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Nurse Education Today
Journal Prestige (SJR): 1.154
Citation Impact (citeScore): 2
Number of Followers: 172  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0260-6917
Published by Elsevier Homepage  [3177 journals]
  • Cyber-incivility, cyber-bullying, and other forms of online aggression: A
           call to action for nurse educators
    • Abstract: Publication date: Available online 29 November 2019Source: Nurse Education TodayAuthor(s): Cynthia M. Clark, Susan Luparell
  • Simulation realism, contextual fidelity, and unintended lessons
    • Abstract: Publication date: Available online 27 November 2019Source: Nurse Education TodayAuthor(s): Cheryl McFaden
  • The perceived importance of soft (service) skills in nursing care: A
           research study
    • Abstract: Publication date: Available online 22 November 2019Source: Nurse Education TodayAuthor(s): Lee Keng NgAbstractNursing education has transformed over time. While this is particularly evident in the integration of technology in pedagogy, it is not evident whether the training of soft (service) skills has also evolved effectively. Though soft (service) skills are much less tangible than technology, they are perennially relevant and important for nursing care which is essentially people-oriented.This study in Singapore was conducted to understand how soft (service) skills were being perceived by patients and their family members. Literature review on nursing pedagogy was augmented by a survey that collected the perceptions with regard to soft (service) skills in nursing care; namely, the dimensions of reliability, assurance, tangibles, empathy and responsiveness.Based on quantitative data, patients and family members rated the soft (service) skills of reliability and responsiveness to be highly important for nursing care. Additionally, the participants' qualitative comments pointed toward the importance of empathy, assurance and responsiveness. The conclusion was that besides knowledge acquisition and technical competency, nursing curriculum could explicitly incorporate more soft (service) skills to enhance the care standard.
  • Mobile apps: An effective, inclusive and equitable way of delivering
           patient and nurse education'
    • Abstract: Publication date: Available online 22 November 2019Source: Nurse Education TodayAuthor(s): Teresa E. Stone, Yue Jia, Wipada Kunaviktikul
  • Actual and perceived knowledge of type 1 diabetes mellitus among school
    • Abstract: Publication date: Available online 22 November 2019Source: Nurse Education TodayAuthor(s): Ewa Kobos, Jacek Imiela, Tomasz Kryczka, Alicja Szewczyk, Barbara KnoffAbstractBackgroundIn general, school nurses are aware that it is important to have knowledge of type 1 diabetes to give adequate care to children with the disease. Many studies assessing diabetes knowledge have found different deficits among nurses. To our knowledge, however, no study has assessed the knowledge of type 1 diabetes among school nurses.ObjectiveTo assess actual and perceived diabetes knowledge among school nurses.DesignCross-sectional studies.SettingsSeventeen primary care facilities in Warsaw that employed school nurses.ParticipantsTwo hundred and thirty school nurses.MethodsWith the Diabetes Knowledge Questionnaire (DKQ), we assessed actual diabetes knowledge. With the Self-Assessed Diabetes Knowledge (SADK), we assessed perceived diabetes knowledge. Both the DKQ and SADK assessed seven domains of diabetes knowledge: general diabetes knowledge; insulin and glucagon; insulin pumps; diabetes complications; nutrition; physical activity, stress, and comorbidities; and glycemia measurements. We related DKQ and SADK scores to each other and to sociodemographic and work-related factors.ResultsThe rate of correct responses in the DKQ was 46.7%, with the lowest rate regarding knowledge of insulin pumps (36.5%), nutrition (37.4%), and insulin and glucagon (37.9%). Actual and perceived diabetes knowledge were moderately positively correlated (rho = 0.18,p = .009). In six of the seven knowledge domains examined, school nurses perceived their diabetes knowledge better compared with their actual knowledge. DKQ scores were higher in nurses with higher education (p = .024), those who had relatives or friends with diabetes (p = .032), and those who had prior diabetes training (p = .050). Interestingly, DKQ scores were higher among nurses with fewer years of experience (rho = − 0.18, p = .011).ConclusionsThere is a need for additional diabetes training among nursing students and practicing nurses to provide safe and effective care for children with type 1 diabetes.
  • ‘InUTERO’: The effectiveness of an educational half day stillbirth
           awareness workshop for maternity care providers
    • Abstract: Publication date: Available online 22 November 2019Source: Nurse Education TodayAuthor(s): Jane Warland, Jillian Dorrian, Danielle Pollock, Claire FoordAbstractBackgroundThere is a disconnect between what maternity care providers consider should be done and what they actually do with respect to talking with their pregnant clients about reducing their risk of stillbirth. This suggests that they would benefit from receiving up-to-date knowledge about stillbirth, alongside education that provides them with strategies for talking about stillbirth with pregnant women.ObjectivesTo gain an understanding of maternity care provider (obstetricians and midwives) knowledge of stillbirth and determine whether delivering a half day workshop improves knowledge and results in intention to change practice.DesignA pre-post intervention study.SettingMaternity care providers (Obstetricians, Midwives) working in the northern areas of Tasmania, Australia were asked, via questionnaire, about their knowledge of stillbirth both before and after attending a half-day workshop.ParticipantsMaternity care providers (n = 51) attended the workshop and 30 (59%) completed both the pre-workshop and post-workshop surveys.MethodsA four hour interactive workshop grounded in understanding the stillbirth experience. Participants were given up-to-date information about stillbirth risks and current prevention research as well as provided with an actionable step wise approach to talking about stillbirth prevention in pregnancy.ResultsStillbirth knowledge scores (total of 8-points) significantly increased following the workshop (pre: mean = 2.9 ± 1.5; post: mean = 4.7 ± 1.4 points, t 29 = 7.9,
  • How do nurses acquire English medical discourse ability in nursing
           practice' Exploring nurses' medical discourse learning journeys and
           related identity construction
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Yi-Ling LuAbstractBackgroundIn Taiwan's hospitals, English medical discourse underpins nursing and medical practice. Much patient care work is done through language work, by both text and talk. This means that when nurses start their nursing careers in the hospital context, where English medical discourse is shared to produce knowledge and engage in practice, knowledge of medical discourse and the ability to use it are prerequisites. In the process of learning and using such specialist language, the formation of professional identities is assumed.ObjectivesThis study aimed to explore nurses' learning journeys relating to medical discourse and the development of their professional identities.MethodsThis research adopted a qualitative approach, using data from 10 nurses working in different hospitals in Taiwan.ResultsThe findings revealed that English medical discourse is employed in Taiwan's hospitals not only for fulfilling professional purposes but also for socialising nurses into the healthcare community. Nurses acquired it through interactions, small talk, relationships, discussions, and nursing tasks. Their professional identities were formed through engaging in meaningful nursing practice based on English medical discourse. However, in the learning process, they encountered difficulties in the areas of listening, speaking, and reading, which raised concerns about patient safety.ConclusionSufficient support is needed to ease nurses' difficulties in learning. We propose having primary and secondary preceptors, establishing a mentorship policy, and creating a learning environment that is supportive of nurses' learning experiences.
  • Developing Korean nursing students' global health competencies: A mixed
           methods approach to service learning in rural Vietnam
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Sangeun Lee, Junghee Kim, Jong gun Kim, Truong Duc Tu, Bừi Thi Thanh Loan, Hyeonkyeong LeeAbstractBackgroundOwing to globalization, there is a need for enhanced global health competencies among nursing students. In this context, global service learning programs are important opportunities for nursing students.ObjectivesTo explore the effect of a short-term service learning program in a developing country on the global health competencies of students attending a South Korean nursing college.DesignA mixed methods design.SettingThe Global Nursing Internship is a two-week pre-experience, eight-day on-site, and one-week post-experience program.ParticipantsThe on-site activities involved 15 nursing students participating in global health activities in a rural Vietnamese community.MethodsA self-reported questionnaire was used to assess changes in global health competencies in six domains, measured on a four-point Likert scale. Student satisfaction with each activity was measured on a five-point Likert scale. After completing the program, the participants wrote a self-reflection essay. The Wilcoxon signed rank test was used to analyze global health competencies, and content analysis was used to analyze participants' self-reflections.ResultsRegarding global health competencies, the overall mean score showed a significant increase at the post-program evaluation (Z = −3.41, p = .001). A pre-post-program comparison showed that the health care in low-resource settings domain displayed the greatest increase in scores. The mean overall satisfaction with the program was high (mean = 4.31, standard deviation = 0.17). In the students' view, as expressed in their essays, their global health knowledge and attitude had improved.ConclusionsThe program was useful in promoting global health competencies, empathy, and confidence and should be embedded among the essential requirements of nursing curricula. Suggestions are provided to develop an enhanced pre-experience program that could help students prepare better for on-site activities. As cultural competency is crucial for nurses, nursing educators should consider integrating similar global service learning programs into their existing nursing curricula.
  • Nursing students' emotions evoked by the first contact with patient's
           body: A qualitative study
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Letizia Dal Santo, Elisa Ambrosi, Michela Maragna, Oliva Marognolli, Federica CanzanAbstractProviding personal care is one of the most significant activities of nursing care. Nursing students, who approach the patient's body for the first time, may experience a wide range of emotions, affecting their attitude toward the nursing profession and performance. Nevertheless, the emotional aspects related to providing personal care in nursing education have remained relatively neglected. A qualitative descriptive study was performed to describe the emotions felt by first-year nursing students when providing personal care and to analyze the situations which triggered their emotions. First-year students (N = 145) were asked to narrate episodes of body care evoking both positive and negative emotions. Emotions were analyzed according to Damasio's theory while trigger situations were inductively found through a content analysis. Our results show that first-year nursing students experienced mostly social emotions, with a significant triggering role played by patients. In most of the narratives, patients were seen as a source of (un)recognition and personal (un)satisfaction. In this pattern, the patients play a fundamental role in supporting their confidence. Providing emotional education and peer discussion/sharing may facilitate the ability of nursing students to become aware of their own feelings and to be focused on patient's needs.
  • Knowledge, attitudes and prejudices of nursing students about the
           provision of transcultural nursing care to refugees: A comparative
           descriptive study
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Betül Tosun, Ozlem SinanAbstractObjectivesThe aim of this study was to determine the knowledge, attitudes, and prejudices of nursing students regarding the provision of transcultural nursing care to refugees.MethodsThe sample of this comparative descriptive study was composed of 317 volunteering nursing students living in Ankara, Turkey. Descriptive statistics were presented as number, percentage, and mean ± standard deviation. The relationships among dependent and independent variables were analyzed with Pearson chi-square test. p ≤ 0.05 was accepted as statistically significant.ResultsThe mean age of the students was 21.19 ± 1.66 years; 88.6% were female. Only 30.0% (n = 95) of students (predominantly seniors) were educated on transcultural nursing. Statistically significant differences were found among grades of nursing students on the answers to the items, “Refugees are under coverage of general medical insurance system,” “The concept of ‘Health’ differs from culture to culture,” “Cultural features of the patient are important for caring nurse,” “In order to provide care to only refugees and foreign patients, nurses from other cultures should be employed in hospitals,” “Interpreters should be employed in hospitals 24 hours for services for refugees,” and “According to my observations, refugees and their relatives admitted to the hospital are not respecting the healthcare workers and hospital rules.” In addition, there was a statistically significant difference in students' comfort level with nursing care activities between those students who were literate in a foreign language and those who were not literate in a foreign language.ConclusionsOur findings show that attending lectures on transcultural nursing in a curriculum of seniors and being literate in a foreign language had a positive impact on the attitudes of students in terms of the provision of medical care to refugees. It is recommended that nursing programs integrate lectures on transcultural nursing into the curricula of all four grades of nursing education and encourage students in language learning to better serve our disadvantageous guests.
  • Collaborative Learning in Practice (CLIP): Evaluation of a new approach to
           clinical learning
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Rebekah Hill, Michael Wooward, Antony ArthurAbstractBackgroundThere are challenges in creating positive clinical learning environments. A new model of practice learning for pre-registration nurse education was pilot-tested in the East of England. The Collaborative Learning in Practice model (CLIP) was developed from a similar model of practice learning used in the Netherlands.ObjectivesWe undertook an evaluation of a new approach to clinical learning. The aims of the project were to consider the challenges of implementation; consider the perception of gains and losses of students and stakeholders experiencing the new model of practice learning; and consider the sustainability of the new model in the context of service delivery.MethodsMixed methods were used. Data were collected in three forms: (1) a survey of students undertaking the CLIP model and those learning within the existing mentorship model to assess the supervisory relationships and pedagogical atmosphere experienced; (2) student focus groups; and (3) qualitative one-to-one interviews with key stakeholders in the provision of practice learning environments.ResultsA total of 607 questionnaires were returned out of the 738 distributed, five focus groups of a total of 30 students were undertaken, and 13 stakeholders were interviewed. Students who had experienced CLIP reported lower supervisory relationship scores compared with those without experience (mean difference = −0.24 points, 95% CI −0.21 to −0.094, p = 0.001). There was no difference in pedagogical atmosphere scores (mean difference −0.085 points, 95% CI −0.21 to 0.040, p = 0.19). Analysis of qualitative data produced two themes: ‘Adapting the environment’ illustrated the importance of learning context and ‘learning to fly’ highlighted the process of students gaining greater autonomy.ConclusionOur findings suggest that collaborative learning in practice offers many benefits as an approach to clinical learning but with important caveats. Attention needs to be paid to particular aspects of the model such as sufficient numbers of students, and an acknowledgement of perceived losses as well as gains.
  • To evaluate the effect of challenge-based learning on the approaches to
           learning of Chinese nursing students: A quasi-experimental study
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Anson C.Y. Tang, Meyrick C.M. ChowAbstractChallenge-based learning (CBL) is a learner-centred, experimental learning strategy that aims to prepare students to manage unforeseeable and complex global issues in the 21st century. It cultivates an active and authentic learning environment that requires students' creative input, collaboration and community involvement. Studies in the past decade have shown that CBL strengthens soft skills essential for future society, such as critical thinking and creativity. However, its effect on students' metacognitive abilities is scarcely mentioned. This study – a quasi-experimental study with non-equivalent groups conducted in a self-financing tertiary institution in Hong Kong – aims to evaluate the effect of CBL on approaches to learning among nursing students. First-year students in the nursing programme who attended a nursing course using CBL were recruited for the intervention group and senior year-one students were included in the control group. Their approach to learning was measured by the Revised Two-Factor Study Process Questionnaire administered at the beginning and at the end of the semester. Analysis of Covariance (ANCOVA) was used to compare the mean difference in scores of deep and surface approaches between the groups. A total of 209 participants were recruited, with 130 in the intervention group and 79 in the control group. The response rates were 65.3% (130/199) and 78.2% (79/101) for the intervention and control groups, respectively. In the intervention group, the mean post-test deep approach score was significantly higher than the pre-test score (F = 5.2, p = 0.023), even though it had only a small effect. There was no statistically significant difference in baseline post-test mean surface scores (F = 2.4, p = 0.125). The results of this study indicate that CBL may facilitate deep learning in nursing students.
  • Effects of a simulation-based education program for nursing students
           responding to mass casualty incidents: A pre-post intervention study
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Jina Kim, Ogcheol LeeAbstractBackgroundThe necessity of disaster preparedness among nursing students has been continuously emphasized.ObjectivesThis study aimed to verify the effectiveness of a simulation-based education program for nursing students responding to mass casualty incidents (MCI) from the perspectives of triage accuracy, response attitude, teamwork, and program satisfaction.DesignThis study employed a pre-post intervention design.SettingsDisaster Simulation Lab and a debriefing room in the University Nursing Simulation Center in South Korea.ParticipantsThe participants were 34 graduating nursing students attending a university in Seoul.MethodsThe program consisted of lectures on disaster nursing, group discussions, practice, debriefings, and a pre- and post-test, conducted over 180 min. Simulation-based training was conducted using the Emergo Train System®. The simulation environment comprised pre-hospital and hospital sections, with videos displayed on a large screen and sound effects played on loudspeakers.ResultsParticipants were likely to undertriage. There was a significant increase in positive attitudes after the intervention (p 
  • Development and psychometric properties of student perceptions of an
           online course (SPOC) in an RN-to-BSN program
    • Abstract: Publication date: Available online 21 November 2019Source: Nurse Education TodayAuthor(s): Joohyun Chung, Hsiu-Chin ChenAbstractBackground and purposeDespite the rapid growth in offering online RN-to-BSN programs, limited information is available on student perception of online courses. The aims were to develop and to evaluate Student Perceptions of an Online Course (SPOC) scale.MethodsA quantitative study using a two-phase methodological design was applied. A convenience sample of 201 RN-to-BSN students was used to establish internal consistency and evidence of validity including exploratory factor analyses.ResultsThree factors of student engagement, organization, and resources were verified. The overall SPOC had high reliability with Cronbach's alpha =0.98.ConclusionsThe SPOC is valid and reliable. It can be used in research and quality assurance/improvement work on the delivery of online nursing education.
  • “If somebody just showed me once how to do it”: How are workplace
           cultures and practice development conceptualised and operationalised for
           early career nurses'
    • Abstract: Publication date: Available online 16 November 2019Source: Nurse Education TodayAuthor(s): Karen Daws, Katherine McBrearty, Deborah BellAbstractBackgroundAn imminent nursing shortage mandates attention to retention of early career nurses. One factor that impacts on intention to stay in the profession is the ability to do the work. Early career nurses rely on supportive cultures to develop the practical skills and knowledge specific to particular workplaces.ObjectivesThis study was conducted to determine the impact of workplace culture on practice development for early career nurses.MethodsWe undertook a qualitative study using semi structured interviews conducted with eleven early career nurses at a single metropolitan hospital in Melbourne, Australia. Interviews were transcribed verbatim and analysed using thematic analysis techniques.ResultsThemes identified were learning in the moment, active welcome, confidence, ambiguities in the culture of learning, bullying and navigating the space.ConclusionsEarly career nurses conceive practice development as the acquisition of skills and knowledge particular to the immediate needs of their patients, which they learnt by asking questions. Developing confidence was integral to all aspects of practice development. Complexity and risk on the wards could negatively impact on confidence. Where welcome was explicit and overt the nurses felt that practice development was facilitated. Transition to practice programs supported nurses and some individual nurses were active in assisting nurses to develop. However, workplace cultures were at times indifferent to the learning needs of the early career nurses and some experienced poor workplace behaviour and bullying.
  • Anxiety among nursing students during their first human prosection
    • Abstract: Publication date: Available online 15 November 2019Source: Nurse Education TodayAuthor(s): Carmen Romo Barrientos, Juan-José Criado-Álvarez, Alberto Martínez-Lorca, Antonio Viñuela, Jose-Luis Martin-Conty, Daniel Saiz-Sanchez, Alicia Flores-Cuadrado, Isabel Ubeda-Bañon, Beatriz Rodriguez-Martín, Alino Martínez Marcos, Alicia Mohedano-MorianoAbstractDissection and prosection practices using human cadavers are a key component of macroscopic anatomy education in different Health Sciences university degrees. However, first-hand interaction with cadavers can be distressing for students, generating anxiety on a number of levels. This study aims to shed light on the reactions, fears and different states of anxiety experienced by nursing students in to a single anatomy room experience over a five-hour period, and examined reactions pre and post same.A descriptive study of these students was designed in order to understand their feelings and emotions, based on the distribution of anonymous “ad hoc” questionnaires before and after the practices. Also, State-Trait Anxiety Inventory (STAI) questionnaires were administered in order to assess their anxiety levels: Trait Anxiety (TA), which measures basal anxiety levels, and State Anxiety (SA), which measures individual emotional responses during a specific event (in this case, the prosection practice). The results of this study indicate that basal anxiety levels, measured as TA, remained stable and unchanged during the practice (p > 0.05). SA or emotional anxiety levels, on the other hand, dropped from 21.3 to 17.8 points (p 
  • The effects of group mindfulness-based cognitive therapy in nursing
           students: A quasi-experimental study
    • Abstract: Publication date: Available online 14 November 2019Source: Nurse Education TodayAuthor(s): Arzu Yüksel, Emel Bahadır-YılmazAbstractBackgroundAcademic and clinical stressors are experienced by most nursing students enrolled in a nursing education program. The students who cannot effectively deal with these stressors experience stress, anxiety and depression.ObjectiveThe aim of this study was to determine the effects of group mindfulness-based cognitive therapy on mindfulness, depression, anxiety, and stress levels in nursing students.DesignThis quasi-experimental study was carried out using a nonrandomized control group pre-test, post-test, and follow up design.SettingDepartment of Nursing, Faculty of Health Sciences, University of Aksaray, Turkey.ParticipantsEighty-two second-year undergraduate university nursing students.MethodsThe group mindfulness-based cognitive therapy program was conducted with the experimental group. The Mindful Attention Awareness Scale (MAAS) and The Depression, Anxiety and Stress Scale (DASS) were measured at pre- and post- intervention, and at a 4-months follow-up.ResultsThe post-test mean scores of MAAS of the experimental group were statistically higher than the control group (p = .006). When the mean scores obtained in the pre-test, post-test and follow-up measurements were compared, the mean scores of MAAS increased (p = .000) and stress scores decreased significantly in the experimental group (p = .004).ConclusionA group mindfulness-based cognitive therapy program conducted with nursing students had an effect on students' mindful attention awareness and stress levels. These study results indicate that this program can be used to reduce the levels of stress in nursing students.
  • The cue-responding behavior of nurses to cancer patients: Implication to
           oncology nursing education
    • Abstract: Publication date: Available online 14 November 2019Source: Nurse Education TodayAuthor(s): Winsome Lam, Fiona Y. Wong, E. Angela Chan
  • Nurses' just-in-time training for clinical deterioration: Development,
           implementation and evaluation
    • Abstract: Publication date: January 2020Source: Nurse Education Today, Volume 84Author(s): Rick C. Peebles, Imogen K. Nicholson, Jordana Schlieff, Amanda Peat, David J. BrewsterAbstractBackground‘Just-in-time training’ is an innovative approach to nursing education. It has demonstrated positive outcomes in other industries, such as manufacturing and aviation, but it has limited published application in the acute-care setting.ObjectivesWe aimed to implement and evaluate a nursing ‘just-in-time training’ program for the recognition and response to patient deterioration.DesignTo promote consistency, one Clinical Deterioration Educator provided education to nursing staff in both recognising the need for escalation and providing subsequent care for the deteriorating ward patient. Nurses' perception of the ‘just-in-time training’ program was determined using electronic questionnaire responses. Medical Emergency Team call prevalence and outcome data was compared before and after the program implementation for further evaluation.SettingThe ‘just-in-time training’ program was implemented in a 508-bed acute metropolitan private hospital over a 12-month period. Education was provided in general medical and surgical wards, not specialty areas.ParticipantsNurses received the just-in-time training based on their patients' perceived risk of deterioration, therefore, participants are not randomised.MethodsA quantitative research study investigated nurses' self-perceived confidence after receiving just-in-time training. Medical Emergency Team call frequency data was also examined to identify trends.ResultsThe ‘just-in-time training’ program consisted of 534 bedside nursing encounters over 12 months. During the study, the need for the educator to recommend that nurses escalate care reduced in prevalence from 20% to 5.5%. Questionnaire responses demonstrated a self-perceived confidence following intervention of 4.32/5.0. Medical Emergency Team call prevalence, per 1000 patient bed days, increased from 13.6 pre-intervention to 15.4 post-intervention.ConclusionsJust-in-time training’ can be effectively implemented to educate ward nursing staff in recognising and responding to the deteriorating patient. The program is well received by nursing staff and leads to high self-perceived confidence to recognise and appropriately care for a deteriorating patient.
  • Use of a flipped classroom in ophthalmology courses for nursing, dental
           and medical students: A quasi-experimental study using a mixed-methods
    • Abstract: Publication date: Available online 7 November 2019Source: Nurse Education TodayAuthor(s): Li Zhu, Zhengmei Lian, Maria EngströmAbstractBackgroundTraditional teaching is associated with dilemmas, such as low motivation to learn and passive learning. In contrast, use of a flipped classroom with the proper learning design has the potential to promote accelerated learning, bolster transmission of competencies (i.e., critical thinking, communication and problem-solving skills) and improve teamwork capacity, all of which are of great significance in professional healthcare practice, including nursing, dentistry and medicine.ObjectiveThe aim of the study was to examine the effects of using a flipped classroom in ophthalmology courses for undergraduate nursing students, dental students and higher vocational medical students.DesignA quasi-experimental design was used with an intervention (n = 100) and a comparison group (n = 100), pre-/post-testing measures and a mixed-methods approach.SettingA university in China.ParticipantsA total of 200 students were included.MethodsStudents' self-rated learning ability was measured before and after the courses, and skill exams were performed after the courses. In addition, interviews were conducted with the clinical medical students concerning their experiences of the flipped classroom.ResultsStudents' self-rated learning ability improved significantly more in the intervention than in the comparison group, for the total scale and the three factors ‘learning goals’, ‘self-efficacy and social learning’ and ‘problem-solving’. Skill exam scores were statistically significantly better in the intervention than in the comparison group. On the whole, the clinical medicine students felt the flipped classroom had a positive impact and improved their learning ability as well as knowledge in ophthalmology.ConclusionsUse of a flipped classroom for nursing, dental and clinical medical students in ophthalmology courses shows promising results in the form of students' skill exam scores and self-rated learning ability.
  • Mobile community learning programme's effectiveness in case management for
           psychiatric nurses: A preliminary randomised controlled trial
    • Abstract: Publication date: Available online 6 November 2019Source: Nurse Education TodayAuthor(s): Wen-I Liu, Chien-Hung Liu, Chang-Ye Liao, Pei-Ru Chao, Kuo-Chung ChuAbstractBackgroundThe global health care system has applied case management (CM) as a care delivery service provided by nurses. Nurses require continuing education in CM to enhance their professional knowledge and competence. Mobile communities have been used to promote continuing education for medical professionals. However, limited studies have examined the effectiveness of such learning programmes in CM for psychiatric nurses.ObjectiveTo evaluate the effectiveness of a mobile community learning (MCL) programme in CM for psychiatric nurses.DesignThis study used an experimental two-group pre- and post-test design.Settings and participantsPsychiatric nurses employed in a psychiatric teaching hospital situated in northern Taiwan were recruited.MethodsNurses were randomly allocated to the experimental or comparison group. The former participated in the learning intervention in CM. The CM knowledge index and a competence scale were used to determine outcomes. Pre-tests and 2-month post-tests were conducted. The MCL programme comprised five simulated learning modules, self-assessment questions, learning cases, learning resources and experience sharing. A two-way repeated-measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes.ResultsThe questionnaires were completed by 48 participants. The two groups possessed high homogeneity with regard to characteristics and pre-test outcomes. Differences between the two groups regarding CM knowledge (F = 22.99, p 
  • Nurses and midwives teaching in the academic environment: An appreciative
    • Abstract: Publication date: Available online 6 November 2019Source: Nurse Education TodayAuthor(s): Lyn Ebert, Lyndall Mollart, Samantha J. Nolan, Elaine JeffordAbstractBackgroundThe past two decades has seen significant change in nursing and midwifery education in Australia. Although, regulatory documents explicate expectations of teaching, and supervising in the context of being a nurse or midwife, the move from hospital-based to higher education learning nessitated a change in how students receive their education and who provides it. The quality of teaching by nurse or midwife academics is subject to the academic's ability to transition from a clinical educator to academic.ObjectiveTo explore the experiences of nurse and midwife academics teaching in the academic environment.DesignAppreciative Inquiry (AI) was used to explore the experiences of academics teaching final year nursing and midwifery students.SettingTwo regional universities in Australia.ParticipantsSeven nursing and midwifery academics teaching a unit of study focusing on mentorship, leadership and teaching.MethodsNarrative data from interviews conducted using AI were collected, transcribed and analysed to produce themes.ResultsThree key themes were identified; ‘Feeling valued’, ‘Feeling safe’ and ‘Having connections’. These themes and related subthemes impacted teaching experiences and role transition from experienced clinician to academic.ConclusionNursing and midwifery academics would benefit from organisational support in their role transition from clinician to academic. Further research is crucial regarding initiatives that can support academics to feel safe, valued and connected when teaching the next generation of nurses and midwives.
  • Migration and mental health care: Identifying the cultural competency of
           Turkish nursing students
    • Abstract: Publication date: Available online 6 November 2019Source: Nurse Education TodayAuthor(s): Yeter Sinem Üzar-Özçetin, Steve Trenoweth, Stephen Tee
  • Impact of death education courses on emergency nurses' perception of
           effective behavioral responses in dealing with sudden death in China: A
           quasi-experimental study
    • Abstract: Publication date: Available online 6 November 2019Source: Nurse Education TodayAuthor(s): Huilin Zhang, Muli Hu, Liyun Zeng, Mingdan Ma, Lezhi LiAbstractBackgroundNurses in emergency departments have to provide rescue care and life support for moribund patients, but also emotional support to patients' relatives. On the other hand, emergency nurses are also the most vulnerable to the sudden death of patients. Nurses working in the emergency department were invited to participate in a death education course.ObjectiveTo explore the impact of a death education course on the emergency nurses' perception of effective behavioral responses in dealing with sudden death.DesignA quasi-experimental study.SettingsA level A tertiary general hospital in China.ParticipantsA total number of 34 emergency nurses who met the inclusion criteria were randomly selected from the emergency department.MethodsParticipants received a death education course of 20 credit hours based on dealing with a sudden-death model. The general data questionnaire and the Chinese version of the list proposed by Fraser & Atkins were completed before the intervention and six weeks post-intervention. The scores of each item in the effective behavioral response to the sudden death questionnaire of the emergency nurses before and after the intervention were compared.ResultsAfter the intervention, the nurses considered that 10 items were relatively helpful (above 4 points) and 2 items relatively less helpful (
  • Building therapeutic connections with the acutely ill through standardised
           patient simulation in nurse education an evaluation study
    • Abstract: Publication date: Available online 6 November 2019Source: Nurse Education TodayAuthor(s): Katherine E.F. Webster, Elisabeth CarlsonAbstractBackgroundPhenomenological empathy and sense of coherence are two researched communication approaches used to improve therapeutic connections with patients in a variety of nurse related settings. The aim of this study is to evaluate students' feedback concerning how this event has enabled that understanding, development and refinement of skill-sets in PE and SoC when managing the acutely ill during simulation.Methods114 third year bachelor degree-nursing students were given the opportunity to complete an evaluation, developed for the specific purpose of this study. The evaluation contained six closed questions on a four point Likert-scale and three open questions, handed out upon completion of the standardised patient simulation of the acutely ill. Comments written in response to the open questions were analysed using manifest content analysis and closed questions using SPSS to produce descriptive frequencies.Results100 students completed the evaluation. Student nurses', regardless of previous experience or age, indicated the need for more education and practice in phenomenological empathy and sense of coherence to enhance their ability to build therapeutic connections with the acutely ill.ConclusionsTeaching phenomenological empathy and sense of coherence, as an integral part of standardised patient simulation is necessary to motivate student nurses ability to build therapeutic relationships with the acutely ill to enhance person centred care.
  • Perspectives of minority nursing students on diversity in the classroom
    • Abstract: Publication date: Available online 5 November 2019Source: Nurse Education TodayAuthor(s): Jennifer Searle, Linh Ngo
  • Nurse academics' experience of contra-power harassment from under-graduate
           nursing students in Australia
    • Abstract: Publication date: Available online 5 November 2019Source: Nurse Education TodayAuthor(s): Martin Christensen, Judy Craft, Sara WhiteAbstractBackgroundThere is growing concern around inappropriate behaviour being perpetrated by under-graduate nursing students towards nursing academics. Coined contra-power harassment, is defined as the harassment of individuals in formal positions of power and authority by those that are not. The type of harassment behaviours reported include: verbal and physical violence, character assassination through social media, stalking and sexually motivated behaviours. The most often cited reasons for the escalation in these behaviours are seen with course progression and the awarding of grades.AimThe aim of this study is to better understand the extent to which nursing academics experience contra-power harassment from under-graduate nursing students.MethodA convenience sample of nursing academics were in Australia were contacted and provided with an introductory letter, a participant information sheet and a link to an online questionnaire. A 41-item Likert scale (Strongly agree-strongly disagree) was used to elicit responses to statements on academics' experiences of and the contributing factors associated with contra-power harassment.ResultsThe main contributing factor identified from this study was seen as the consumerism of higher education; in particular paying for a degree gave a sense of entitlement with academics experiencing the highest levels of student harassment around grades.ConclusionsContra-power harassment is becoming common place in higher education especially in nursing education. The competitive nature of obtaining employment post-university has meant that some nursing student's behaviours are becoming increasingly uncivil, challenging and unprofessional.
  • Health science student teachers' perceptions of teacher competence: A
           qualitative study
    • Abstract: Publication date: January 2020Source: Nurse Education Today, Volume 84Author(s): Heli-Maria Kuivila, Kristina Mikkonen, Tuulikki Sjögren, Meeri Koivula, Minna Koskimäki, Merja Männistö, Pirjo Lukkarila, Maria KääriäinenAbstractBackgroundHealth science teacher competence is multifaceted and continuously changing according to national and international healthcare standards. Organizational restructuring and emphasis on cost effectiveness is changing the scope of health science teachers' practical work and their role in healthcare (worldwide).AimThis study aimed to describe student teachers' perceptions of the competencies needed to work as an educator in the healthcare field. Objective of study was to gain new knowledge which can be used in the development of teacher education programs in nursing science and to define a broader definition of the health science educators.MethodsA qualitative study was conducted. Data were collected from 23 Finnish students completing a master's degree in teaching in the healthcare context using focus group interviews. The data were analyzed by inductive content analysis.ResultsThe student teachers identified eight main categories of teacher competence: leadership and management competence; evidence-based practice competence; subject competence; ethical competence; pedagogical competence; collaboration competence; internationalization competence; and continuous professional development competence.ConclusionThis study identified essential teacher competencies that can be evaluated among students to develop health science teacher curricula. The findings can be used in follow-up studies or comparative research to investigate competence differences between novice and experienced teachers.
  • A web-based clinical pedagogy program to enhance registered nurse
           preceptors' teaching competencies – An innovative process of development
           and pilot program evaluation
    • Abstract: Publication date: January 2020Source: Nurse Education Today, Volume 84Author(s): Xi Vivien Wu, Yuchen Chi, Yah Shih Chan, Wenru Wang, Emily Neo Kim Ang, Shengdong Zhao, Vibhor Sehgal, Fong Chi Wee, Umadevi Panneer Selvam, M. Kamala DeviAbstractBackgroundRegistered Nurse Preceptors guide students to integrate theory into practice, assess clinical competencies, and enhance problem-solving skills. Researches have indicated that the teaching competencies of nurse preceptors can be transferred to students' clinical learning.ObjectivesThe aims of the study are to develop a web-based clinical pedagogy (WCP) program for Registered Nurse Preceptors and conduct pilot program evaluation.DesignA three-step process was applied to integrate the theoretical framework, evidence from the systematic review, and content validity by the experts and pilot test with the Registered Nurse Preceptors in the content and technical development of the program. The WCP program has unique features including use of dashboard, interactive videos, consultation with experts, discussion forum and backend data analysis.ResultsA committee of six content experts evaluated the comprehensiveness, appropriateness, and relevancy of the program. The item-Content Validity Index (CVI) score ranged from 0.83 to 1.00 and the scale-CVI score was 0.87, which indicated that the WCP program had a strong content validity. Ten nurse preceptors were invited to use the WCP program. Preceptors shared that the website was easy to use and navigate. They commented that the videos in each module are beneficial for nurses to understand the real situation in the clinical setting. This feature also makes the website more interactive. Feedback from preceptors was subsequently used to further refine the program.Discussion and conclusionThe WCP program is an evidence-based program that provides a comprehensive coverage on clinical teaching pedagogy and assessment strategies. The unique web-based technology and interactive features provide a platform for nurse preceptors to discuss clinical encounters with peers and consult experts. The flexible and resource-rich nature of web-based learning encourages nurses to use it for continuing education.
  • Nursing student and faculty perceptions of reciprocity during
           international clinical learning experiences: A qualitative descriptive
    • Abstract: Publication date: January 2020Source: Nurse Education Today, Volume 84Author(s): Natalie L. Gosse, Anna Katic-DuffyAbstractBackgroundExposure of nursing students to global health care systems and cultures that are vastly different from which they are accustomed allow them to gain a unique perspective of our global village. A plethora of research has studied the lived experiences of visiting students during international clinical placements. Many studies have noted a multitude of benefits for visiting students. However, very little research examined the perspectives of host participants.ObjectivesThis study explores both visiting and host students and faculty's perceptions of reciprocity during international learning experiences.DesignA qualitative descriptive design was utilised.SettingIntercultural collaboration between visiting and host participants occurred over a two week clinical learning experience in a regional hospital in Jamaica.ParticipantsTen third year undergraduate Bachelor of Nursing students and two faculty from Canada engaged in clinical learning experiences with twelve fourth year host nursing students and three faculty from Jamaica.MethodVisiting students submitted reflective papers, participated in interviews, and a focus group two months later. Two separate focus groups were held to gather data from the hosting students and faculty. All data was analysed using thematic analysis for recurring themes.ResultsThe findings of this study show that both host and visiting students and faculty mutually gain benefits from intercultural exchange and collaboration. Reciprocity was noted in experiential knowledge acquisition, cultural awareness from educational and professional perspectives, and personal and professional transformative learning. Although notable differences from contrasting health care worlds were identified, the recognition of similarities and opportunities for transformative learning greatly outweighed the differences.ConclusionThere are reciprocal benefits to be gained in nursing education for visiting and host participants through the development of collaborative international partnerships. More research is required to further explore mutuality for students and faculty from different countries.
  • Trauma-informed education: Creating and pilot testing a nursing curriculum
           on trauma-informed care
    • Abstract: Publication date: Available online 1 November 2019Source: Nurse Education TodayAuthor(s): Lindsay M. Cannon, Elizabeth M. Coolidge, Julianne LeGierse, Yael Moskowitz, Courtney Buckley, Emily Chapin, Megan Warren, Elizabeth K. KuzmaAbstractBackgroundTrauma is a significant contributor to morbidity and mortality. Trauma-informed care (TIC) provides a safe and supportive healthcare environment for patients who have experienced trauma. Educating healthcare providers improves knowledge, attitudes, and skills related to TIC. However, nursing programs do not systematically integrate TIC education.PurposeTo create, implement, and evaluate nursing content on TIC at the graduate and undergraduate levels at one university.MethodA pretest-posttest survey was utilized to assess changes in knowledge, attitudes, and skills related to TIC related to the delivery of content on trauma and TIC to students in three courses at one large Midwestern university in January 2019. Safety, acceptability, and transferability were also measured.FindingsThe content improved nursing students' knowledge and skills related to providing TIC. Further, content on TIC is acceptable to both undergraduate and graduate students and is transferrable to non-nursing students.DiscussionThe current study provides a trauma-informed nursing education model that is safe, appropriate, acceptable, and efficacious.
  • An international cross-cultural study of nursing student's perceptions of
    • Abstract: Publication date: Available online 31 October 2019Source: Nurse Education TodayAuthor(s): Majda Pajnkihar, Primož Kocbek, Kasandra Musović, Yuexian Tao, Natalia Kasimovskaya, Gregor Štiglic, Roger Watson, Dominika VrbnjakAbstractBackgroundSingle studies suggest that nursing students perceive caring as more an instrumental than expressive behaviour and indicate some differences between caring perceptions in junior and senior nursing students. However, there are limited studies investigating caring perceptions in nursing students across multiple cultures.ObjectiveTo determine perceptions of caring in Slovene, Croatian, Chinese and Russian nursing students and explore whether there are statistically significant differences in perceptions of caring between countries and between first and third-year nursing students.DesignA cross-sectional descriptive study design was used.Settings and participantsThe study included 604 nursing students enrolled in first and third year in seven different nursing faculties in four countries: Slovenia; China; Croatia; and the Russian Federation.MethodsThe 25-item Caring Dimension Inventory (CDI-25) was used to measure caring perceptions. We also included demographic questions regarding age, gender, country, year of study and type of study. Demographic data were analysed using descriptive analysis while a two-way analysis of variance (ANOVA) adjusted for unequal sample sizes was performed together with a post hoc analysis of the results.ResultsThe results of two-way ANOVA showed that both main effects (country and year of study) were statistically significant, as well as their interaction at the 0.05 significance level. The main effect for country was F(3, 596) = 3.591, p 
  • “Delirium: An essential component in undergraduate
    • Abstract: Publication date: Available online 19 October 2019Source: Nurse Education TodayAuthor(s): Claire Copeland, Derek T. BarronAbstractDelirium is an acute medical emergency, the presenting features are significant disturbances in the person's cognition, both their attention and awareness. Delirium develops over a short period of time and predominantly relates to an underlying medical condition. It is significantly under-recognised in the older adults who present to acute medical services and in those living within a care home setting. Up to 30% of older adults who present via the Emergency Department may be experiencing signs and symptoms of delirium, with up to 33% of older adults within the care home setting also experiencing delirium. In both settings the delirium may go unrecognised and be incorrectly considered as a deterioration of an existing dementia.Nurses and care staff in the care home setting, spend more time with older adults than any member of the multi-disciplinary team e.g. GP, physiotherapist, district nurse etc. and as such, their knowledge and skills in the recognition and early intervention when delirium is present can have a significant impact on the outcome for the older adult.Using a Freedom of Information request (Freedom of Information (Scotland) Act, 2002), a legal process designed to elicit transparency and guarantee a response, the authors invited responses from Scottish universities, to enable a review of the current approach in the teaching of delirium to undergraduate nursing students.At the outset, the authors were interested to establish the extent to which delirium featured in the nursing undergraduate programme in Scotland. Having established that the approach to teaching was highly variable, this paper poses the question whether more structured focus should be given to the topic within the undergraduate nursing curriculum.
  • Students' mental health clinical placements, clinical confidence and
           stigma surrounding mental illness: A correlational study
    • Abstract: Publication date: Available online 18 October 2019Source: Nurse Education TodayAuthor(s): Lim Hui Jing Victoria, Lorna Moxham, Christopher Patterson, Dana Perlman, Violeta Lopez, Yong Shian GohAbstractTheory and clinical practicum in mental health are an important component for students in most nursing curriculum. Some studies have shown that knowledge and confidence in caring for people with mental illness improve after mental health clinical placements while others had contrasting results. Our study examined the relationship between clinical placement, confidence and stigma surrounding mental illness. We undertook a cross-sectional, descriptive correlational study in a sample of 144 undergraduate nursing students in Singapore who had completed their theoretical and clinical practicum in mental health using the Clinical Placement Survey Clinical Confidence Scale and Social Distance Scale. Descriptive, correlations and multiple regression were used to analyse the data. The results showed the mean scores for the social distance scale, clinical confidence scale and clinical placement survey were 19.92 out of 35, 49.29 out of 80 and 103.43 out of 154 respectively. Attitudes toward clinical placement experiences were significantly correlated with both stigmatising attitudes and clinical confidence of which, intentions of working in mental health settings were specifically significantly associated with stigmatising attitudes and attitudes toward clinical placement experiences, with emphasis on greater sense of preparedness, lesser perceived anxiety and greater preference for a future career in mental health nursing. This study highlighted the need to improve current mental health clinical placements to better build nursing students' confidence in caring for mentally ill patients. The interest toward specialising in mental health nursing is still lacking in nursing undergraduate students despite mental health clinical placements.
  • Nursing student's expectations for their future profession and motivating
           factors – A longitudinal descriptive study from Sweden
    • Abstract: Publication date: Available online 18 October 2019Source: Nurse Education TodayAuthor(s): Lindberg Maria, Carlsson Marianne, Engström Maria, Kristofferzon Marja-Leena, Skytt BerniceAbstractBackgroundThe shortage of registered nurses is a global concern. Motives to become registered nurses can be to help others, altruism, personal development and career security. Motives in combination with student expectations regarding the role are not explored.ObjectiveTo describe students' motives to become registered nurses and their expectations regarding their future profession.DesignA longitudinal descriptive design with a qualitative approach was used to follow nursing students in the beginning, during and at the end of their education.Participants and settingA purposive sampling of a group with initially 75 students starting a three-year nursing program at a university in Sweden.MethodsA study specific questionnaire with open-ended questions was used in the beginning, during and the end of the students' education. At data collection two and three, a copy of the earlier answers was attached. Data were analysed using manifest and latent content analysis.ResultsAn important profession with career opportunities, interesting duties and team work were described. Students expected diversified duties, possibilities for development and work satisfaction. Increased concerns regarding their upcoming work life was described at the end of the education.ConclusionThe students had a positive understanding of the profession and perceived their forthcoming role as interesting. The leading role of coordinating patient care was more comprehensive than expected. Supportive conditions and well planned transition periods could strengthen newly graduated nurses in their professional role and could be an important aspect in the future retention of RNs.
  • An (interpretive) phenomenological analysis of nursing professionals
           experience of developing a transnational curriculum
    • Abstract: Publication date: Available online 31 October 2019Source: Nurse Education TodayAuthor(s): Amanda LeeAbstractAimThe purpose of this phenomenological study is to reveal how senior staff who have engaged in the development of a transnational nursing curriculum make sense of the opportunity.BackgroundMerging two, country specific curricula for a dual award bachelor degree nursing program, taught exclusively in China through ‘flying faculty’ model is an innovative way to deliver a global nursing education. As with any innovation, lessons can be learned through reflection, to streamline future institutional investments which are responsive to country specific needs.MethodsFour senior staff involved in curriculum development were recruited through purposive sampling. Semi structured interviews were undertaken to elicit data on their experiences during the merger.DiscussionFive main themes were key to participant's sense making during the curriculum development process. These were: managing and overcoming differences in expectations and pedagogy, meeting deadlines, engaging stakeholders and the need to think creatively. All participants revealed there had been a significant learning curve during the process, and highlighted the benefits of this in their own development.ConclusionsParticipants perceived transnational education curriculum development as complex. They cited differences in learning, teaching, pedagogy and quality processes as factors to address and identified the most crucial elements to success, were communication, mutual engagement, meeting deadlines and the ability to think creatively. Their continual efforts to understand systems and processes allowed them to make sense of this complex undertaking.
  • The development of a six-station OSCE for evaluating the clinical
           competency of the student nurses before graduation: A validity and
           reliability analysis
    • Abstract: Publication date: Available online 31 October 2019Source: Nurse Education TodayAuthor(s): Kwo-Chen Lee, Ching-Hsuan Ho, Chin-Ching Yu, Yann-Fen ChaoAbstractBackgroundAssessing clinical competency in undergraduate nursing students is essential before they enter clinical practice. The objective structured clinical examination (OSCE) is widely used and is part of clinical competency assessment.AimThe aim of this study was to develop and validate a six-station OSCE for evaluating the clinical competency of the student nurses before graduation.MethodsOne-group longitudinal observational study. An OSCE of 6 stations of 10 min each was adopted. Blueprint setting, checklist development, and standard patient and examiner training were conducted. The mean, standard deviation, item scale (item-total correlation) and comparisons of extreme groups for item analysis. The inter-coder of examiners and inter-case of students were used to test reliability. Content Validity and concurrent validity were used to evaluate validity of OSCE.ResultsOne hundred nursing students participated in this study. The mean OSCE score of students who passed the registered nurses' examination was significantly higher than that of students who failed. Significant differences in OSCE score between students who remain versus left clinical job were observed at 3, 6 and 9 months after graduation.ConclusionThe OSCE is predictable method for assessing undergraduate students' first year clinical retention.
  • Does a novel teaching approach work' A Students' perspective
    • Abstract: Publication date: Available online 30 October 2019Source: Nurse Education TodayAuthor(s): Mohammed Munther Al-Hammouri, Jehad A. Rababah, Michael L. Rowland, Allison Serra Tetreault, Mohammed AldalaykehAbstractBackgroundThere is always a call for educational reform and further research to improve educational programs. The continuous development of new educational approaches is a work in progress. Educational strategies like team-based learning, flipped classroom, and lottery-based token economy, were used to develop a novel teaching approach.AimThis study had two major goals. The first goal was to introduce a novel teaching approach in professional healthcare academies. The second goal was to get an in-depth understanding, from the students' perspective, about the benefits and limitations of this new teaching approach.MethodThe study was conducted using a qualitative, phenomenological research design. Third and fourth-year nursing students completed reflective journals to describe their personal experience with the new teaching approach at the end of the semester. The students' responses were analyzed and coded using Kember's four-category coding schema for reflective writing, to extract themes using thematic analysis.FindingsSeventy-five students completed and returned their reflective journals. The analysis showed various challenges and facilitators/benefits of the students' experiences. The themes that emerged from the analysis were: lack of exposure vs. a sense of achievement; lack of teamwork skills vs. role fulfillment; working with new people vs. conflict resolution; variation vs. collaboration/creativity; time management vs. constructive competition; wasting resources vs. flexibility, and proactivity/active engagement. These themes summarized why the new teaching approach worked and what barriers students faced with the new assembly.ConclusionResults from the current study demonstrated the great potential of the new teaching approach. Recommendations for future research were also discussed.
  • More than a cultural experience: Assessing the impact of a
           medical-surgical international clinical on nursing students' academic
    • Abstract: Publication date: Available online 25 October 2019Source: Nurse Education TodayAuthor(s): Heather Englund, Jennifer Basler, Katherine Meine, Erin McArthurAbstractA review of the extant literature suggests that there remains a dearth of evidence regarding the evaluation of well-defined outcomes related to international nursing clinical experiences. The purpose of this study was to explore the relationship between students' clinical experience (traditional versus international) and a number of academic outcomes including final medical-surgical course grades, performance on relevant Assessment Technologies Institute (ATI) proctored exams, and National Council Licensure Examination (NCLEX) pass rates. A non-experimental design was implemented using retrospective data obtained from a small university in the Midwest. Students complete a medical-surgical clinical in India during the interim of their third semester in the nursing program. Results of the t-tests show a statistically significant difference in final grades for Adult Health II theory when comparing students who completed a traditional clinical (M = 83.1, SD = 3.8) with those who completed an international clinical (M = 81.6, SD = 5.2); t(100) = 2.0, p = .043. The difference in mean scores for traditional clinical students (M = 70.3, SD = 6.6) versus international clinical students (M = 66.2, SD = 7.2) for the Adult Medical-Surgical proctored exam reached statistical significance, t(119) = 4.5, p ≤ .001. In contrast, there was no significant difference in means scores between the two groups with regard to scores on the Comprehensive Predictor proctored exam (traditional clinical, M = 76.1, SD = 5.9; international clinical, M = 75.2, SD = 6.4); t(121) = 1.0, p = .316. Finally, a chi square test of independence found that the relationship between clinical status and performance on NCLEX was not statistically significant, χ2 (1, N = 197) = 0.132, p = .716. Further research is needed to examine the impact of international clinicals on a broader range of outcomes including academic, cultural competency, and clinical performance measures.
  • Exploring the relationship between resilience and grit among nursing
           students: A correlational research study
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Geralyn Meyer, Bobbi Shatto, Orawan Kuljeerung, Lisa Nuccio, Adam Bergen, Courtney Rae WilsonAbstractBackgroundNurse turnover is a critical issue around the world. Finding factors that can increase job persistence in nursing can have a positive impact on both the quality and cost of health care. Resilience and grit have been studied as factors that help an individual persist in the pursuit of their goals. Resilience and grit are related terms that have frequently been used interchangeably, although some studies suggest that they are different constructs. Determining if they are different constructs is important as we seek to develop qualities in new nurses that increase their job persistence and satisfaction.ObjectivesThe purpose of this study was to explore the relationship between resilience and grit in pre-licensure nursing students.Design/settingThis descriptive correlational study was conducted at a midsize private University in the United States.ParticipantsThe convenience sample consisted of students from 3 pre-licensure programs: Traditional Bachelor of Science in Nursing (TBSN), Accelerated Bachelor of Science in Nursing (ABSN) and Direct Entry Masters of Science in Nursing (DEMSN). The final sample was 348 students: 79% TBSN, 7% ABSN and 14% DEMSN.MethodsResilience was measured with the Conner-Davidson Resilience 10 item scale. Grit was measured utilizing the Short Grit Scale.ResultsInspection of the interfactor correlations suggest that resilience and grit scales are distinct, though tend to correlate well. Notably, the relationship between resilience and the persistent effort component of grit was moderate. That correlation was higher than the relationship between the consistent interest component of grit and resilience.ConclusionThis study concludes that grit and resilience are related concepts but are not synonymous. Being mindful of the difference in these two attributes may be important in the development of educational offerings in both Schools of Nursing and in new nurse residency programs to increase retention in nursing.
  • Medication error encouragement training: A quasi-experimental study
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Kyoungja Kim, Insook LeeAbstractBackgroundMedication errors are the most common clinical errors in healthcare practice and can lead to serious consequences. Medication error encouragement training (MEET) brings students face-to-face with potential errors in the medication process, in a safe environment where they are encouraged to understand both the error and the context in which it occurred.ObjectivesThe study aimed to examine the effects of a MEET intervention on medication safety confidence among nursing undergraduates.DesignThis was a quasi-experimental study with a nonequivalent control group design.ParticipantsOur sample was recruited from the nursing education department of a university, with 47 participants randomly assigned to the experimental group, and 50 to the control group.MethodsBoth groups received theoretical training, followed by applied training. The experimental group received the MEET intervention developed specifically for this study, while the control group received traditional error avoidance training. Participants' medication administration confidence was measured pre- and post-intervention.ResultsFollowing training, the experimental group's confidence was significantly higher than that of the control group. With regard to individual medication administration procedures, the experimental groups' medication safety confidence increased significantly after training compared to the control group in patient identification, drug information confirmation, and drug preparation.ConclusionsIntroducing MEET into nursing curricula could reduce medication errors and related complications in healthcare institutions. Further studies are needed to investigate the long-term effects of MEET interventions, as well as the generalizability of our findings.
  • ‘Speaking up for safety’: A graded assertiveness intervention for
           first year nursing students in preparation for clinical placement:
           Thematic analysis
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Julie Hanson, Samantha Walsh, Matthew Mason, Daniel Wadsworth, Ann Framp, Karen WatsonAbstractBackgroundThe international literature highlights patient safety as a critical issue in contemporary health care. Poor interpersonal relationships and ineffective health care team communication are identified as dominant human factors contributing to clinical errors and adverse events. Of concern is that some students appear to lack the skills to speak up for themselves, their patients and others when witnessing unsafe practice on clinical placement.Study aimsTo elicit student and staff perspectives on the quality, effectiveness and appropriateness of an assertiveness-based communication activity prior to clinical placement.DesignThe study used a qualitative design. A communication module was offered in the second week of the practice laboratory and involved the use of two graded assertiveness frameworks.SettingSchool of Nursing, Midwifery and Paramedicine, at a regional university in South East Queensland, Australia.ParticipantsOf the 535 first year undergraduate nursing students enrolled in the laboratory courses, 73 (13.6%) completed an anonymous online survey. Individual interviews were conducted with a university student wellbeing coordinator and student mentor to gain their perspectives of the data.MethodsAn evaluation survey with seven qualitative questions and individual semi-structured interviews were employed. Data was analysed using a thematic approach.ResultsFive major themes emerged from the survey data: vicarious learning, establishing boundaries, support in practice, advocacy awareness and practice utility. Three themes emerged from the interviews: empowerment and confidence; support and preparation for advocacy; and authentic learning.ConclusionsFindings indicate that teaching assertiveness skills and establishing a preparatory framework for ‘speaking up for safety’ early in a nursing student's tertiary education can have important psychosocial implications for their confidence, empowerment and success. The activity provided an authentic learning experience with perceived practical application to the workplace and, has the potential to enhance first year curricula by improving communication tools used for students preparing for practice.
  • The type and amount of paid work while studying influence academic
           performance of first year nursing students: An inception cohort study
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Yenna Salamonson, David Roach, Ruth Crawford, Belinda McGrath, Angela Christiansen, Peter Wall, Mandy Kelly, Lucie M. RamjanAbstractBackgroundWorking while engaging in tertiary studies can have potential benefits for students in developing their repertoire of employability skills, including teamwork, time management, customer service and interpersonal communication. Not unexpectedly engaging in excessive hours of work can have a detrimental effect on students' grades. Yet little is known about the impact of engaging in different types of paid work (nursing or non-nursing), and the amounts, on first year nursing students' academic performance across different nursing programs.ObjectivesThe aim of this study was to examine the association between: a) amount; and b) type of term-time weekly paid work, particularly its effect on academic performance, among commencing undergraduate students in the first semester of nursing studies across different nursing programs.DesignInception cohort study.SettingsFour tertiary institutes across Australia and New Zealand.ParticipantsAll commencing Bachelor of Nursing students attending Orientation sessions at their respective institutes were invited to participate in the study. The median age of participants was 23 years, the majority (87.5%) were female and nearly two-thirds were non-school leavers. Among those in paid work, the median hours worked was 20 h.MethodsA baseline survey, completed by consenting students at the start of their Orientation session included items related to respondents' demographic data, self-reported paid work engagement (type and hours); we also requested their permission to link grade point average (academic performance data) at the end of first semester. Data were analysed using SPSS Version 25.ResultsA total of 1314 students completed the survey and 89% of survey respondents agreed for their survey to be linked to academic grades at the end of the semester. There was an inverse relationship between time spent in weekly paid work and academic performance. Additionally, three predictors emerged as statistically significant for high grade point average: (i) engaging in non-nursing related work (AOR: 1.64, 95% CI: 1.19–2.26); (ii) not being first in family to attend university (AOR: 1.57, 95% CI: 1.20–2.07) and; (iii) being a school-leaver (AOR: 1.49, 95% CI: 1.12–1.98).ConclusionsDespite the diversity among undergraduate nursing students studying across Australasia, it is evident that the amount and type of paid work engagement can impact on students' academic performance while studying. This underscores the importance for tertiary institutes to not only support students in their learning but also understand the need to achieve the right balance, in working while studying, to support students' academic success.
  • Effects of pressure ulcer prevention training among nurses in long-term
           care hospitals
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Yukyeong Seo, Young Sook RohAbstractBackgroundNurses caring for elderly patients with a high risk of pressure ulcer at long-term care hospitals require the necessary knowledge, behaviors, and attitudes regarding preventing pressure ulcers.ObjectivesTo identify the effects of pressure ulcer prevention training on nurses' knowledge, behaviors, and attitudes regarding pressure ulcer prevention.DesignA comparison group pretest-posttest design.SettingsLong-term care hospitals in a metropolitan area of the Republic of Korea.ParticipantsParticipants were conveniently assigned to team-based learning (n = 30) or lecture-based learning (n = 30) groups.MethodsWe examined pre-post differences in the scores for pressure ulcer prevention knowledge, behaviors, and attitudes in each group using the paired t-test. Additionally, pre-post difference scores were compared between the two groups using the independent samples t-test.ResultsBoth groups exhibited significant increases in scores for pressure ulcer prevention knowledge, behaviors, and attitudes after the intervention as compared before it. However, we found no significant differences in the pre-post difference scores for any of the variables between the two groups.ConclusionsPressure ulcer prevention training, regardless of whether it utilizes team-based or lecture-based learning, is useful for enhancing nurses' pressure ulcer prevention knowledge, behaviors, and attitudes. Further study is needed to verify the longitudinal effects of pressure ulcer prevention training on nurses' actual performance and the incidence of pressure ulcers among patients.
  • Measuring professional nursing value development in students participating
           in international service learning: A quasi-experimental study
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Heather FerrilloAbstractBackgroundInternational service learning is becoming widely used in nursing education as a means to provide global learning opportunities as well as part of a clinical learning experiences. Concrete outcomes for these experiences have not been clearly supported in previous research. Professional nursing values are an important learning outcome for nursing students and development of professional nursing values has been found to occur through various learning experiences. Determining if international service learning experiences facilitate the development of professional nursing values can support the use of international service learning as a viable pedagogy.ObjectiveThe purpose of the study was to determine if there was a difference in professional nursing values development in students who participate in international service learning as part of their clinical experiences compared to those who do not.DesignThe research was a quasi-experimental study with a pre-test, post-test design.Setting/participantsUndergraduate students participating in one week international service learning as part of their clinical hours were compared with students who did not participate in international service learning.MethodsComparison of professional nursing values development between the experimental and control group was completed using the Nurses Professional Values Scale.ResultsThe study showed the use of international service learning as part of clinical was at least equivalent in the development of professional nursing values as traditional clinical. In addition, it supported the development of professional nursing values through clinical learning overall.ConclusionThe use of international service learning is a viable option for clinical experiences as a means to develop professional nursing values.
  • Undergraduate nursing students' use of video technology in developing
           confidence in clinical skills for practice: A systematic integrative
           literature review
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Renee Stone, Marie Cooke, Marion MitchellAbstractAims and objectivesThis review examines the current evidence of the effectiveness of the use of video or video podcast technology produced either commercially or in-house in developing nursing students' confidence in clinical skills for practice.BackgroundThe ability of graduates to provide safe, quality, nursing care is the core of any nursing education curriculum. Developing teaching and learning strategies to enhance skills development and confidence is challenging for educators, particularly with contemporary and diverse student populations requiring student-centred, technology-enhanced learning.DesignAn integrative review framework.Review methodsA systematic search was conducted using the following eight databases: CINAHL, MEDLINE, ProQuest, PubMed, ERIC, Scopus, EMBASE, and Google Scholar. Selection criteria included: published in English, involving undergraduate nursing students, measuring confidence in relation to skills development, and using video or video podcasts.ResultsFour studies met the inclusion criteria, with six themes identified. Four themes emerged: Pedagogy; Skills performance and competency; Student satisfaction and confidence in relation to skills development; Technical constraints. Two additional themes related to the impetus for introducing video podcasts: first, time as an institutional, curricular, and academic/student challenge; and second, meeting the generational needs of students.ConclusionThis review demonstrates that video technology teaching methods and traditional teaching methods used in conjunction with each other create the most positive learning environment. Although video technology methods provide a flexible teaching option for the contemporary student population, developing and delivering videos in a clinical skills program need to be conceptualised within an appropriate pedagogical approach to ensure a purposeful and meaningful learning experience. Whilst student confidence was embedded within other evaluations, it is not clearly reviewed or understood; therefore, further research is required in this area.
  • Male nursing students' experiences of simulation used to replace
           maternal-child clinical learning in Qatar
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Daphne M. Kennedy, Justine J. Jewell, Jason E. HickeyAbstractBackgroundIn today's health care context, nurse educators teach with limited clinical placement availability, competition for available spaces and increasingly complex clients.SettingAs part of the baccalaureate of nursing program at the University of Calgary in Qatar, students are required to complete 208 h of maternal-child clinical. Unfortunately, due to social and cultural norms in this predominantly Muslim country, male nursing students are prohibited from practicing with mothers and babies in Qatar. In order to address this need, we developed a fully simulated clinical practice module for these male students.ObjectivesThe aim of the current study was to better understand the learning experiences of the students undertaking this experience.DesignThe authors developed and implemented a fully simulated, campus-based, maternity clinical experience that used a variety of levels of fidelity, incorporated the tenets of Kolb's (1984) experiential learning theory, and Jeffries' (2005) simulation design framework. Post-simulation debriefing sessions were recorded and transcribed. Typed weekly reflections were provided. All data was blinded.ParticipantsA convenience sample of ten adult, male participants was obtained.MethodsUsing an inductive qualitative approach, researchers analyzed transcripts of debriefing sessions and reflective journals.ResultsThe main themes were knowledge application, clinical judgement, communication, and crossing cultural barriers.ConclusionsThemes from this study can be used to support and/or change existing practices in a way that supports learner-centered, experiential teaching practices.
  • An exploration of the influences on under-representation of male
           pre-registration nursing students
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Heather M. Whitford, Glenn R. Marland, Maggie Carson, Heather Bain, Jacqueline Eccles, John Lee, James TaylorAbstractBackgroundWorldwide, men are under-represented in the nursing profession. In Scotland less than 10% of pre-registration nursing students are male. Reasons for this imbalance need to be understood.ObjectivesTo explore the views of male pre-registration nursing students, nursing lecturers and school teachers about this imbalance.DesignMixed methods study using focus groups and online survey.SettingsFocus groups in four locations across Scotland. Online survey sent to teachers across Scotland.Participants and methodsEight focus groups with 33 male nursing students; four focus groups with 21 university and college nursing lecturers; 46 school teachers returned the online survey.ResultsAlthough nursing was considered a worthwhile career with job stability and many opportunities, it was also viewed as not being a career for men. Assumptions about the profession and femininity were challenging for men and use of the term ‘male nurse’ was felt to be anomalous. In some circumstances the provision of intimate care to particular patient groups caused difficulty. Positive encouragement from others, a positive role model or knowledge of nursing from significant others could be helpful. However concerns about low earning potential and negative media publicity about the NHS could be a disincentive. Being mature and having resilience were important to cope with being a male nursing student in a mainly female workplace. Some more ‘technical’ specialties were felt to be more attractive to men.ConclusionsNursing is viewed as a worthwhile career choice for men, but the gendered assumptions about the feminine nature of nursing can be a deterrent.
  • Effects of peer-led debriefing using simulation with case-based learning:
           Written vs. observed debriefing
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Eun-Ho HaAbstractBackgroundPeer-led written debriefing (PLWD) and peer-led observed debriefing (PLOD) are types of peer-led debriefing. Despite their advantages, these methods are sparingly used among debriefing experts.ObjectiveTo identify effects of peer-led debriefing (written versus observed) using simulation with case-based learning (CBL) and compare levels of satisfaction with CBL, debriefing, and simulation-based learning (SBL) between the two groups.DesignQuasi-experimental study used a pretest-posttest non-equivalent control group.SettingDepartment of Nursing in C province, South Korea.ParticipantsSixty-nine third-year undergraduate nursing students (PLWD, n = 33; PLOD, n = 36).MethodsDifferences in clinical performance competency, and satisfaction of CBL, SBL, and debriefing between the PLWD and PLOD groups were determined.ResultsClinical performance competency scores of posttest in both the PLWD and PLOD groups were significantly higher than those of pretest. There were no significant differences in any item except for item of ‘communication’ (t = −2.150, p = .047) between the PLWD and PLOD groups. There were no significant differences in satisfaction with CBL (t = −0.874, p = .385), simulation (t = −0.701, p = .485), or debriefing (t = −1.024, p = .309) between the two groups.ConclusionThis study suggests that both the PLWD and PLOD could be used to achieve students' learning outcomes when debriefing experts are unavailable.
  • Simulated patient scenario development: A methodological review of
           validity and reliability reporting
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Noeman Mirza, Julie Cinel, Heather Noyes, Wendy McKenzie, Kim Burgess, Sheila Blackstock, Darlene SandersonIntroductionSome healthcare scholars (educators and researchers) develop their own simulated patient scenarios to address specific learning objectives. Clear processes of validity and reliability are needed in the development of simulated scenarios for the purpose of replication and the transfer of findings to other contexts.MethodsThis paper reports a methodological review of CINAHL to determine how valid and reliable simulated patient scenarios are developed. We reviewed 357 abstracts based on inclusion and exclusion criteria to yield 16 qualifying records. The search was repeated in 2019 and yielded one additional record, making it a total of 17 records which were included in the review. Data about the discipline, population, type of simulation, and validity and reliability processes were extracted.ResultsSelected records were from nursing, medicine, and paramedicine. While some studies used high-fidelity simulations, some used low-fidelity or a combination of high- and low-fidelity simulations. Scholars validated scenarios by using personal experience, consulting experts or participant feedback. They also examined different types of validity (face, content, construct). Most studies did not address how reliability of scenarios was determined. To ensure consistency in scenario delivery, some studies piloted scenarios with participants, or examined performance through video-tapes or virtual patients.ConclusionsThis review shows that scholars use inconsistent processes to develop valid and reliable simulated patient scenarios, often overlooking evidence-based approaches to determining validity and reliability. Future practices around scenario development should use systematic processes in determining validity and reliability so simulation exercises can be replicated in other contexts.
  • Effect of creativity training on teaching for creativity for nursing
           faculty in Taiwan: A quasi-experimental study
    • Abstract: Publication date: Available online 23 October 2019Source: Nurse Education TodayAuthor(s): Hsing-Yuan Liu, I-Teng Wang, Nai-Hung Chen, Chun-Yen ChaoAbstractBackgroundCreativity and innovation are considered important core competencies in Taiwan for nursing students. The role teacher's play is critical to the development of student creativity. Although studies have investigated creativity training, there is no consensus on how best to evaluate the effectiveness of the training.ObjectiveTo evaluate whether a teaching for creativity module (TCM) can enhance teaching behaviors and self-efficacy of teaching creativity for capstone course nursing faculty. The TCM intervention was taught in two stages by experts in diverse areas of industrial design. A 2-day teaching creativity workshop was followed by reinforcement of creativity skills in the classroom with nursing and design faculties teaching side-by-side for 6 h of the 18-week capstone course.DesignThis quasi-experimental study employed a pretest-posttest design to compare an intervention and control group.Participants and settingCapstone course nursing faculties were recruited from five science and technology universities in Taiwan.ResultsForty-two capstone faculty members participated; 21 completed the TCM intervention and 21 were in the control group. Analysis of covariance (ANCOVA) demonstrated the TCM intervention group had significantly better post-test mean scores for creative teaching behaviors and self-efficacy of teaching creativity than the control group. Our findings suggest participation in a creativity workshop and reinforcement of teaching skills with classroom interdisciplinary teacher training can augment teaching for creativity of nursing faculty.ConclusionThe findings of this study indicate that an intervention program in creativity can increase teaching behaviors as well as perceptions of self-efficacy regarding teaching for creativity, which could foster student creativity. These findings have important implications for educational settings, as they suggest that the workshop and reinforcement of learning with hands-on guidance in creativity with interdisciplinary teaching should be integrated into the curriculum, which could facilitate student creativity by increasing teaching behaviors and improving self-confidence regarding teaching creativity.
  • Preceptors´ experiences of student supervision in the emergency medical
           services: A qualitative interview study
    • Abstract: Publication date: Available online 22 October 2019Source: Nurse Education TodayAuthor(s): Kim Wallin, Ulrica Hörberg, Carina Werkander Harstäde, Carina Elmqvist, Anders BremerAbstractBackgroundClinical placements play a central part in the education of future emergency medical services (EMS) staff and their development of clinical skills and competence. A key aspect of students' integration of theory and praxis and development into an independent clinician is a supportive mentorship with the preceptor. However, students report barriers for learning within the EMS, while the preceptors' experiences of their role have received scant attention in research.ObjectivesTo describe preceptors' experiences of student supervision in the EMS during clinical placements.DesignA descriptive qualitative design was used.Participants and setting.Twenty specialist nurses were recruited among EMS staff from all parts of Sweden.MethodsData were collected using individual interviews and analyzed with latent qualitative content analysis.FindingsEMS preceptors develop a competence in combining caring and learning adapted to individual student needs when facing students with varying needs in an ever-changing healthcare setting. A trustful relationship between student and preceptor is fundamental when coping with a dual responsibility for student and patient needs. However, several aspects in the EMS setting hinders the preceptors' ability to support the development of the students' independence. Surrounding support structures are important if the preceptors are to feel safe and secure in their role as assessor, teacher and ambulance nurse.ConclusionsPreceptors need to develop a didactic flexibility through preceptor courses adapted to the complex premises found in the EMS. Ambulance services and universities should recognize the importance of preceptors´ colleagues, student continuity, university support and cooperation for improving quality and clarity in supervision during clinical placements.
  • What are students' needs and preferences for academic feedback in higher
           education' A systematic review
    • Abstract: Publication date: Available online 22 October 2019Source: Nurse Education TodayAuthor(s): Catherine Paterson, Nathan Paterson, William Jackson, Fiona WorkAbstractObjectiveFeedback is a fundamental factor within the learning process for students. However, it is widely known that students generally report that feedback is done sub-optimally in higher education. Therefore, this systematic review aims to identify students' needs and preferences for academic feedback in higher education.Design, Data sources, review methods.A systematic review was conducted according to the PRISMA Statement Guidelines. Electronic databases were searched using a range of keywords and the findings were integrated in a narrative synthesis. Quality appraisal was undertaken.Results5884 articles were retrieved, and 36 papers included. Three themes emerged across a wide range of academic disciplines which included: 1) preferences for feedback, 2) multimodality feedback and 3) emotional impact. Overall, quality feedback was related to the timeliness of feedback; balance between positive and constructive comments; direct feedback on content; linguistic clarity and legibility; grade justification and feeding forward.ConclusionThis review has informed several important implications for practice uniquely from the students' perspectives. Educators are encouraged to implement the evidence-based preferences for student feedback in their daily practice. Students value multimodality feedback which is personalised to enable students to feed forward in their own individual learning journeys. Future research should explore whether demographic variables influence student feedback needs over time. We would recommend that future studies need to employ a rigorous methodology to avoid the shortcomings in the studies already conducted in this area.
  • Professional identity and its influencing factors of first-year
           post-associate degree baccalaureate nursing students: A cross-sectional
    • Abstract: Publication date: Available online 22 October 2019Source: Nurse Education TodayAuthor(s): Chen Wu, Mary H. Palmer, Kaihui ShaAbstractBackgroundProfessional identity is an important and universal concept in the field of nursing because it not only affects nurses' perceptions of their role in nursing, but it also affects retention rates. However, the influential factors that impact the professional identity of nursing students currently are not well known.PurposeThis exploratory study aims to investigate the concept of professional identity and confirm its influencing factors among post-associate degree baccalaureate nursing students in China.MethodsWe conducted a cross-sectional study of 198 first-year post-associate degree baccalaureate nursing students enrolled in full-time study at two provincial medical colleges in China. We used paper and pencil questionnaires to conduct the survey and obtain the results used in this study.ResultsThe overall mean score for ‘professional identity’ of the sample was 3.63 ± 0.62 on a scale of 1 through 5, with the means for the five dimensions of professional identity ranging from 3.29 to 4.02. A clinical learning experience that is longer than eight months (ref. = 8 months) (β = 0.138, p 
  • Criteria for describing and evaluating training interventions in
           healthcare professions – CRe-DEPTH
    • Abstract: Publication date: Available online 22 October 2019Source: Nurse Education TodayAuthor(s): Van Hecke Ann, Duprez Veerle, Pype Peter, Beeckman Dimitri, Verhaeghe SofieAbstractBackgroundDescriptions of training intervention in healthcare include a lot of vagueness, leaving the reader in doubt about the intervention and the true value of the reported effects. A set of reporting criteria to improve the transparency and comprehensiveness in reporting training interventions in healthcare is recommended.ObjectiveThis study aimed to develop and content validate a set of reporting criteria for the development and evaluation of training interventions for healthcare professionals.MethodThe set of criteria was developed along three stages: (1) a literature review, (2) the design of the criteria, and (3) a Delphi and consensus meeting process with ten experts from different professional disciplines.ResultsThe Criteria for Reporting on Development and Evaluation of Professional Training interventions in Healthcare (CRe-DEPTH) set was systematically developed and consisted of 12 items representing four categories: (1) development of the training, (2) characteristics of the training, (3) characteristics of the providers, and (4) assessment of the training outcomes. Each item has a detailed description to support its unambiguous interpretation.ConclusionsThe developed CRe-DEPTH reporting criteria guide high quality development, evaluation and reporting for complex training interventions, while preserving the flexibility to incorporate various teaching content or teaching methods. The Cre-DEPTH criteria will allow for detailed reporting on the training, its developmental process, as well as on the rationale for underlying choices, and will avoid non-reporting of training details.
  • Are student nurses ready for new technologies in mental health'
           Mixed-methods study
    • Abstract: Publication date: Available online 22 October 2019Source: Nurse Education TodayAuthor(s): Alexis Bourla, Stéphane Mouchabac, Laetitia Ogorzelec, Christian Guinchard, Florian Ferreri, In collaboration withAbstractBackgroundTechnical innovations such as ecological momentary assessment (EMA), machine learning (ML), computerized adaptive testing (CAT), Digital Phenotyping, Clinical Decision Support Systems (CDSS), Algorithms, and Biomarkers have caused a paradigm shift in psychiatric care. The aim of the present study was to explore how student nurses view this paradigm shift, by assessing the acceptability of smartphone-based EMA, CAT, and biosensor-based Digital Phenotyping. We also investigated the factors affecting this acceptability.MethodStudent nurses recruited via nursing schools participated in a quantitative study involving the screenplay method, in which they were exposed to two scenarios about depression care, one featuring EMA and CAT, the other featuring a connected wristband (CW) for Digital Phenotyping. Four acceptability domains (usefulness, usability, reliability, risk) were investigated.ResultsWe recorded 1216 observations for the first scenario and 1106 for the second. Regarding overall acceptability, the CW was viewed less positively than CAT and EMA. Regarding reliability, whereas respondents believed that the CW could correctly detect depressive relapse, they did not think that EMA and CAT were sufficiently reliable for the accurate diagnosis of depressive disorder. More than 70% of respondents stated that they would nevertheless be interested in offering EMA, CAT or CW to their patients, but more than 60% feared that these devices might hinder the therapeutic relationship.ConclusionThis was the first study assessing student nurses' views of EMA, CAT and CW-based digital phenotyping. Respondents were interested in these new technologies and keen to offer them to their patients. However, our study highlighted several issues, as respondents doubted the reliability of these devices and feared that they would hinder the therapeutic relationship. Subgroup analysis revealed correspondences between acceptability profiles and demographic profiles. It is therefore essential for nurses and student nurses to receive training and become involved in the development of this new technologies.
  • Closing the gap on nurse retention: A scoping review of implications for
           undergraduate education
    • Abstract: Publication date: Available online 22 October 2019Source: Nurse Education TodayAuthor(s): Sarah S. Collard, Janet Scammell, Stephen TeeAbstractObjectivesNewly qualified nurses leave the profession at a higher rate than any other year of experience. Undergraduate education influences nurse retention following qualification. However, it is unclear if the factors associated with intent to leave are included within programmes to aid retention once qualified. A scoping review was conducted to explore the literature within nursing as well as social work undergraduate education to obtain viewpoints from an allied profession with similar retention barriers.Design and data sourcesFollowing PRISMA extension guidelines for scoping review, the research question used to explore the literature was: What is the impact of undergraduate nurse and social work education on retention when newly qualified' Databases searched were BNI, CINAHL complete, Science Direct, PsycINFO, Medline Complete, Academic Search Complete and ERIC.Review methodOne author undertook a comprehensive electronic and hand-search of relevant research articles. These were then discussed with two authors for inclusion within the review and data extracted for thematic analysis.ResultsLimited through search inclusion and quality of research, ten research papers met the criteria for this review. Main themes found were resilience and commitment, perceived knowledge and confidence, preparation for transition and expectation of supervision.ConclusionThe literature presents the need to strengthen resilience-building within undergraduate education in the transition to newly qualified practitioner, support to cope with the emotional and physical impact of professional practice as well as developing confidence in one's skills, guidance for career progression, promotion of authentic leadership in work-place mentors and commitment of both the University and health or social organisation to support staff to be healthy and feel valued.
  • Care home nursing: Co-creating curricular content with student nurses
    • Abstract: Publication date: Available online 21 October 2019Source: Nurse Education TodayAuthor(s): J. Watson, Z. Horseman, T. Fawcett, J. Hockley, S. RhynasAbstractBackgroundMeeting the complex care needs of an ageing population is a global issue and long term care settings, such as care homes, play an essential role. However, there is a crisis in the recruitment of registered nurses within care homes. Higher educational institutions have a critical part to play in addressing the crisis in recruitment in care homes and it is argued that student nurses can have a significant role to play in co-creating curricular content responsive to population need.ObjectiveTo co-create curricular content on care home nursing with student nurses.DesignCo-creation through collaborative enquiry and a three stage thematic analysis.SettingUndergraduate, preregistration nursing programme in a university in the United Kingdom.ParticipantsStudent nurses from Years One to Four undertaking a Bachelor in Nursing with Honours degree.MethodsSix focus groups and two one to one interviews.ResultsFindings revealed predominantly negative attitudes towards care home nursing. Teaching and practice placements appeared to play a minor role in shaping student's attitudes but rather, gave the unspoken message that for the acquisition of necessary knowledge and skills, care homes were less important than other settings. Most students were initially averse to care home nursing as a career choice. During focus groups/interviews, views shifted from seeing care homes as places where you ‘lose clinical skills’ to places where there is ‘a lot of responsibility’, and also a potentially rewarding career choice. From this attitudinal shift, students made suggestions for developing better curricular content and more positive learning opportunities.ConclusionsA co-creative framework can create a space for mutual learning between students and staff about challenges and opportunities for equipping nurses to meet the needs of an ageing populations. Student nurses are open to learning about care home nursing as part of their education and keen to have a more positive exposure.
  • Nursing students' attitudes towards obese people, knowledge of obesity
    • Abstract: Publication date: Available online 21 October 2019Source: Nurse Education TodayAuthor(s): Nicola Gormley, Vidar MelbyAbstractBackgroundThe rates of people being overweight and obese are recognised as global public health concerns. Negative attitudes towards obese and overweight people are prevalent among health care professionals. Nurses and nursing students have a significant role in health promotion of people who are obese or overweight and can assist people in achieving healthy lifestyles. However, evidence suggests that nurses and nursing students fail to engage in healthy lifestyles themselves and display negative attitudes towards obese and overweight people. Such negative behaviours put nurses and nursing students in a precarious position when advising overweight and obese people to adopt healthy lifestyles.ObjectivesThis study aimed to ascertain nursing students' obesity risk knowledge, their attitudes towards obese and overweight people, and their own health promoting lifestyle behaviours.DesignA descriptive correlational study was used.SettingOne university in the United Kingdom.ParticipantsA total of 210 nursing students enrolled on a university degree course in Adult or Mental Health Nursing in years 1, 2 and 3.MethodsData were collected using three valid and reliable questionnaires: Obesity Risk Knowledge Scale, Attitudes Towards Obese Persons Scale and the Health Promoting Lifestyle Profile. Dependent variables were correlated with independent variables on field of study, year of study, and gender.ResultsResults showed that nursing students engage in unhealthy lifestyle behaviours and fail to meet government recommended levels for physical activity. Nursing students had poor knowledge on obesity risk and displayed neutral attitudes towards overweight and obese people.ConclusionsEducational providers of nursing courses should embrace the need for nursing students to interrogate and enhance their own healthy lifestyle behaviours as an integral component of the pre-registration education course. This may strengthen the credibility and suitability of nursing students as future nurses in health promoting activities of patients who are overweight and obese.
  • Low interest in clinical practicum placement is associated with increased
           stress in nursing students in Taiwan: A cross-sectional survey study
    • Abstract: Publication date: Available online 20 October 2019Source: Nurse Education TodayAuthor(s): Shoa-Jen Perng, Huei-Chuan Sung, Chen-Jung Chen, Tzu-Ying Lee, Malcolm KooAbstractBackgroundNursing students often find themselves in a highly competitive environment, and stress is a commonly acknowledged experience in nursing students.ObjectivesThe aim of this study was to explore factors, particularly an interest in nursing and in clinical practicum placement, associated with stress in Taiwanese nursing students.DesignCross-sectional survey study.SettingsA nursing college in central Taiwan and a university in eastern Taiwan.Participants814 nursing students.MethodsLevel of stress of the participants was measured using the 43-items Stressors in Nursing Students (SINS) scale, which was translated into a traditional Chinese version (TC-SINS). Simple and multiple linear regression analyses were used to evaluate factors significantly associated with stress.ResultsA total of 814 nursing students completed the questionnaire with a return rate of 83.6%. The mean age of the participants was 18.9 years and 94.8% was female. Regarding the students' interest in nursing, 2.6% expressed that they strongly or somewhat disagree. In addition, regarding the students' interest in clinical practicum placement, 7.2% indicated that they strongly or somewhat disagree. Results from multiple regression analysis showed that students who expressed somewhat or strong disagreement to interest in clinical practicum placement were significantly associated with a higher level of stress. Of the various strategies for stress relief, listen to music (75.2%) was the most popular choice, followed by talk to a friend (72.3%), and catch up on sleep (61.3%). A third of the participants used three strategies for stress relief.ConclusionsLow interest in clinical practicum placement was associated with increased stress levels in nursing students in Taiwan. Future studies should explore the underlying reasons for stress induced by clinical practicum placement, and possible solutions for stress reduction in nursing students.
  • Acceptability, utility, and undergraduate nursing student satisfaction
           with a video assessment of clinical skills
    • Abstract: Publication date: Available online 19 October 2019Source: Nurse Education TodayAuthor(s): Peter Lewis, Leanne Hunt, Lucie M. Ramjan, Miranda Daly, Rebecca O'Reilly, Yenna SalamonsonAbstractBackgroundClinical skill assessment via Objective Structured Clinical Assessment (OSCA) has many challenges for undergraduate nursing students. These include high levels of anxiety that can compromise performance during the assessment, inconsistency with assessor reliability and is inconsistent with clinical skills performance in the real world. The implementation of a Video Assessment of Clinical Skills (VACS) that integrates formative feedback may be a way to address the challenges posed by OSCA assessment.ObjectivesThe aim of this study was to examine the acceptability, utility, and nursing student satisfaction with a formative feedback strategy – the Video Assessment of a Clinical Skill (VACS).DesignA cross sectional survey.SettingsUndergraduate Bachelor of Nursing degree students from a large Australian University.ParticipantsThird year undergraduate nursing students (final year) enrolled in a Bachelor of Nursing Program.MethodsParticipants were recruited via purposive sampling. A pre-survey (prior to VACs assessment) and post-survey (after VACS assessment) were completed. This paper reports on the open-ended responses in the post-survey that explored students' insights and perceptions into formative feedback and its impact on their learning for the VACS assessment.ResultsA total of 732 open-ended responses were analysed with findings being organised into 3 major themes; (i) Flexibility and reflexivity, (ii) Editing and repeated attempts, and (iii) Working together.ConclusionsVideo Assessment of a Clinical Skill has demonstrated good utility, acceptability, and satisfaction among undergraduate nursing students.
  • The effect of psychiatric nursing students' internships on their beliefs
           about and attitudes toward mental health problems; a single-group
           experimental study
    • Abstract: Publication date: Available online 19 October 2019Source: Nurse Education TodayAuthor(s): Nurhan Çingöl, Mehmet Karakaş, Seher Zengin, Ebru ÇelebiAbstractBackgroundIt is important that nursing students develop positive beliefs and attitudes toward individuals with mental health problems during nursing education in order to provide an effective nursing care and create a therapeutic environment.ObjectiveThis study was conducted to analyze the effect of psychiatric nursing internship practice and the personal characteristics and preferences of psychiatric nursing interns on their beliefs and attitudes toward mental illnesses.DesignThis is a single group experimental study with a pre-test and post-test.ParticipantsThe study sample included 33 fourth-year nursing students enrolled in the School of Health who participated in an internship in psychiatric nursing.MethodologyThe study data were collected using a student information form, the Community Attitudes Toward the Mentally Ill Scale (CAMI) and the Beliefs Toward Mental Illness Scale (BMI) at the beginning and end of the 14-week internship of 32 h per week.FindingsThe students' beliefs and attitudes toward mental health problems were found to be moderate with no significant differences between mean pre-test and post-test scores.ConclusionThe psychiatry nursing internship practice yielded minimal positive changes in students' beliefs and attitudes toward mental health problems. Initiation of the process of developing positive attitudes and beliefs in the first year of nursing education and increasing the internship period may provide more effective results.
  • The effects of training with simulation on knowledge, skill and anxiety
           levels of the nursing students in terms of cardiac auscultation: A
           randomized controlled study
    • Abstract: Publication date: Available online 19 October 2019Source: Nurse Education TodayAuthor(s): Birgul Vural Doğru, Leyla Zengin AydınAbstractBackgroundThe use of simulation methods in nursing education is important in terms of decreasing anxiety of students in a safe and realistic environment due to the improvement of knowledge and skills of students in terms of cardiac auscultation and their attitudes to prepare for clinical applications.ObjectivesThe aim of this study is to compare the effectiveness of high-fidelity simulator and traditional teaching method on nursing students' knowledge and skill development in terms of cardiac auscultation and their anxiety levels.DesignRandomized controlled study.SettingThe study was conducted in the simulation laboratory of the Nursing Department in the Health College and in the inpatient clinics of the Medicine Faculty Hospital.Participants72 first-year nursing students (simulation group = 36, control group = 36).MethodsThe students were randomly distributed to the simulation and control groups. The students in the simulation group received a cardiac auscultation training by using a high-fidelity simulator while the students in the control group received training with the traditional teaching method. After the training sessions, all students practiced their skills in the laboratory and on real patients in clinical setting under the supervision of the researcher. The data were collected by using the Demographic Information Form, Knowledge Assessment Form for Cardiac Auscultation, Skill Evaluation Form for Cardiac Auscultation and State Anxiety Inventory (SAI).ResultsHigh-fidelity simulators and traditional teaching method were found to be effective in increasing the students' knowledge and skill levels in terms of cardiac auscultation. However, it was found that the high-fidelity simulator method was more effective than the traditional teaching method to increase the students' knowledge (p = 0.001) and skill (p 
  • Training in communication and interaction during shift-to-shift nursing
           handovers in a bilingual hospital: A case study
    • Abstract: Publication date: Available online 19 October 2019Source: Nurse Education TodayAuthor(s): Jack Pun, E. Angela Chan, Suzanne Eggins, Diana SladeAbstractAimTo explore the perceptions and practices of nurses on handovers.BackgroundAt handover, accountability must be transferred to ensure a consistent quality of patient care. Studies highlighted unstructured handovers as a major factor contributing to critical incidents. The design of handover training requires a systematic method for evaluating nurses' practices.DesignAn explorative case study, qualitative design that combined ethnography with discourse analysis.MethodsA training programme based on these practices was administered to 50 nurses, and a protocol focused on CARE was implemented. The nurses' perceptions and practices were evaluated, and 80 handovers were recorded.ResultsThree areas likely to enhance the continuity of care emerged: 1) explicit transfer of responsibility by outgoing nurses; 2) responsible engagement of incoming nurses in the handover and 3) adherence to a systematic handover structure.ConclusionThe change in practice from monologic handovers with passive incoming nurses before training to interactive and collaborative handovers, where all nurses appeared to take an active role in clarifying patients' cases, after training was significant.
  • Student feedback delivery modes: A qualitative study of student and
           lecturer views
    • Abstract: Publication date: Available online 18 October 2019Source: Nurse Education TodayAuthor(s): Clare Killingback, Dawn Drury, Preeti Mahato, Jonathan WilliamsAbstractBackgroundStudent feedback on assessment is fundamental for promoting learning. Written feedback is the most common way of providing feedback yet this has been criticised by students for its ineffectiveness. Given the wide range of feedback modes available, (written, audio, video, screencast, face-to-face, self and peer-feedback) a better understanding of student and lecturer preferences would facilitate recommendations for optimising feedback delivery. The aim of this study was to explore the experiences and preferences for summative feedback modes of physiotherapy students and lecturers.MethodsA sample of convenience was used to recruit participants from one undergraduate physiotherapy programme in the UK. A total of 25 students were recruited for three focus groups and five lecturers for semi-structured interviews. Focus groups and individual interviews were guided by a semi-structured interview guideline and carried out by a research assistant who was not involved in teaching on the programme and therefore unknown to participants. Data were analysed using inductive thematic analysis.ResultsThree themes were developed in relation to student and lecturer experiences of feedback to date: the importance of dialogue; the value of feed forward; and feedback disparity. From the student perspective, three themes were identified supporting their feedback preference: the importance of human connection; added information from non-verbal communication; valuing the lecturer view. From the lecturer perspective, two themes were identified around feedback preferences: challenges of spoken feedback and the importance of self-assessment.ConclusionsThis study identifies challenges around selecting optimal feedback modes due to the lack of student-lecturer consensus. Students preferred lecturer-led modes, providing the highest quality personal interaction with lecturers (face-to-face, screencast, video, audio). Lecturers most often advocated for student led feedback modes (peer or self-assessment) as a means to students valuing the feedback and developing reflective skills.
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