Experiences and challenges of enrolled nurses undertaking a Bachelor of Nursing Science programme in Namibia

BACKGROUND

 Globally, enrolled nurses (ENs) are embarking on an educational journey to become registered nurses (RNs) in order to enhance their knowledge and career opportunities. However, their aspiration is not without challenges. In Namibia, the experiences of these nurses have not been extensively researched.

OBJECTIVES

 This study aims to explore and describe the experiences and challenges of ENs undertaking a Bachelor of Nursing Science at the University of Namibia.

METHOD

 A qualitative, exploratory, descriptive and contextual research strategy was followed as the basis of conducting the study. A sample of 15 nursing students was purposively selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes. The collected data were analysed thematically using an inductive approach.

RESULTS

 Three main themes subsequently emerged from the study: ENs' positive experiences advancing in the Bachelor of Nursing Science (BNSc) programme; nurses' negative experiences advancing in the BNSc programme; and recommendations to ensure effective advancement in the BNSc programmeConclusion: The findings of this study revealed that ENs positively experience becoming a RN when it comes to self-development; however, they have negative experiences such as not receiving exemptions for prior learning and having to learn a new curriculum.Contribution: These findings may be used by the Faculty of Health Sciences, School of Nursing and Public Health management in order to develop targeted interventions and ongoing strategies during their curriculum review cycles to ensure positive student experiences and success within the programme.

Assess the feasibility of flipped classroom pedagogy in undergraduate nursing education in Sri Lanka: A mixed-methods study

Background

The nursing education system has evolved with an increased emphasis on student-centred education, such as implementing flipped classroom pedagogy. Given the promising positive educational outcomes, the trend of using flipped classroom pedagogy has become increasingly popular in undergraduate nursing education. However, little is known about how these flipped classroom methods impact on nursing educational practices in limited-resource settings situated in South Asia.

Objective

To assess the feasibility of implementing flipped classroom pedagogy in undergraduate nursing education from the nursing students’ perspective.

Methods

This mixed-methods study employed a quantitative survey and six focus group discussions conducted in three state universities in Sri Lanka. The Nursing Students’ Readiness for Flipped Classroom (NSR-FC) questionnaire was used to collect quantitative data. The semi-structured focus group discussions were conducted by using 18 reflective and open-ended questions. Descriptive statistics and multivariate analysis of variance methods were employed when analysing quantitative data. An inductive thematic analysis approach was used to summarize the focus group discussions.

Results

The questionnaire survey revealed that nursing students reported high levels of personal, technical, and pedagogical readiness across all three universities, while environmental readiness was perceived as low. The inductive thematic analysis identified three themes, namely: enablers, challenges, and benefits. Specifically, nursing students valued the student-centred approach. They were ready to utilize their own devices to overcome limited technological provision; however, a short training session about how to engage in the flipped classroom was desirable. Also, their exposure to basic educational technology was perceived as adequate and they were aware of the positive outcomes of flipped classroom pedagogy.

Conclusion

Nursing students were ready to enrol in a flipped classroom programme. The provision of technological resources in the education environment was identified as a great challenge for flipped classroom implementation. Overall, the findings indicate there are promising feasibilities for the flipped classroom implementation.

Simulated Wound Care as a Competence Assessment Method for Student and Registered Nurses

OBJECTIVE

To describe the development and use of a wound care simulation assessing RNs' and graduating student nurses' practical wound care competence and to describe observations of participants' wound care competence.

METHODS

A descriptive, qualitative design was used. Data were collected in 2019 from 50 healthcare professionals and students using a simulated wound care situation and an imaginary patient case. The simulation was based on a previously developed and tested wound care competence assessment instrument, which included a 14-item checklist that assesses practical wound care competence of chronic wounds. The data were analyzed and described based on the 14 competence areas or as other competencies.

RESULTS

Participants showed competence in identification of wound infection, debridement, dressing selection, tissue type identification, and consultation. Participants' shortcomings were related to pain assessment and management, asepsis, offloading, and documentation. Simulation was shown to be a promising tool to assess healthcare professionals' and students' practical wound care competence in a safe and standardized situation.

CONCLUSIONS

This study provided new information about simulation as a method to assess student nurses' and RNs' wound care competence. The results could be used in wound care education planning and development in both undergraduate nursing education and continuing education for nursing professionals.

Student Nurse Knowledge of and Attitudes Toward Pressure Injury Prevention: How Sufficient Is Undergraduate Education?

OBJECTIVES

To assess the knowledge and attitudes of student nurses regarding evidence-based guidelines for preventing pressure injuries.

METHODS

This study used a descriptive research design. The participants included second-, third-, and fourth-year nursing students completing their bachelor's degrees at a faculty of nursing in Turkey. Data collection forms consisted of a student nurse information form, the Pressure Ulcer Prevention Knowledge Assessment Instrument, and the Attitude Towards Pressure Ulcer Prevention Instrument.

RESULTS

The overall mean score for knowledge was 49.9% (11.7/26). The highest scores for the instrument's subthemes were for nutrition (72%), and the lowest were for etiology and development (40.1%). The overall mean attitude score was 42.20 ± 2.40, although a statistically significant difference among grades was found (P < .001). The highest mean scores showed agreement among students that pressure injury prevention should be a priority (10.50 ± 1.43). A significant difference was found in the competence subscale according to the number of dressing changes observed and sense of competence in pressure injury care (P = .003). A weak but statistically significant positive relationship was found between knowledge and attitude scores (r = 0.158; 95% confidence interval, .040-.269; P < .001).

CONCLUSIONS

This study revealed that certain revisions are needed in the nursing curriculum to improve the knowledge and attitudes of nursing students toward the prevention and care of pressure injuries. More details should be covered in the classroom and laboratories through simulation or clinical practice for improved management of pressure injuries.

Impostor Phenomenon in Undergraduate Nursing Students: A Pilot Study of Prevalence and Patterns

BACKGROUND

Impostor phenomenon (IP) is an experience of doubt in personal ability and a sense that achievements are fraudulent, resulting in increased psychological distress. This pilot study explored the prevalence and pattern of IP in baccalaureate nursing students related to gender, level in program, and racial identity.

METHOD

A convenience sample of prelicensure baccalaureate nursing students (n = 150) was surveyed using the Clance Impostor Phenomenon Scale (CIPS).

RESULTS

The mean CIPS score was 60.13 (range, 26-92). Patterns observed across gender, level in program, or racial identity did not differ significantly. However, frequent to intense feelings of impostorism were reported by 48.7% of students, and 92% reported at least moderate IP characteristics.

CONCLUSION

Many students in this study reported IP experiences, indicating risk for negative effects such as anxiety and lack of confidence. Further study in this population and specifically among minority nursing students is needed. [J Nurs Educ. 2021;60(6):329-332.].

Honors and Nursing: Reasons for Enrollment, Persistence, and Withdrawal

BACKGROUND

The intertwining of honors within collegiate nursing education can be rewarding and challenging for students. This study examined why students enroll in honors, why students persist in honors, why some students withdraw from honors, and what resources are beneficial to honors success.

METHOD

An online survey was sent to 130 nursing students enrolled in an honors program at one midwestern university.

RESULTS

Forty-six nursing students completed the survey. Students indicated they enrolled in honors programs to attend classes with fewer students, to achieve Honors College Distinction, and to gain skills in professionalism and leadership. Reasons for withdrawal from honors included lack of time, increased workload, and added stress.

CONCLUSION

Nursing students face many challenges in successful completion of an honors program. The results from this study led to the development of Honors and Nursing: A Supplemental Honors Nursing Guidebook for Honors Student Success, a resource for nursing honors students at the university. [J Nurs Educ. 2021;60(6):333-336.].

Seizing opportunity: Diverse early-entry nursing students' perceptions of seeking a PhD

BACKGROUND

The aging and retirement of the current nursing professoriate and the increasing numbers of nurses pursuing practice doctorates has precipitated decreasing numbers of nurses, specifically diverse nurses pursuing a research doctorate, thus limiting the development of nursing science.

PURPOSE

To describe factors influencing decisions about entering a PhD program from the perspectives of early-entry PhD nursing students.

METHOD

A qualitative descriptive design using semistructured interviews to explore the perceptions of making the decision to pursue a PhD in nursing of the students who participated in two early-entry mentoring programs.

FINDINGS

A model, entitled "Seizing Opportunity" was developed from the findings about the process of students deciding to pursue a PhD.

DISCUSSION

Motivators and detractors that can help nursing educators understand how to successfully recruit diverse PhD students were uncovered. Providing knowledge and mentoring for early entry students can increase the numbers of diverse students pursuing a PhD in nursing.

Faculty Perceptions of Teaching Nursing Content Online in Prelicensure Baccalaureate Nursing Programs

BACKGROUND

The purpose of this study was to explore the perceptions of nursing faculty regarding the nature, challenges, and strengths of teaching course content online in prelicensure collaborative baccalaureate nursing programs and the implications for online course delivery.

METHOD

This was an exploratory-descriptive, mixed-methods design based on document analysis, an online survey completed by 32 faculty, and interviews with 16 faculty in a representative sample of 13 English speaking colleges in Ontario.

RESULTS

Participants perceived content containing complex cognitive concepts, experiential learning as in relational practice, and psychomotor skill mastery as better suited for traditional classroom delivery. Faculty identified challenges with developing higher level online discussions and having students collaborate.

CONCLUSION

Online teaching took much more time and should be acknowledged in workload assignments. A hybrid teaching environment was preferred. Online education was useful when the content and the semesters/years were appropriate, and necessary supports were in place. [J Nurs Educ. 2020;59(12):683-691.].

Presence of the Reflective and Critical Thinking Capacity in Nursing Curricula in Iberian America

OBJECTIVES

The objective was to identify the presence of the capacity for reflexive-critical thinking or similar, in Nursing Curricula in Iberian America.

METHODS

The article gathers the results of one of the objectives of the macro-project developed by the Iberian American Network on Nursing Education Research, titled Strategies to develop reflective and critical thinking in nursing students: Iberian America situation. To achieve this, a descriptive and exploratory research was conducted with qualitative approach. An instrument created for this project was used, along with some guiding questions to focus the information.

RESULTS

Eight countries participated (Bolivia, Brazil, Colombia, Ecuador, Spain, Mexico, Peru, and Venezuela), which contributed information from 189 curricular plans. The R&CT was found in the majority of the curricula, although with diverse denominations. The principal learning strategies used were problem-based learning, group dynamics, reflective reading, clinical practice, and simulation laboratories. The evaluation methods used are the knowledge test, case analysis, and practical exam.

CONCLUSIONS

Significant stress exists in the discourse and curricular organization. Incongruences were found and a clear inclination toward the formation of professionals with broad technical skills under a traditional, memory, banking and knowledge accumulation education.

A National Survey of RN-to-BSN Programs: Are They Reaching Rural Students?

BACKGROUND

Increased representation of Bachelor of Science in Nursing (BSN)-prepared nurses improves health and reduces costs. Fewer rural U.S. nurses have BSN degrees compared with the national average. RN-to-BSN programs provide an opportunity to increase the number of BSN-prepared rural nurses. However, the number of these programs targeting rural students is unknown.

METHOD

Directors of RN-to-BSN programs were surveyed regarding program characteristics and efforts to target rural learners. Using mail and online return options, the response rate was 31.3%.

RESULTS

Only 38% of programs targeted rural RNs for recruitment. Supports for rural student recruitment and retention, including partnerships with community colleges, rural clinical placements, and online offerings, were limited in number and/or scope.

CONCLUSION

RN-to-BSN programs with the capacity to recruit and retain rural learners may help increase the number of BSN-prepared rural nurses. Increased collaboration among stakeholders will support rural nurses in continuing their education. [J Nurs Educ. 2020;59(10):557-565.].

Chronic and acute fatigue and intershift recovery in undergraduate nursing students working 12 or 6-hour faculty-supervised clinical shifts

BACKGROUND

Nursing student fatigue and recovery time are important considerations.

PURPOSE

This descriptive research compared chronic/acute fatigue and recovery time between one 12-hour shift or two 6-hour faculty-supervised clinical shifts per week.

METHODS

The Occupational Fatigue and Exhaustion Recovery (OFER) scale was completed by undergraduate students in pediatric and obstetrical courses.

RESULTS

The student (N = 106) mean score on OFER was 37.57 for chronic fatigue, 56.57 for acute fatigue, and intershift recovery was 56.57. No differences in chronic fatigue (P = .40), acute fatigue (P = .14), or intershift recovery (P = .35) were found between groups. Nursing students (79%) preferred 12-hour clinical shifts as compared to 21% who chose two 6-hour clinical.

CONCLUSIONS

No differences in chronic/acute fatigue or intershift recovery between a 12-hour clinical shift or two 6-hour clinical shifts were found. Nursing students preferred the one 12-hour clinical shift.

Despite Challenges: Nursing Student Persistence

BACKGROUND

Seeking to improve nursing student retention in their small university, faculty conducted a literature review on attrition in nursing education and discovered it to be a significant global problem with nearly one third of qualified students discontinuing. Improved nursing student persistence could stem the growing worldwide nursing shortage. The existing research on retention indicates multi-faceted challenges and impacts but offers scant solutions or insight into student perspectives.

METHOD

The nursing faculty piloted a bridge course for the freshman cohort to develop intrinsic strengths for student persistence and begin soliciting student feedback using a mixed-methods phenomenological approach.

RESULTS

Faculty describe the bridge course framework and activities and present initial student responses.

CONCLUSION

The pilot bridge course serves as one step toward identifying challenges and interventions from students' perspectives to support persistence as a means of meeting nursing shortage demands. [J Nurs Educ. 2019;58(7):427-430.].

The Association of Nurse-Physician Teamwork and Mortality in Surgical Patients

In this study we describe nurse-physician teamwork, estimate its association with surgical patient outcomes (30-day mortality and failure-to-rescue), and determine whether these relationships depend upon other modifiable hospital nursing characteristics (nurse staffing and education levels) known to be associated with patient outcomes. This cross-sectional analysis included linked data from 29,391 nurses representing 665 acute care hospitals and 1,321,904 adult patients who underwent a general surgical, vascular, or orthopedic procedure. Surgical patients cared for in hospitals with better nurse-physician teamwork had significantly lower odds of 30-day mortality (odds ratio [OR] = 0.95) and failure-to-rescue (OR = 0.95). In addition, the odds of death and failure-to-rescue were lower for patients in hospitals with both higher nurse-physician teamwork and more favorable patient-to-nurse staffing ratios. Similar trends were observed related to nursing education levels. Improving interprofessional teamwork is one strategy to improve patient outcomes with the added importance of also considering additional features of their nursing workforce.

Exploring the meaning of undergraduate nursing students' experiences and confidence in clinical skills using video

BACKGROUND

Students and health care faculty staff report a lack of confidence in graduating nurses' clinical skills practice. Traditional approaches to support nursing students' clinical skills development have relied on small group, face-to-face, practice-based learning in clinical laboratories. However, with changing curricula, increased numbers of students, and pressure on laboratory timetables and availability, alternate methods of delivery are necessary to ensure students gain confidence in the development of their clinical skills. Video podcasting is an innovative approach that is being used to stimulate active and ongoing learning of clinical skills.

DESIGN

A hermeneutic phenomenological approach.

METHOD

Data were collected through in-depth interviews with 10 second-year, undergraduate nursing students about their experiences using three clinical skills video podcasts and their perceptions of how this impacted on their learning of these clinical skills and confidence in practice.

FINDINGS

Three themes emerged from the data: 'Accessibility for learning the skill'; 'Preparation for learning and practice'; and 'Student-directed learning'. These themes provided an insight into the students' engagement with video podcasts, demonstrating their sense of confidence was increased in clinical skills development.

CONCLUSION

The findings of this study provide an insight into the students' engagement with video podcasts in relation to their confidence in clinical skills development, and indicate that undergraduate nursing students value the use of video podcasts in their learning of clinical skills. However, it was evident that students still value face-to-face delivery to guide their study, which suggests that video podcasts could be used as an adjunct to teaching to support learning.

Nursing students' perceptions of clinical learning opportunities and competence in administration of oral medication in the Western Cape

BACKGROUND

Medication errors may result in patients' harm and even death. The improvement of nursing students' competence in the administration of medication through education and training can contribute to the reduction of medication errors.

OBJECTIVES

This study aimed at describing the Bachelor of Nursing students' perceptions about clinical learning opportunities and competence in the administration of oral medication.

METHOD

A quantitative descriptive design was employed. An all-inclusive sample of 176 nursing students registered at a university in the Western Cape, South Africa, in 2014 was considered for the study, of whom 125 students consented to participate and completed the questionnaires. Statistical Package for the Social Sciences (SPSS) version 22 was used for data analysis and descriptive statistics were conducted.

RESULTS

The findings showed that a minority of students did not have opportunities to rotate in all specific types of wards. The findings indicated that a total of 92% (115) and 86.4% (108) of the 125 respondents were placed in medical and surgical wards, respectively, where they more likely had opportunities to practise the administration of oral medication. However, 59.2% (74) did not practise administration of oral medication on a daily basis. Only 19.2% (24) of respondents perceived themselves as competent in the administration of oral medication.

CONCLUSION

The findings indicated that many students perceived their education and training as not providing sufficient learning opportunities to practise the administration of oral medication, whilst the majority of respondents perceived themselves as competent in some of the aspects related to the administration of oral medication, and very few perceived themselves as competent overall in the administration of oral medication.

Collaborative Learning in Practice (CLIP): Evaluation of a new approach to clinical learning

BACKGROUND

There are challenges in creating positive clinical learning environments. A new model of practice learning for pre-registration nurse education was pilot-tested in the East of England. The Collaborative Learning in Practice model (CLIP) was developed from a similar model of practice learning used in the Netherlands.

OBJECTIVES

We undertook an evaluation of a new approach to clinical learning. The aims of the project were to consider the challenges of implementation; consider the perception of gains and losses of students and stakeholders experiencing the new model of practice learning; and consider the sustainability of the new model in the context of service delivery.

METHODS

Mixed methods were used. Data were collected in three forms: (1) a survey of students undertaking the CLIP model and those learning within the existing mentorship model to assess the supervisory relationships and pedagogical atmosphere experienced; (2) student focus groups; and (3) qualitative one-to-one interviews with key stakeholders in the provision of practice learning environments.

RESULTS

A total of 607 questionnaires were returned out of the 738 distributed, five focus groups of a total of 30 students were undertaken, and 13 stakeholders were interviewed. Students who had experienced CLIP reported lower supervisory relationship scores compared with those without experience (mean difference = -0.24 points, 95% CI -0.21 to -0.094, p = 0.001). There was no difference in pedagogical atmosphere scores (mean difference -0.085 points, 95% CI -0.21 to 0.040, p = 0.19). Analysis of qualitative data produced two themes: 'Adapting the environment' illustrated the importance of learning context and 'learning to fly' highlighted the process of students gaining greater autonomy.

CONCLUSION

Our findings suggest that collaborative learning in practice offers many benefits as an approach to clinical learning but with important caveats. Attention needs to be paid to particular aspects of the model such as sufficient numbers of students, and an acknowledgement of perceived losses as well as gains.

Anxiety among nursing students during their first human prosection

Dissection and prosection practices using human cadavers are a key component of macroscopic anatomy education in different Health Sciences university degrees. However, first-hand interaction with cadavers can be distressing for students, generating anxiety on a number of levels. This study aims to shed light on the reactions, fears and different states of anxiety experienced by nursing students in to a single anatomy room experience over a five-hour period, and examined reactions pre and post same. A descriptive study of these students was designed in order to understand their feelings and emotions, based on the distribution of anonymous "ad hoc" questionnaires before and after the practices. Also, State-Trait Anxiety Inventory (STAI) questionnaires were administered in order to assess their anxiety levels: Trait Anxiety (TA), which measures basal anxiety levels, and State Anxiety (SA), which measures individual emotional responses during a specific event (in this case, the prosection practice). The results of this study indicate that basal anxiety levels, measured as TA, remained stable and unchanged during the practice (p > 0.05). SA or emotional anxiety levels, on the other hand, dropped from 21.3 to 17.8 points (p < 0.05). Before the start of the practical exercise, 17.6% of the students admitted experiencing some kind of anxiety. Afterwards, however, 90.2% of the students said they would recommend these practices. They considered that prosection practices very useful for their education and recommended that they be retained for future courses. However, our study also showed the relevance of using coping mechanisms before the first contact with the dissecting room, especially for those students who did not feel emotionally prepared for it beforehand.

The impact of an educational intervention on nursing students' critical thinking skills: A quasi-experimental study

AIM

In this study, we identified the impact of educational activities that focused on improving the competence and critical thinking skills of university nursing students.

DESIGN

A prospective quasi-experimental study was conducted, and assessments were conducted before and after the educational intervention, which consisted of seminars, lectures, case studies, and problem-solving activities.

METHODS

The Critical Thinking Questionnaire was used to collect data before and after the educational intervention between September 2017 and May 2018. The sample consisted of 112 first-year undergraduate students. To examine the data that were collected as a part of this quasi-experimental study, inferential statistics were used, and the results were tested against a significance level of P < 0.05.

RESULTS

The students obtained higher scores on the substantive dimension than on the dialogic one, and women scored higher than men. The educational intervention led to an improvement in every critical thinking skill across both dimensions, except listening and speaking skills, whereby men demonstrated a greater change in average scores for critical thinking skills.

CONCLUSIONS

The educational intervention improved the critical thinking skills of undergraduate students and had a greater impact on men than on women. This finding underscores the need for educational interventions that can enhance critical thinking skills. Developing these skills will improve future nurses' ability to make health care management decisions in a reflective, agile, and evidence-based manner.

To evaluate the effect of challenge-based learning on the approaches to learning of Chinese nursing students: A quasi-experimental study

Challenge-based learning (CBL) is a learner-centred, experimental learning strategy that aims to prepare students to manage unforeseeable and complex global issues in the 21st century. It cultivates an active and authentic learning environment that requires students' creative input, collaboration and community involvement. Studies in the past decade have shown that CBL strengthens soft skills essential for future society, such as critical thinking and creativity. However, its effect on students' metacognitive abilities is scarcely mentioned. This study - a quasi-experimental study with non-equivalent groups conducted in a self-financing tertiary institution in Hong Kong - aims to evaluate the effect of CBL on approaches to learning among nursing students. First-year students in the nursing programme who attended a nursing course using CBL were recruited for the intervention group and senior year-one students were included in the control group. Their approach to learning was measured by the Revised Two-Factor Study Process Questionnaire administered at the beginning and at the end of the semester. Analysis of Covariance (ANCOVA) was used to compare the mean difference in scores of deep and surface approaches between the groups. A total of 209 participants were recruited, with 130 in the intervention group and 79 in the control group. The response rates were 65.3% (130/199) and 78.2% (79/101) for the intervention and control groups, respectively. In the intervention group, the mean post-test deep approach score was significantly higher than the pre-test score (F = 5.2, p = 0.023), even though it had only a small effect. There was no statistically significant difference in baseline post-test mean surface scores (F = 2.4, p = 0.125). The results of this study indicate that CBL may facilitate deep learning in nursing students.

The type and amount of paid work while studying influence academic performance of first year nursing students: An inception cohort study

BACKGROUND

Working while engaging in tertiary studies can have potential benefits for students in developing their repertoire of employability skills, including teamwork, time management, customer service and interpersonal communication. Not unexpectedly engaging in excessive hours of work can have a detrimental effect on students' grades. Yet little is known about the impact of engaging in different types of paid work (nursing or non-nursing), and the amounts, on first year nursing students' academic performance across different nursing programs.

OBJECTIVES

The aim of this study was to examine the association between: a) amount; and b) type of term-time weekly paid work, particularly its effect on academic performance, among commencing undergraduate students in the first semester of nursing studies across different nursing programs.

DESIGN

Inception cohort study.

SETTINGS

Four tertiary institutes across Australia and New Zealand.

PARTICIPANTS

All commencing Bachelor of Nursing students attending Orientation sessions at their respective institutes were invited to participate in the study. The median age of participants was 23 years, the majority (87.5%) were female and nearly two-thirds were non-school leavers. Among those in paid work, the median hours worked was 20 h.

METHODS

A baseline survey, completed by consenting students at the start of their Orientation session included items related to respondents' demographic data, self-reported paid work engagement (type and hours); we also requested their permission to link grade point average (academic performance data) at the end of first semester. Data were analysed using SPSS Version 25.

RESULTS

A total of 1314 students completed the survey and 89% of survey respondents agreed for their survey to be linked to academic grades at the end of the semester. There was an inverse relationship between time spent in weekly paid work and academic performance. Additionally, three predictors emerged as statistically significant for high grade point average: (i) engaging in non-nursing related work (AOR: 1.64, 95% CI: 1.19-2.26); (ii) not being first in family to attend university (AOR: 1.57, 95% CI: 1.20-2.07) and; (iii) being a school-leaver (AOR: 1.49, 95% CI: 1.12-1.98).

CONCLUSIONS

Despite the diversity among undergraduate nursing students studying across Australasia, it is evident that the amount and type of paid work engagement can impact on students' academic performance while studying. This underscores the importance for tertiary institutes to not only support students in their learning but also understand the need to achieve the right balance, in working while studying, to support students' academic success.

The effects of training with simulation on knowledge, skill and anxiety levels of the nursing students in terms of cardiac auscultation: A randomized controlled study

BACKGROUND

The use of simulation methods in nursing education is important in terms of decreasing anxiety of students in a safe and realistic environment due to the improvement of knowledge and skills of students in terms of cardiac auscultation and their attitudes to prepare for clinical applications.

OBJECTIVES

The aim of this study is to compare the effectiveness of high-fidelity simulator and traditional teaching method on nursing students' knowledge and skill development in terms of cardiac auscultation and their anxiety levels.

DESIGN

Randomized controlled study.

SETTING

The study was conducted in the simulation laboratory of the Nursing Department in the Health College and in the inpatient clinics of the Medicine Faculty Hospital.

PARTICIPANTS

72 first-year nursing students (simulation group = 36, control group = 36).

METHODS

The students were randomly distributed to the simulation and control groups. The students in the simulation group received a cardiac auscultation training by using a high-fidelity simulator while the students in the control group received training with the traditional teaching method. After the training sessions, all students practiced their skills in the laboratory and on real patients in clinical setting under the supervision of the researcher. The data were collected by using the Demographic Information Form, Knowledge Assessment Form for Cardiac Auscultation, Skill Evaluation Form for Cardiac Auscultation and State Anxiety Inventory (SAI).

RESULTS

High-fidelity simulators and traditional teaching method were found to be effective in increasing the students' knowledge and skill levels in terms of cardiac auscultation. However, it was found that the high-fidelity simulator method was more effective than the traditional teaching method to increase the students' knowledge (p = 0.001) and skill (p < 0.001) levels; this increase was significant. In addition, it was found that the students in the high-fidelity simulator group showed a significant decrease in anxiety scores compared to the students who were trained with traditional education method (p < 0.001).

CONCLUSIONS

The results showed that the use of high-fidelity simulator in nursing education was more effective than traditional method in terms of improving the students' knowledge, skill levels for cardiac auscultation and reducing their anxiety.

Characterization of adverse events occurring during nursing clinical rotations: A descriptive study

INTRODUCTION

Patient safety is a pillar of quality health care. Nursing students may commit errors during clinical practice, compromising patient safety.

OBJECTIVE

Analyze the adverse events, as well as the factors associated with the errors, reported by students from a private university in Santiago, Chile during nursing clinical rotations.

METHODS

Quantitative cross-sectional descriptive study. A total of 68 errors by first- through fifth-year nursing students were reported between 2012 and 2018. The data collection instrument was the Adverse Events Notification Form from the School of Nursing. This form documented information about the study as well as about the event.

RESULTS

After this reporting system was established in 2012, the number of events reported increased steadily each year. The greatest numbers of reported errors were committed by fifth-year students (73.5%), and the most common type of error was associated with medication administration (94.2%), including incorrect dose (27.9%) and incorrect medication (17.6%). The major factors contributing to errors were failure to review the "10 rights of medication administration" (85.3%) or lack of critical judgment (7.4%). Most of the errors occurred in public institutions (72.1%).

CONCLUSION

The results suggest that it would be beneficial to re-evaluate how safety and quality of care are taught at the school of nursing, with an emphasis on understanding the learning styles of students and teaching strategies of instructors. It is crucial that the academic institution remain actively involved in teaching safety-related skills to future nursing professionals. Furthermore, we suggest modifications to the adverse events reporting system that would avoid the need for personal interpretations of the event by the student.

A Closer Look at the Introduction of the NCLEX-RN in Canada

In 2015, the nursing faculty across most of Canada were informed by provincial nursing regulators that the America-based National Council Licensure Examination-Registered Nurse (NCLEX-RN) was going to replace the Canadian Registered Nurse Examination for our nursing students to become registered as nurses. This change in the exam has presented a number of challenges to both faculty and students as they transitioned from a Canadian exam for the Canadian context to an exam that was originally formulated for nursing registration in the United States. This manuscript examines the differences in the Canadian and American healthcare systems; explores the variations in Canadian and American nursing practice and education; outlines concerns surrounding the use of standardized testing that panders to corporate interests, encourages "teaching to the test" and is costing nursing programs and nursing students considerable resources; and explores the controversy surrounding the validity of the NCLEX-RN in both Canada and the United States. This manuscript asks Canadian nursing leaders, educators, clinicians and researchers to question why Canadians have taken on this exam when Americans themselves state that this exam "gives a false and incomplete picture of practice readiness."

Effectiveness of the e-NurSus Children Intervention in the Training of Nursing Students

The paediatric population is the most vulnerable to exposure to environmental risk factors. Institutions of higher education have to equip nursing students with the attitudes, knowledge, and skills to respond to this using blended learning. The aim of this study was to evaluate the effect of e-NurSus Children intervention on student nurses' attitudes, knowledge, and skills. A quasi-experimental study of time series was designed using pre and post educational intervention evaluation in 2018. The participants were nursing students (N = 267) from Spain (n = 110) and the United Kingdom (n = 157). Three instruments were used: the Sustainability Attitudes in Nursing Survey, the Children's Environmental Health Knowledge Questionnaire, and the Children's Environmental Health Skills Questionnaire. The attitudes (15.81%), knowledge (39.02%), and skills (29.98%) of nursing students improved following the e-NurSus Children intervention. It is necessary to include topics on children's environmental health in nurse education as students are aware of this issue but do not have the knowledge or skills required to manage problems or illness caused by the environment. The e-NurSus Children intervention is an effective tool to address this educational gap.

Does the use of annotated exemplars by nursing students predict academic performance? A cohort study

AIMS

To examine the usefulness of the annotated exemplar as an academic support strategy, and explore the characteristics of students who were more likely to engage with this academic support tool. Additionally, to identify if there was any influence on the academic performance in the assessment activity among those who engaged with the annotated exemplar.

BACKGROUND

Annotated exemplars have the potential to target students en masse and provide meaningful, task specific comments that guide students prior to assessment submission. Effective strategies to support student learning are needed as nursing students are increasingly entering tertiary studies from non-traditional backgrounds.

DESIGN

A cohort study was used to collect administrative data, academic grades and annotated exemplar usage statistics.

SETTING

A large multi-campus university in NSW, Australia during Spring semester 2016.

PARTICIPANTS

Second year undergraduate students enrolled in a single unit in the Bachelor of Nursing Program.

METHODS

Quantitative data related to marks, grades and usage information; and demographic data and contact details were extracted from the online learning management system and student electronic records.

RESULTS

Of the 1120 students enrolled in the unit, 49.5% of students engaged with the annotated exemplar. Students more likely to engage with the tool were older, female, born outside of Australia and had higher hit rates on the online learning management site. Of those who engaged with the annotated exemplar, there was no demonstrated increase in assessment mark.

CONCLUSION

To improve student performance it is essential that feedback is engaging and effective. While, in this study, use of the annotated exemplar was not reflected in student marks, it is unclear how students may have performed without access to the exemplar. Further research is required to explore the reasons why students did not engage with the annotated exemplar and, for those who did, why the intervention did not impact on assessment mark.

A process evaluation of a mobile cooperation intervention: A mixed methods study

BACKGROUND

A mobile cooperation intervention was developed to facilitate the cooperation of nursing students with nurse teacher and to improve the students' clinical learning outcomes. The intervention consisted of training in a mobile application's functionality and its use during clinical practicum cooperation procedures.

OBJECTIVES

To describe the development of a mobile application for student-teacher cooperation and to examine the acceptability of the mobile cooperation intervention for advancing intervention development.

DESIGN

A user-centred design and a mobile application development lifecycle model were applied to develop a mobile application. A process evaluation that used mixed methods design was conducted within the intervention group after a randomized controlled trial of a complex mobile cooperation intervention.

SETTING

The clinical practicum wards of seven hospitals in a hospital district in Finland.

PARTICIPANTS

Second-year pre-registration nursing students (N = 52) from one nursing school.

METHODS

Process evaluation questionnaires were completed upon completion of the five week intervention and essays were written by the students eleven weeks after the intervention ended.

RESULTS

A system usability scale (SUS) assessed the overall usability of the mobile application as rather good (a mean SUS score of 69.86 out of 100). Positive feedback about the mobile application's usability and utility was reported and recommendations for further development were highlighted. The intervention demonstrated high acceptability. In general, the students actively used the mobile application for intervention procedures at home and in the clinical practicum ward.

CONCLUSIONS

The findings support the high acceptability of mobile cooperation intervention and its potential while also providing evidence for the development team's future development of the mobile application. Additionally, this study provides an example of mobile application development and process evaluation in nursing education research.

Bachelor of Nursing students' HIV and AIDS knowledge in KwaZulu-Natal province: An evaluation study

BACKGROUND

 Currently, human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) education and training in nursing suffer from various inadequacies and lack any real formalisation in their governance. As a result, Bachelor of Nursing students find themselves challenged in providing effective HIV and AIDS healthcare management, largely because of the deficit in training identified. An HIV and AIDS education intervention programme was introduced at a selected KwaZulu-Natal university to assist in bridging the perceived knowledge gap. This article communicates programme evaluation findings.

OBJECTIVES

 The aim of this article was to determine levels of HIV knowledge achieved following an HIV education intervention programme.

METHODS

 A pure, descriptive quantitative research design was employed, using total population sampling (N = 133). A modified G3658-11 Collecting Evaluation Data: End-of-Session Questionnaire, developed by the University of Wisconsin-Extension, was administered for data collection.

RESULTS

 Females predominated in the study, and most participants were African with 1 to 3 years of education programme exposure. Perceived HIV knowledge increase was evident: pathophysiology (n = 93, 70.2%); immunology (n = 97, 72.9%); transmission (n = 116, 87.5%); diagnosis (n = 109, 81.8%); prevention strategies (n = 118, 88.4%); staging and monitoring (n = 106, 80%); pre- and post-test counselling (n = 104, 78%).

CONCLUSION

 Pre- and ongoing in-service HIV and AIDS training can improve perceived HIV knowledge levels for both nursing students and professionals. Mandatory HIV and AIDS healthcare management training is therefore recommended in planning for its effective impartation by nursing educators.

Nursing students' involvement in shift-to-shift handovers: Findings from a national study

BACKGROUND

Effective performance of clinical handovers should be one of the priorities of nursing education to promote efficient communication skills and ensure patient safety. However, to date, no studies have explored to what extent nursing students are involved in handovers.

OBJECTIVE

To explore nursing students' handover involvement during their clinical rotations and associated factors.

METHOD

This was a secondary analysis of a large national cross-sectional study that involved 9607 undergraduate nursing students in 27 universities across 95 three-year Italian baccalaureate nursing programs. The involvement in the clinical handovers was the end point (from 0, never, to 3, always). A path analysis was performed to identify variables directly and indirectly affecting students' handover involvement.

RESULTS

Handover involvement was reported as 'only a little', 'to some extent', and 'always' by 1739 (18.1%), 2939 (30.6%), and 4180 (43.5%) students, respectively; only 749 (7.8%) of students reported never being involved. At the path analysis explaining the 19.1% of variance of nursing students' involvement, some variables emerged that directly increased the likelihood of being involved in handovers. These were being female (β = 0.115, p < 0.001); having children (β = 0.107, p = 0.011); being a 3rd-year student (β = 0.142, p < 0.001) and being a 2nd-year student as compared to a 1st-year student (β = 0.050, p = 0.036); and having a longer clinical rotation (β = 0.015, p < 0.001) in units with high 'quality of the learning environment' (β = 0.279, p < 0.001). Moreover, students who were supervised by the nurse teacher (β = -0.279, p < 0.001), or by a nurse on a daily basis (β = -0.253, p = 0.004), or by the staff (β = -0.190, p < 0.001) reported being less involved in handovers as compared to those students supervised by a clinical nurse. Variables with indirect effects also emerged (model of student's supervision adopted at the unit level, and number of previous clinical rotations attended by students). Moreover, handover involvement explained 11.5% of students self-reported degree of competences learned during the clinical experience.

CONCLUSIONS

Limiting students' opportunity to be involved in handover can prevent the development of communication skills and the professional socialization processes. Strategies at different levels are needed to promote handover among undergraduate nursing students.

The role of universities in attracting male students on to pre-registration nursing programmes: An electronic survey of UK higher education institutions

The UK nursing workforce is facing a crisis. More nurses are leaving than entering the profession, and there are tens of thousands of unfilled vacancies. Political factors are having a significant impact on numbers, in particular the decision to withdraw bursaries for nursing undergraduates, and a steep decline in EU nurses registering to work in the UK post-Brexit. Against this backdrop, there is a stark gender imbalance in the workforce, with only around 11% of registered nurses being male. We surveyed UK higher education institutions to try to identify whether the gendered nature of nursing was considered a concern and whether steps were being taken to address it. We sent an electronic survey to every UK university offering undergraduate nurse training validated by the Nursing and Midwifery Council (NMC). With a response rate of 42%, the majority of respondents felt that nursing departments should take much more responsibility to increase the proportion of male nurses entering the nursing profession. More needs to be done to diversify the workforce and make nursing an appealing career choice for men and women.

Assessment of Prelicensure Undergraduate Baccalaureate Nursing Students: Ostomy Knowledge, Skill Experiences, and Confidence in Care

Care of the patient with an ostomy is included in the curriculum of prelicensure nursing programs, but no studies examining student nurses' knowledge about stoma care have been published. The purpose of this project was to examine the ostomy knowledge, experiences, and confidence of nursing students in order to assess and improve the curriculum. At the end of the fall 2016 semester, students enrolled in 3 separate nursing courses in an undergraduate program were asked to participate in a project to examine students' ostomy knowledge, their experiences, and their confidence in providing care. This project was undertaken to explore the college's ostomy curriculum. Participation was voluntary, and no student who was willing to participate was excluded. Students completed a 50-question knowledge test, answered questions about the frequency of performing ostomy-related skills, and rated their confidence in providing ostomy care. Responses were examined with descriptive and inferential statistics. Of 189 possible participants, 138 completed the questionnaires and included mostly women (113, 81.9%); participant mean age was 27.26 ± 6.22 years. The mean number of correct knowledge responses was 35.66 (71.32%); 66 participants (47.8%) reported no experience caring for a patient with an ostomy. The most common skills performed in clinical rotations were emptying (49) and changing (24) the pouch. A scale of 1 to 5 was used to evaluate 6 confidence items, with students having a mean confidence score of 19.54 ± 5.20. They had the most confidence in their ability to empty a pouch and to size and fit the pouching and the least confidence in teaching and community resources. Confidence was related to the number of skills performed in the lab (r = .32; P <.001), the number of skills performed in clinical practice (r = .38; P <.001), and ostomy knowledge scores (r = .23; P <.007). Total correct knowledge scores did not differ significantly by year in the educational program. Based on the results of this survey, it was concluded that students had a beginning knowledge about ostomy care and very limited clinical experience, yet confidence in providing ostomy care was high. Curriculum adjustments were implemented, including strategies for increasing ostomy knowledge, opportunities to provide care, and confidence; these need further investigation in prelicensure undergraduate nursing programs. The effect of curriculum adjustments remains to be evaluated.

Pain Education in Schools of Nursing: a Survey of the Italian Academic Situation

INTRODUCTION

Proper assessment of pain is imperative for the development of an effective pain management plan and is a core responsibility of nurses and healthcare professionals. This article describes the contents of Italian on-line bachelor's in nursing degree programs, with particular focus on pain management.

METHOD

A descriptive study was made on curricula published and available on-line in Italian Nursing Schools, and the concordance with the standards set by the Consensus Curriculum on Pain for Nursing ofthe International Association for the Study of Pain (IASP, 2015) was analyzed.

RESULTS

Of all the bachelor programs published on-line, 42.6% offered programs and courses specifically centred on pain education, while in general pain teaching seemed to be delivered as part of other topics. Results showed that the contents of the programs were partially in line with those suggested by the IASP. True is that on-line results may underestimate the actualdiffusion of pain education programs and topics in Italian Universities.

CONCLUSION

The Italian academic system does not seem to comply with any specific international standard. Only by interviewing the university administrative staff we may investigate the amount and type of pain education received by Italian healthcare undergraduates and the existing educational curricula and plans, as on-line information may be only partially complete.

Efficacy of empathy training in nursing students: A quasi-experimental study

BACKGROUND

Empathy is a competency to be learned by nurses and a therapeutic tool in the helping relationship that has repercussions on the health of both patients and professionals.

OBJECTIVES

To determine the efficacy of an experiential training for improving the empathy of nursing students in terms of capacity building, empathic performance and increased learning perception and retention of the material.

DESIGN

A quasi-experimental study of a single group with pretest-posttest measurements of the educational intervention and follow-up at one month after the training.

SETTINGS

Faculty of Nursing, University of Cádiz, Spain.

PARTICIPANTS

Forty-eight second-year undergraduate university nursing students.

METHODS

The educational intervention was conducted during a single semester, with 20h of training. The methodology of role-playing, behavior assay, and a flipped classroom was followed. Measurements of student performance were collected before and after the intervention. The Reynolds Empathy Scale was used to evaluate the student's perception of his/her performance; The Consultation and Relational Empathy Measure was used to evaluate the patient's perception of the student's behavior during the simulation; and three independent external observers assessed the student's behavior, guided by The Carkhuff Scale. Descriptive analysis and non-parametric contrast tests were performed to compare the scores before and after the training (Mann-Whitney U and Wilcoxon rank-sum). Spearman's correlation coefficient was used for the correlation between the measurements.

RESULTS

The mean scores improved for all of the variables, with the differences being statistically significant. The students assessed their learning positively.

CONCLUSIONS

The training was shown to be effective for improving the empathy of the university students in the study. The results are promising in terms of the students retaining the competencies adquired. Therefore, this type of experiential training is recommended for empathy training of future health professionals.

Changes in nursing students' expectations of nursing clinical faculties' competences: A longitudinal, mixed methods study

BACKGROUND

Changes in nursing students' expectations of their clinical nursing faculty competences over the course of time are an insufficiently researched phenomenon.

OBJECTIVES

To explore what competences BSc nursing students expect from their clinical faculties during their clinical training, and whether their expectations changed during their three-year studies. Furthermore, to survey factors which influenced their expectations and whether the fulfilment levels of their expectations influenced their feelings, learning, and behaviour.

DESIGN

A two-phase, mixed-methods design was used.

SETTINGS

The Higher Nursing Education Institution in Osijek, Croatia, European Union.

PARTICIPANTS

A cohort of 34 BSc nursing students, who were followed over the course of their three-year studies.

METHODS

In Phase I, in each year, prior to their clinical training, participants responded to the same modified Nursing Clinical Teacher Effectiveness Inventory questionnaire about their expectations of clinical faculties' competences (52 items representing six categories of competences). In Phase II, seven days after their graduation, participants wrote reflections on the aforementioned expectations during their studies.

RESULTS

The results show that Clinical faculties' evaluation of student was the category in which participants had the highest expectations in all three years. Results of Wilcoxon signed rank test indicate a significant increase of participants' expectations in all categories of clinical nursing faculties' competences during their study. Participants' reflections confirm these results and indicate that actual competences of clinical faculties and behaviour have the most significant effects on the change in these expectations. Participants reported that expectations, if fulfilled, facilitate their learning and motivation for better performance.

CONCLUSIONS

BSc nursing students' expectations of clinical nursing faculty competences represent an important concept, as they obviously determine the quality of faculty practice. Hence, they should be considered in the preparation, implementation, and evaluation phase of this vital part of nursing education.

Widening participation in nurse education: An integrative literature review

BACKGROUND

Widening participation into higher education is espoused within educational policy in the UK, and internationally, as a mechanism to promote equality and social mobility. As nurse education is located within higher education it has a responsibility to promote widening participation within pre-registration educational programmes. It could also be argued that the profession has a responsibility to promote equality to ensure its' workforce is as diverse as possible in order to best address the health needs of diverse populations.

OBJECTIVES

To undertake an integrative review on published papers exploring Widening Participation in undergraduate, pre-registration nurse education in the UK.

DESIGN

A six step integrative review methodology was utilised, reviewing papers published in English from 2013-2016.

DATA SOURCES

Search of CINAHL, Education Source, MEDLINE, PsychINFO, SocINDEX, Science Direct, Business Source Complete, ERIC, British Library ETOS, Teacher Reference Centre, Informit Health Collection and Informit Humanities and Social Science Collection which highlighted 449 citations; from these 14 papers met the review inclusion criteria.

REVIEW METHODS

Both empirical studies and editorials focusing upon widening participation in pre-registration nurse education in the UK (2013-2016) were included. Papers excluded were non UK papers or papers not focussed upon widening participation in pre-registration nursing education. Research papers included in the review were assessed for quality using appropriate critical appraisal tools.

RESULTS

14 papers were included in the review; these were analysed thematically identifying four themes; knowledge and identification of WP, pedagogy and WP, attrition and retention and career prospects.

CONCLUSIONS

Whilst widening participation is a key issue for both nurse education and the wider profession there is a lack of conceptualisation and focus regarding mechanisms to both encourage and support a wider diversity of entrant. Whilst there are some studies, these focus on particular individual widening participation groups rather than a wider strategic focus across the student lifecycle.

Transition experiences, intrapersonal resources, and job retention of new graduate nurses from accelerated and traditional nursing programs: A cross-sectional comparative study

BACKGROUND

With increasing numbers of new graduate nurses from accelerated nursing programs entering the workforce, it is important to understand their transition experiences, as they may differ from those of traditional graduates.

OBJECTIVES

The aim of this study was to describe and compare the intrapersonal resources, transition experiences, and retention outcomes of these two groups.

DESIGN

A descriptive cross-sectional comparison study was conducted.

PARTICIPANTS

A random sample of 3655 registered nurses with <3years of nursing experience were invited to participate from across Canada; 1020 responded (27.9%). The final sample included 230 nurses from accelerated programs and 768 from four-year programs (total n=998).

METHODS

Following ethics approval, participants were mailed a questionnaire to their home address. One month later non-responders were sent a reminder letter, followed by a second questionnaire one month later (January to March, 2013). Descriptive statistics were conducted using SPSS. Group differences were assessed using independent samples t-tests for continuous variables and χ² tests for categorical variables.

RESULTS

Overall, there were few significant differences between new graduate nurses from accelerated and traditional programs. Nurses in both groups had high levels of intrapersonal resources, positive transition experiences, were satisfied with their jobs and their choice of nursing as a career, and their intentions to leave were low.

CONCLUSIONS

All new graduate nurses need to have a strong educational preparation and transition support, regardless of their age and previous work and career experiences.

The effects of nursing education on professional values: A longitudinal study

BACKGROUND

It is considered to be extremely important to ensure that nurses adopt professional values during their education in order to improve nursing practices and develop a professional identity.

OBJECTIVES

The aim of this study is to investigate the effects of nursing education on development of professional values.

DESIGN

This study was designed as a longitudinal study.

SETTINGS

The study was conducted in a nursing department at a nursing school in the western Turkey.

PARTICIPANTS

The population of the study consisted of nursing students who were enrolled in the nursing department in academic year of 2011-2012. The data of the study were collected from 59 first-year students in 2011 and 83 fourth-year students in 2015.

METHODS

The data of the study were collected using Personal Information Form and Nursing Professional Values Scale-NPVS. The participants responded to the same questionnaire in their first and fourth years in the department.

RESULTS

The scale mean score of the students in their first year was 3.44±0.635. The highest scores were obtained from the subscales of responsibility, security, and autonomy. Their scale mean score in their fourth year was 3.93±0.727. The highest scores were obtained from the subscales of dignity and autonomy. The difference between the mean scores was statistically significant (p=0.001).

CONCLUSIONS

It was concluded that nursing education had a significant effect on development of professional values.

To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students

BACKGROUND

The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP.

OBJECTIVES

This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles.

DESIGN

A longitudinal panel study.

SETTINGS AND PARTICIPANTS

A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014.

METHODS

Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence.

RESULTS

Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory.

CONCLUSIONS

Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on students' initial positive attitudes towards EBP and its use in their practice.

Nurses in the labor market: professional insertion, competencies and skills

OBJECTIVE

to characterize nurses graduated from the School of Nursing of the University of São Paulo, from 2006 to 2012; verify their entry, facilitating factors and difficulties of these graduates in the labor market and to consider their skills and competences in the world of work.

METHOD

an exploratory, descriptive study with a qualitative approach.

RESULTS

out of 505 graduates, 172 (34.1%) participated in the research. Entry into the labor market was mainly via public hospital institutions, in the SE of Brazil, in the caregiving sectors. The greater part remained from one to two years in their first job. Most agreed that they were prepared to meet the health needs of the population.  Furthermore, they had been encouraged to seek systematic and continuous improvement in a critical, reflexive and creative way, while combining technical-scientific knowledge and personal skills.

CONCLUSION

the results show that the University of São Paulo has been preparing nurses for work in the labor market, in accordance with the provisions of the National Curricular Guidelines.

Spirituality and spiritual care perspectives among baccalaureate nursing students in Saudi Arabia: A cross-sectional study

BACKGROUND

No study has been undertaken to understand how spirituality and spiritual care is perceived and implemented by Saudi nursing students undergoing training for their future professional roles as nurses.

OBJECTIVES

This study was conducted to investigate the perception of Baccalaureate nursing students toward spirituality and spiritual care.

DESIGN

A descriptive, cross-sectional design was employed.

SETTINGS AND PARTICIPANTS

A convenience sample of 338 baccalaureate nursing students in two government-run universities in Saudi Arabia was included in this study.

METHODS

A self-administered questionnaire, consisting of a demographic and spiritual care background information sheet and the Spiritual Care-Giving Scale Arabic version (SCGS-A), was used for data collection. A multivariate multiple regression analysis and multiple linear regression analyses were performed accordingly.

RESULTS

The mean value on the SCGS-A was 3.84±1.26. Spiritual perspective received the highest mean (4.14±1.45), followed by attribute for spiritual care (3.96±1.48), spiritual care attitude (3.81±1.47), defining spiritual care (3.71±1.51) and spiritual care values (3.57±1.47). Gender, academic level and learning spiritual care from classroom or clinical discussions showed a statistically significant multivariate effect on the five factors of SCGS-A.

CONCLUSIONS

Efforts should be done to formally integrate holistic concept including all the facets of spirituality and spiritual care in the nursing curriculum. The current findings can be used to inform the development and testing of holistic nursing conceptual framework in nursing education in Saudi Arabia and other Arab Muslim countries.

Attrition of undergraduate nursing students at selected South African universities

BACKGROUND

The nursing profession forms the backbone of many healthcare systems. It therefore needs a consistent supply of registered nurses to deliver continuous and safe quality healthcare, and to replace the nurses leaving or retiring from the profession. Attrition actively occurs among nursing students in South Africa and threatens the future supply of registered nurses.

AIM

The aim of the study was to describe the attrition rate at selected South African universities and the factors influencing undergraduate nursing students to discontinue their nursing studies at these universities.

METHOD

A quantitative descriptive design was followed. Heads of the nursing departments at the selected universities captured data with a specifically designed questionnaire. Thereafter their former nursing students provided information via a structured telephonic interview on the reasons why they discontinued the nursing programme.

RESULTS

The study revealed that attrition of undergraduate nursing students for three intake years (2007, 2008 and 2009) at the participating universities was between 39.3% and 58.7%. Academic and financial reasons as well as poor wellness and health were the main causes for attrition. Another factor was failure to cope with the demands of the clinical environment.

CONCLUSION

Attrition might not occur immediately when a nursing student is challenged, as the student might exploit the various types of support offered. Although some nursing students do benefit from the offered support, a large number of nursing students still discontinue the undergraduate nursing programme.

The continuing quest for parity: HBCU nursing students' perspectives on nursing and nursing education

The benefits of a diverse nursing workforce are well-recognized, yet, the attainment of a sustainable, competent and diverse nursing workforce continues to be a global challenge. In this qualitative study, we describe nursing students' perceptions on nursing and nursing education at a Historically Black College/University (HBCU). Focus groups were conducted with 16 graduate and undergraduate nursing students. Four themes emerged: communication, lack of resources, support systems and professional socialization. Mentoring and civility were identified as factors important to enhance a diverse workforce.

A Nursing Workforce Diversity Project: Strategies for Recruitment, Retention, Graduation, and NCLEX-RN Success

AIM

The purpose of this article is to describe a collaborative project designed to recruit and retain students from underrepresented minorities and disadvantaged backgrounds into nursing education.

BACKGROUND

Ethnic minorities remain underrepresented in the nursing workforce in comparison to the general population. The numbers of minorities enrolled in nursing education programs are insufficient to meet the health care workforce diversity needs of the future.

METHOD

High school students were provided with a preprofessional education program to prepare them for admission into a nursing program. Retention strategies were implemented for newly admitted and enrolled nursing education students.

RESULTS

Twenty-one high school students enrolled in a nursing education program. The students enrolled in the nursing education program graduated and passed the licensure examination.

CONCLUSION

Early recruitment and multiprong retention programs can be successful in diversifying the registered nurse workforce.

Preparing the health workforce in Ethiopia: A Cross-sectional study of competence of anesthesia graduating students

BACKGROUND

Efforts to address shortages of health workers in low-resource settings have focused on rapidly increasing the number of higher education programs for health workers. This study examines selected competencies achieved by graduating Bachelor of Science and nurse anesthetist students in Ethiopia, a country facing a critical shortage of anesthesia professionals.

METHODS

The study, conducted in June and July 2013, assessed skills and knowledge of 122 students graduating from anesthetist training programs at six public universities and colleges in Ethiopia; these students comprise 80% of graduates from these institutions in the 2013 academic year. Data was collected from direct observations of student performance, using an objective structured clinical examination approach, and from structured interviews regarding the adequacy of the learning environment.

RESULTS

Student performance varied, with mean percentage scores highest for spinal anesthesia (80%), neonatal resuscitation (74%), endotracheal intubation (73%), and laryngeal mask airway insertion check (71%). Average scores were lowest for routine anesthesia machine check (37%) and preoperative screening assessment (48%). Male graduates outscored female graduates (63.2% versus 56.9%, P = 0.014), and university graduates outscored regional health science college graduates (64.5% versus 55.5%, P = 0.023). Multivariate linear regression found that competence was associated with being male and attending a university training program. Less than 10% of the students believed that skills labs had adequate staff and resources, and only 57.4% had performed at least 200 endotracheal intubations at clinical practicum sites, as required by national standards.

DISCUSSION

Ethiopia has successfully expanded higher education for anesthetists, but a focus on quality of training and assessment of learners is required to ensure that graduates have mastered basic skills and are able to offer safe services.

Recent Changes in the Number of Nurses Graduating from Undergraduate and Graduate Programs

Since the 1970s, a number of initiatives have attempted to increase the proportion of nursing graduates with a baccalaureate degree, but with little national effect. Now market forces, health reforms, and an Institute of Medicine report (2011) have combined to transform the educational composition of the nursing workforce. Today, there are considerably more graduates of baccalaureate nursing programs than associate degree programs. The educational transformation of the nursing workforce is not limited to baccalaureate education but includes the rapidly increasing numbers of registered nurses who have earned graduate degrees. These changes in nursing education are increasing the readiness of nursing professionals to capitalize on new opportunities, overcome challenges, and take on new roles and responsibilities as the nation's health care delivery and payments systems evolve in coming years.

eHealth Literacy Skills Among Undergraduate Nursing Students in the U.S. and South Korea

Online health information is a critical resource for health consumers. Nursing professionals need to be eHealth literate to support patients and their families. The purpose of the study was to explore eHealth literacy skills among undergraduate nursing students in the U.S. and South Korea. One hundred and sixty-nine undergraduate nursing students in two universities, one in the southern area of the U.S. and one in the eastern area of South Korea, participated. Participants were asked to complete the eHealth Literacy Scale. The majority of participants perceived that the Internet is a useful or very useful tool in helping them make health-related decisions. The participants either agreed or strongly agreed with the 7 items of the eHealth literacy scale except an item such as they can call high to low quality of online health information. The U.S students have higher mean scores of all eHealth literacy items than students of South Korea.

Nursing Students' Satisfaction with Mobile Academic Electronic Medical Records for Undergraduate Clinical Practicum

The purpose of study was to evaluate satisfaction with and usability of mobile academic electronic medical records (AEMR) for undergraduate nursing students' clinical practicum. After an AEMR application on mobile devices was applied to the experimental group while a PC-based EMR system was used for the control group as usual in the fall semester, 2014. Two items of practicum satisfaction such as preparation of lab test and understanding of the results, and nursing intervention and documentation were significantly higher in the experiment group. The findings of usability survey showed that students in the experiment group consider the use of mobile AEMR in their job would increase their productivity.

Predictors of Undergraduate Nursing Student Satisfaction with Clinical Learning Environment: A Secondary Analysis

Nurse educators must develop evidence-based strategies that prepare new graduates to function in a dynamic health care environment. Student satisfaction with their clinical learning has been identified as a particular outcome of interest. A secondary analysis of pilot study data was performed to determine predictors of student satisfaction in the medical-surgical clinical environment. All dimensions of the clinical learning environment were measured using a published, validated instrument. Two dimensions, Task Orientation and Individualization, significantly predicted satisfaction, explaining 57 percent of the variance. To improve satisfaction, clinical faculty should make clear assignments, provide specific instructions, maintain organization, and provide individualized attention.