Collaborative learning linking nursing practice and education - Interview study with master's students and teachers

BACKGROUND

Collaborative and innovative educational approaches are essential to building nurses' competencies in responding to healthcare challenges and to enhance high-quality nursing practice. Nurses are increasingly learning in various contexts, and thus, the understanding and organising of collaborative learning needs further exploration.

AIM

To describe collaborative learning in nursing practice and education from the point of view of nurses, involved as students and teachers in master's education in nursing.

DESIGN AND METHODS

Qualitative study using semi-structured focus groups involving 33 nurses as master's students and teachers from Estonia and Norway. The data were analysed using inductive content analysis.

FINDINGS

The essence of collaborative learning in the context of nursing practice and education was identified as the aggregation of diverse learners' skills and reflections while working towards shared aims. This fostered the development of workplace competencies, professional attitudes, and personal growth. Organising collaborative learning requires careful planning and synchronisation between clinical and educational organisations.

CONCLUSIONS

Collaborative learning is an inclusive method, aiding nurses at different phases of their career to gain knowledge and enhance their soft skills, and potentially reducing professional hierarchies. Further research is needed to develop methods for evaluating the outcomes of collaborative learning.

Qualitative comparative analysis of learning engagement among Chinese part-time master's students in nursing

BACKGROUND

Graduate nursing education plays an important role in the development of an innovative nation. Such education benefits the health of the community by cultivating competent and highly skilled nurses who can provide safe and quality nursing care. The number of students pursuing nursing degrees in China is insufficient, to meet the social demand for advanced practice nurses. The part-time Master of Nursing Specialist program for students offers flexible learning options for working nurses. However, the relatively low level of learning engagement exhibited by this group has raised concerns among policy-makers and nursing educators. An in-depth study of the factors affecting the learning engagement of part-time Master of Nursing Specialist postgraduates, especially with regard to their combined effect, is expected to provide a basis for improving the level of learning engagement among such students.

METHODS

This study used ability-motivation-opportunity-theory and fuzzy-set qualitative comparative analysis to analyze the relationships between five conditions (i.e., supportive campus environment, supportive work environment, student-faculty interaction, research motivation and time management ability) and learning engagement by reference to data collected from a sample of 225 part-time Master of Nursing Specialist students who were enrolled in China.

RESULTS

The fuzzy-set qualitative comparative analysis results indicated that individual examples of these antecedent conditions were insufficient to influence learning engagement. In contrast, three combinations of the five conditions led to high levels of learning engagement, and substitutability and complementarity were observed among the various elements in the configuration.

CONCLUSIONS

Research motivation, student-faculty interaction, a supportive work environment and time management are factors that can influence part-time postgraduates' learning engagement. Supervisors can enhance their research skills and expertise, hospitals can establish supportive environments for students, and students can strengthen their research motivation and time management abilities.

A Mixed-Method Pilot Project: The Evaluation of Telehealth Training in a College of Nursing

ABSTRACT

Telehealth has become ubiquitous, and advanced practice nurses will need to be proficient in its use. Recent literature has shown that graduate nursing curricula may not fully prepare students for clinical telehealth practice. This article describes an interactive, module-based course that was built using instructional design principles for the training of graduate nursing students to prepare them to conduct telehealth encounters. The course was proven to be efficacious based on pre-post test results and critical reflections. The blueprint described can be used by nurse educators and administrators to prepare nurses to provide safe and effective telehealth services.

Transforming Nursing Education: Developing Augmented Reality Procedural Training

The shortage of nursing faculty and the scarcity of clinical placements have compelled researchers to investigate innovative solutions for procedural development to bridge the gap between didactic teaching and clinical experiences. This feasibility study uses augmented reality (AR) with Microsoft HoloLens2 and Dynamics 365 Guides to train graduate nursing students on advanced nursing procedures, focusing on lumbar puncture. A convenience sample of 24 nurse practitioner students participated in the study. The System Usability Scale, Acceptability Scale, and Engagement Scale were used to assess participant's experiences and perceptions. The results are positive for the feasibility and acceptance of AR technology for procedural training. Participants found the HoloLens2 device easy to use and showed confidence in its functionality. The step-by-step instructions provided by Microsoft 365 Guides were understandable, useful, and satisfactory. The students reported high levels of engagement and found the AR experience to be helpful and motivating for learning. Faculty time was significantly reduced using the HoloLens2 for procedural training compared to traditional methods. This study demonstrates the potential for AR as an effective and efficient modality for nursing education. The findings support the integration of AR technology to enhance procedural development, address the challenges of limited clinical sites, and provide students with an immersive and self-paced learning experience. Additional studies will need to explore the impact of AR on clinical competency, patient outcomes, and cost-effectiveness. Overall, the use of AR technology may be useful and effective for nursing pedagogy.

To choose or not to choose a nurse practitioner fellowship: An opinion piece on why to choose

ABSTRACT

New graduate nurse practitioners (NPs) often face a challenging learning curve, especially in specialized fields. The quality of clinical experiences and education varies widely across NP programs, and NP Fellowships offer an extension of formal education and clinical experiences. This editorial offers a personal perspective into the NP Fellowship experience and affirms their value to improve the standard of patient care and equip novice NPs for a sustainable career.

Integrating Strengths-Based Nursing and Healthcare in Pediatric Nursing Education: A Case Study of the Ghana-SickKids Partnership

There is growing recognition of the critical role nursing leadership plays in healthcare. Integrating strengths-based approaches into nursing education enables positive learning settings and empowers nurses as leaders who foster healing and well-being for patients and their families. This paper describes an effort to integrate Strengths-Based Nursing and Healthcare (SBNH) and Strengths-Based Nursing and Healthcare Leadership (SBNH-L) into the development, implementation and evaluation of a postgraduate pediatric nursing program in Ghana. In the evaluation of the program in Ghana, three themes emerged related to strengths-based nursing: transformation of teaching and learning, impact on relationships with colleagues and impact on relationships with patients.

Exploring the status and critical issues in mixed methods research in doctoral nursing education in the Philippines

BACKGROUND

Mixed methods research (MMR) can be a pathway for doctoral nursing students to create innovative and noble contributions for the advancement of nursing theory, practice, and education. Several issues and challenges must be identified to successfully train, mentor, and support doctoral nursing students in conducting MMR.

AIM

The study aimed to explore the status and critical issues in conducting, mentoring, and training MMR in doctoral nursing programs in the Philippines.

METHODS

A descriptive qualitative study was conducted by performing semi-structured online interviews with 10 purposively selected participants who were faculty and educators with doctoral degrees, involved in teaching and mentoring MMR among doctoral nursing students in the last 10 years. Data were analyzed using Braun and Clarke's thematic analysis.

FINDINGS

Four key themes emerged, namely, (1) perceptions on the use of MMR, (2) facilitators to use MMR, (3) barriers to the use of MMR, and (4) recommendations to promote the use of MMR focused on the student, faculty, and educational institution levels.

CONCLUSION

Providing educational, institutional, and research support for doctoral nursing students and faculty could flourish the use of MMR in doctoral nursing programs with deeper meaning and reasoning.

A programmatic taxonomy to define, differentiate, and classify nurse practitioner postgraduate training

ABSTRACT

Postgraduate residencies and fellowships have become a growing foundational element in the early career path for new nurse practitioners (NPs) and for NPs changing areas of specialization. The proposed programmatic taxonomy provides a straightforward method to recognize and classify NP postgraduate training programs with differing missions, structures, and outcome objectives. Models of postgraduate training for NPs are identified, defined, and differentiated. Each model can serve as an essential and specific purpose for the sponsoring organization. The programmatic models for NP postgraduate training programs are residency, fellowship, and "additional programs." Differences between residency and fellowship are described. The taxonomy then compares and contrasts the three models on five overarching programmatic characteristics, namely, mission, goals, environment, evaluation, and duration. The potential impact of adopting the NP postgraduate training taxonomy on the NP profession, the public, funding, accreditation, and the early career development of NPs is explored. Recommendations for next steps are suggested.

A Virtual World: New Graduate Education in the Era of COVID-19

In this article, the authors share strategies of adult learning principles for successful transition to virtual learning for new graduate clinical nurses. Knowles' theory was used to redesign a simulation-based education approach to fulfill the diverse learning needs during the COVID-19 pandemic. The delivery of efficient, effective, and meaningful education was achieved by leveraging technology. This evidence-based strategy was delivered via a cost-effective virtual platform that offered improved accessibility and convenience of education without compromising the quality of the educational outcomes, participant engagement, or learner satisfaction. This virtual platform incorporating a variety of active learning strategies exhibited effective practices, engaging the new graduate clinical nurses and enhancing their acquiring, retaining, and applying knowledge in providing high-quality and safe patient care. It demonstrated the promise that virtual education holds for future programs to enhance professional development and build the nursing workforce. Nurse educators can be instrumental in advancing this virtual agenda. [J Contin Educ Nurs. 2022;53(7):307-311.].

Postgraduate Programs in Orthopaedic Surgery for Physician Assistants and Nurse Practitioners

Postgraduate orthopaedic programs for physician assistants (PAs) and nurse practitioners (NPs) number 14 as of 2020. To better understand the characteristics of these programs a census was undertaken. The result is that most programs are 1 year in duration and in 2019 produced 40 graduates. The role of the orthopaedic PA and NP fellow is to gain an understanding of a wide range of musculoskeletal disorders, develop procedural skills, first assist in the operating room, and facilitate management of patients and discharge throughput. PA and NP fellows work alongside categorical orthopaedic physician residents. The number of graduates from PA orthopaedic training programs is estimated at 200, spanning 20 years. The other 11,145 + PAs (99%) are trained on-the-job. For hospital systems, the employment of orthopaedic postgraduate PA and NP fellows provides value through cost management and billable services.

Quantifying and Remediating the New Graduate Nurse Resident Academic-Practice Gap Using Online Patient Simulation

BACKGROUND

There is an ever-widening academic-practice gap. Less than one third of new graduates demonstrate entry-level competencies required for practice. Hospitals expend many resources to create nurse residency programs to remediate this gap. Online interactive case simulation is effective to increase competencies and decrease the length of orientation and rate of turnover. The aims of this pilot research study were to quantify the academic-practice gap and to strengthen areas of development for competent and safe clinical practice through use of an online patient simulation program.

METHOD

A pretest-posttest quasi-experimental study using an online patient simulation program was implemented in a convenience sample of nurse residents over 16 months.

RESULTS

Twenty-nine residents completed more than 3,400 patient simulations. Improvement in pretest and posttest metrics included 100% of nurse residents committing a sentinel error event decreased to 20.7%, 766 medication errors decreased to 160, and failed-to-rescue an average of 81% of the time decreased to 23%.

CONCLUSION

Interactive online patient simulation programs provide a powerful learning methodology in which learners improve patient safety and reduce failures to rescue. [J Contin Educ Nurs. 2021;52(5):240-247.].

Using a Manuscript Template to Foster Dissemination of Doctoral Students' Literature Reviews

BACKGROUND

The author was asked to teach a new PhD course, Developing Literature Reviews. The course objective is to have students prepare a structured (e.g., integrative, systematic) literature review manuscript that is suitable for publication submission.

METHOD

Course pedagogy and materials were created, including a novel literature review manuscript template. The template served as a guide for communicating essential section components of a rigorous and reproducible literature review manuscript and allowed for an iterative process and efficient faculty-student evaluation system to simulate the peer-review process. To measure student outcomes, standardized course evaluations were reviewed, and the number of students who were successful in disseminating manuscripts was recorded.

RESULTS

Students' standardized course evaluations were high. Eighteen students published integrative or systematic literature reviews as first author. Eleven students have presented peer-reviewed abstracts at scientific conferences.

CONCLUSION

The template successfully facilitates PhD student dissemination. The Doctor of Nursing Practice student pedagogy may also benefit from the template. [J Nurs Educ. 2021;60(2):111-115.].

Inconsistency in Faculty and Student Perceptions of DNP and PhD Leader Scholarly Activity

OBJECTIVE

We aimed to quantify faculty and student perceptions of scholarly activities for doctor of nursing practice (DNP) and PhD leaders.

BACKGROUND

The American Association of Colleges of Nursing describes DNP as a practice-focused degree and PhD as a research-focused degree. In 2016, the Council on Graduate Education for Administration in Nursing (now Association for Leadership Science in Nursing) published in the Journal of Nursing Administration sample practice objectives for DNP and research objectives for PhD leaders.

METHODS

Using the published objectives, we surveyed faculty and students to quantify congruence with the publication and consistency within groups. The data informed intraprofessional education constructed using action research.

RESULTS

There was low congruence between faculty and student responses with the article. PhD faculty had the least, and PhD students, the greatest, consistency in survey responses.

CONCLUSIONS

Confusion exists within our faculty and students around differentiating PhD and DNP scholarly activities. Data supported need to clarify scholarly role boundaries through intraprofessional education.

An Assessment of Lesbian, Gay, Bisexual, and Transgender Health Competencies Among Bachelors-Prepared Registered Nurses in Graduate-Level Study

PURPOSE

To assess graduate nursing students' lesbian, gay, bisexual, and transgender (LGBT)-specific health competencies.

METHOD

Using a cross-sectional design, a 13-item multiple response survey, derived from The Joint Commission guidelines and LGBT health competencies proposed by the Association of American Medical Colleges, was administered online to 116 registered nurses enrolled in graduate study. Survey items assessed nurses' knowledge of LGBT health, professionalism, provision of patient care, communication skills, care environment, gaps in learning, and systems-based practice. Descriptive analyses were used to summarize frequencies and proportions of study variables.

RESULTS

Respondent nurses' knowledge about health, prevalent conditions, and social factors that influence LGBT health was somewhat limited. Respondents did not rate their knowledge about LGBT health high (µ = 3.11 [1.1], median = 3) and did not feel qualified to educate other colleagues about LGBT health issues (µ = 2.43 [1.26], median = 2). But 58% (n = 65) indicated that they felt comfortable performing prostate exams on transgender female patients (born with male genitalia); 62% (n = 70) felt comfortable doing pap smears for transgender male patients (born with female genitalia). Sixty nurses (52%) stated that they would advocate reforms within existing health care institutions to improve the care of LGBT patients. Cultural competency training was offered in some health care settings and environmental indications of inclusivity were inconsistent.

CONCLUSIONS

LGBT health competence among graduate nursing students was limited. There is a need to reevaluate LGBT health-related content in nursing curricula as well as robust assessment of competence in LGBT health.

Making explicit the development of PhD-prepared nurses to steward the discipline

Leadership is a core curricular element of PhD programs in nursing. Our PhD faculty began a dialogue about being a leader, a steward of the discipline. We asked ourselves: (a) What expertise do PhD prepared nurse needs to begin to steward the discipline? (b) How do faculty engage PhD nursing students to assume responsibility for stewarding the discipline? Lastly, (c) How do we work with PhD nursing students to create their vision for how their work contributes to stewarding the discipline, from doctoral coursework throughout their career? We support the need for PhD graduates to have the skills to generate knowledge, conserve that which is important, and transform by disseminating new knowledge to a broad audience. Examples of nurses stewarding the discipline when pioneering research, critiquing traditional approaches to inquiry or trends in nursing practice, and developing policy, are highlighted along with examples of how PhD nursing students begin to steward the discipline.

Use of Course-Specific Open Educational Resources in a Graduate Nursing Course

BACKGROUND

This article evaluates a single-institution educational innovation using course-specific open educational resources (OER).

METHOD

This educational innovation uses a course-specific library resource guide of OERs and evaluates students' perspectives on the quality, integration, and experience with the resources. At the completion of a nursing graduate course, the OER Satisfaction Scale was administered to the course participants. The course-specific OERs were assessed compared to students' experiences with traditional course materials.

RESULTS

The overall score on the OER Satisfaction Scale was 4.01 on a 5-point Likert Scale. Students appreciated that the resources were free and found that the information was manageable and easy to navigate. However, they were challenged with shutting out other distractions and taking useful notes.

CONCLUSION

Using OERs enhanced student engagement with the course content by requiring learners to assume a more active role as course participants. Further work is needed to understand the effectiveness of OERs, particularly in graduate nursing education. [J Nurs Educ. 2020;59(10):577-580.].

Nurse practitioner students' observations of preceptor engagement in obesity management and weight bias: A mixed-methods approach

BACKGROUND

Obesity is considered a growing epidemic in the United States. Nurse practitioners (NPs) have the opportunity to serve as leaders in addressing concerns related to disease management, particularly obesity. Currently, we lack an awareness of how NP students are learning obesity management from their preceptors.

PURPOSE

Thus, the current study sought to explore how NP students perceive preceptors' behaviors when managing patients with obesity.

METHODOLOGICAL ORIENTATION

This study used a mixed-methods design. Participants were asked to report how often they observed their preceptors engage in different strategies when interacting with patients with obesity (e.g., calculate body mass index, identify goals). Students were then asked to respond to the statement: "share observations you made of how patients with obesity were treated in this environment." Students completed 2 clinical rotations during this period and, thus, were asked to answer the questions twice to capture experiences at both clinical sites.

SAMPLE

Researchers surveyed 225 NP students completing clinical rotations in 3 settings (Family Practice, Pediatrics, and Obstetrics/Gynecology).

CONCLUSIONS

Quantitative results revealed significant differences in the frequency of observed obesity management behaviors by all preceptors. Qualitative results revealed that NP students most often observed preceptors displaying interpersonal warmth without weight bias when working with patients with obesity. Contrary to current literature, this sample of NP students observed their preceptors engaging in positive interactions with individuals with obesity.

IMPLICATIONS FOR PRACTICE

Educators must continue to teach students to engage in unbiased behavior toward patients. It is critical to continue to improve obesity management content offered in NP programs.

Strategies for progression in a PhD nursing program within a transition model

BACKGROUND

There is a need for interventions to improve the PhD pipeline for nursing program enrollment. PhD nursing students who have navigated the program successfully are in a strategic position to help by sharing their stories. Several strategies for successful completion of a PhD program and some common expected barriers have been documented in the literature.

METHOD

The authors used personal reflections from their first and second years of study in a PhD nursing program to identify strategies to progress through a program. The personal reflections were analyzed by their student cohort and a faculty advisor using the Bridges' Transition Model as a theoretical framework. The cohort members included five females and one male, ages 29-48, attending a PhD nursing program in the Southeastern, US.

RESULTS

The following strategies were identified from the personal reflections: seeking and offering support within your cohort; establishing a relationship with mentors; identifying and using a reference manager; mastering time management; soaking up statistics; and focusing on your focus. The strategies listed above occurred within the ending and/or neutral zone phases of the Bridges' Transition Model.

CONCLUSION

It is important to note the early phases of transition and need for success strategies in these specific phases of transition. PhD nursing students are in a strategic position to positively influence the PhD pipeline by providing personal reflections that inform future PhD nursing students as well as PhD nursing programs.

Integrating an Online Statistics Course With a Graduate Nursing Research Course for Enhanced Learning

BACKGROUND

Exploration for innovative pedagogical techniques to teach statistics led to examination of the Open and Free Courses offered through the Carnegie Mellon University Online Learning Initiative (CMU OLI). This study examined the impact of the CMU OLI statistics course on graduate nursing students' course grades and course evaluations.

METHOD

This retrospective study of a hybrid course compared three teaching modalities for statistics: 1) face-to-face workshop, 2) CMU OLI course, and 3) CMU OLI course plus online discussions.

RESULTS

Mean grade point averages increased sequentially and significantly. Individual students' grades improved and student evaluations of instruction mean scores for critical thinking, teaching effectiveness, overall course rating, and overall learning increased significantly (p < .01).

CONCLUSION

Future studies are needed that build knowledge of how open and free online courses can be used in nursing education to facilitate retention of content, allay statistics anxiety, and increase student motivation toward research. [J Nurs Educ. 2020;59(4):227-230.].

Applying Complexity Science as a DNP Quantum Leader

As Doctor of Nursing Practice (DNP) students and graduates begin to apply new knowledge in real-life situations, they are transforming their organizations. The impact of DNP projects is noted by measurable outcomes in diverse settings. This article presents 4 unique clinical/organizational examples of DNP projects. The authors have identified an application of complexity science and leadership theory in their practice changes. In addition, they share their thoughts and feelings as emerging leaders.

Educational characteristics and content of postgraduate nurse practitioner residency/fellowship programs

BACKGROUND

Nurse practitioner (NP) residency/fellowship programs are an emerging industry across the country.

PURPOSE

This study aimed to conduct an in-depth exploration about postgraduate NP residency/fellowship programs in the United States and to gain an understanding of program characteristics, educational content, and implementation methods to assist NPs to transition to practice.

METHODS

This exploratory study used a quantitative design to conduct an online survey of program directors of NP residency/fellowship programs to collect data about program characteristics to assist graduates to transition to practice. Descriptive statistics were calculated for continuous variables, whereas frequency and percentage were calculated for categorical variables.

RESULTS

Nurse practitioner residency/fellowship programs lack consistency in standards for educational content and delivery methods. Only 26% of the programs were accredited, and the programs were not consistently based on nationally recognized competencies. Ninety percent of the programs relied on didactic and clinical supervision delivery methods. More than 90% of the residents/fellows cared for adults older than 65 years of age and managed chronic diseases. Family Nurse Practitioner was the most commonly cited population track offered (73%). Nurse practitioner residency/fellowship programs are sparsely offered in the most rural states with underserved populations.

IMPLICATIONS FOR PRACTICE

This study provides data and insight into the emerging industry of postgraduate NP residency/training programs for educators and employers. In addition, it informs regulators and decision makers about the quality and consistency of programs and the impact of programs on the care delivered by new graduate NPs.

An innovative course to prepare advanced practice registered nurses to spearhead quality and safety initiatives for older adults

ABSTRACT

Current trends dictate that advanced practice registered nurses (APRNs) must be competent to address quality/safety issues specific to older adults. A gap analysis and review of key competencies in an adult-gerontology APRN-Doctorate of Nursing Practice (DNP) curriculum prompted the design and evaluation of an innovative online course, Quality and Safety for the Aging Adult. Course objectives align with key competencies, including graduate-level Quality and Safety Education for Nurses (QSEN) and the DNP Essentials. The course purpose was to prepare adult-gerontology APRN-DNP students as leaders to promote quality/safety outcomes for aging adults. The six-step Knowledge-to-Action Framework guided course development and evaluation. Select graduate-level QSEN competencies were used to construct a 20-item Quality and Safety Survey (4-point Likert scale) (Cronbach's alpha, 0.916). This survey was used during week 1 (pre) and week 15 (post) of the semester to evaluate students' preparation and confidence to perform key QSEN competencies. Significant improvements (p < .000) between pre/post scores on the Quality and Safety Survey were found across five classes. Students felt more prepared and confident to apply selected QSEN competencies on course completion. Moreover, nearly 60% (primary care) and nearly 35% (acute care) adult-gerontology APRN students selected the older adult population for their DNP projects. The Quality and Safety for the Aging Adult course positively influenced five classes of adult-gerontology APRN-DNP students. Integrating QSEN competencies with gerontology and quality/safety content is an effective strategy to prepare APRNs to lead quality/safety initiatives in aging adults. This innovative online course offers a successful model for innovative DNP education of adult-gerontology APRNs.