Nurse Education Today

Editorial Board

2010-02-01

Employers prefer BSN nurses: But where’s the financial compensation?

Debra Shipman, Jack Hooten — 2009-11-02

Studies in the USA have shown nurses who have a Baccalaureate of Nursing Science (BSN) deliver more competent care than nurses with an associate degree (ADN) (). However, despite the recommendation for a BSN as entry level to practice many nurses do not continue their education. Financial compensation may be the reason.

Nursing professional values: Validation of a scale in a Spanish context

2009-06-29

Summary: Purpose: To validate culturally the “Nursing Professional Values Scale: NPVS-R” for use in Spain.Methods: We used the forward and backward translation method with complementary qualitative methodology. We first formed discussion groups to detect cultural differences, then set up a multidisciplinary group to ascertain the equivalence or discrepancies between the English and Spanish versions and to decide on the final pre-test version. This was used in the pilot test given to 10 second-year nursing students of the School of Nursing of Vitoria, Spain.Results: The majority of the questions were classified as equivalents (23 of 26). Some questions were modified by the discussion group. Following the backward translation and evaluation by the multidisciplinary group, two questions needed small changes and four needed significant changes. The differences were resolved by decentralization.Conclusions: The resulting Spanish version of the NPVS-R, is culturally and semantically equivalent to the original English version and is appropriate for measuring the perception of nursing professional values in nursing professionals and students in Spain. To verify reliability and validity of the scale, the final version after the pilot test has been passed to 960 nursing diploma students all over Spain.

The development and evaluation of a computer-based resource to assist pre-registration nursing students with their preparation for objective structured clinical examinations (OSCEs)

Jacqueline Bloomfield, Carol Fordham-Clarke, Anne Pegram, Brent Cunningham — 2009-08-20

Summary: This paper presents a narrative discussion of an innovative, computer-based resource developed, implemented and evaluated by a small project team at a school of nursing and midwifery in London. The interactive resource was designed to assist first and second year pre-registration nursing students with both their clinical skills revision and formative preparation for Objective Structured Clinical Examinations and involved a small range of clinical skills. These included: skin assessment; hand hygiene; reading a drug prescription chart, weighing a baby and assessment of an intravenous cannulae site. The processes involved in the development of the tool are described and, the key drivers informing its development are identified.Although a formal research approach was not adopted a summary of feedback obtained from anonymous student evaluations is included. This provides important insights into the perceived usefulness of the tool and is discussed in light of the challenges and practicalities associated with the content development and technical issues. The paper concludes by identifying proposed future developments and wider applications of this innovative clinical skills education initiative within nursing and healthcare education.

Help is just a text away: The use of short message service texting to provide an additional means of support for health care students during practice placements

2009-07-27

Summary: This article discusses the findings from a pilot study using short message service (SMS) texting to provide an additional means of support for health care students in practice placements. Pre-registration students were recruited students from 2nd year cohorts in Adult Nursing, Children’s Nursing, Occupational Therapy, and Radiography to pilot the use of SMS texting with their private mobile phones from their work-based learning placements. The pilot was evaluated using an online questionnaire for students with follow-up telephone interviews, and face-to-face interviews with the four tutors. Data on the use of the service by students was also collated. Although the students made less use of the service than was anticipated, both staff and students were positive about the potential of this type of communication in providing an additional form of support for students in placements.

Nurse educators’ teaching of codes of ethics

Olivia H. Numminen, Helena Leino-Kilpi, Arie van der Arend, Jouko Katajisto — 2009-08-06

Summary: Although codes of ethics are thought to be an important element of nursing ethics curriculum research focusing on nurses’ codes is scarce and negligible in the area of education. This study explores Finnish nurse educators’ teaching of codes of ethics. A total of 183 nurse educators from polytechnics providing basic nursing education in Finland answered a structured questionnaire with one open-ended question. The data was analysed statistically by SPSS and by content analysis.The responding educators’ teaching of the codes was rather extensive. The focus of teaching was on the nurse-patient relationship. Nursing in a wider social context was less emphasized. Integrated teaching was the prevalent teaching format. Educators’ use of teaching and evaluation methods was fairly narrow aiming at a student-centred approach. Educators’ knowledge of the codes was mainly based on informal learning. The majority assessed their knowledge as adequate for teaching the codes. Educators who were motivated to build their knowledge voluntarily also taught the codes more. Educators assessed nursing students’ knowledge and ability to apply the codes as mediocre.Organization of integrated teaching, objective assessment of nurse educators’ competence to teach the codes, and evaluation of student outcomes need further exploring.

Knowledge use in nursing practice: The importance of practical understanding and personal involvement

Randi Skår — 2009-07-24

Summary: Understanding knowledge use in everyday nursing practice is important to the improvement of educational preparation and quality in health care. This paper reports registered nurses’ experiences in different parts of the Norwegian health care system. The aim of the study was to elucidate nurses’ experiences of knowledge use in work situations. Eleven nurses, each with two to three years of experiences after graduation, participated in both in-depth interviews and focus group interviews in 2006. A qualitative hermeneutic approach, inspired by Gadamer’s philosophy, guided the research process and the analysis and interpretation of the transcribed interview-texts. Experiences related to coping with frequent changes and complexity in work situations were captured in this study. The participants emphasised that knowledge use is connected to their ability to get involved in and assess particular situations, and so is their skill in integrating situational experiences into their existing knowledge framework. A challenge in nursing education is as follows: for students to understand these interpretive modes of knowledge use and to develop personal abilities, they should have access to and be active participants in certain health care situations, and they should have the opportunity to reflect on acting personally in professional relationships.

Developing and examining an Objective Structured Clinical Examination

Anne Jones, Anne Pegram, Carol Fordham-Clarke — 2009-08-05

Summary: Objective Structured Clinical Examinations are commonly used within pre-registration and post-qualification nurse education to test clinical competence. Station development and refinement of the pass mark is essential to the examination process. In this paper the process of blue-printing and standardisation are described as one method of agreeing examination content and subsequent pass mark. Issues of validity and reliability are discussed in relation to these and to the process of examining. The development of good practice guidelines to ensure consistency between different markers of the same station and of a single marker examining different students on one station is described. Recommendations in relation to transparency are made to optimise student understanding of what they are being tested on and hence their performance in the examination.

Access to and support for continuing professional education amongst Queensland nurses: 2004 and 2007

Desley Hegney, Anthony Tuckett, Deborah Parker, Eley Robert — 2009-07-31

Summary: This paper reports on the findings of a prospective exploratory study related to nurses’ self-reports of continuing professional education access and support. The data were gathered by two postal surveys undertaken in 2004 and 2007 each which sampled 3000 nurses of the 30,000 nurse members of the industrial body – Queensland Nurses’ Union. The response rates were 44.9% and 39.7% for 2004 and 2007, respectively. Over 85% of the nurses reported they had access to continuing professional education activities. However, it is apparent that the majority of these activities are either partially or completely self-funded. Further, between 2004 and 2007 the amount of financial support provided by employers for continuing education and training activities has decreased significantly. While there were differences between 2004 and 2007, the major barrier to be able to attend continuing professional education were financial (could not afford the fee involved; could not afford to take unpaid leave to attend). Another major barrier in both 2004 and 2007 was having the time to undertake the activity. Analysis for differences between nurses in different geographical locations indicated that distance remains a major barrier for nurses in rural and remote areas. These quantitative findings were supported by the qualitative findings on nurses’ work where ‘education and training’ was, overall, the fifth highest ranked issue requiring further attention.

The nursing and medical students motivation to attain knowledge

Mariette Bengtsson, Bodil Ohlsson — 2009-08-19

Summary: Objectives: The aim was to gather information regarding what students consider important for their motivation to attain knowledge, in order to shape courses that foster this motivation.Method: A qualitative design comprising focus groups including 31 nursing and medical students for interviews, semi-structured questions, and content analysis was utilized.Result: The students thought it was important to coordinate more superficial knowledge with learning in depth, and to apply the theoretical knowledge in practise. Self-motivation, committed teachers and discussions with other students were considered to be important for learning. The difference between the groups was that the nurses were focused on their assessments because of lack of time, while the medical students were more learning for life. Their greatest problem was to know what of all knowledge they needed to learn and should focus on.Conclusion: The motivation must come from the students themselves, but dedicated teachers giving performance feed-back, discussions in different forms and choices of learning and assessment methods enhance enthusiasm and learning. By providing an educational environment that resonates with the students’ needs, teachers may be successful in their teaching.

Association between academic and non-academic variables and academic success of diploma nursing students in Pakistan

Parveen Azam Ali, Paul B. Naylor — 2009-08-17

Summary: This paper reports findings of an exploratory study conducted to determine an association between academic and non-academic factors and academic success of nursing diploma students in a province of Pakistan. Data were collected from the academic records of a cohort of 628 students. Multiple linear regression was used to identify the predictive association between certain academic and non-academic factors and academic success of the students. Regression models for each of three years were developed. Results indicated academic factors including preadmission qualifications, previous academic performance, academic performance in year one, academic performance in year two and type of school are significantly associated with the academic success of the students. Among non-academic factors, gender and place of domicile were found to be significantly associated with the academic success of the students.

Professional approach: The key feature of effective clinical educator in Iran

Fatemeh Heshmati-Nabavi, Zohreh Vanaki — 2009-08-25

Summary: Clinical educators have an important role in the successful completion of a student’s clinical education. Clinical educating is a dynamic process that occurs in a variety of socio-cultural contexts. This study was conducted to determine Iranian nursing students and faculty members’ perceptions of effective clinical educator characteristics. This study was based on Grounded Theory method. A total of 10 nursing students and clinical educators voluntarily participated in this study. Data was obtained through semi-structured interviews. The analysis was carried out by the Straus and Corbin method. Findings of the study yielded five significant categories. These include (1) personal traits; (2) meta-cognition; (3) making clinical learning enjoyable; (4) being a source of support; (5) being a role model. The core variable “professional approach” in clinical education integrates these categories.The results of the study illustrated that, in an Iranian context, effective clinical educators are those who are in harmony with the spirit of nursing, adopt a reflective approach, make clinical learning enjoyable and provide a patient-centred care. They act as a role model enabling their students to manage their vocational challenges, which are a direct result of the specific socio-cultural conditions of nursing profession in Iran.

Faculty mentors’ and students’ perceptions of students’ research self-efficacy

Elise L. Lev, John Kolassa, Lori L. Bakken — 2009-08-17

Summary: Mentoring in nursing is an important process for socializing nurse researchers, developing a body of professional knowledge, and influencing career choices of students. Self-efficacy () is concerned with one’s perceived ability to perform tasks within a specific domain.The purpose of this study was to compare undergraduate and graduate student’s perceptions of their abilities to pursue research (research self-efficacy) with their mentors’ perceptions. A cross-sectional design was used to study mentors in any academic discipline who received external funding and worked with an undergraduate or graduate student on the research study. Recruitment and data collection were completed using the Internet and included 21 faculty mentors and student dyads. The Clinical Research Appraisal Inventory was used to measure research self-efficacy. Differences between the faculty mentor’s perception of the student’s confidence in research and students’ perception were significant at p=<0.001.Misjudgment of efficacy appraisals can result in opportunities forsaken and careers not pursued. Assisting mentors to guide students’ skill perfection may increase students’ choice of research careers, promote the effectiveness of mentorship, aid in the development of a body of professional knowledge and benefit careers of both mentors and students.

Integrating problem-based learning in a nursing informatics curriculum

George Demiris, Brenda Zierler — 2009-08-17

Summary: In recent years employers in health care organizations have been recognizing the need for nurses to enter the workforce with a set of informatics competencies. Numerous nursing informatics programs have been established worldwide. The challenge becomes to explore innovative tools that will equip nurses with the appropriate skills to utilize information technology to improve health care quality and patient safety and redesign health care services. This paper presents the introduction of problem-based learning (PBL) modules into an existing nursing informatics curriculum, the Clinical Informatics and Patient Centered Technologies Master program at the School of Nursing, University of Washington. Additionally, we discuss recommendations and challenges associated with the integration of PBL in nursing informatics graduate education including the need for facilitators, flexible technology platforms, promotion and documentation of group work, faculty training and supervision by a program committee.

Who enters nursing schools and why do they choose nursing? A comparison with female non-nursing students using longitudinal data

Sung-Hyun Cho, So Young Jung, Sunyoung Jang — 2009-08-17

Summary: Understanding who enters nursing schools and why they choose nursing is essential for the nursing profession to recruit and retain their successors. This study was conducted to examine the characteristics of nursing students and factors influencing their career decision, as compared with non-nursing students. We used public databases of the Korean Education & Employment Panel that followed 4000 high school students in their final year of school. Out of those students, 2456 students entered a college or university and 40 students (39 females and one male) entered a nursing school. Nursing students were compared with 1011 female non-nursing students. Nursing students had lower household income. Nursing students had better high school academic achievement overall and in science. A more studious attitude and lower absenteeism were found among nursing students. For nursing students, employability (55%) followed by aptitude (20%) were the most influential factors in choosing a nursing major, while conversely, aptitude (48%) followed by employability (23%) were most important to non-nursing students. About half of nursing students answered “herself/himself” as the most influential person in choosing nursing, whereas three quarters of non-nursing students did. Nursing students had a higher rate (75%) of satisfaction with their major than non-nursing students (60%).

New graduate nurse practice readiness: Perspectives on the context shaping our understanding and expectations

Angela C. Wolff, Barbara Pesut, Sandra Regan — 2009-08-25

Summary: Workforce shortages, fiscal restraint, complex healthcare organizations, increasing patient acuity, the explosion of knowledge and technology and the ever expanding role of nurses in healthcare have reinforced the importance of new graduates arriving in the work setting with the ability to move seamlessly into practice. This idea of moving seamlessly into practice is often referred to as practice readiness. Differing perspectives exist between nurses in the practice and education sector about the practice readiness of new graduates. The aim of this study was to understand the perspectives of nurses about new graduate nurse practice readiness and the underlying context shaping these perspectives. Focus groups involving 150 nurses with varying years of experience in the practice, education and regulatory sector were conducted. The findings revealed that participants’ expectations and understandings of new graduate practice readiness were influenced by the historical and social context within which nursing education and professional practice is grounded. These differences centered around three main areas: the educational preparation of nurses (diploma or degree), the preparation of the technical versus the professional nurse, and the perceived responsibilities and accountabilities of the education and practice sector for the educational preparation of nurses. To shift the discourse around practice readiness, nurses from all sectors must focus on unique, innovative and cooperative solutions to ensure the seamless transition of all nursing graduates in the 21st century healthcare system.

Nursing students as research participants: A framework for ethical practice

Caroline Bradbury-Jones, John Alcock — 2009-09-04

Summary: Aim: The aim is to discuss a new framework that can aid ethical decision making in educational nursing research.Background: Nurse researchers have a significant amount of guidance to inform their ethical decision making in relation to research. However, research governance and professional guidance only go so far in promoting ethical research practice. Nurse researchers who work in higher education institutes face particular ethical challenges when nursing students are used as research participants.Method: We explore the complexities of educational research and introduce a framework that can help nurse researchers to make ethically sound research decisions. We draw inspiration from [Wendler, D., Grady, C., 2008. What should research participants understand to understand they are participants in research? Bioethics, 22(4), 203–208] who explored the issue of informed consent in bioethical research. They proposed three key issues that researchers need to consider: research contribution; research relationship and research impact. Inspired by their work, we have developed the Framework for Ethical Research Practice for use in a nursing context. Using examples from our research, we show how the framework can be a useful tool for nurse researchers to assist them in making ethically sound research decisions.Conclusion: This new framework should appeal to researchers seeking innovative ways of enhancing the ethical realm of their practice.

The who and where of clinical skills teaching: A review from the UK perspective

Anne-Marie Borneuf, Carol Haigh — 2009-08-19

Summary: Over the years, the debate on clinical skill acquisition in Nursing is one that has been subject to constant scrutiny within educational settings, locally and globally. Indeed, the Nursing and Midwifery Council (NMC) have endeavoured to provide some clarity with the publication of the Essential Skills Cluster statements [NMC, 2006. Advance Information Regarding Essential Skill Clusters for Preregistration Nursing Programmes (NMC Circular 35/2006). NMC, London] and the recently updated Standards to Support Learning and Assessment in Practice [NMC, 2008. Standards to Support Learning and Assessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers, second ed. NMC, London]. In this paper, we seek to provide a review of the evidence and debate produced thus far surrounding skills acquisition in general and the role of the nurse lecturer in particular from a UK perspective.

Understanding student nurse attrition: Learning from the literature

2009-11-13

Abstract: Student attrition in nursing causes concern, but is not a new phenomenon. Challenges in defining and understanding attrition, changes in the commissioning of nurse education and developments within the United Kingdom National Health Service (UKNHS) and the profession contribute more generally to making this a complex topic for managers and for research. In this paper we discuss findings from an integrative review of the UK literature and discuss three levels of possible contributory factors identified from the literature (micro/individual; meso/institutional; and macro/political and professional). In conclusion, we argue that a concern with attrition is legitimate and that strategies should be put in place to respond to each level of contributory factors. Factors contributing to attrition are complex and interact. We argue that some degree of attrition is inevitable if we are to maintain standards within the profession. There is, therefore, an ethical and professional imperative for attrition in some circumstances. We suggest that Tinto’s model relating to social integration might inform further research.

Jackie Jones — 2009-06-29

As an experienced health professional I found reading this book a sober and insightful read. The authors decision to write such a book has provided her readers with a carefully documented account of her experiences within the health service and in particular the NHS Cancer Services of the 1980s .She takes the reader from the moment when she was completely unaware of any serious problems right through her journey of cancer diagnosis, her subsequent treatment, to the point where she is now a highly regarded and effective campaigner for patient focussed services within the health care system. Her style of writing and ability to capture the emotional experiences she felt whilst trying to negotiate her journey through the NHS provide a compelling list of the right and wrong way to care for patients. Her use of poetry to capture her thoughts is both revealing and poignant and contributes to the messages in this book. Messages which are powerful and thought provoking; as they are based on a working mothers attempts to shield her family and friends from the situation, whilst coming to terms with her illness. It was all too easy to see how the misunderstandings, confusion and barriers were created when the patient was treated as a ‘condition’ rather than a person.