Nurse Education Today

Editorial Board

2010-05-01

Attachment, belonging and identity are important to effective health curricula

Alun Jones — 2009-12-14

Encouraging student nurses, midwives and related professionals to contribute to the advancement of their educational programmes is important. Actively participating in laying down firm foundations for their professional development, may bring gains in the form of a greater sense of belonging along with feelings of self-confidence and security.

The supervision of professional doctorates: Experiences of the processes and ways forward

Susan M Carr, Monique Lhussier, Colin Chandler — 2010-02-08

Summary: The doctoral research terrain is changing, as new-styles, for example professional doctorates, are being developed (Park, C., 2005. New variant PhDL the changing nature of the doctorate in the UK. Journal of Higher Education Policy and Management 27(2), 189–207). There is a scarcity of literature aimed at supervisors (Gatfield, T., 2005, An investigation into PhD supervisory management styles: development of a dynamic conceptual model and its managerial implications. Journal of Higher Education Policy and Management 27(3), 311–325) and this is particularly so in relation to professional doctorates.In this position paper we argue that the supervisory approach required for a professional doctorate student is different than that required for a PhD. Professional doctorate students, like PhD students, are required to make an explicit contribution to knowledge. Their emphasis, however, needs to be in producing knowledge that is theoretically sound, original, and of relevance to their practice area. This is of increasing importance within healthcare with the growing emphasis on patient driven translational research. As such, the students and their supervisors face unique challenges of balancing academic requirements with praxis. We suggest this requires specific tools to make explicit the dialogical relationship between a particular project and the cultural, social, educational and political aspects of its environment. We expose the potential of soft systems methodology as a means to highlight the emergent aspects of a doctoral practice development project, their respective and evolving supervisory interactions. This focus of this paper is therefore not about guiding supervision in a managerial sense, but rather at offering methodological suggestions that could underpin applied research at doctoral level.

Development of a sexual assault evidence collection kit – The need for standardization in Turkey

M.R. Gökdoğan, J. Bafra — 2009-09-23

Abstract: Sexual offences are recognized to be one of the most critical of crimes throughout the world. In Turkey, forcible rapes show, in the sexual crime rates, an increase of approximately 3% every year. It becomes even more critical, when realizing that less than half of all rapes, which are believed to occur, are reported to law enforcement, and of those few assailants who are arrested even fewer are convicted of rape. Often, little or no knowledge of the correct methods of locating, recovering, packaging, and preserving evidence specimens are the causes for compromising the forensic examination in court. This problem occurs when medical personnel are not adequately trained or properly advised in the evidentiary aspects and medical features of treating a victim.The current survey is aimed to increase the awareness of the need of an initial and continuing education by health care policies to cope with increasing professional demands for forensic practice sexual assault cases, to take judicial and social precautions, and medico-legal evidence. To determine the likelihood of obtaining corroborating evidence this paper presents the results of a study referring to this problem. An updated questionnaire has been applied at random to medical personnel, a total of 543 participants, throughout Turkey. Taking certain criteria into consideration the findings revealed a significant deficiency of knowledge regarding medical-legal examination. In comparison, a one-semester course of basic forensic sciences proved to be sufficient to recognize the amount of knowledge required to work as a forensic professional.Based on the results, recommendations are presented in the form of a sexual assault evidence collection kit (SAECK). A kit, which takes into consideration the needs of crime laboratories, law enforcement agencies, medical personnel, and above all the victim. This is the first step in building a responsible and successful evidence collection program that will survive the rigors of courtroom challenge.

Researching student absence: Methodological challenges and ethical issues

2009-09-16

Summary: This article describes the challenges encountered in a research project aiming to explore non-attendance from the perspective of absent students. These students are nursing students in a Faculty of Health and Social Care, but the issues raised here are of wider interest. Although attendance at the sessions monitored for this project is stated to be compulsory, there is typically a non-attendance rate of around 20%. Previous studies within the Faculty have reported positively on students’ views of the sessions, but have relied on data collected from students present in the university and attending the sessions. We felt it was important to correct this imbalance with the views of those students who do not attend. We hoped to access the views of students not present in the university by means of telephone interviews, carried out by a researcher independent from the course management. This article explores a number of ethical and methodological issues which arose from the research, focusing on the difficulties in gaining informed consent from students who do not attend, and the challenges in moving beyond surface responses to questions on reasons for non-attendance.

Preceptoring nursing students: Registered Nurses’ perceptions of nursing students’ preparation and study approaches in clinical education

Karin Hallin, Ella Danielson — 2009-09-07

Summary: Preceptorship influences Registered Nurses’ (RNs) daily work to different degrees depending on nursing students’ knowledge, and willingness to learn. Consequently, it is of the utmost importance to investigate how RNs assess nursing students in clinical education. The aim of this study was to describe RNs’ perceptions of nursing students’ preparation and study approaches at hospital workplaces, and to explore relationships between RNs’ perceptions and their personal/clinical characteristics. A cross-sectional design was used. In 2006, 142 of 196 RNs at a Swedish hospital answered a questionnaire (response rate 72.5%). The majority of RNs (63–84%) rated students’ study approaches highly and thought students comprehended the outcomes of learning. Fewer (45–49%), rated students as having adequate theoretical knowledge highly and were of the opinion that they had acquired knowledge about the unit. Statistically, non specialist nurses rated significantly higher compared with specialist nurses. Significant positive correlations were found between the RNs’ perceptions of nursing students and their interest in preceptoring. The extent to which preparation programmes, established in collaboration between a university and a hospital, had improved preceptors and nursing students was not graded. Further descriptive and intervention studies are therefore needed.

Gender, gender roles and completion of nursing education: A longitudinal study

Katrina McLaughlin, Orla T. Muldoon, Marianne Moutray — 2009-09-16

Summary: The current worldwide nursing shortage and high attrition of nursing students remain a challenge for the nursing profession. The aim of this paper was to investigate how key psychological attributes and constructions differentiate between completers and non-completers of nursing education. A questionnaire including measures of gender role identity and perceived gender appropriateness of careers was administered to 384 students early in the first year of the course. At the end of the programme attrition rates were obtained. The findings indicate that males were more likely to leave the course than females. Furthermore, those who completed the course tended to view nursing as more appropriate for women, in contrast to the non-completers who had less gender typed views. The female-dominated nature of nursing, prevalent stereotypes and gender bias inherent in nursing education seem to make this an uncomfortable place for males and those with less gendered typed views. Whilst it is acknowledged that attrition is undoubtedly a complex issue with many contributing factors, the nursing profession need to take steps to address this bias to ensure their profession is open equally to both female and male recruits.

Israelis’ perceived motivation for choosing a nursing career

Merav Ben Natan, Fainna Becker — 2009-09-07

Abstract: Recruitment problems are one of the main reasons for the shortage of nurses in Israel and elsewhere. The purpose of this study is to clarify factors affecting choice of ideal careers and nursing careers among the general population. A questionnaire constructed by was administered to 309 men and women aged 18–50. Data were analyzed by quantitative methods.Research findings indicate that 8% of respondents expressed interest in studying nursing. Significant differences were reported between the choice of ideal and nursing careers. Nursing careers were perceived as lacking interest, challenge, creativity, responsibility, varied wages, high status, comfortable conditions, versus ideal careers. A moderately positive correlation was identified between choice of a nursing career and intrinsic factors affecting this choice. People motivated by desire to help others rather than personal interest or challenges are predisposed to choose a nursing career. Finally, a negative correlation was identified between psychometric scores and choice of a nursing career. The study also identified a positive correlation between both the image of nursing as a profession and the availability of nursing jobs – and the decision to choose a nursing career. This study may facilitate the development of nurse recruitment programs.

Improving cross-cultural care and antiracism in nursing education: A literature review

Jacqui Allen — 2009-09-16

Summary: Purpose: To appraise through literature review the available research evidence to guide teaching and learning regarding cross-cultural care for nursing students. Cross-cultural education of nurses with a focus on both culture and antiracism is one way of promoting ethical and effective cross-cultural health systems for people from culturally diverse backgrounds. Although cross-cultural care has long been recognised as necessary to nursing education there is no clear consensus regarding how it is to be taught or which theoretical perspectives should underpin this teaching.Findings: Current literature supports the effectiveness of cross-cultural teaching interventions in promoting cultural competence and in facilitating attitudinal and belief changes in nursing students. The literature further suggests that racism persists in some students following participation in cross-cultural education and that there is a paucity of theory, teaching interventions and evaluations addressing antiracism.Conclusions: Cross-cultural education alone is insufficient to combat racism. Cross-cultural education focused on both cultural competence and antiracism is necessary to promote effective cultural care in nursing students.

Literacy and numeracy for pre-registration nursing programmes: 1. An innovative way to widen access to nursing programmes for students without formal qualifications by enabling them to give evidence of their literacy and numeracy skills

Sheri Rhodes-Martin, Wendy Munro — 2009-09-23

Abstract: The Nursing and Midwifery Council () removed standard entry criteria for nursing programmes and asked Higher Education Institutions (HEIs) to consider the literacy and numeracy skills of prospective students. This triggered admissions staff within a Faculty of Health to consider ways of attracting people with the right skills but not the qualifications to prove it. It is important to encourage a wide range of people into nursing to meet the demands of strategic plans and policy, as well as to ensure the nursing profession reflects the diverse client groups it serves. Removing standard entry criteria and the widening participation agenda gave an ideal opportunity to try something new.A course entitled ‘Portfolio of Evidence for Entry to Level 1 Study’ was developed within the Faculty of Health at Staffordshire University to enable potential nursing students without standard entry qualifications to demonstrate their skills in numeracy and literacy. This paper reports on the background to this course and its success for three student cohorts (over an 18 month period) who have completed their first year of pre-registration nursing. The methodology employed is descriptive, qualitative analysis, comparing portfolio and standard entry students’ assignment results.

Valuing the gap: A dialectic between theory and practice in graduate nursing education from a constructive educational approach

Cheryle Moss, Laurie Grealish, Sarah Lake — 2009-12-07

Summary: Within nursing education, graduate pedagogies are relatively unexplored, with research commonly focused upon undergraduate and continuing education. In order to address the increasingly complex organisational challenges in the workplace, mid-career nurses and midwives are turning to graduate education. In one graduate course on cultures of learning in the workplace, a constructivist approach to learning was adopted. Post-course analysis of data, from the feedback on the course from students, student choice of assignment topics, and reflections of the course facilitators, revealed three pedagogies unique to graduate education. The pedagogies were labelled ‘keeping the space open’, ‘theoretical concepts as tools’, and ‘resonance and action as praxis’. The intended outcome of the course is revealed in a fourth theme, ‘developing practice in the workplace’. This evaluation suggests that constructivist pedagogies used with graduate students may be different to those pedagogies used with undergraduate and continuing education students. We argue that graduate pedagogies move nursing education beyond strategies that seek integration of theory and practice, towards a dialectic between theory and practice.

Masters at work: A narrative inquiry into the experiences of mental health nurses qualifying with an undergraduate Masters degree

Gemma Stacey, Anne Felton, Kirstie Joynson — 2009-10-07

Summary: The University of Nottingham provides a unique course in the UK that enables undergraduate students to obtain a Masters degree and registration with the Nursing and Midwifery Council (NMC). The curriculum equips graduates with the skills to practice nursing with an analytical attitude and adopt both professional and humanistic values. This research aims to explore significant experiences of graduates, from the undergraduate Masters course, relating to their education and nursing practice in mental health care. A narrative approach to data collection was employed using unstructured individual interviews.Participants worked through a process of contemplation. Their commitment to working with people in a relational manner and studying at graduate level were of high importance. The process continued with assimilation to a philosophy which was intrinsic to the course, including developing therapeutic relationships, self awareness and critical thinking. Participants encountered conflict relating to a perceived dissonance between this philosophy and nursing practice. As a consequence, participants questioned mental health nursing and their abilities as nurses. Resolution occurred when participants were able to work within the constraints of the system whilst effectively realising their philosophy. The findings demonstrate the importance of supportive networks to maintain values and criticality.

Relationship between coping, self-esteem, individual factors and mental health among Chinese nursing students: A matched case–control study

Chunping Ni, Xiwen Liu, Qianzhen Hua, Aili Lv, Bo Wang, Yongping Yan — 2009-10-05

Summary: Purpose: To investigate the relationship between ways of coping, self-esteem, individual factors and mental health among Chinese nursing students.Method: A sample of 515 nursing students was selected from four public institutes and colleges in Xi’an of China by a random sampling method. They were surveyed by a self-evaluation questionnaire including the Symptom-Checklist 90 (SCL-90), the Simplified Coping Style Questionnaire, the Self-Esteem Scale and the Personal Data Form. On the basis of the total score of SCL-90 obtained in the survey, high and low score groups were formed, each consisting of 100 nursing students. Then a matched case–control design was carried out to explore the relationship between ways of coping, self-esteem, individual factors and mental health. Besides descriptive statistics, the Chi-square analysis, t-test and Multivariate Logistic Regression Analysis were also employed.Results: The active coping and self-esteem scores of the high score group were found to be much lower than those of the low score group (P<0.05), while it was the opposite for passive coping scores (P<0.01). Multivariate Logistic Regression Analysis suggested that study stress (OR=10.017, 95%CI: 3.273–30.654) and physical health problems in the past year (OR=4.384, 95%CI: 1.492–12.877) were independent risk factors of mental health among nursing students, whereas self-fulfillment satisfaction (OR=0.037, 95%CI: 0.014–0.097) and a higher level of self-esteem (OR=0.357, 95%CI: 0.152–0.838) were preventive factors.Conclusion: The mental health of Chinese nursing students was related to the ways of coping, self-esteem, study stress and physical health problems in the past year. In order to improve the mental health of nursing students, aside from reducing the study stress and avoiding passive coping, it is very necessary for them to be supported to ensure that academic stress is minimized, autonomy is promoted, and self-esteem is developed.

Description and evaluation of an initiative to develop advanced practice nurses in mainland China

2009-10-12

Summary: This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004–2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs.

Professional collaboration in students of Medicine Faculty and School of Nursing

Melek Ardahan, Başak Akçasu, Esra Engin — 2009-10-05

Summary: This descriptive study has been planned to analyze the professional collaboration among the students of Ege University, Faculty of Medicine and School of Nursing. The study group consisted of 137 5th and 6th grade students from the Faculty of Medicine and 142 3rd and 4th grade students from the School of Nursing. The participation rate is 94%. For data collection, a questionnaire form (30 questions) which was specially developed for the purpose of the study and the Jefferson Scale of Attitudes toward Physician–Nurse Collaboration (15 questions) were used. Permission was granted for the research by Ege University School of Nursing Ethical Committee and the Office of the Dean of the Faculty of Medicine.The professional collaboration mean score of the students from the Faculty of Medicine who participated in the study was 30.40±5.82 and the professional collaboration mean score of the students from the School of Nursing was 26.11±5.27. The difference between the mean scores of professional collaboration was found to be significant in terms of their profession (p<0.01). Physicians expressed more positive attitudes toward collaboration than nurses while female physicians expressed more positive attitudes toward collaboration than male physicians.

Student nurses’ experiences and challenges in providing health education in Hong Kong

W.H. Hui Choi, Gabriel K.H. Hui, Angel C.K. Lee, Maureen M.L. Chui — 2009-10-12

Summary: Despite a call for increased emphasis on health education within the Hong Kong acute healthcare setting, in reality nurses conduct only minimal health education and do not model good educational practice for students. At the baccalaureate level, nursing education programmes aim to provide students with practical experience of best practice and international standards of care. This study describes the experiences of nursing students in providing health education to in-patients at an obstetric unit in Hong Kong. A qualitative research study using a phenomenological approach was conducted at a major public hospital. Data were collected using participant observation, debriefing notes, students’ reflective journals and semi-structured interviews. Four themes emerged from the data: (a) effective knowledge building, (b) being a professional nurse, (c) refining learned skills, and (d) greater cultural awareness. The student experiences were further influenced by the patients’ responses, the expectations of both patients and nurses concerning the health educator’s role, and the role of the clinical teacher. Study findings highlight the experience of the students in conducting health education, something which has not been adequately examined previously, and demonstrates the benefits of independent clinical learning.

Nurse lecturers’ perceptions of what baccalaureate nursing students could gain from clinical group supervision

Barbro Lindgren, Elsy Athlin — 2009-10-09

Summary: The extensive amount of studies on clinical supervision during the nursing students’ clinical programmes has shown that supervision most often is given on a one-to-one basis, and that many challenges are embedded in this kind of supervision. In some studies group supervision has been used, with mostly successful effects according to the nursing students. At a university in Sweden, a model of group supervision was included in the baccalaureate nursing programme, conducted by nurse lecturers. The purpose of this study was to describe the value of clinical group supervision to nursing students, as perceived by the nurse lecturers. Data consisted of field notes written by the nurse lecturers after 60 supervision sessions, and qualitative content analysis was performed. The findings showed how reflection in a group of equals was considered to give the nursing students opportunities to increase their understanding of themselves and others, prepare them for coming events, increase their personal and professional strengths, and inspire them for further development. On the basis of the findings and previous studies the value of using nurse lecturers as group supervisors was discussed. The impact of a contract to achieve a good learning environment in group supervision was also stressed.

Tutorials for large classes of Common Foundation Program biomedical science students: Successes and challenges

Abdul-Kadhum J.A. al-Modhefer, Sean M. Roe — 2009-10-19

Summary: The aim of this paper is to investigate the problems encountered conducting biomedical science tutorials for nursing students in large classes with a typical student: staff ratio of 45:1. The study is based on level 1 Common Foundation Program students from the School of Nursing and Midwifery, Queen’s University Belfast at the conclusion of two phases of biomedical sciences education which include a course of 12 interactive tutorials.Survey and interview methodologies were employed to investigate difficulties encountered by students in these large tutorial classes, to ascertain what characterises a good tutor and to explore student attitudes to interactive learning.The barriers to effective teaching and learning in tutorials are discussed and subsequently, a set of guidelines is proposed to enhance learning in them. These include being aware of the ability of the student group, having a compassionate questioning style, tailoring the teaching environment to fit the aims of the class and experimenting with different tutorial formats.

Teaching nursing’s history: A national survey of Australian Schools of Nursing, 2007–2008

Margaret McAllister, Wendy Madsen, Judith Godden, Jennene Greenhill, Rachel Reed — 2009-10-16

Summary: This paper reports on a survey of Australian Schools of Nursing that took place over an 8months period between 2007 and 2008. This study was implemented to extend understanding of effective teaching of nursing history, an area not previously researched in Australia. A critical interpretive method enabled us to problematise the issue, to highlight what was said about the importance of history teaching as well as ad hoc practices and barriers. The study found that participants value history of nursing teaching, but the crowded curriculum is erasing history’s place and potential. It revealed ideological tensions shaping and constraining history of nursing teaching. In Australia, the way nursing’s history is taught varies and teaching content, strategies and resources utilised are not evenly available. Pedagogical innovations are not effectively disseminated. Our recommendations for Australian Schools of Nursing that have more general applicability are: (1) Nursing curriculum needs to be developed from a set of principles and standards that define the attributes of the professional nurse, not in response to interest groups and (2) History of nursing pedagogy should be systematically developed and disseminated through a national virtual centre, linked to international centres, to enhance teachers’ understanding of the discipline area and to support their teaching practice.

Research odyssey: The evolution of a research partnership between baccalaureate nursing students and practicing nurses

Mary Tod Gray — 2009-11-06

Summary: This longitudinal descriptive study evaluates the implementation of an innovative teaching strategy: a research partnership between baccalaureate nursing students and nurses in two acute care hospitals. The impetus for this partnership was to introduce a concrete, clinical dimension to a junior level introductory nursing research course. Formative analysis was used to evaluate the success and weaknesses of this innovative strategy over 3years. Following each year, an evaluation by students and nursing unit managers led to refinement of the partnership goals and logistics for the following year. The third year culminates in a comparison between student responses to the partnership in the small community hospital and those assigned to a larger magnet status hospital. Conclusions, based on content and descriptive analysis indicate the partnership’s educational benefits for students and a few logistical concerns. Future directions for this educational strategy are presented.