95% CI 0.92-0.95) (p = 0.0001) and Cronbach's alpha of 0.93. According to the confirmatory factor analysis, the fit of the model was satisfactory in all indices, with a χ²/df value of 1.08, GFI 0.96, TLI 0.99, NFI 0.97 and RMSEA 0.24 (90% CI 0.000-0.066).

CONCLUSIONS

The rubric obtained is culturally adapted to the Spanish educational context, and is valid and reliable for nursing students. Further prospective studies should be undertaken to evaluate the responsiveness, potential for transfer to clinical practice and cost-benefit ratios of different simulation designs.

Student perception of initial transition into a nursing program: A mixed methods research study

BACKGROUND

Transition into undergraduate education programs is stressful and impacts students' well-being and academic achievement. Previous research indicates nursing students experience stress, depression, anxiety, and poor lifestyle habits which interfere with learning. However, nursing students' experience of transition into nursing programs has not been well studied. Incongruence exists between this lack of research and the desire to foster student success.

OBJECTIVES

This study analyzed students' experiences of initial transition into a nursing program.

DESIGN

An embedded mixed method design.

SETTING

A single site of a direct-entry, four year baccalaureate Canadian nursing program.

PARTICIPANTS

All first year nursing students enrolled in the fall term of 2016.

METHODS

This study combined the Student Adaptation to College Questionnaire (SACQ) with a subset of participants participating in qualitative focus groups. Quantitative data was analyzed using descriptive statistics to identify statistically significant differences in full-scale and subscale scores. Qualitative data was analyzed utilizing thematic analysis.

RESULTS

Significant differences were seen between those who moved to attend university and those who did not, with those who moved scoring lower on the Academic Adjustment subscale. Focus group thematic analysis highlighted how students experienced initial transition into a baccalaureate nursing program. Identified themes included reframing supports, splitting focus/finding focus, negotiating own expectations, negotiating others' expectations, and forming identity. These findings form the Undergraduate Nursing Initial Transition (UNIT) Framework.

CONCLUSION

Significance of this research includes applications in faculty development and program supports to increase student success in the first year of nursing and to provide foundational success for ongoing nursing practice.

Stressors for Spanish nursing students in clinical practice

BACKGROUND

Clinical practice is critical for nursing students to acquire the knowledge and skills needed to properly develop professionally. The presence of stress in clinical practice may negatively affect their training.

OBJECTIVES

To understand the extent to which clinical practice can be stressful for nursing students at a Spanish university and to determine the main stressors associated with the practice.

DESIGN

Cross-sectional, descriptive, and observational study conducted in 2016 at the two nursing colleges of the University of Oviedo, located in Oviedo and Gijón in the Principality of Asturias, Spain.

METHODS

A total of 450 nursing students at a Spanish university served as participants in this study from January to April 2016. A data collection sheet was developed to track different sociodemographic variables, and was distributed together with the KEZKAK questionnaire, a validated scale adapted to Spanish nursing students. It is composed of 41 items using a 4-point Likert scale, rating how much the described situation worries them from 0 ("Not at all") to 3 ("A lot").

RESULTS

Students were most concerned about issues relating to causing harm to patients and lack of competence. Women found clinical practice to be more stressful than men did, both in general terms (p < 0.001) and with respect to all individual factors included in the questionnaire. In addition, there were associations between the "lack of competence" factor and having a job simultaneously (p = 0.011), the "contact with suffering" factor and the school year (p = 0.018), and the "being harmed by the relationship with patients" factor and the age group (p = 0.013).

CONCLUSIONS

Nursing students, particularly women, see clinical practice as "rather stressful", with the main stressors being those related to causing harm to patients.

[Threats to Identity: A Grounded Theory Approach on Student Nurses' Experience of Incivility during Clinical Placement]

PURPOSE

This qualitative study aimed to explore the experience of incivility among nursing students.

METHODS

Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents.

RESULTS

Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as "being mistreated as a marginal person," and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses.

CONCLUSION

The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments.

Organizational learning in a college of nursing: A learning history

BACKGROUND

College of nursing leaders can foster organizational learning as a means of achieving their desired organizational outcomes. Organizational learning has not previously been studied in colleges of nursing, leaving college administrators and faculty little guidance as they strive to improve outcomes in their own colleges.

OBJECTIVES

The purpose of this study was to discover new insights related to organizational learning in a college of nursing.

DESIGN

The learning history method was used to document and describe organizational learning in a college of nursing.

SETTING

This study was conducted with a college of nursing situated in a private, religious-based university in the western United States.

PARTICIPANTS

Six stakeholders and 16 individuals familiar with the college's history were purposively recruited for this study. Participants included college administrators, faculty, students, alumni, and individuals with university-level responsibilities related to the college.

METHODS

Semi-structured interviews and college artifacts were used to gather data. Data was reviewed and themes identified through a process called "distillation."

FINDINGS

The college's vision, "Learning the Healer's Art" provides purpose and motivation within the college. Four themes provide additional insight into how the college established a learning culture and fosters behavior conducive to organizational learning: (1) Character and Quality, (2) Long-Term Perspective, (3) Collaborative Leadership and Adaptation, and (4) Mentoring.

CONCLUSION

College of nursing leaders can foster organizational learning and pursue improvement within their colleges. Recommended actions include developing a shared vision for the college, building a cadre of qualified faculty and students who have strong personal character, maintaining a long-term perspective, using a collaborative approach to leadership and adaptation, and facilitating mentoring.

Nursing students' attitudes toward persons who are aged: An integrative review

OBJECTIVES

To analyze empirical studies from the United States and Canada to gain an understanding on how nursing education affects nursing students' attitudes toward persons who are aged.

DESIGN

An integrative literature review was completed using Garrard's (2011) Matrix Method.

DATA SOURCES

Articles were identified through the electronic database search engines of CINAHL, Pub Med, and Academic Search Complete. Only peer reviewed research articles from 2009 to 2015 were reviewed.

REVIEW METHODS

A review matrix was created to abstract information from 11 studies so that synthesis could occur. Information in the columns of the review matrix was used to compare the studies. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 27 item check list was used to help with reporting the findings. Studies were graded using the American Association of Critical Care Nurses' (AACN) level of evidence.

RESULTS

A key finding is student engagement with gerontological content in the classroom or clinical setting results in improving nursing students' attitudes toward persons who are aged.

CONCLUSIONS

Several gaps exist in the literature. Further research including longitudinal studies and large scale, multi-site samples would add to the existing knowledge.

Desperately seeking consistency: Student nurses' experiences and expectations of academic supervision

BACKGROUND

Academic supervision - the support available to students when writing assignments - is a fundamental element in the provision of support within nurse education. Not only can it underpin high levels of academic achievement, but it also has a role in enhancing the retention of students. Despite its importance, there is little investigation of undergraduate academic supervision within the nursing literature.

OBJECTIVES

To explore students' experiences and expectations of academic supervision as part of an undergraduate programme of nurse education.

DESIGN

A qualitative approach to explore student perceptions.

SETTING

The research was undertaken at a Higher Education Institution in the United Kingdom. The institution offers undergraduate nurse education programmes to approximately 800 students.

PARTICIPANTS

Eight pre-registration nursing students from a Bachelor of Science programme participated in a focus group interview. All were in the first semester of their final year.

METHODS

Data were collected using focus group interviewing, based around a semistructured question framework. The focus groups explored students' expectations and previous experiences of academic supervision. The focus group was recorded, responses were transcribed and thematic analysis was undertaken to identify key findings.

RESULTS

Three themes were identified from the data: relationship with supervisor, variation between supervisors, and the link between supervision and marking. Overall, students identified frustration with variability in the provision of academic supervision.

CONCLUSIONS

Effective academic supervision depends on a strong relationship between student and supervisor - something that can be difficult to achieve if supervision is only for a short period of time. Equally, students crave a consistent approach to supervision, in terms of both the amount and content of feedback. Students are able to identify and articulate a clear link between effective supervision and academic achievement.

Learning how to learn: Meta-learning strategies for the challenges of learning pharmacology

BACKGROUND

Nursing students have difficulty with pharmacology courses because of the complicated nomenclature and the difficulty of applying drug information to actual patient care.

OBJECTIVES

As part of a new pharmacology course being created, meta-learning strategies designed to diminish the difficulties of learning this difficult content were part of the course pedagogy.

DESIGN

Strategies were demonstrated, reviewed in class, and implemented through homework assignments.

SETTING

The setting was an Academic Health Center's School of Nursing in the southern United States.

PARTICIPANTS

Participants were third-year nursing students in an undergraduate nursing program.

METHODS

Surveys of students' opinions of learning gains were conducted at the end of the course over several semesters. In addition, pharmacology scores on a standardized exit exam were compared prior to implementing the course and after.

RESULTS

Students reported learning dry material more easily, having greater confidence, and finding substantial value in the learning strategies. Students indicated the most helpful strategies, in descending order, as follows: making charts to compare and contrast drugs and drug classes, writing out drug flash cards, making or reviewing creative projects, prioritizing information, making or using visual study aids, and using time and repetition to space learning. Implementation of the new course improved pharmacology scores on a standardized exit exam from 67.0% to 74.3%.

CONCLUSIONS

Overall response to learning strategies was positive, and the increase in the pharmacology standardized exit exam scores demonstrated the effectiveness of this instructional approach.

Theory and practice in the construction of professional identity in nursing students: a qualitative study

BACKGROUND

The problem of nurses' professional identity continues to be seen in the disjunction between theoretical training and clinical placements. Moreover, it is not known how nursing students perceive these contradictions or how this discrepancy influences the construction of professional identity.

OBJECTIVE

To gain insight into nursing students' perception of their theoretical and practical training and how this training influences the process of constructing their professional identity.

DESIGN

Qualitative, ethnographic study.

PARTICIPANTS/SETTINGS

Third-year nursing students at the l'Escola Universitària d'Infermeria Vall d'Hebron de Barcelona.

METHODS

Participant observation was conducted in the hospital setting and primary care. Discussion groups were held. The constant comparative method was used for the analysis. The study adhered to the criteria of credibility, transferability, dependability and confirmability.

RESULTS

Students believed that both theoretical and practical trainings were indispensable. Nevertheless, clinical placements were considered essential to confer sense to the theory and to shape their identity, as they helped student nurses to experience their future professional reality and to compare it with what they had been taught in theoretical and academic classes. The role of the clinical placement mentor was essential. With regard to theory, the skills developed in problem-based learning gave novice nurses' confidence to approach the problems of daily practice and new situations. Equally, this approach taught them to reflect on what they did and what they were taught and this ability was transferred to the clinical setting.

CONCLUSIONS

For students, both strategies (theory and practice) are vital to nursing education and the construction of a professional identity, although pride of place is given to clinical placements and mentors. The skills developed with problem-based learning favor active and reflective learning and are transferred to learning in the clinical setting.