Using an E-learning activity to enhance student nurses' understanding of cognitive impairment

BACKGROUND

Nurses often lack the knowledge and expertise to work with older people with cognitive impairment, which includes dementia, delirium and depression. This is due in part to deficits in their basic nursing education related to older people and managing the care needs of people with cognitive impairment. We developed an e-learning activity to facilitate student nurses' knowledge of cognitive impairment.

OBJECTIVES

To test if the e-learning activity could improve student nurses' knowledge of cognitive impairment and whether they would find the style of learning beneficial.

DESIGN

A quasi-experimental pre-post-test design was used to test if the cognitive impairment e-learning activity could improve student nurses' knowledge about assessing and managing the needs of older people who are experiencing cognitive impairment. A 12-item true/false quiz was completed by participants.

SETTINGS

One large Western Canadian university.

PARTICIPANTS

Second year nursing students in the four-year baccalaureate degree program, second year nursing students in the bilingual four-year baccalaureate degree program, and first year nursing students in the two-year after-degree nursing program were invited to participate. Data from 166 students were included in the analysis (n = 166).

RESULTS

Based on the results of a paired t-test (p < 0.001 and an average score increase of 1.12 out of nine), we conclude that students' knowledge about cognitive impairment in older people increased following the e-learning activity. Students also offered qualitative feedback that identified the activity as both helpful and as an enjoyable way to learn and provided suggestions for improvement.

CONCLUSIONS

This e-learning activity was effective in helping students learn about how to work with older people experiencing cognitive impairment. This mode of learning might be useful for other difficult-to-teach content areas.

Undergraduate Nurses' Attitude Change to Health Technology Implementation

The poster will report upon a longitudinal study exploring the attitudes towards the implementation of health technology into clinical and community nursing practice from the perspective of third year undergraduate students studying adult, child, mental health and learning disability nursing.

Demographic profiling of Caribbean and United Kingdom student nurses' use of social media for professional development

BACKGROUND

Most students are adept in using technology and have developed skills and confidence utilising SoMe for professional purposes. SoMe is used by both registered nurses and student nurses.

PURPOSE

The purpose of this study was to investigate the professional use of SoMe by student nurses in Trinidad and Tobago, Jamaica and the UK to guide, support and develop implementation of effective and appropriate use of SoMe for professional development.

METHODS

An online cross-sectional survey was completed by student nurses from the three countries. Data were analysed using descriptive statistics.

RESULTS

The main reason for using social media among Caribbean participants was to watch videos or short clips whereas in UK it was downloading articles. Over 75% participants of all ages believed that social media was likely to help their career. There is no social media guidance for student nurses in Trinidad and Tobago and Jamaica.

CONCLUSION

Our study demonstrated that social media is embedded in student nurses' professional development throughout their education, with some variation in their use by country. Despite the fundamental place that social media plays in student nurses' professional development, there is no national or international guidance on how student nurses should use social media for professional development.

International student nurses' use of social media for learning: A cross sectional survey

BACKGROUND

Students use social media for sharing information and connecting with their friends, also for peer support, peer learning and student engagement. Research indicates that approximately twice the number of students were using social media for educational purposes compared to academic staff and almost all students discuss academic issues on social media. However, little is known about how diverse cohorts of student nurses use social media for specific purposes at different stages of their learning.

OBJECTIVES

Identify how student nurses in each country of study use social media for learning. Identify how each generation of student nurses use social media for learning. Identify how student nurses use social media as their education progresses.

DESIGN

A cross-sectional survey.

SETTINGS

The study was undertaken across three countries Jamaica, Trinidad and Tobago and the UK.

PARTICIPANTS

Student nurses from each of the countries that consented to participate met the inclusion criteria.

METHODS

1050 student nurses across the three countries self-completed the cross-sectional survey between March and September 2019. Data was analysed using descriptive and inferential statistics.

RESULTS

WhatsApp® was the most used platform for learning amongst participants. Watching videos and downloading articles represented two-thirds of social media usage for learning. Smart phones were the most used device to access social media. Kruskal-Wallis tests were significant (≤0.001) for checking social media and messaging in lecture, use of social media for studies and classroom activities by country, generation (except classroom activities) and year of education. Use of social media for classroom activities had no significance by generation.

CONCLUSION

Country, generation and year of education are factors that influence the use of social media in student nurses' learning. These should be considered by Universities in curriculum development and in teaching and learning delivery. From a pragmatic approach, social media is available and used by a majority of student nurses and can be widely assimilated into the nursing curriculum.

"Nursing and speech and language students' perspectives of reflection as a clinical learning strategy in undergraduate healthcare education: A qualitative study"

AIM

The aim of this study was to explore nursing and speech and language students' perspectives of reflection as a clinical learning strategy during years three and four of their undergraduate education programmes.

BACKGROUND

Reflection is recognised as a core student learning activity which is widely used in undergraduate healthcare education for clinical practice. Studies indicate that structured models and frameworks do help novice students to develop the process of reflection-on-practice particularly in years one and two. However, there is limited research on healthcare students' perspectives of reflection as a clinical learning strategy in the latter years of their undergraduate healthcare education (years 3 and 4).

DESIGN

A qualitative descriptive design was used.

METHODS

Using a self-reporting method whereby students respond to a series of questions posed by the researchers, data were collected from nursing (n = 20) and speech and language students (n = 26) in one university in Ireland and analysed using thematic analysis.

RESULTS

The findings from both nursing and speech and language students were similar. Three themes identified included: description of reflection, undertaking reflection and contribution to clinical learning. Most students expressed beneficial effects of reflection for personal and professional clinical learning. Some students reported negativities to the written reflections, expressing a preference for more diverse and less structured strategies and more face-to-face reflective discussions with clinical educators.

CONCLUSIONS

Whilst the benefits of reflection for clinical practice are well versed in this study, the authors suggest that academic and clinical educators employ more diverse and innovative reflective tools for healthcare students who are at a more competent level of their undergraduate education programme. Further interprofessional research in relation to different clinical reflective strategies for healthcare students in years three and four of their undergraduate education programmes is warranted.

Supporting student nurses to develop healthy conversation skills

As advocates for health, nurses are ideally situated to deliver effective health promotion in their daily interactions with people. This work evaluates the integration of healthy conversation training, making every contact count (MECC), into a health promotion module in an undergraduate nursing degree at a higher education institute (HEI). In all, 108 students completed the online questionnaire I year after receiving healthy conversation training. 67% of students reported the regular or occasional use of healthy conversation skills and identified a wide range of scenarios where they had used the skills. 65% of students used health action planning framework in their own personal self-care. Student nurses acknowledged barriers and enablers to their use of healthy conversation skills. Having knowledgeable mentors who role modelled healthy conversations skills in their consultations was the most frequently raised factor, in addition to lack of knowledge of local resources, time and confidence. All placement settings should ensure that registered nurses, especially those undertaking mentorship responsibilities have access to healthy conversation training.

The experiences of student nurses in a pandemic: A qualitative study

Aim/objective

To record and learn from the experiences of students working on clinical placement in a pandemic.

Background

In March of 2020, final and second year student nurses in England were given the option to join the Covid-19 pandemic work-force, paid as high-level health care assistants.

Methods/design

Using qualitative methods and rapid analysis techniques, this study gathered the unique experiences of 16 final year students, from all fields of nursing at a University in the East of England, who chose to complete their final extended placement in a diverse range of clinical placements at the height of the first wave of the pandemic. Data was collected between July and September 2020.

Results

Five key themes were identified across our data: rationale for undertaking the extended placement, role tensions, caring for patients and their families, the impact on teaching and learning, and personal health and wellbeing.

Conclusions

While our participants reported largely positive experiences including a perceived heightened preparedness for qualification, their experiences provide important insights for nurse educators for the education and support of future students going into similar situations, in particular relating to welfare and support, preparation for placement, resilience, e-learning and learning on the front line.

Developing a consensus-based scoring rubric to enhance practice-based assessment of student nurses' clinical competence: A Delphi study

BACKGROUND

Concerns about reliability and validity of practice-based assessment of professional competencies are frequently reported in the literature. Difficulty in understanding competency statements or distinguishing different achievement levels has been found to be a major factor.

OBJECTIVES

To develop a consensus-based scoring rubric based on stakeholders' interpretations of level descriptors for student nurses' professional values competencies.

DESIGN

Two rounds of Classic e-Delphi.

SETTINGS

This study was conducted in a London based university using Bristol Online Survey website as a host.

PARTICIPANTS

100 stakeholders with vested interests in undergraduate pre-registration nurse education were purposefully invited to participate.

METHOD

Round one collected free-text interpretations of the United Kingdom Nursing and Midwifery Council professional values competency statements. Round two used a Likert scale questionnaire to measure the level of agreement to the level descriptor statements generated through round one. Responses were analysed through content analysis in round one and consensus measure in round two. A threshold of 70% agreement to determine consensus was set in advance.

RESULTS

In round one, 47 participants provided their interpretations of the competency statements. In round two, 51 participants completed the questionnaire. All 24 items achieved a strong consensus with 86%-100% of participants agreeing or strongly agreeing with the statements.

CONCLUSIONS

A Delphi study was successfully used to develop a consensus-based scoring rubric with clearly stated descriptors for professional values competency statements. This scoring rubric holds the potential to enhance practice-based assessment across all healthcare professional disciplines.

South African student nurses' experiences of professional nurses' role-modelling of caring

BACKGROUND

Student nurses are expected to implement a caring practice in order to become professional nurses. Caring has remained the art and science of nursing, which student nurses learn from professional nurses during clinical practice. The South African Nursing Council mandates professional nurses to teach and supervise student nurses to master the art of caring during clinical practice. Caring is taught through role-modelling of daily nursing activities.

RESEARCH PURPOSE

This study was performed to gain an understanding of South African student nurses' experiences of professional nurses' role-modelling of caring.

METHODS

Phenomenological, qualitative research. Purposive sampling of fourth-year student nurses.

DATA COLLECTION

focus groups, observations and field notes. The data were analysed using Giorgi's modified Husserlian five-step method. Ethical principles were respected.

RESULTS

Three themes were identified. Theme 1: inconsistency in the clinical environment; Theme 2: effective and ineffective role-modelling of caring and Theme 3: carelessness cascading.

CONCLUSIONS

The study facilitated an understanding of student nurses' experiences of professional nurses' role-modelling of caring. Recommendations to facilitate professional nurses' role-modelling of caring in a public hospital were formulated: Mentorship training, recognition system for professional nurses, clinical support for student nurses, open channels of communication, random nurse leader rounds, employee wellness program, workshops and positive learning environment promotion.

COVID-19 vaccination readiness among nurse faculty and student nurses

BACKGROUND

Unprecedented efforts are underway to develop COVID-19 vaccines, widely seen as critical to controlling the pandemic. Academic nursing leaders must be proactive in assuring widespread faculty and student vaccination uptake.

PURPOSE

The purpose of this study was to describe nursing faculty and student nurse factors associated with COVID-19 vaccine readiness.

METHODS

Cross-sectional online survey of nursing faculty and student nurses at a university affiliated with an academic medical center was conducted.

FINDINGS

Most full-time faculty (60%) intended to receive the vaccine; but only 45% of adjunct faculty and students reported intending to get vaccinated. The major reasons for not getting vaccinated were vaccine safety and side effects. Collectively, participants reported a low level of knowledge related to vaccine development.

DISCUSSION

As the most trusted profession, nurses will play a decisive role in counseling patients about COVID-19 risks and benefits. Findings suggest that academic nursing leaders need to consider faculty and student vaccine concerns and provide vaccine development education.

Delivering resilience training to pre-registration student nurses in partnership with a reservist military organisation: A qualitative study

BACKGROUND

Nurses need resilience to safeguard their well-being. In collaboration with a military reservist organisation the Team Series was designed to foster resilience by promoting teamwork and leadership skills in student nurses.

OBJECTIVES

To explore participants' experiences of engaging with the Team Series and the skills and knowledge acquired.

DESIGN

A qualitative design.

SETTING

A Scottish University.

PARTICIPANTS

Fourteen 3rd year pre-registration nursing students, ten academic staff and ten reservists.

METHODS

Audio-taped focus groups and interviews thematically analysed.

RESULTS

Students conceptualised resilience as clinical competence, valuing an active learning process enabling them to practice clinical and interpersonal skills, utilising a range of communication, team-building, leadership and problem-solving skills. Participation in the Team Series fostered self-awareness and self-confidence, the foundations of resilience, helping students feel more competent in coping effectively in stressful situations.

CONCLUSION

The positive impact of collaborating with a military organisation experienced in developing team-working and leadership skills is demonstrated. Learning experiences designed to promote physical and emotional resilience should be threaded throughout curricula to ensure these attributes are developed and sustained over time.

Creating safety in care: Student nurses' perspectives

Nursing is often hazardous work. Promoting safety and care requires nurses to apply knowledge, skill and creativity in patient encounters. Nurses' risk exposures are well documented, with research on student nurses' safety more limited. We studied final-year nursing students' risk perceptions using questionnaire-based vignettes involving four patient presentations on patient aggression, manipulating patient and resource risk factors. We found student nurses were most likely to ask for help and wait when managing high-risk patient aggression scenarios. Student nurses placed most importance on their own safety and patient condition in making decisions. Resource risk significantly interacted with gender, with male nurses more likely to seek help when risks were high. There is need to improve student nurse training on managing patient aggression by promoting creative approaches to problem solving and critical thinking using simulation techniques to enhance situation awareness and translate knowledge to practice.

Introduction of patient electronic medical records (EMR) into undergraduate nursing education: An integrated literature review

BACKGROUND

To prepare student nurses for clinical practice where patient electronic medical records (EMR) competence is required, nursing undergraduate curricula must provide simulation access to developing this skill set. At this stage, however, the integration of electronic documentation into the Australian undergraduate nursing curriculum has been piecemeal. Aim The aim of this integrated literature review was to identify benefits and challenges for faculty nursing staff and nursing students in relation to the integration, use and evaluation of EMR in an undergraduate nursing program.

METHODS

A systematic search of relevant peer-reviewed research and project report articles was conducted in the electronic databases. Generic qualitative thematic analysis was then undertaken with themes generated from the data itself.

RESULTS

Fifty eight articles were identified, of these 23 were found to meet the inclusion criteria. Three major themes were identified: 1) Advantages of using EMR in academic settings, 2) Identified Challenges and Limitations of EMR programs; and 3) Developing an academic EMR program and implementing EMR education program in stages. All papers acknowledged that EMR will be standard in healthcare and should be viewed as an 'essential tool' for inclusion in undergraduate nursing programs.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

There is a significant increase of electronic technology in healthcare settings, especially relating to patient documentation. Therefore, teaching the use of EMR in the simulated clinical learning environment for new healthcare providers such as nursing students is essential. The papers reviewed identified an urgent need for higher education nursing programs to support undergraduate nursing students and faculty staff to ensure EMR can be implemented effectively into the undergraduate nursing curriculum.

Does a specialised orthopaedic trauma module utilising high fidelity simulation improve student nurses' perceptions of their competence? A pilot study

BACKGROUND

Trauma is the fourth leading cause of death in the western world, and traumatic injuries are recognised as clinically challenging to care for. Orthopaedic trauma care is not standard content in pre-qualifying nursing curriculums, compounded by a dearth in specialised post-qualifying education internationally. As a result, registered nurses may not have the clinical skill set to appropriately manage patients with traumatic conditions.

AIMS

To understand pre-qualifying student nurses' perceptions of their own competence in orthopaedic trauma care and understand if utilisation high fidelity simulation improves confidence, knowledge and application of theory.

METHODOLOGY

A small-scale qualitative pilot study utilising purposive sampling, designed to inform the development of a larger longitudinal study. A 5-point likert scale questionnaire with options for qualitative comments was administered after 8 weeks of a specialised module culminating in a high-fidelity simulation and in-depth debrief session. Thematic analysis was conducted.

FINDINGS

All students found that the module improved their confidence and knowledge in their skills set. The high-fidelity simulation was found to be an effective learning environment to translate theory to practice.

CONCLUSIONS

Specialised orthopaedic trauma training is effective in improving student nurses' knowledge and perceived competence in trauma care. High fidelity simulation is a valuable teaching tool to develop student's skill sets in complex scenarios and support application of theory to practice.

Student nurses, increasing placement capacity and patient safety. A retrospective cohort study

One solution to the global nursing shortage is to increase the numbers of student nurses: clinical placements need to increase their capacity to host them. Capacity increases have previously been viewed as problematic if they increase the supervisory burden on registered nurses, and unsafe if they dilute students' supervision. The aim of this study was to assess the impact on specific patient safety measures (pressure ulcers, falls and medications errors) of having students in placement being educated in Collaborative Learning in Practice (which increases capacity) compared to when they were not. Audit data were collected from four NHS trusts in the South West of England in a retrospective cohort study. We received data on 5532 adverse events from 15 clinical areas in four NHS trusts, with 996 students on placement between January 2018 and August 2019. The risk ratio and mean differences for adverse patient events were favourable (RR = 0.9842; 95%CI 0.9604-1.008; mean difference 279, 95%CI 213-346, p = 0.01). There was no statistically significant correlation between increased student numbers and increased adverse patient events. Our data must be interpreted with caution, but we conclude that increasing capacity for student nurses in placements appears to have a positive impact on patient safety.

Conflict, confusion and inconsistencies: Pre-registration nursing students' perceptions and experiences of speaking up for patient safety

There is growing evidence demonstrating that nursing students encounter unsafe and poor clinical practice when on clinical placement. The impact on nursing students remains relatively under-explored, especially in the Australian context. This two-phased qualitative study used Interpretive Description to explore 53 pre-registration nursing students' perceptions and experiences of speaking up for patient safety. Results of the study identified students believe speaking up is the right thing to do, and their professional responsibility. The study results add to previous research by describing the dissonance students experience due to the inconsistencies between what is taught at university and performed in practice. Student's distress arises when observing nurses taking short cuts, justifying such actions and making excuses about poor practice. Students report experiencing dissonance, bewilderment and confusion and at times, anger when observing poor practice. The clinical environment culture influences students' decisions to speak up or remain silent. Understanding students' perceptions and responses will promote awareness and discussion essential to the future development of curricula and clinical support strategies that will enable students to speak up.

Co-production of an intervention to increase retention of early career nurses: Acceptability and feasibility

Co-production is a process employed to solve complex issues, recognising the expertise of all stakeholders. This paper reports on co-production undertaken by nursing students, early career nurses and researchers as part of a larger study to design an intervention to increase retention of early career nurses. Mixed methods were used to evaluate the acceptability and feasibility of the co-production process in a UK university.

Data were collected prospectively, concurrently and retrospectively via interview and questionnaire, between April 2018 and January 2019.

Twelve co-production group members completed the questionnaire and six group members and facilitators were interviewed. Students and early career nurses reported personal benefit from participating; they developed and practised transferrable communication and problem-solving skills, believed they were able to make a difference, enjoyed contributing, found benefit from using the group as a reflective space and considered that co-production produced a credible intervention.

Findings indicated co-production equipped participants to function more effectively in their nursing roles; incorporating co-production into the development of future interventions may prove beneficial. The relative novelty of this approach, and the potential application of the findings to a diverse range of geographical and organisational settings, add to the utility of the findings.

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Co-production is acceptable and effective for designing nurse retention interventions 84.

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Co-production helped develop skills that were transferrable to the clinical area.

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Facilitators found co-production subject to competing demands and expectations.

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Co-production should be considered to promote a credible retention interventions.

A guide to the NMC emergency standards for nurse education during the current deployment of student nurses

The Nursing and Midwifery Council (NMC) recognises the important contribution that nursing students are making to the national response to the COVID-19 pandemic. This article reports on the Greater Manchester Supervision and Delegation Framework, providing practical guidance for students and practice staff (practice supervisor/practice assessor and registered nurse) on how to support student nurses who have opted into a paid (deployed) healthcare role. The framework operationalises NMC emergency standards for Nursing and Midwifery education, enabling students to complete their pre-registration undergraduate or postgraduate nursing programme while also supporting the healthcare workforce (NMC, 2020).

Pharmacy students as educators: An interprofessional approach to insulin management education

INTRODUCTION

Student pharmacists may increase the knowledge and comfort level of student nurses and student physicians through peer-assisted teaching (PAT) on insulin management for patients with type 2 diabetes mellitus.

METHODS

Fourth-year student pharmacists completing their primary care rotation provided instruction to third-year student nurses and third-year student physicians on the selection, dosing, administration, and counseling of insulin products in type 2 diabetes. Learners were asked to complete a pre- and post-survey to determine comfort level and knowledge before and after the educational experience.

RESULTS

A total of 200 student nurses and student physicians were included in the analysis. All but two questions from the pre- to post-survey resulted in a statistically significant increase in the number of respondents who agreed or strongly agreed with the statements. In both the pre- and post-survey, >90% of participants agreed or strongly agreed that pharmacists add value to the medical team. An overwhelming majority of students indicated that this learning experience would assist them with making clinical decisions regarding insulin therapy for patients with type 2 diabetes during clinical rotations.

CONCLUSION

The education provided by student pharmacists improved knowledge and confidence in selecting, dosing, administering, and counseling on insulin products, but not with adjusting therapy. Although the student nurses and student physicians valued pharmacy prior to the study, their willingness to reach out to pharmacists increased. This study demonstrates the usefulness of PAT for collaboration between healthcare professional students for improved knowledge and confidence to ultimately enhance patient-centered care.

Upward feedback in nursing: A matter of giving, taking and asking

The educational program for nurses takes place in school and at the workplace. At the workplace, student nurses and their supervisors work together while providing the best care for their patients. In this context, it is important that both, students and supervisors, provide feedback to each other. However, it can be difficult for nursing students to provide feedback to professionals who are higher up in the hierarchy. The goal of this study is to investigate the factors that facilitate nursing students to provide so-called upward feedback and nursing supervisors to receive it. Seven focus groups of nursing students (n = 40) and two focus groups of nursing supervisors (n = 12) were organized. The qualitative data analyses of the focus group interviews and a literature study show that a feedback-friendly culture is essential in enabling upward feedback. The following aspects contribute to a feedback-friendly culture: (1) the role of the feedback receiver, (2) the role of the feedback provider, (3) relations between feedback receivers and providers and (4) the context. This study shows that nursing students and supervisors are open to provide and receive upward feedback. However more attention is needed in nursing education for the factors that facilitate this process.

An evaluation of nurses' experiences of mentoring pre-registration students

Nurse education in the UK has undergone a radical change over the past 30 years. The integration of nursing students within practice has evolved from an apprenticeship style to bespoke mentoring support. To act as mentors, registered nurses must have met stage 2 outcomes of the Nursing and Midwifery Council (NMC) Standards to Support Learning and Assessment in Practice, which clearly stipulate that mentors should have a reduced clinical commitment when supporting students, with one hour per week being protected, in addition to the 40% of time through direct or indirect supervision with their mentor/sign off mentor when facilitating a student on their final 12-week experience. However, this does not seem to be the case in reality. A qualitative study comprising six semi-structured interviews was undertaken across one health and social care trust. Data were analysed using Braun and Clarke's thematic analysis. A number of themes and subthemes were identified: engagement (barriers versus strategies), support (inclusivity versus exclusivity), and lack of recognition (strategic versus organisational). Due to the expected changes of supervising and assessing nursing students in practice, it is imperative that an innovative, collaborative and engaged approach is facilitated from all key stakeholders to ensure the sustainability of supporting and assessing students by registered nurses and the safeguarding of the public within clinical practice.

Effective interventions for preventing work related physical health complaints in nursing students and novice nurses: A systematic review

From the start of their career, nursing students and novice nurses are at risk of developing physical health problems due to high physical workload, which may lead to early exit from nursing. To provide an overview of interventions preventing physical health problems in early career, a systematic review was performed. A comprehensive search of the literature was conducted up to December 2017. Primary outcome of interest was education/work dropout. Secondary outcomes were musculoskeletal symptoms. Independent authors selected studies, appraised quality and extracted data. After screening 7111 titles and abstracts, eleven studies were included. Seven studies evaluated interventions for moving/handling training. Four evaluated other interventions. None focused on our primary outcome education/work dropout. All studies reported on physical complaints among student nurses only. Overall, risk of bias was high and clinical heterogeneity prohibited pooling of data. Intervention effects were small and inconsistent. In conclusion, evidence for the effectiveness of interventions in the nursing curricula for the prevention/treatment of physical complaints is scarce and where available conflicting. We recommend high quality research on dropout due to physical health problems, as well as on the prevention/treatment of physical complaints.

Compassionate care in the community: reflections of a student nurse

Reflecting on practice and analysing situations when compassionate care has been delivered can be a valuable way of helping student nurses develop their understanding of humanising care. This exemplar showcases a scenario when a second-year student nurse studying for a BSc (Honours) in adult nursing explored an experience while working in the community. She critically reflected on an incident highlighting a simple yet powerful example of how she helped an older couple manage an aspect of their care. This exercise helped the student to explore and understand what compassionate care means and highlighted how the value of reflection can be used to gain new insights to enhance the care of older people in her future practice in the community.

Building therapeutic connections with the acutely ill through standardised patient simulation in nurse education an evaluation study

BACKGROUND

Phenomenological 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.

METHODS

114 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.

RESULTS

100 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.

CONCLUSIONS

Teaching 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.

Emotions and feelings evoked in nursing students exposed to bullying behaviors in clinical settings

Background and objective

Though not fully integrated into the profession, student nurses have been exposed to and experienced bullying behaviors with limited skills to mitigate the effects of the behaviors. This qualitative study analyzed the emotions evoked due to exposure to bullying behaviors. Desired to address the question: "How do student nurses feel when they are the recipient of bullying-type behaviors?"

Methods

DESIGN: Qualitative descriptive design. SETTING: A nursing college at an urban university in the Midwestern United States; PARTICIPANTS: Matriculated students enrolled in a pre-licensure nursing program. METHODS: As part of a larger mixed informed pilot study, each participant was assigned to either the control or intervention group. Participants in the intervention group received an educational intervention focused on bullying two weeks prior to a scheduled clinical simulation. Participants in both groups each completed an individual clinical simulation during which they were exposed to bullying-type behaviors meant to replicate behaviors they may encounter in actual clinical settings. All participants were informed of their right to disenroll from the study at any point. For the health and safety of participants, individuals were provided with safeguards during the study as well as upon conclusion of their participation. Immediately following the simulation, participants completed an individual debrief interview during which they were asked to describe how the simulation made them feel. Responses were audio recorded and transcribed verbatim. Data were analyzed using a descriptive qualitative to generate thematic results.

Results

The three major themes developed included Past Bullying-like Behavior, Feelings Experienced during Simulation, and Perceptions of the Simulation. Participants reported experiencing negative emotions due to the bullying behavior exposure despite receiving an educational intervention. Harmful emotions, such as sadness, led participants to question their ability to perform simple tasks. Student nurses possess the skills and knowledge to perform routine tasks; however, when bullying behaviors target nursing students, the negative behaviors have the potential to adversely affect the whole student.

Conclusions

Further research is warranted to identify programs to aid students in overcoming the negative bullying behaviors in the clinical setting.