Nurse Education Today - Articles in Press

Developing as a scholarly writer: The experience of students enrolled in a PhD in nursing program in the United States - Corrected Proof

Elizabeth A. Gazza, Teresa Shellenbarger, Diane F. Hunker — 2012-05-18

Summary: Graduates of doctoral nursing programs are expected to disseminate knowledge through scholarly writing, yet faculty teaching doctoral nursing students in two specific programs in western Pennsylvania in the United States noted students enter their doctoral programs with varying writing skills. The purpose of this hermeneutic phenomenological study was to uncover the lived experience of developing as a scholarly writer. Data were collected through the use of a demographic questionnaire and personal interviews with 10 students enrolled in their first semester of coursework in a traditional, rather than online, 60-credit PhD in nursing program at a large state university in western Pennsylvania. All interviews were recorded and transcribed and served as rich data sources. Data were analyzed using a systematic approach consistent with hermeneutic phenomenology. Themes uncovered included (a) coming to know about scholarly writing, (b) shifting thinking in order to write scholarly, (c) giving birth: the pain and the pleasure of scholarly writing, and (d) putting all the pieces together into the final product. Findings from this study can help faculty to understand the experiences of nursing student scholarly writing development. Recommendations based on the findings include a collection of teaching strategies that can be used to facilitate scholarly writer development across all levels of nursing education.

How do nurses solve drug calculation problems? - Corrected Proof

Kerri Wright — 2012-05-17

Summary: This article reports on a pilot study that examined the cognitive processes and strategies used by senior nurses to solve written drug calculation problems.Methodology: Verbal protocol methodology was used to gain and analyse data from eight senior nurses now working in the education setting. The data was analysed using verbal protocol analysis.Results: Nurses used a range of strategies to solve the problems, not just the nursing formula. The cognitive processes of the nurses showed a larger number of steps devoted to problem representation and only a few steps devoted to actually solving the problem.Conclusion: Nurse educators need to consider the importance of problem representation in solving drug calculations and in particular ensure that written questions are representative of clinical practice.

Educating tomorrow's clinical researchers: A review of research preparation in undergraduate education - Corrected Proof

Frances J. Badger, William Daly, Collette Clifford — 2012-05-17

Summary: Background: One large health region in England was experiencing difficulties in recruiting to clinical research posts which required registered nurse or allied health professional skills.Objectives: Pre-registration preparation may influence practitioners' career choices and the study reviewed the research content in pre-registration nurse/AHP degree level programmes in the region to i) describe key features of the modules, and ii) determine the extent to which clinical research featured.Design and settings: There are eight universities in the region. We reviewed and analysed 46 research and evidence-based practice module guides from relevant pre-registration degree level programmes. Documentary analysis was used and the findings were reviewed by the project group.Results: Modules aimed to produce practitioners who were aware of the principles of evidence based practice, and who could locate and evaluate research findings. There was some exposure to clinical research, though this was largely indirect, through considering research findings. Therapy students were more likely than nursing students to conduct a small clinical study for their final year assignment.Conclusions: Pre-registration programmes focused on producing practitioners who were competent users of research evidence to inform practice, rather than clinical researchers, and this was inevitably the focus of the research modules. However, feasible opportunities for increasing students' exposure to clinical research were identified.

Factors influencing nursing students' academic and clinical performance and attrition: An integrative literature review - Corrected Proof

Victoria Pitt, David Powis, Tracy Levett-Jones, Sharyn Hunter — 2012-05-17

Summary: Predicted workforce shortages have resulted in government initiatives to increase student numbers in preregistration nursing education. In tandem schools of nursing need to ensure students' progress and complete. The aim of this review was to identify factors that influence preregistration nursing students' academic performance, clinical performance and attrition. An integrative review of both quantitative and qualitative literature was conducted using validated appraisal checklists. The review included studies published from 1999 to 2011 in the databases: MEDLINE, CINAHL, Proquest nursing, Proquest Education (via Proquest 5000), ERIC, Journals@Ovid, PsychINFO and ScienceDirect. Studies were categorised according to their impact on academic progression, clinical progression and attrition. Forty four studies were found; most used quantitative methodologies. The review identified that few studies explored factors that impact on students' clinical performance. The four categories that potentially impact on nursing students' academic performance and attrition were: demographic, academic, cognitive and personality/behavioural factors. The challenge for universities committed to students' success is to develop strategies aimed at addressing these factors that are appropriate to specific contexts and student cohorts.

Pitfalls, perils and payments: Service user, carers and teaching staff perceptions of the barriers to involvement in nursing education - Corrected Proof

Shaun Speed, Jane Griffiths, Maria Horne, Philip Keeley — 2012-05-17

Summary: Background: There is an impetus to involve service users and carers in the education of nurses and a general consensus in the literature about the benefits that this brings to all involved. Whilst these benefits are well rehearsed in the literature there is little written about the potential barriers to service user and carer involvement in nurse education.Objective: The objective of this study was to investigate service users, carers and staff views on the potential barriers to becoming engaged in nurse education.Design: A qualitative study using focus group discussions (FGD) was used to canvas the views of service users, carers and teaching staff.Setting: A large school of nursing in the North West of England.Participants: 38 service users and carers recruited from the North West of England and 23 nursing and midwifery teachers and lecturers.Methods: Focus group discussions were employed as the main data collection method. The data were analysed using thematic analysis.Results: Six themes occurred in the data as being negatively associated with potential and actual involvement: not knowing the context of the group, lack of preparation of the group, not being supported, not being allowed to be real, not receiving feedback, not being paid appropriately.Conclusions: The process of involvement is not without difficulties. These data show that some consideration needs to be given to the potential barriers to involvement if the engagement of service users and carers is to be effective.

Master's level education in Jordan: A qualitative study of key motivational factors and perceived impact on practice - Corrected Proof

Zainab Zahran — 2012-05-14

Summary: Aim: To explore key motivational factors of Jordanian nurses to undertake a Master's degree and explore perceived impact on practice.Background: In Jordan, there are postgraduate educational programmes offering a Master's degree in clinical nursing for registered nurses. These programmes are intended to prepare nurses to practise at an advanced level as potential clinical nurse specialists. Little is known about the motivation of nurses to undertake such Master's degree preparation programmes and their perceived impact on practice.Methods: Using an ethnographic design, narratives from semi-structured interviews with participants (n=37) from five Jordanian hospitals and two public universities were collected and thematically analysed.Findings: Four main themes emerged from the data: self development; broadening career opportunities; developing practice; and the perceived impact of Master's level nurses on practice.Conclusion: The majority of Jordanian nurses chose to undertake a Master's degree because of a desire for self and practice development. The majority of participants referred to M-level nurses in terms of knowledge transfer, highlighting their clinical teaching and in-service education activities. M-level nurses were also associated with managerial and supervisory roles in clinical practice. Controversy over the impact of M-level nurses in enhancing patient care is not limited to the Jordanian setting. Future research needs to focus on comparative studies between nurses with M-level qualifications and experienced nurses without either M-level qualifications or specialist courses to establish if there is any significant relationship between practice performance and educational preparation and experience. Evaluation research could be undertaken for the purpose of developing measurable and observable criteria related to educational and skill based outcomes.

Student nurse socialisation in compassionate practice: A Grounded Theory study - Corrected Proof

Katherine Curtis, Khim Horton, Pam Smith — 2012-05-14

Summary: Compassionate practice is expected of Registered Nurses (RNs) around the world while at the same time remaining a contested concept. Nevertheless, student nurses are expected to enact compassionate practice in order to become RNs. In order for this to happen they require professional socialisation within environments where compassion can flourish. However, there is concern that student nurse socialisation is not enabling compassion to flourish and be maintained upon professional qualification. In order to investigate this further, a Glaserian Grounded Theory study was undertaken using in-depth, digitally recorded interviews with student nurses (n=19) at a university in the north of England during 2009 and 2010. Interviews were also undertaken with their nurse teachers (n=5) and data from National Health Service (NHS) patients (n=72,000) and staff (n=290,000) surveys were used to build a contextual picture of the student experience. Within the selected findings presented, analysis of the data indicates that students aspire to the professional ideal of compassionate practice although they have concerns about how compassionate practice might fit within the RN role because of constraints on RN practice. Students feel vulnerable to dissonance between professional ideals and practice reality. They experience uncertainty about their future role and about opportunities to engage in compassionate practice. Students manage their vulnerability and uncertainty by balancing between an intention to uphold professional ideals and challenge constraints, and a realisation they might need to adapt their ideals and conform to constraints. This study demonstrates that socialisation in compassionate practice is compromised by dissonance between professional idealism and practice realism. Realignment between the reality of practice and professional ideals, and fostering student resilience, are required if students are to be successfully socialised in compassionate practice and enabled to retain this professional ideal within the demands of 21st century nursing.

Using the arts and humanities to promote a liberal nursing education: Strengths and weaknesses - Corrected Proof

Andrew McKie — 2012-05-14

Summary: Background: The requirement that all student nurses in the United Kingdom will be educated to degree level from 2013 permits a review of the current state of nursing education in university contexts. Recent educational standards for these new programmes (NMC, 2010) allow a liberal, or broad-based, education, with its features of breadth of knowledge, formativity, critical thinking and working with others, to be considered.Objective: Select narratives from a PhD study featuring student nurses and nurse teachers exploring the relationship between reading literature and poetry and ethical practice are presented to critically support the place of liberal education within these programmes.Design: These narratives are drawn from a research study based upon the use of a narrative methodology.Settings: The study was set within the educational context of a school of nursing and midwifery in one Scottish university.Participants: Eight student nurses and four nurse teachers participated in the study.Methods: These narratives were constructed from data derived from focus groups and individual interviews.Results: These narratives suggest that liberal education can be promoted within international curricula via careful positioning of, and student nurse engagement with, the arts and humanities. A liberal education can influence student nurses' sense of discernment, enhance their own responsibility for learning, support ethical regard for others, provide different perspectives on human experience and contribute to a balanced curriculum. Although a liberal education cannot guarantee fully skilled and ethically sensitive practitioners, it can contribute towards its achievement.Conclusion: The current university education climate presents obstacles to the promotion of liberal education. Nevertheless, the considerable professional and personal challenges of nursing practice in global terms make such an educational preparation essential. If nursing education to degree level is to commence from 2013, these principal features of liberal education, via these educational standards, must be embedded prominently into new programmes.

“Putting the words ‘I am sad’, just doesn't quite cut it sometimes!”: The use of art to promote emotional awareness in nursing students - Corrected Proof

Kirsten Jack — 2012-05-14

Summary: This paper explores a way in which Heidegger's later philosophy on meditative thinking can be used to support the development of emotional self awareness in pre registration nursing students. The development of art work supported the consideration of feelings in relation to particular incidents from practice. The students were afforded the opportunity to think ‘for thinking's sake’ about their feelings around emotionally challenging situations. They were then more able to consider others' feelings and think differently about the situations encountered.The students found the process beneficial although in an already packed curriculum, it may be difficult to afford the time and space needed to adopt more transformatory ways of learning. A more objective and focused delivery may be preferable to the nurse educator, but when exploring human emotion, consideration could be given to whether this is beneficial to the student.

Enhancing student nurses' medication calculation knowledge; integrating theoretical knowledge into practice - Corrected Proof

Elisabeth Coyne, Judith Needham, Hazel Rands — 2012-05-10

Abstract: Background: Accurate calculation of dosages and safe administration of medications in clinical practice is an essential skill for the registered nurse. Appropriate educational preparation of student nurses is the key to ensuring they become safe practitioners in the workforce. A review of the literature on different approaches for teaching and assessing medication calculation with student nurses revealed three main factors that influenced student nurses' ability to calculate medications accurately and identify mistakes. These factors include mathematical ability, particularly around multiplying with decimals, understanding medication formulas, and conceptualising medication dose.Objectives: This study evaluated teaching interventions that focused on improving the students' understanding of mathematical calculations, medication formulas and conceptualising medication doses.Design: Evaluation study with teaching interventions and Time 1 and Time 2 medication tests.Participants: 156, 2nd year Bachelor of Nursing students from an Australian University.Method: The teaching interventions over 8weeks included teaching decimals and basic mathematical skills, using the correct mathematical formula for the medication and linking the medication to the patient case study. Time 1 and Time 2 medication tests out of ten, student demographics and reasons for attending tutorials were collected to evaluate the effectiveness of the teaching interventions.Results: For Time 1 medication test pre interventions, the mean was 7.3 with a mode of 8 out of ten. Maths and incorrect medication formula were the most common mistake. For Time 2 medication test post interventions, the mean was 9.3 with a mode of 10. The most common reason for incorrect answer Time 2 was incorrect medication formula. The students identified that the smaller tutorial sizes and remediation of errors was the main reason for continued attendance.Conclusions: The teaching intervention improved the accuracy of students' medication calculation, specifically, understanding the correct formula to use and identifying errors of calculation.

The effect of human patient simulation on critical thinking and its predictors in prelicensure nursing students - Corrected Proof

Mary Ann Shinnick, Mary A. Woo — 2012-05-08

Summary: Human patient simulation (HPS) is becoming a popular teaching method in nursing education globally and is believed to enhance both knowledge and critical thinking.Objective: While there is evidence that HPS improves knowledge, there is no objective nursing data to support HPS impact on critical thinking. Therefore, we studied knowledge and critical thinking before and after HPS in prelicensure nursing students and attempted to identify the predictors of higher critical thinking scores.Methods: Using a one-group, quasi-experimental, pre-test post-test design, 154 prelicensure nursing students (age 25.7±6.7; gender=87.7% female) from 3 schools were studied at the same point in their curriculum using a high-fidelity simulation. Pre- and post-HPS assessments of knowledge, critical thinking, and self-efficacy were done as well as assessments for demographics and learning style.Results: There was a mean improvement in knowledge scores of 6.5 points (P<0.001), showing evidence of learning. However, there was no statistically significant change in the critical thinking scores. A logistic regression with 10 covariates revealed three variables to be predictors of higher critical thinking scores: greater “age” (P=0.01), baseline “knowledge” (P=0.04) and a low self-efficacy score (“not at all confident”) in “baseline self-efficacy in managing a patient's fluid levels” (P=.05).Conclusion: This study reveals that gains in knowledge with HPS do not equate to changes in critical thinking. It does expose the variables of older age, higher baseline knowledge and low self-efficacy in “managing a patient's fluid levels” as being predictive of higher critical thinking ability. Further study is warranted to determine the effect of repeated or sequential simulations (dosing) and timing after the HPS experience on critical thinking gains.

The impact of spiritual care education upon preparing undergraduate nursing students to provide spiritual care - Corrected Proof

Katherine L. Cooper, Esther Chang, Athena Sheehan, Amanda Johnson — 2012-05-08

Summary: Spiritual care is an important component of holistic care. In Australia competency statements relating to nursing practice emphasise the need to provide care that addresses the spiritual as well as other aspects of being. However, many nurses feel they are poorly prepared to provide spiritual care. This is attributed largely to lack a of spiritual care education provided in undergraduate nursing programmes. A few higher education providers have responded to this lack of spiritual care education by incorporating specific content related to this area into their undergraduate nursing programme. Minimal international studies have investigated the impact of spiritual care education on undergraduate nursing students and no Australian studies were identified. This review explores spiritual care education in undergraduate nursing programmes and identifies the need for an Australian study.

Learning concepts of cinenurducation: An integrative review - Corrected Proof

Jina Oh, Jeongae Kang, Jennie C. De Gagne — 2012-05-04

Summary: Background: Cinenurducation is the use of films in both didactic and clinical nursing education. Although films are already used as instructional aids in nursing education, few studies have been made that demonstrate the learning concepts that can be attributed to this particular teaching strategy.Aim: The purpose of this paper is to describe the learning concepts of cinenurducation and its conceptual metaphor based on a review of literature.Method: The databases CINAHL, MEDLINE, PsychINFO, ERIC, EBSCO, ProQuest Library Journal, and Scopus databases were searched for articles. Fifteen peer-reviewed articles were selected through title and abstract screening from “films in nursing” related articles found in internationally published articles in English from the past 20years.Result: Four common concepts emerged that relate to cinenurducation: (a) student-centered, (b) experiential, (c) reflective, and (d) problem-solving learning. Current literature corroborates cinenurducation as an effective teaching strategy with its learning activities in nursing education.Conclusion: Future studies may include instructional guides of sample films that could be practically used in various domains to teach nursing competencies, as well as in the development of evaluation criteria and standards to assess students' learning outcomes.

Reciprocity of service learning among students and paired residents in long-term care facilities - Corrected Proof

Huei-Lih Hwang, Hsiu-Hung Wang, Chin-Tang Tu, Shiue Chen, Su-Hsien Chang — 2012-05-03

Summary: Many intergenerational service learning projects have been designed for service providers and recipients, few studies have analyzed the providers and recipients of such projects in terms of caring behavior. In accordance with the Taiwan Ministry of Education initiative to develop curricular service learning, a service learning project was initiated during a nursing school course before the students performed their clinical practicum. The aim of this mixed method design was to report the development of an intergenerational service learning project and to test its effects both on nursing students paired with residents and residents of facilities. A pre-and post-test with non-randomized control group design was used to evaluate the effects of the project on caring perceived by the residents, and a one-group pre- and post-test design was used to test its effects among nursing students. The analysis included valid questionnaires received from 59 eligible residents and 210 nursing students. The 20-hour project included pre-service training, service, and an end-of-project presentation. At post-test, the residents showed that perceived caring significantly differed between the intervention group and the control group (F=8.99; p=.004). Paired t test analysis of nursing students also showed significant increases in both caring and attitude scores after the project (t=8.56; p=.000; t=6.35; p=.000). The project significantly affected the caring perceived by the residents and the achievements of the junior nursing students. This experimental study provides information of interest to nursing educators, long-term care administrators, and researchers in elderly care.

Teachers' views of using e-learning for non-traditional students in higher education across three disciplines [nursing, chemistry and management] at a time of massification and increased diversity in higher education - Corrected Proof

Helen T. Allan, Mike O'Driscoll, Vikki Simpson, Jill Shawe — 2012-05-01

Summary: Background: The expansion of the higher educational sector in the United Kingdom over the last two decades to meet political aspirations of the successive governments and popular demand for participation in the sector (the Widening Participation Agenda) has overlapped with the introduction of e-learning.Objectives: This paper describes teachers' views of using e-learning for non-traditional students in higher education across three disciplines [nursing, chemistry and management] at a time of massification and increased diversity in higher education.Design: A three phase, mixed methods study; this paper reports findings from phase two of the study.Settings: One university in England.Participants: Higher education teachers teaching on the nursing, chemistry and management programmes.Methods: Focus groups with these teachers.Findings: Findings from these data show that teachers across the programmes have limited knowledge of whether students are non-traditional or what category of non-traditional status they might be in. Such knowledge as they have does not seem to influence the tailoring of teaching and learning for non-traditional students. Teachers in chemistry and nursing want more support from the university to improve their use of e-learning, as did teachers in management but to a lesser extent.Conclusions: Our conclusions confirm other studies in the field outside nursing which suggest that non-traditional students' learning needs have not been considered meaningfully in the development of e-learning strategies in universities. We suggest that this may be because teachers have been required to develop e-learning at the same time as they cope with the massification of, and widening participation in, higher education. The findings are of particular importance to nurse educators given the high number of non-traditional students on nursing programmes.

Difficulties experienced by nurses in older patient care and their attitudes toward the older patients - Corrected Proof

Derya Adibelli, Dilek Kılıç — 2012-04-30

Summary: Background: There is little known about nurses' attitudes toward older people in Turkish society, particularly within centers providing care to older patients.Objective: This research was conducted to determine nurses' attitudes toward older patient care and the difficulties they experience.Design: A descriptive research design was used.Settings: The research population comprised 282 nurses working in the clinics of public hospitals in central Erzurum that mostly accommodate older patients.Methods: Participants completed questionnaires regarding descriptive characteristics, the type of difficulties they experienced in older patient care, and the Turkish version of Kogan's Attitudes Toward Old People Scale. Data were evaluated by using percentage, Kruskal–Wallis variance analysis, t test and Mann–Whitney U test.Results: The study revealed that nurses experienced difficulties due to the inadequacy of physical conditions and technical equipment in hospitals; administrative problems; communication problems; and insufficient knowledge, skills and experience in older patient care. The nurses' overall attitude toward the older people was found to be positive (98.83±11.19).Conclusions: The difficulties experienced by nurses in this sample resulted from the lack of technically equipped hospitals or clinics for older patients and the inadequacy of nurses' gerontology education. Despite these factors, the nurses' attitude toward older people was positive.

Professional identity in nursing: Are we there yet? - Corrected Proof

Nicola Andrew — 2012-04-25

Summary: Nursing in the United Kingdom (UK) has been part of higher education for more than a decade and is now moving towards graduate status as a profession. Increasingly, through adherence to good practice guidelines and professional body regulation, the profession is incrementally involving communities of reference to help shape current and future identity. The desire to articulate the impact of nursing practice underscores the new undergraduate programmes and propels professional preparation beyond an existence at the fuzzy fringes of medicine towards a unique and fully fledged contemporary identity.

Investigating the language needs of culturally and linguistically diverse nursing students to assist their completion of the bachelor of nursing programme to become safe and effective practitioners - Corrected Proof

Tonia Crawford, Sally Candlin — 2012-04-23

Summary: Background: Australia has an increasing number of nursing students from culturally and linguistically diverse backgrounds however problems communicating in the clinical setting, difficulty with academic writing and a tendency to achieve lower grades have been reported.Objectives: To identify the language needs of culturally and linguistically diverse students, and evaluate the English language support programme to develop appropriate strategies and assist academic progression and clinical communication skills.Design and methods: An action research approach was adopted and this paper reports findings from the first round of semi-structured individual interviews. The strategies suggested by the participants will subsequently be implemented and evaluated during the first cycle of action research.Setting: An Australian Bachelor of Nursing programme which has students from culturally and linguistically diverse backgrounds.Participants: Eight second and third year students who have a primary language other than English.Results: Four strategies emerged from initial student interviews. The English language support programme to be conducted during semester breaks, ongoing focus on reading and writing but also to include some International English Language Testing System exam strategies and practice, increase the use of nursing specific language and context in the English language support programme, and informing or reminding lecturers of the impact of their lecture delivery style on learning for students from diverse backgrounds.Conclusion: Themes emerging from the initial round of interviews inform both the implementation of the English language support programme and teacher delivery. It is hoped that implementing these strategies will support the English language development of nurses from diverse backgrounds. Proficient communication will more likely contribute to providing safe and effective culturally sensitive care in a culturally diverse health care environment. Additional cycles of action research may be conducted to further improve the programme.

Fast food for thought: How to survive and thrive in the corporate university - Corrected Proof

Gary Rolfe — 2012-04-23

Summary: Michael Oakeshott warned in 1950 that the very existence of the university as a place of learning and scholarship was under threat from corporate interests, and that the provision of education was being replaced by the sale of qualifications. By the end of the century, Bill Readings had pronounced that the university was in ruins, just as nurse education in the UK was making the move into higher education. It is against this backdrop of a corporate university sector that is increasingly coming to resemble a fast-food business that nurse academics are struggling to assert their values and make a difference to nursing practice through education, research and scholarship. As it becomes ever more difficult to make our way in the university with any degree of integrity, this paper offers some thoughts and suggests some strategies for not only surviving in the corporate university, but for thriving both personally and professionally in ways that do not compromise our commitments and values as healthcare professionals and human beings. It is offered as a personal reflection, based on nearly 40years of experiences in UK universities, firstly as a student and latterly as a lecturer and a professor of nursing. As such, it is delivered from a particular geographical and disciplinary perspective, the only perspective I can talk from with any real authority and authenticity. However, I believe that these ideas, thoughts and suggestions can be applied with a degree of success to other healthcare disciplines in other parts of the world.

Improving student learning on a midwifery education programme by using a benchmark course portfolio as a means of reflection and peer review - Corrected Proof

Margaret M. Murphy, Mary Hughes, Cathy O. Sullivan — 2012-04-20

Summary: The idea of scholarship within disciplines has long been discussed in the relevant literature. The concept of scholarship in teaching and learning has its foundations in seminal work Scholarship Reconsidered. In this, Boyer made the case for teaching to be enhanced and made public and to be credited with equal weight as research activity within academic institutions. The activities of teaching and learning are truly academia's raison d'être however they get obscured in the mists of the importance placed on research activity. To this end it is vital that educators begin to critically examine their teaching to fully inform research and practice. One of the lenses through which this can be done is through the act of reflection. Reflection on action as a process first described by Schön in 1983 () necessitates not only the critical examination of what we do but also what are the underlying assumptions about why we do what we do. The paper outlines such reflective portfolio submitted as part requirement for Postgraduate Diploma in Teaching and Learning in Higher Education. It examines student midwives learning using the reflective lens of the benchmark course portfolio.

Cultivating understanding of health issues for adults with intellectual disability - Corrected Proof

Sue Read, Amy Rushton — 2012-04-20

Summary: Going into hospital may be a frightening experience. Fears and anxieties may be particularly compounded when the patient has an existing health diagnosis such as a mental health condition or intellectual disabilities (ID). While people with ID often have worse health than other people, they can experience more difficulty accessing healthcare.Objectives: The aim of this paper is to describe the self-evaluation process and outcome of a series of workshops designed to cultivate understanding of the health needs of adults with ID.Design: The research was designed to explore the impact of the workshops for generic healthcare professionals, using a mixed methods inquiry.Settings: The workshops were interactive, and facilitated by health care clinicians, three people with an ID, advocates and academics.Sample: Participants were mainly qualified and unqualified nurses and other allied health professionals (N=157).Methods: Quantitative questionnaires comprised of 16 questions with multiple choice answers were distributed to all participants (pre and post workshop). A qualitative feedback sheet to promote shared dialogues was circulated on completion of each workshop.Results: Triangulated research methods of data collection demonstrate a positive impact of the workshops and the learning experienced from a participant perspective.Conclusions: While resources alone will never replace nurse education and training, they can reinforce best practice, and the resource developed in this paper was maximized by workshops to explore its potential. The remaining challenge is measuring the impact of this work on clinical practice in the longer term.

Simulation-based education (SBE) within postgraduate emergency on-call physiotherapy in the United Kingdom - Corrected Proof

Suzanne Gough, Abebaw M. Yohannes, Catharine Thomas, Judith Sixsmith — 2012-04-20

Summary: Background: The application and extent of simulation-based education use within cardiorespiratory physiotherapy postgraduate education (in-house/regional provisions) and emergency oncall services were previously unexplored.Objectives: This survey aimed to investigate the extent to which simulation-based education is currently utilised by physiotherapy services in the UK.Design: A national postal questionnaire-based survey.Setting: All 280 National Health Service Critical/Intensive Care Units in England, Northern Ireland, Scotland and Wales, providing emergency on-call physiotherapy services were included in the survey.Participants: Emergency on-call physiotherapy service leads.Method: A self-administered 20-item postal questionnaire survey was designed to establish the extent to which simulation-based education was currently being used within cardio-respiratory physiotherapy post-registration training.Results: A useable response rate of 55% (155/280) was achieved, representing a range of respiratory and emergency on-call service leads. Sixty-one Trusts (39%) currently use simulation within acute respiratory or emergency on-call postgraduate training. The provision of simulation equipment varied with respect to type, fidelity and accessible to the physiotherapy service. Simulation-based education featured in emergency on-call induction, updates, competency assessment, assessment skills, treatment skills and scenarios (75, 92, 39, 28, 82, 48% respectively).Conclusions: Simulation is currently used to teach a wide variety of cardio-respiratory physiotherapy skills relevant to the acute respiratory and on-call environments. Adoption was dependent upon local facilities, needs and training requirements. National inconsistencies in availability, fidelity and accessibility were identified. The evidence base surrounding the current use of simulation-based education within physiotherapy is limited and evidence of transferability to the practice arena remains relatively unknown. Future research is warranted to determine the education outcomes, impact on skill performance, competency, retention and patient safety when integrating SBE within EOC training activities.

The nursing students’ attitude toward using blogs in a nursing clinical practicum in Taiwan: A 3-R framework - Corrected Proof

Kai-Yin Lin, Yen-Fen Shen — 2012-04-20

Summary: Background: Some nursing educators have been using blogs as a channel to reflect on, share, and discuss questions and ideas for educational purpose. There were not many studies focused on the application of blog technology to the professional development of nursing education in Taiwan.Objectives: The major goal of this study was to use a blog platform for students, writing their reflection notes, and observing the feedbacks from peers during their clinical practicum. Then we tried to probe the nursing students' attitude toward adopting 3-R categories based blog, which included wRiting reflection notes, Reading peers' notes, and Receiving peers' feedback.Participants: Of the 179 fourth grade from one five-year technical college students enrolled in a clinical practice course in Taiwan were used as a pool of sampling. Four-eight students were invited by the researcher to take part in this project.Results: 90% of the participants agreed that blogs provided them with opportunities to share personal experiences with others. 81% of them valued that blogs provided opportunities to offering encouragement and emotional support to their peers. A majority of the participants believed that reading peers' journals was helpful in enhancing their professional development. In addition, all of them agreed that reading peers' journals can help them understand their peer's viewpoints. Most of the participants agreed that they were benefited through receiving feedbacks on the blogs. About 98% of them agreed that feedbacks can promote interaction with peers.Conclusions: The findings of this study generally indicated the participants' positive attitude toward using blogs in their clinical practicum. A majority of the participants also claimed that blogs provided them the opportunities to share personal experiences with their peers as well as to see things from their peers' viewpoints. They believed that reading peers' notes was helpful in enhancing their professional development. In addition, most of them agreed that receiving feedbacks could promote in-depth reflections; therefore, they were encouraged to write more reflective notes. Thus, future clinical practicum design should exert efforts to foster students' collaboration, reflections, and dialogues by providing blog platform.

A theoretically informed education program designed specifically for acute surgical nurses - Corrected Proof

Beverley Duff — 2012-04-19

Summary: Aim: The aim of the research was to evaluate the effectiveness of implementing the Respiratory Skills Update (ReSKU) education program using integrated teaching and learning strategies, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment.Background: Technological advances and changes in healthcare delivery have necessitated that nurse educators adopt innovative teaching and learning strategies to better prepare acute care nurses for their increasingly complex roles. This 2007 study used a robust overarching theoretical framework to develop and evaluate an educational model using the ReSKU program as a basis for the content.Methods: The study was conducted in a 400 bed regional referral public hospital, in Australia. The research was guided by the work of Forneris (2004) to operationalise a critical thinking process incorporating the complexities of the clinical context. The theoretical framework used multi-modal, interactive educational strategies that were learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators.Conclusion: The construct of critical thinking in practice combined with clinical reasoning and purposeful and collective reflection is a powerful educational strategy to enhance competency and capability in clinicians.

Reclaiming craftsmanship in nursing - Corrected Proof

Andrew G. Meal, Stephen J. Timmons — 2012-04-18

The Craftsman () has attracted a degree of attention and approval unusual for a sociological work. In this book Sennett talks at some length about nurses (and doctors) and it is thus surprising that his work has not attracted more attention in health care education. We will show how Sennett shares many of our central concerns as educators, but also how he offers potential educational approaches which address those concerns.

Transformative learning during nursing education: A model of interconnectivity - Corrected Proof

Tamara M. Kear — 2012-04-18

Summary: Higher education strives to transform students by opening their minds to different world views. This study investigated the transformative experiences of students using narrative analysis methodology to describe the experience of learning during nursing education. Phases of Transformative Learning Theory guided the analysis of narratives. The study yielded 5 narrative threads: 1) the multi-faceted process of learning, 2) experiential learning, 3) human interactions as central to defining nursing and caring, 4) personal life experiences intertwining with nursing, and 5) transformative learning. Results indicated that students perceived the greatest learning and transformation through experiential learning with humans. Such experiences included caring for immigrants, children in lower socioeconomic environments, and patients with a variety of physical and mental health needs in numerous settings. Other participants described personal experiences that took on new meaning or contributed to learning as a result of academic experiences. Some students entered with a personal history of service and charity work that provided a foundation for their educational experiences.

Assessment of goals in problem-based learning - Corrected Proof

Şeyda Özbıçakçı, Özlem Bilik, Şeyda Seren İntepeler — 2012-04-18

Summary: Assessing the learning goals set by faculty is an important part of problem-based learning (PBL). Students also develop individual and group goals during module tutorials. They choose learning activities and create a framework for their self-directed study in order to achieve these goals. This investigation analyzes perceptions of the depth of understanding that students acquire. The effects of setting learning goals by faculty and by students themselves are examined, and we explore differences within groups and within the different years in the program.Nursing students responded to a questionnaire indicating how well they thought they had understood new material, according to both the goals preset by the faculty and those developed by the students themselves. A five-point Likert scale was used for this. The findings indicate no significant difference between tutors' and students' evaluations of student level of understanding within the different years of the program. Students and tutors in all three years indicated that they achieved adequate or good understanding of learning goals. (Students: First year: 91.6%, second year: 76.5%, third year: 90.1%; Tutors: First year: 76.8%, second year: 65.7%, third year: 89.1%)These findings are useful for evaluation of PBL outcomes for curriculum committees. Based on these research results, our faculty curriculum committee has decided to give the students a list of faculty generated learning goals at the end of every curriculum module. The students then compare these with their own self-directed goals in feedback sessions with faculty members. These feedback sessions have been very popular with students.

Using e-learning to enhance nursing students' pain management education - Corrected Proof

Gemma Keefe, Heather J. Wharrad — 2012-04-18

Summary: Context: Absence of standardised pain curricula has led to wide diversity in the understanding and awareness of pain by healthcare students. Indeed pain management is frequently under-prioritised in nursing education, providing potential to negatively impact upon patient care. Yet the recent addition of Pain to the UK National Health Service's Essence of Care Benchmarks has highlighted the need to address this issue, and in response pain educators have called for the development of high quality, globally accessible e-learning resources in pain management.Objectives: This study will determine the effectiveness of an e-learning intervention on pain management developed for nursing students.Methods: Two variants of an e-learning resource on pain management were developed, each containing the same core content but one with a section focusing on pain assessment and the other on pharmacological management. Nursing students (n=42) were randomly assigned to trial one resource, after which they undertook a questionnaire adapted (to ensure alignment with the content of the e-learning resources) from Ferrell and McCaffrey's Nurses Knowledge and Attitudes Towards Pain Survey. Scores were analysed for each resource and year of study, and compared with scores from a standard non-intervention group completing the questionnaire only (n=164).Results: Scores averaged 19.2% higher for students undertaking the e-learning resources (p<0.005). Specifically, undertaking the assessment resource improved assessment knowledge more, whilst assignment to the treatment resource particularly enhanced pharmacological knowledge (p<0.005). Correlation was found between year of study and pain knowledge.Conclusion: Results support the effectiveness of the resources independent of voluntary-response bias. Conclusions recommend that introducing e-learning has substantial benefit to enhance pain education in nursing.

Telehealth nurse practitioner student clinical experiences: An essential educational component for today's health care setting - Corrected Proof

Shelley Yerger Hawkins — 2012-04-16

Summary: In order to meet the continuous changes and innovations within the health care system, nurse practitioner faculty must look to the future and prepare nurse practitioner graduates who deliver safe, quality patient care addressing the realities of a global society with a fast-paced expansion of technologies. Preparing nurse practitioner students for practice must include more than information technology knowledge in graduate nursing programs. Formal clinical experiences using various telehealth applications must be integrated into nurse practitioner training. Innovative strategies must be explored by nurse practitioner faculty to assure that graduates can meet the demanding technological demands of our current health care society.

Ethical concerns in the student/preceptor relationship: A need for change - Corrected Proof

Iris Epstein, Kathleen Carlin — 2012-04-16

Summary: Nursing schools are required to ensure that the clinical and academic milieu prepares nurses not only to recognize but also to act on various ethical issues. As a result of our years teaching nursing ethics to undergraduate nursing students we have come to believe there is a disconnect between classroom teaching and students' experiences in practice. How then can nurse educators help nursing students not only to see the ethical components of their work but also to take the necessary steps to solve ethical dilemmas and challenge unethical practice? One such strategy is the use of preceptorship. In this paper, we set out to learn about nursing students' ethical encounters in the clinical area, specifically those within the preceptor/student relationship. To this end we conducted an integrative review and are weaving in Gesler's (1992) concepts who argued that ethical issues play out in our physical and social environments. We identified nine articles that describe students' perceptions of ethical problems in their relationships with preceptors. However, it was rare for the authors of these articles to label these as ‘ethical’ issues. The integrative review revealed first, that students describe ethical issues in their narratives, and second, their most common response to these issues is silence. We continue to be concerned that nursing students' classroom learning of ethics is disconnected from their everyday nursing practice. Further research and education implications are discussed and explored in this paper.

Comparison of problem-based learning and lecture-based learning in midwifery - Corrected Proof

Gita Sangestani, Mahnaz Khatiban — 2012-04-16

Summary: Background: Lecturing is the most common teaching method in the medical education. Problem-based learning (PBL) is one of the active and student-oriented learning strategies which have gained attention in the recent decades.Objective: To compare the effect of PBL and lecture-based learning (LBL) on the satisfaction and learning progress of undergraduate midwifery students.Design: Quasi-experimental study.Settings: Hamadan University of Medical Sciences, Hamedan, Iran.Participants: Fifty-six undergraduate midwifery students in two different classes participated in the study.Methods: Randomly, one class (experimental group) received PBL in addition to LBL and the other one (control group) received traditional LBL. “Pregnancy and childbirth”, a 2-credit course, was selected for this purpose. Scientific pre-test and post-tests were performed and satisfaction questionnaire was filled in for both groups. A questionnaire to compare PBL and LBL was filled in only for the experimental group. The instruments used in the study were “Demographic data form”, “Students' learning progress test”, “Student's satisfaction of teaching method”, and the “Teaching method evaluation”.Results: Learning progress in PBL group was significantly more than control group. PBL improved application of theory lesson in clinical practice, increased learning motivation and enhanced educational activity in class. There was more satisfaction with PBL method. There was no relationship between the students' satisfaction and learning progress. 81.8% of students considered PBL the more suitable and better method.Conclusion: PBL should be applied more in undergraduate midwifery courses. According to these advantages, the quality of midwifery education can be improved via this method.

Becoming a nurse in Italy: A multi-method study on expenditures by families and students - Corrected Proof

2012-04-16

Summary: Potential nursing students and their families are faced with difficult decisions regarding the amount of time and money required to complete the nursing programme and the availability of funds to cover the costs and this seems to have received little no attention to date. With the aim of describing the costs incurred by Italian nursing students and/or their families per academic year and compare cost trends incurred from 2004–05 to 2010–11, a multi-centre qualitative/quantitative study design was adopted. Italian Nursing students attending the first, second and third academic years in 2004–05 and those attending the first, second and third academic years in 2010–11 were eligible. Five hundred and six students were involved: 215 (out of 300 eligible, 71.6%) attended the bachelor's degree in nursing in 2004–05 and 291 (out of 383 eligible, 75.9%) in 2010–11. On an annual basis, the average annual expenditures increased by 12% for nursing education from 2004–05 to 2010–11. Given that qualification as a nurse requires at least three years, and considering inflation, for a student who matriculated in 2005 an average of 2485.7€ per year (7457.0€ in total) was required. Data suggest that students have modified their spending behaviour (limiting lunches at public bars, buying books and photocopies) in order to handle the rise of non-discretionary costs, such as tuition fees and the costs of attending lectures and hospital/district trainings. Policies supporting nursing education in general and for those students who are motivated but unable to undertake the course for economic reasons are urgently needed.

Drawing in nursing PBL - Corrected Proof

Zenobia C.Y. Chan — 2012-04-09

Summary: The implementation of art education in nursing is said to have positive effects on nursing students. Most studies applied visual art dialogues or object design, whereas the effectiveness of drawing as a teaching and learning method is rarely examined and discussed. This paper aimed to discuss the potential and effectiveness of drawing as a learning and teaching method. Four drawings which were created by Hong Kong nursing students are demonstrated and the students’ perspectives of how drawing enhanced learning are shown in this paper. Topics on drawing as a fun teaching and learning method and the way it can enhance critical thinking and creativity are also discussed. In conclusion, the activity was a great success, and students enjoyed the learning process and reflected positive comments. However, we cannot conclude that drawing is an effective teaching and learning method based on a single paper, therefore more similar studies should be conducted to investigate this method.

Building a bridge for nursing education and clinical care in Taiwan — Using action research and Confucian tradition to close the gap - Corrected Proof

2012-04-06

Summary: Background: Nursing workplaces in Taiwan are unable to retain talent. An examination of this problem has revealed that the causes of this phenomenon are that nursing education fails to cultivate the skills that meet workplace requirements and that there are gap between nursing education and clinical practice.Objectives: This paper is an action research that aims is to design educational programs that can close the gap between nursing education and clinical practice in Taiwan.Design: In this action research project, 4 action cycles were used to design educational programs including concept mapping and focused discussion strategies.Settings: Participants were invited to join the research in three teaching hospitals and one university.Participants: Two groups of participants, student nurses (SN) and nursing staff personnel (NS), were sampled and invited to participate in the research.Methods: Participant observation, focus groups, and qualitative interviews were used to collect data. Qualitative data were not only profiled by content analysis, but they were also compared continuously between the two groups as well as between the 4 cycles.Results: The qualitative data collected for the 135 participants were analysed. The themes of an effective nursing program were summarized.Conclusions: Many fundamental values of traditional Chinese education have gradually faded due to the Westernization of education. In this study, we discovered that Western educational models may play a critical role in improving traditionally taught nursing education programs.

Improving nursing students' knowledge using online education and simulation to help smokers quit - Corrected Proof

Kawkab Shishani, Kevin Stevens, JoAnn Dotson, Christina Riebe — 2012-04-06

Summary: The purpose of this study was to examine an evidence-based smoking cessation education program effect on nursing students' perceptions and self-confidence to help smokers quit smoking.Method: Upon completion of an on-line educational program students were provided opportunities to practice through simulation. Data were collected by pre and post assessment tools for the online-education and by a post assessment tool for the simulation.Results: 110 senior nursing students participated in this study. Students' confidence in their overall ability to assist smokers to quit smoking was statistically significant compared to baseline (t=4.09, p<.001). Students self-rated higher levels of smoking cessation skills on Advising, Assessing, Assisting, and Arranging compared to baseline (p<0.00).Conclusion: Integration of evidence-based didactic and practical smoking cessation program into curricula improves nursing students' clinical skills in helping smokers to quit.

“What made me stay?” A review of the reasons student nurses enrolled in a Bachelor of Nursing programme completed their studies: A descriptive phenomenological study - Corrected Proof

2012-04-06

Summary: Schools of nursing in New Zealand are now being asked for data on retention and completition rates for inclusion within their Tertiary Institution's performance. A continuing issue facing Schools of Nursing in their Bachelor of Nursing degree level studies are the struggles that some students face during their studies. Some overcome these difficulties and may complete the programme within the three year plan of study. Others take up to the five years allowed by the Nursing Council of New Zealand. This study, using a qualitative phenomenological research methodology, aimed to determine common themes that emerged as to why students stayed and completed their programme of study to become a Registered Nurse. The initial thematic analysis indicated that the greatest reason that students stayed related to the broad theme of “support”. There were secondary themes under this related to family, friends and peers, and the tutorial staff. A second broad determinant of the decision to stay and complete their study related to the impact of financial costs on themselves and their families. Although support from family, friends, peers, and the education provider were important, participants stated that their goal setting and desire to achieve were critical to their completition of the programme. For us in the Faculty we believe that a major indicated theme is that we need to be more involved in the pastoral care of our students.

The negative influence of significant others on high academic achieving school pupils' choice of nursing as a career - Corrected Proof

Gavin R. Neilson, Jim McNally — 2012-04-05

Summary: The International Council of Nurses proposes that the shortage of nurses is global in scale and is expected to become much worse in the years ahead. A major factor impacting on the worldwide nursing shortage is the diminishing number of young people choosing nursing as a career ().One important dimension of the school pupils' career choice process is their interactions with significant others and the influence of these significant others (Hodkinson and Sparkes, 1997).As Schools/Departments of Nursing endeavour to attract more intellectual school leavers it is important to examine what advice and opinions are significant others giving regarding nursing as a career choice and how influential is this advice.This paper is based on interview data from 20 high academic achieving 5th and 6th year school pupils in Scotland, paradigmatic cases from a larger sample, who had considered nursing as a possible career choice within their career preference cluster, but then later disregarded nursing and decided to pursue medicine or another health care profession. The data was particularly striking in revealing the negative influence of significant others on high academic achieving school pupils' choice of nursing as a career. The influence of significant others, these being specifically parents, guardians, guidance teachers and career advisors was very apparent in the data in that they had a very negative view regarding nursing as a career choice for high academic achieving school pupils.

Perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a RN-to-BSN program - Corrected Proof

Chiu-Yueh Hsiao, Shu-Hsin Lee, Suh-Jen Chen, Shu-Chin Lin — 2012-04-05

Summary: Background: Advances in genetics have had a profound impact on health care. Yet, many nurses, as well as other health care providers, have limited genetic knowledge and feel uncomfortable integrating genetics into their practice. Very little is known about perceived genetic knowledge and clinical comfort among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program.Objectives: To examine perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program and to assess how genetics has been integrated into their past and current nursing programs. The study also sought to examine correlations among perceived knowledge, integration of genetics into the nursing curriculum, and clinical comfort with genetics.Design: A descriptive, cross-sectional study.Settings: Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program were recruited.Methods: A total of 190 of 220 nurses returned the completed survey (86.36% response rate). Descriptive statistics and the Pearson product–moment correlation were used for data analysis.Results: Most nurses indicated limited perceived knowledge and clinical comfort with genetics. Curricular hours focused on genetics in a current nursing program were greater than those in past nursing programs. The use of genetic materials, attendance at genetic workshops and conferences, and clinically relevant genetics in nursing practice significantly related with perceived knowledge and clinical comfort with genetics. However, there were no correlations between prior genetic-based health care, perceived knowledge, and clinical comfort with genetics.Conclusions: This study demonstrated the need for emphasizing genetic education and practice to ensure health-related professionals become knowledgeable about genetic information. Given the rapidly developing genetic revolution, nurses and other health care providers need to utilize genetic discoveries to optimize health outcomes.

Responsibilities of nursing schools with regard to peer mentoring - Corrected Proof

Yvonne Botma, Sarene Hurter, Reneé Kotze — 2012-04-05

Summary: This article reports on the postgraduate critical care students' mentoring of the third-year undergraduate nursing students during integrated work-based learning in the critical care units. The purpose of the research was to describe what the nursing school could do to improve this mentoring programme. A qualitative descriptive design was used. The nominal group technique was used to gather data from the mentors and mentees. Data from the groups were combined and qualitatively analysed into themes. Thereafter the themes were quantitatively ranked. The themes, ranking from the highest to the lowest, were orientation, organisation, mentoring process, characteristics of the mentor, and feedback to the mentor. Findings suggest that the nursing school does not always optimally support the mentoring programme. It is recommended that more than one communication medium be used to disperse information among role-players. Nursing schools should develop mentors, monitor their interactions with mentees and give them feedback on their mentoring skills. It is also the responsibility of the nursing school to select mentors that match the desired profile of mentors.

A study of emotion work in student paramedic practice - Corrected Proof

Angela Williams — 2012-04-05

Summary: Student paramedics are exposed to the harsh reality of paramedic practice early within preregistration education (British Paramedic Association (BPA) 2006). Active involvement in the emergency assessment, management and treatment of potentially life threatening and traumatic incidents involves exposure to human suffering, pain, trauma and death. Managing their own and others' emotions would appear to be integral. There is however, a paucity of research evidencing the emotional aspects of paramedic practice and none which specifically captures the student perspective.A qualitative, exploratory design and semi-structured interviews were undertaken with eight second year undergraduate paramedic science students to explore their perceptions and experiences of emotion work and the strategies used to deal with it. Thematic content analysis revealed three main themes, ‘getting on with the job’, ‘struggling with emotion’ and ‘talking it through’. This paper presents the findings on the first two themes.Emergency resuscitation and getting on with the job emerged as a priority in a number of the experiences and subthemes included control and suppression of emotion, ‘got to deal with it’ and ‘don't see them as a person’. Students struggled to deal with patients' and relatives' emotions and their own in some situations and subthemes included ‘not sure of what to say’, ‘stop myself crying’, and ‘personal links’. The findings provide evidence of the emotional demands of student paramedic practice and have important implications for the curriculum content which must prepare and support students to perform emotion work effectively.

Using a critical reflection process to create an effective learning community in the workplace - Corrected Proof

Rachel Walker, Marie Cooke, Amanda Henderson, Debra K. Creedy — 2012-03-29

Summary: Learning circles are an enabling process to critically examine and reflect on practices with the purpose of promoting individual and organizational growth and change. The authors adapted and developed a learning circle strategy to facilitate open discourse between registered nurses, clinical leaders, clinical facilitators and students, to critically reflect on practice experiences to promote a positive learning environment. This paper reports on an analysis of field notes taken during a critical reflection process used to create an effective learning community in the workplace. A total of 19 learning circles were conducted during in-service periods (that is, the time allocated for professional education between morning and afternoon shifts) over a 3month period with 56 nurses, 33 students and 1 university-employed clinical supervisor. Participation rates ranged from 3 to 12 individuals per discussion. Ten themes emerged from content analysis of the clinical learning issues identified through the four-step model of critical reflection used in learning circle discussions. The four-step model of critical reflection allowed participants to reflect on clinical learning issues, and raise them in a safe environment that enabled topics to be challenged and explored in a shared and cooperative manner.

Supporting rural/remote primary health care placement experiences increases undergraduate nurse confidence - Corrected Proof

Paul Bennett, Debra Jones, Janie Brown, Veronica Barlow — 2012-03-27

Summary: This paper reports on the analysis of data from undergraduate nursing students who participated in the Primary Health Care Intensive Programme (PHCIP) in far west New South Wales between 2006 and 2008. This analysis looks specifically at pre/post confidence levels of participants in relation to their grasp of underlying principles associated with primary health care practice and Indigenous health care delivery. Bachelor of nursing curricula remains heavily weighted towards acute care in large metropolitan facilities however; universities actively seek clinical fieldwork experiences in rural/remote and Indigenous communities for their students. The PHCIP was developed and delivered through the Broken Hill University Department of Rural Health, University of Sydney, and sought to address the disparity in student preparedness for practice in these settings through the provision of a structured and educational rural and remote clinical placement experience. Pre/post questionnaires, focus groups and three month post-placement phone interviews provided data on levels of participant confidence in the areas of primary health care delivery and culturally knowledgeable practice. This study indicates that structured preparation for practice, underpinned by authentic learning experiences and aligned with comprehensive education programmes can have a positive impact in the areas of skills, knowledge and attitudes and enhance the confidence of undergraduate nurses undertaking clinical placements in these settings. These findings are relevant to contemporary nursing education and evolving models of health care delivery for rural and remote communities.

The clinical teaching preference questionnaire (CTPQ): An exploratory factor analysis - Corrected Proof

Brett Williams, Lisa McKenna, Jill French, Simon Dousek — 2012-03-26

Summary: Background: Peer assisted learning is growing internationally as a beneficial pedagogical strategy in health care and tertiary education. Therefore having instruments such as the Clinical Teaching Preference Questionnaire (CTPQ) with strong measurement properties to use in educational research is vital.Objectives: To investigate the factor structure of the CTPQ when completed by a group of respondents from a large Australian university.Methods: Data from the CTPQ completed by first year undergraduate nurses were analysed with a factor analysis using a Principal Axis Factoring (PAF) with Oblique Oblimin rotation.Findings: A total of (n=265) first year undergraduate nursing students participated in the study. The vast majority of the participants were female 89% (n=236) and aged between 17 and 21years of age 74% (n=197). Factor analysis of the 10 items revealed two factors with eigenvalues above 1, accounting for 68.3% of the total variance. Items with loadings greater than±.30, with the factor in question, were used to characterise the factor solutions.Conclusions: Findings from the exploratory factor analysis provide preliminary results that the CTPQ has adequate construct validity and reliability. This offers those involved in peer-assisted teaching and learning with a practical and usable instrument.

What are reasonable expectations? Healthcare student perceptions of their programmes in the North West of England - Corrected Proof

Claire Hamshire, Thomas G. Willgoss, Christopher Wibberley — 2012-03-23

Summary: Background: Concerns about current levels of attrition from some healthcare programmes have emphasised the need to gain a greater insight into students' expectations and experiences.Objectives: The aim of this study was to determine how students in the North West of England perceived their studies and to identify the factors that could contribute to students' dissatisfaction.Design: A mixed methods sequential exploratory study.Settings: Nine universities in the North West of England.Methods: Phase one used narrative interviews with a purposive sample of 24 students to investigate their expectations and experiences. Data from these interviews were analysed using a thematic framework and direct quotes from key themes were incorporated into online survey for phase 2. Survey respondents were asked to rate their agreement to statements on a four-point Likert-type response format. There was also an opportunity to leave comments through open questions relating to each theme.Results: A total of 1080 respondents completed the online survey in phase 2. The majority of students reported positive experiences of their course. There was strong agreement in the importance of the role of the personal tutor and of a supportive placement mentor. Some students indicated that the workload and academic level were a shock at first. Students identified difficulties around the cost of placement travel and the impact of placements on family life. Financial hardship was a frequently cited issue that students attributed to thoughts of discontinuation.Conclusions: Most students had positive learning experiences which meet their expectations. Students who have unmet expectations report poor placement experiences, lack of support, unexpectedly high workloads and financial difficulties. Clear guidance on the role of personal tutor and placement mentor is recommended.

Clinical placement and case study methodology: A complex affair - Corrected Proof

Frank Donnelly, Rick Wiechula — 2012-03-21

Summary: Clinical placement is a valuable component of nursing education, helping students to authenticate, integrate and develop a range of nursing skills and knowledge. The diversity of nursing curricula throughout the world and the many models of clinical placement make this a difficult subject to research using typical qualitative and quantitative research methodologies. The potential for case study methodology to address the complexity of learning in the clinical environment is significant. This paper argues that Complexity Theory provides an interpretive paradigm that articulates well with case study methodology. This paper also provides an example of the development of a theoretical proposition based on pattern matching. Pattern matching is an approach to data analysis that encourages a consideration of predicted patterns with those that are empirically based.

It's not my fault: Understanding nursing students' causal attributions in Pathophysiology - Corrected Proof

Karee E. Dunn, Cara Osborne, Glenda C. Rakes — 2012-03-19

Summary: Pathophysiology is a difficult subject matter for many nursing students. This course is also critical for safe clinical practice. However, little research has explored what variables may influence nursing students' success in this course. This study is the first in a forthcoming series that seeks to better understand how to facilitate student success in Pathophysiology. In this study, students' causal attributions for successes and failures were explored as these attributions greatly influence future academic motivation and behavior. Students were asked to respond to two open-ended questions in order to better understand what causal attributions students were making for their successes and failures in Pathophysiology. Seventy-five Bachelor of Science in Nursing students who were enrolled in Pathophysiology returned their responses (92.6% response rate). Content analysis was utilized to determine whether students were making internal or external causal attributions for their successes and failures. Additionally, responses were evaluated in order to identify common themes shared by respondents. The majority of respondents (84%) attributed their academic successes in Pathophysiology in part to internal causes, and the majority of respondents (68%) attributed their academic failures, in part, to external causes. In this study the majority of students attributed their successes to controllable, unstable causes—primarily effort. Research indicates that attributing success to effort may reflect that students' confidence in their abilities is suffering, and that attributing failures to external causes, such as task difficulty, are also detrimental to performance and learning (). The results of this study are further presented and discussed.

The structure of stress: Confirmatory factor analysis of a Chinese version of the stressors in Nursing Students Scale (SINS) - Corrected Proof

2012-03-19

Summary: Background: Stress is a feature of the life of nursing students and this had been well studied. However, there are very few instruments to measure stress in nursing students specifically. One such instrument, the Stressors in Nursing Students Scale has been developed in Scotland and applied in studies in Hong Kong and Australia and proved useful alongside other measures of individual differences and psychological distress.Objectives: To translate the Stressors in Nursing Students Scale into Chinese, test it with Chinese nursing students and explore the psychometric structure of stress in this population.Design: Cross-sectional survey using a self-administered questionnaire.Setting: A large teaching hospital in Southwest Mainland China.Participants: Nursing students (n=1090) participated (1000 in the classroom and 90 on clinical placement); 862 from the classroom and 79 from clinical placements returned questionnaires (n=914) representing a return rate of 86.3%.Methods: Principal component analysis and confirmatory factor analysis using structural equation modelling.Results: A four-factor structure was obtained from principal component analysis. This was confirmed (fit indices>0.9 and RMSEA<0.06) using structural equation modelling. The stress-related factors were: Clinical (0.83), Finance (0.81), Confidence (0.82), and Education (0.70).Conclusions: The original structure of the SINS in English was confirmed in this large sample of Chinese nursing students. This will allow cross-cultural studies of stress in nursing students.

Corrected Proof

Elsie Tan — 2012-03-14

I found this updated fourth edition on basic essentials to effective teaching in nursing refreshing and pragmatic. The authors, with 50years of combined experience in nursing education, identified this as a “hands-on” book with intent to “avoid a theoretical approach.” In my view, the book serves as an effective resource for novice nursing educators. The 14 chapters encompass clinical and classroom teaching, course evaluation, grading designs, and improvements in student writing skills. I also regard this book as having utility as a reference for seasoned educators because it provides updated teaching information.

Delegating and supervising unregistered professionals: The student nurse experience - Corrected Proof

Felicity Hasson, Hugh P. McKenna, Sinead Keeney — 2012-03-14

Summary: Background: Changing models of healthcare have resulted in the need for registered nurses to be competent in delegating and supervising the unregistered health care assistant. However research evidence suggests nurse education does not prepare students for the practicalities of this role.Objectives: This paper reports on undergraduate student nurses' level of preparation when working with health care assistants (HCA). It is part of a large scale project, undertaken between 2005 and 2011, which explored pre-registration student nurses' perceptions of the role of the HCA and how this affects their clinical learning.Design: A sequential transformative mixed method research design was adopted.Setting: One higher educational institution in the United Kingdom.Participants: Forty-five pre-registration nursing students took part in phase one and 662 participated in phase two.Methods: Phase one used focus groups (n=32) and interviews (n=13) and phase two used a semi-structured questionnaire.Results: Whilst most students reported that they were familiar with the role of the health care assistant, findings showed that nurse training did not initially prepare students for the realities of clinical practice, however as students progressed they became more aware of such issues. For some such skills were learnt on the job and they identified a number of barriers they faced when delegating tasks such as fear of causing conflict. Overall the lack of initial preparation was perceived by participants to be a hindrance to meeting the goals of clinical learning and to understanding the dynamics within the nursing hierarchy.Conclusions: Students in this study highlighted gaps in their educational programme and clinical experiences regarding their preparation for a delegatory and/or supervisory role. Given the importance of such skills, it is imperative that universities provide pre-registration student nurses with the education necessary to develop delegation strategies and to adapt to their evolving professional role.

An evaluation of nursing students' communication ability during practical clinical training - Corrected Proof

Jianfei Xie, Siqing Ding, Chunmei Wang, Aizhong Liu — 2012-03-14

Summary: Objectives: To investigate communication abilities and other influential factors on nursing students at the beginning of clinical practical session.Methods: A cluster sample of 312 nursing students from 22 nursing colleges or universities was recruited. Communication ability of these participants was evaluated by 4 questionnaires for demographic data, clinical communication behavior, treatment communication skills and interpersonal communication skills at the beginning of clinical practical session.Results: The stability and accuracy of the questionnaires were established with an overall content validity index of 0.78, the Cronbach's Alpha index ranged from 0.872 to 0.951, and the letter index fluctuates from 0.85 to 0.89. Results demonstrated that 88.1% of the nursing students require extra training in clinical communication behavior, treatment communication skills, and interpersonal communication skills. The Pearson analysis revealed significantly positive correlations between communication abilities and the students' educational level, clinical training experience, living circumstances and number of siblings.Conclusion: Most nursing students need communication skill training. Multiple factors, including educational level, living circumstances, number of siblings, and training experience significantly affect nursing students' communication abilities. Our study suggested a need to widely establish a communication course or clinical communication training program to improve nursing students' communication skills.