Challenges and facilitators of professional socialization: A systematic review

Latent profiles of narrative competence and professional identity among nursing students: A cross-sectional analytic study based on the Ring theory of personhood

AIM

To identify latent profiles of narrative competence in nursing students and examine the association between the potential competence profiles and professional identity from a person-centred perspective.

BACKGROUND

According to the Ring theory of personhood, nursing students can develop their professional identities from individual, relational and social aspects through interaction with patients, as well as listening to, understanding and responding to patients' disease narratives. However, few studies have examined the relationship between narrative competence and professional identity through the quantitative method.

DESIGN

A cross-sectional analytic study.

METHODS

A total of 472 nursing students responded to the survey between March and May 2023. The Professional Identity Questionnaire for Nurse Students and the Narrative Competence Scale were given to participants. Latent profile analysis was conducted to identify narrative competence profiles. The Bolck-Croon-Hagenaars method was used to analyse whether these latent profiles for narrative competence affected nursing students' general, individual, interpersonal and social professional identities.

RESULTS

Latent profiles were identified as "low narrative competence" (12.1 %), "relatively low narrative competence" (39.9 %), "moderate narrative competence" (40.1 %) and "high narrative competence" (7.9 %). The profiles only show level differences rather than combinations of competence areas. These profiles had varying effects on the nursing students' general professional identities, as well as their individual, relational and social professional identities.

CONCLUSION

This study highlights the significance of providing tailored guidance and support to nursing students, taking into account their unique narrative competency profile, to promote the formation of professional identity from individual, relational and social aspects. Nursing educators should effectively distinguish nursing students with inadequate narrative competence and value patients' disease narratives to promote narrative competence and professional identity.

Nursing Students' Operating Room Experiences: A Qualitative Metasynthesis

PURPOSE

This study was conducted to analyze the findings of qualitative studies about nursing students' experiences with operating room (OR) practices. There is a need to conduct metasynthesis studies to highlight the overarching dimensions of nursing students' experiences in the OR learning environment, identify and summarize key elements, draw attention to the professional implications of the experience, and then help define the future research agenda. This original study is the first metasynthesis of qualitative studies focusing on nursing students' OR practice experiences.

DESIGN

A qualitative metasynthesis.

METHODS

This metasynthesis study was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and registered with PROSPERO (International prospective register of systematic reviews) (CRD42021252129). This metasynthesis consists of qualitative studies that included themes, were conducted with nursing students with OR experience, and were published in English between December 2000 and June 2022. Data were analyzed using the two-step metasynthesis procedures proposed by Sandelowski and Barroso.

FINDINGS

This metasynthesis study was carried out by analyzing 12 qualitative studies that met the inclusion criteria, reflected the results of a total of 244 nursing students, and were conducted in 7 different countries. As a result of the analysis of the studies, two main themes and seven subthemes were determined about the OR experiences of nursing students. The main themes of the study included (1) the OR environment and (2) professionalism and career choices.

CONCLUSIONS

The synthesis of studies in this research revealed nursing students' OR experiences and provided evidence about the association between these experiences and their professionalism and career goals. The research drew attention to the limitations and facilitators of the OR learning environment for nursing students and provided guidance for a positive interactive learning environment.

Nursing Students' Perception of Missed Perioperative Nursing Care: Hermeneutic Phenomenology

PURPOSE

Missed nursing care is a condition that is likely to be encountered frequently in the surgical care process and is generally related to the educational and emotional needs of the patients. Perception of and witnessing missed care can affect nursing images, expectations, and experiences by causing nursing students to experience professional disappointment. The purpose of the study was to explore nursing students' perception of perioperative missed nursing care (PMNC) according to "role theory" and Benner's "novice to expert" theories.

DESIGN

The study used a qualitative design based on Heidegger's hermeneutical phenomenological approach.

METHODS

Study data were collected using a semistructured interview form prepared by the researchers through face-to-face interviews lasting approximately 50 minutes. The analysis of the data was conducted using van Manen's thematic analysis. The Standards for Reporting Qualitative Research checklist was used in reporting the study.

FINDINGS

This study, which was conducted to explore awareness of PMNC, consisted of 12 students, including five males and seven females. It was understood that nursing students noticed PMNC in clinical practice, experienced internal conflict about the issue, were concerned about the image of nursing, and experienced role and professional identity confusion. The themes of the study were formed in light of these experiences of nursing students. Three themes and 11 subthemes emerged in the study. The themes of the study were (1) perceived PMNC application-behavior patterns, (2) internal reflections of PMNC-its impact on professional identity development, and (3) perceptions of professionalism in perioperative nursing.

CONCLUSIONS

This study provided important data about the awareness of PMNC in the surgical clinical practice of nursing students in Turkey and the effects of this awareness on the professional roles and professional identity process. Students were aware of the behavioral patterns of PMNC and that they experienced internal conflict, anxiety about the nursing image, role confusion, and professional identity confusion due to this awareness. Some students justified the PMNC behaviors of the nurses and others saw themselves as the power to change the PMNC behaviors.

Nursing students' perceptions of unfinished nursing care: A cross-sectional study

AIM

To investigate the prevalence, patterns and reasons for unfinished nursing care as perceived by nursing students.

BACKGROUND

Unfinished nursing care (UNC) is a frequently observed phenomenon in the acute care setting. To date, studies have focused primarily on the perspective of nurses or patients, but another important perspective is that of nursing students who provide nursing care in all healthcare settings.

DESIGN

A descriptive cross-sectional study.

METHODS

The study included 738 undergraduate nursing students from nine Slovak universities. Data were collected between September 2022 and February 2023 using the Slovak version of the Unfinished Nursing Care Survey tool (UNCS). Data were analyzed using descriptive and inferential statistics.

RESULTS

The mean composite score of UNCS was 2.48 (SD=0.68). In general, 100% of nursing students reported that nurses missed at least one or more nursing care activities during their last clinical placement. The average number of missed nursing care activities was 11.2 per nurse as perceived by nursing students during their last clinical placement. Nursing students reported that the most frequently omitted nursing care activity was spending time with patients and their caregivers (3.15 ± 1.11; 92.9%). The most frequently reported reason for UNC was an inadequate number of nurses on the ward (4.31 ± 1.01; 98.1%). In the study, reported UNC could be predicted by previous experience in healthcare, previous clinical rotation, number of patients per shift, perceived staff adequacy and outcome expectations (p <0.05).

CONCLUSIONS

The findings reveal that UNC is a widespread phenomenon and all nursing students report this phenomenon during their clinical placements. Spending time with patients and their caregivers emerged as the most frequently omitted nursing care activity, highlighting the importance of patient-centered care. The primary reason cited for UNC was an inadequate number of nurses, highlighting staffing issues as a significant contributing factor. These findings emphasize the need for targeted interventions to address staff shortages and improve nursing education to prepare students to address UNC in their future practice.

Graduate entry nursing students' development of professional nursing self: A scoping review

BACKGROUND

Accelerated graduate entry nursing programmes require students to rapidly socialise to the profession. Professional identity is an important element of becoming a nurse.

OBJECTIVE

This scoping review aimed to synthesise published literature reporting the development of professional identity, belongingness and self-concept as a nurse in students enrolled in a pre-registration graduate entry nursing programme.

DESIGN

Scoping review.

SETTING

Graduate entry nursing programmes.

PARTICIPANTS

Graduate entry nursing students.

METHOD

Following a pre-registered protocol, we searched electronic databases for publications investigating graduate entry nursing students' development of professional identity, belongingness and self-concept. Screening, data extraction and analysis were initially in duplicate and independent, and then by consensus.

RESULTS

Of the 871 records identified, twenty met the inclusion criteria. Publications were from the USA, Australia, New Zealand, Canada, and the UK. We identified one overarching theme of 'professional nursing self', with four sub-themes: 1) professional socialisation, 2) professional self-concept, 3) developing nursing agency, and 4) identity formation. Socialisation into nursing and belongingness to the profession occurred concurrently as students moved through their programme of learning. Due to the accelerated nature of the programmes, rapid professional socialisation was required, supported by positive relationships in the clinical setting. Strategies that enhanced belongingness and wellbeing enabled students to feel connected to the profession.

CONCLUSIONS

The development of professional identity in graduate entry nursing students is impacted by their rapid professional transition through an accelerated programme. Students' growing sense of nursing agency is embodied in their experiences of thinking and acting as a nurse. Their previous professional identity is then reconstituted in their new graduate selves; educational programmes support this transition.

TWEETABLE ABSTRACT

Scoping review finds professional identity development in graduate entry nursing students is rapid in accelerated preregistration degrees #belonging #connection.

Professionalism in pre-licensure nursing education: Core values, didactic coursework and clinical training

AIM

To discuss professionalism for pre-licensure nursing students and identify recommendations for inclusion in core values, didactic coursework and clinical training.

BACKGROUND

Professionalism is part of the nursing identity that encompasses integrity and honesty. This concept has been difficult to translate into formal education in nursing programs and clinical practice.

DESIGN

A discursive paper.

DATA SOURCES

A search of national literature without date restrictions in PubMed, CINAHL, Google Scholar and frameworks for nursing education. We explored principles of professionalism in nursing education and practice.

DISCUSSION

Evidence-based literature supports the integration of core values of altruism, autonomy, human dignity, integrity, honesty and social justice into didactic curricula, and clinical training. Principles of professionalism can be incorporated intentionally in nursing education to maintain patient safety and trust.

CONCLUSION

The principles of professionalism, related to core values of the nursing profession, are abundantly described in the literature. However, these principles represent core values that have not been formally conceptualized. With the changing landscape of healthcare, there is a need for deliberate, measurable integration of professionalism into pre-licensure education.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public involvement in the design or drafting of this discursive paper.

Professional nurses supporting learners during professional socialisation in Limpopo province

Background

Professional nurses play a significant role in the professional socialisation of learner nurses during clinical placement. Clinical placements are areas of experiential learning as learner nurses come in contact with real-life experiences. Professional nurses are custodians of learners and need to offer them support.

Aim

The study sought to explore the role of professional nurses in supporting learner nurses during professional socialisation.

Setting

Four clinical health facilities in Limpopo province at different levels of care were purposely sampled to obtain information from different levels of care.

Methods

An ethnonursing approach and qualitative, explorative design was used. Non-probability purposive sampling was used to select 25 professional nurses. The criteria were professional nurses with 3 years of experience in professional socialisation and working in institutions accredited for clinical placement of learner nurses registered in the undergraduate programme. Data were collected through a face-to-face interview until data saturation was reached. Tesch's open coding system was used to analyse data.

Results

Professional nurses acknowledged that their responsibilities in supporting learners during professional socialisation are mentoring, teaching and being competent practitioners. Professional nurses were aware of their role in transferring ethical skills and knowledge to learners through professional socialisation.

Conclusion

The effectiveness of professional socialisation of learner nurses depends on the support offered during clinical placements.

Contribution

The study adds to the body of knowledge in nursing education and practice because when learners are offered support in the clinical areas, their learning journey will be of positive experience leading to competent practitioners.

The learning experiences of student nurses in the perioperative environment: An integrative literature review

OBJECTIVES

For the Student Nurse placement in the perioperative environment provides an opportunity to observe and engage in preoperative, intraoperative, and immediate postoperative care of the surgical patient. To date no synthesis of empirical studies has been undertaken to ascertain the learning impact of the perioperative experience. The objectives of this review were to identify and synthesise the literature on the learning experiences of student nurses within the perioperative environment.

DESIGN

An integrative review that followed Whittemore and Knafl's (2005) framework.

DATA SOURCES

Studies published between 2012 and 2022 were identified via a comprehensive search of the following databases: CINAHL, Medline (OVID), Medline (Pubmed), Medline (EBSCO), EMBASE, PsychINFO, ISI Web of Science and SCOPUS.

REVIEW METHODS

The review was reported in line with the Preferred Reporting for Systematic Reviews and Meta-Analysis (PRISMA). The initial search located 1475 Articles. After screening and checking for eligibility 17 articles were selected. These were critically appraised using the Critical Appraisal Skills Programme (CASP). The papers were analysed and reported in a narrative synthesis.

RESULTS

Seventeen studies met the inclusion criteria for the review. Three categories with five sub categories were identified including: Learning opportunities, Appreciation for perioperative role and intent to return and Factors influencing student learning.

CONCLUSIONS

A large variety of student learning occurs within the perioperative clinical environment. Students viewed staff nurses as positive role models in an environment that posed opportunities and challenges for student learning. Anxiety and stress in an unfamiliar environment were commonly mentioned with students offering recommendations to improve their experience.

Do professional nurses practice what they preach? A qualitative study on professional socialisation of student nurses in the clinical learning environment

While working alongside professional nurses, student nurses develop professional identity and learn the professional nursing role, a process known as professional socialisation. Professional nurses should model professional behaviour to be emulated by student nurses. We used a qualitative exploratory design to explore if professional nurses behave in a manner that supports professional socialisation of student nurses in a clinical learning environment. According to our observations, two main categories emerged regarding professional nurses' behaviour. The first category was unprofessional conduct with sub-categories that included disrespect, infringed patient privacy, breached confidentiality, inappropriate dress code and lack of punctuality. The second category was ward disorganisation which was related to delegating duties and structured orientation programmes for student nurses. In this study, professional nurses did not behave in a manner consistent with professional socialisation in the clinical learning environment. Student nurses may struggle to develop professional identity, leading to reduced confidence and poor patient quality care. Student nurses need to be professionally socialised in a clinical learning environment and professional nurses need to be empowered on how to carry out this process.

Professional Socialization of Nurses in Humanized Care: A Qualitative Study

Background

Professional socialization of nurses is the process of transferring knowledge, skills, techniques, attitudes, and values among nursing professionals in order to enhance their capacity consistently. The objective of this research was to study the professional socialization of nurses in humanized care in 2 phases: in a nursing study phase, and in a nursing professional phase.

Materials and Methods

The study was implemented in the form of a qualitative study by using an in-depth interview technique for the data collection. The informants of the study were 12 professional nurses who were granted the Award of Ratchaphiphat Role Model of Best Moral Practice.

Results

During the nursing study phase, it was found that the professional socialization of nurses operated through course content, teaching management, extra-curricular activities, the interaction between nursing instructors and students, interaction among peers, observation of nursing instructors, and observation of nurses. On the other hand, in the nursing professional phase, professional socialization is performed through orientation, on-the-job training, supervision, ethical and moral promoting activities, and interaction with and observation of colleagues.

Conclusions

Based on the findings, some recommendations were proposed as guidelines to develop nursing educational management for promoting humanized care in the development of nursing students and professionals.

How to choose a preceptor: aspects to consider based on a grounded theory study

BACKGROUND

Nurses in clinical practice settings share responsibility with academy teachers in the education of nursing students in clinical teaching. This dynamic is essential for the students' learning and their skill development. During preceptorship, the nurse has to mobilize the available resources to act competently and effectively. The purpose of this article is to identify the aspects that should be considered when selecting a nurse preceptor.

METHODS

A qualitative study was carried out based on Grounded Theory using Strauss and Corbin's version. The study took place in a medicine ward and a surgery ward of a hospital in the Lisbon metropolitan area. The authors conducted fourteen semi-structured interviews with nurses who were at different stages of Benner's Professional Development Model and with different outlooks on nursing preceptorship. The initial script was reorganized after the pilot test. It was also adjusted after the first exploratory interviews and after the in-depth interviews in order to reflect the interviewees' work experience and outlooks on preceptorship. The interviews had an average duration of 45 min and were audio recorded. Theoretical sampling was conducted considering the needs identified in data coding until we reached theoretical saturation. Data analysis began after the first interview, first by open coding, followed by axial and selective coding, always in a logic of constant comparison with theory. Ethical principles, scientific integrity and methodological rigour were ensured throughout the study.

RESULTS

Two categories emerged that were supported by all nurses: skills and individual characteristics. The former includes communication skills, relational skills, reflective skills, technical-scientific skills, and emotional skills, while the latter includes perceptiveness, responsibility, motivation, and professional initiative.

CONCLUSION

Nurses value both the individual characteristics they possess and the skills they have developed throughout their career. The recognition of the aspects found in this study for the selection of nurse preceptors allows for an informed and reasoned decision making, with a view to the success of the preceptorship and to the improvement of the quality of nursing education.

Socialization in professional reality integration for nursing student transition (SPRINT) to improve professional competence: A quasi-experimental study

Background

Professional socialization could support competency achievement and assist the transition phase. It is rare to find quantitative studies examining the effects of professional socialization for nursing students (NS).

Objectives

To investigate the effects of a socialization in professional reality integration for nursing student transition (SPRINT) to improve the professional competence of undergraduate NS in Indonesia.

Design

A quasi-experimental study non-equivalent control group pre-test post-test design was conducted using convenience sampling.

Participants

One hundred twenty NS (60 participants in the experimental group and 60 participants in the control group) from two nursing departments in private universities in Indonesia.

Methods

The SPRINT educational intervention consisted of professional socialization training using several learning methods and activities. Meanwhile, the control group received conventional socialization. The Nurse Professional Competence short-form (NPC-SF) scale was evaluated prior to the participants' internship program, lasting from 6 to 12 weeks after clinical education in both groups.

Results

SPRINT intervention significantly increased overall professional competence scores of the experimental groups higher than the control group. By comparing the mean scores in three times measurement, the six competency areas mean score increased significantly for the experimental group while, for the control only three areas of competence increased in twelve week post-test.

Conclusion

A "SPRINT" as an innovative educational program developed in collaboration with academia, clinical preceptors, could improve professional competence. It is recommended to implement SPRINT program to assist the smooth transition from academic into clinical education.

Role transition of newly graduated nurses from nursing students to registered nurses: A qualitative systematic review

BACKGROUND

The transition experience of newly graduated registered nurses is highly stressful and associated with high attrition rates.

OBJECTIVES AND DESIGN

This qualitative systematic review aims to consolidate the available evidence on the experiences of newly graduated registered nurses' role transition from nursing students to registered nurses.

DATA SOURCES

English language research published between 2010 and 2022 was searched using PubMed, CINAHL, Scopus, Embase, PsycInfo and ProQuest Dissertations and Thesis databases.

REVIEW METHODS

Data were extracted using a data extraction form and appraised using the Critical Appraisal Skills Programme (CASP) tool for published studies or the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for unpublished studies or grey literature, respectively.

RESULTS

The review included 25 studies and the meta-synthesis identified four themes: (a) Knowledge deficit, (b) Overwhelming clinical practise, (c) Importance of workplace support, and (d) Meaning of "being a nurse".

CONCLUSIONS

Newly graduated registered nurses experienced facing knowledge deficits in the clinical setting and felt overwhelmed with work, especially for newly graduated registered nurses during the Covid-19 pandemic. Support from colleagues was invaluable, and they wished for better support through standardised transition programs. Despite nursing being mentally and physically exhausting, many newly graduated registered nurses regarded their profession satisfying and meaningful, however some eventually resigned. Understanding the transition experiences of newly graduated registered nurses can provide valuable insights on how to facilitate their transition and in turn decrease attrition rates, and ensure safe care for the patients and that public healthcare needs are met.

Belonging in high acuity settings: What is needed for newly graduated registered nurses to successfully transition? A qualitative systematic review

BACKGROUND

A worldwide shortage of nurses providing clinical care, coupled with an increase in severity of illness of hospitalised patients has led to newly graduated Registered Nurses being placed into high acuity settings, such as the emergency department, intensive care unit and operating theatre. The feeling of belonging in these settings impacts on successful transition of newly graduated Registered Nurses, their learning, and may lead to high attrition rates.

OBJECTIVE

To comprehensively synthesise qualitative research on newly graduated Registered Nurses' experiences of belonging, while working in high acuity clinical settings.

DESIGN

Elements of the Joanna Briggs Institute (JBI) systematic review protocol were utilised. The Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to conduct the review. Data were analysed using thematic analysis.

DATA SOURCES

Ovid Emcare, PsychInfo, CINHAL, Proquest and Scopus.

METHODS

The PICo (population, interest and context) strategy was used as a guide to develop search terms. Published literature from January 2007 to April 2021 was searched. Screening, selection and data extraction were performed by two authors independently. All discrepancies were resolved through discussion with a third reviewer.

RESULTS

A total of 506 studies were identified following the systematic search; after duplicates were removed, 440 were screened by title and abstract and 29 by full text. Six articles were included in this systematic review. Methodological quality was assessed utilising the JBI critical appraisal checklist, and discrepancies ratified through team consensus. The themes; emotional lability, structured program design, preceptors' influence and acceptance were identified.

CONCLUSIONS

Newly graduated Registered Nurses in the high acuity setting feel emotionally insecure related mainly to their educational unpreparedness. They have need for a structured program, inclusive of both theory and supported practice. The role of the preceptorship team is vital in enabling a feeling of belonging, as is acceptance by nursing staff of the learning journey.

Professional socialization of hospital nurses: A scale development and validation study

BACKGROUND

Tools currently available to measure professional socialization are outdated or could not reflect various properties of professional socialization of nurses. Thus, the objective of this study was to develop and validate a professional socialization measurement instrument for hospital nurses.

METHODS

Fifty-two items were initially extracted from literature reviews and in-depth interviews with 32 nurses. After content validity testing, 48 items remained. They were used to survey 881 hospital nurses in Korea in the testing phase for construct validity and reliability.

RESULTS

Four factors (21 items) were extracted: ethical practice and reflection, perception of respect and recognition, clinical competency based on leadership, and desires and motivation for professional development. These factors demonstrated good construct validity and reliability. Correlation coefficients of professional socialization with professional value, compassion satisfaction, secondary traumatic stress, and burden were 0.58 (p < 0.001), 0.70 (p < 0.001), - 0.08 (p = 0.014), and - 0.56 (p < 0.001), respectively. Reliability had a Cronbach's alpha of 0.95. Test-retest reliability intraclass correlation coefficient was 0.90.

CONCLUSIONS

The four professional socialization scale factors in this study reflected attributes of knowledge, skills, values, and professional roles. Professional socialization of nurses can be continuously developed by emphasizing elements of the professional socialization scale in nursing education programs. Nursing managers should help nurses go through the professional socialization process. The professional socialization scale will serve as a tool for developing careers of hospital nurses.

Learning in and across communities of practice: health professions education students' learning from boundary crossing

Learning to adapt to new contexts is crucial in health professions education (HPE). Boundaries between and within contexts challenge continuity in students' learning processes. Little is known about how HPE students can make these "boundary experiences" productive for learning. We investigated how and what nursing students learn from boundary experiences while they are simultaneously growing into a community of practice (CoP). Using a boundary-crossing lens, experiences of discontinuity were identified in pre-placement and post-placement interviews and diary fragments with 14 nursing students during their placement in an academic hospital. We found that students experience discontinuity as a result of different approaches to nursing care and to learning, both between (academic and clinical) settings and within a setting. When students feel safe enough, they can convert boundary experiences into meaningful learning situations, such as critical discussions with staff. Successfully overcoming boundary experiences improves students' understanding of healthcare and professional development and helps them to develop a personal approach to learning. Students critically address boundary experiences when they are motivated to learn and when they perceive a violation of ethical standards but not when they are concerned that it will affect their assessment. Objects designed to bridge theory and practice can generate additional barriers. This study adds to the HPE literature by demonstrating the learning potential of boundaries and to the broader literature by showing how responses to boundary experiences are intertwined with the process of growing into a CoP. The findings can be used to design future boundary objects.

Perceptions and experiences of psychological trauma in nursing and psychiatric nursing students: A small scale qualitative case study

Entry-level health care professionals are socialized to accept the norms and values associated with institutions in which violence and suffering is considered an anticipated and even routine and normalized part of frontline care. The objective of the study was to illuminate the subjective experience of psychological trauma in graduates from a baccalaureate nursing and psychiatric nursing program using the McGill Illness Narrative Interview, an ethnographic interview guide. Participants included graduates from each program in a western Canadian province who reflected back on their experiences of trauma as students and newly-graduated nurses within their first year of practice as a regulated health professional. Results: Six key themes were identified. Witnessing sudden change in patient or client status and unexpected death; Emotional labour; Faculty incivility; Sabotage, bullying and verbal abuse from the health care team; Exposure to physical violence and sexual inappropriateness; and Mobilizing supports. All exposures were linked to the participants’ definition of psychological trauma. Conclusions: The study findings highlight the power dynamic, abuses, and vulnerability between students, faculty, and their clinical counterparts without adequate recourse. There is a need to foster emotional intelligence, self-efficacy, and resilience when potentially traumatic and stressful experiences occur with student nurse and early-career nursing populations.

Experiences of socialization in clinical education among Indonesian nursing students: A phenomenology study

BACKGROUND

Professional socialization is an essential process of the nursing profession to internalize the values into behavior, resulting in professional identity. However, research into students' experience of professional socialization in clinical nursing education remains limited.

AIM

To explore Bachelor nursing students' (NS) experience of professional socialization in clinical education in Indonesia.

DESIGN

This study used a descriptive phenomenology qualitative approach. Four sessions of focus group discussions (FGD) were conducted with ten final-year NS from five teaching hospitals using the purposive sampling technique. Data were analyzed using Colaizzi methods and NVivo 12 Plus.

RESULTS

The analysis identified two themes and four-subthemes in this study. The first theme is the facilitators of the socialization experience, consisting of "being a professional nurse" and "Islamic culture". The second theme hinders the socialization experience, including "inadequacy of socialization" and "nurses' unprofessional behavior."

CONCLUSION

Bachelor NS experience is challenging in Indonesia in both a positive and negative way, which facilitates or hinders professional socialization. Thus, the role of a nurse educator in establishing a comprehensive professional socialization program for new NS to assist their transition from the academic setting into clinical education needs to be reassessed.

Impacts of COVID-19 pandemic on professional identity development of intern nursing students in China: A scoping review

PURPOSE

Clinical experience plays a vital role in the development of the professional identity (PI) of nursing students. China has applied a strict zero- COVID health policy in combating the COVID-19 pandemic since December 2019 and studies have been conducted in different places of China to explore PI development of nursing students during the pandemic time among the intern nursing students who are on clinical practices. This review study aims to synthesize the previous studies and provide a comprehensive picture of the impacts of the pandemic on the PI development of intern nursing students.

METHODS

Arksey and O'Malley's five-stage scoping review framework was used. Combinations of keywords were used to search relevant articles in both Chinese and English databases published from inception of the articles until the final search date (10 March 2022). The initially included articles were also appraised for their quality, and those that passed the appraisal were left for data analysis. The analytic results were cross-checked among the reviewers.

RESULT

Three themes emerged from the included studies: 1) the PI levels, 2) the impacts of personal and social factors of PL, and 3) the specific impact of the COVID-19 pandemic. The levels of students' PI ranged from 66%-80% of the total scores in PI instruments, almost the same levels as in pre-pandemic time, despite the elevated social image of nurses after the COVID-19 pandemic. There is no consensus about the impacts of most personal and social factors on students' PI across the studies. The impacts of COVID-19 on PI were both positive and negative.

CONCLUSIONS

COVID-19 epidemic exerted complicated impacts on the PI of intern nursing students. While it is necessary to address the fear of the COVID-19 pandemic among intern nursing students, the pandemic may not be an opportunistic time to enhance the students' PI.

Facilitators of professional socialisation of learners in the clinical learning areas: A qualitative systematic review

Background

Professional socialisation is significant in nursing as it involves immersing learners in the profession so that they adopt the ethical values and conduct of the profession. It is in the clinical learning areas where learners observe and practise those values. The objective of the review was to explore the factors that promote professional socialisation of learners in the clinical learning areas. The problem is the inadequate support for learner nurses in the clinical learning areas. The South African community has lost trust in nurses and that was even acknowledged in the national nursing summit in 2011.

Objectives

To present a review of the factors that facilitate professional socialisation among undergraduate nursing learners.

Method

A systematic review was conducted on literature from 2008 to 2018. The literature search focused on factors that facilitate professional socialisation of learner nurses. A search of databases was conducted in CINAHL, MEDLINE, Google Scholar and Science Direct. The search focused on literature on professional socialisation of learner nurses published from 2008 to 2018. The search resulted in 3035 articles which were further reduced to 13 after further synthesis. Critical appraisal skills programme was used to assess the quality of the studies.

Results

Three main themes emerged. Learner factors, factors in the clinical learning areas and interpersonal factors were identified as the factors that facilitate professional socialisation of learners.

Conclusion

Learners should have self-motivation and be supported and assisted to develop a positive professional identity. The clinical learning environment should have effective communication that fosters learning. Professional nurses should act as exemplary role models so that learners can emulate the conduct and practice. The review brought to light that the professional socialisation of learners is affected by the learner factors, clinical learning areas and personal factors.

Positive consequences of the hidden curriculum in undergraduate nursing education: An integrative review

Background:

Hidden Curriculum (HC) plays an essential role in nursing education and professionalism. However, its positive consequences have been overlooked. Thus, this study aimed to explore and discuss the positive consequences of HC in nursing undergraduate education.

Materials and Methods:

A comprehensive literature search was conducted to investigate articles published between January 2010 and December 2020. Furthermore, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to select articles, and Consolidated criteria for Reporting Qualitative research (COREQ) and Strengthening the Reporting of Observational studies in Epidemiology (STROBE) tools were employed to appraise qualitative and quantitative studies, respectively. The applied search strategy resulted in a final list of 16 articles out of a total of 132 articles. Next, the data were integrated and categorized using the Whittemore and Knafl methodology.

Results:

Three categories were identified: Individual Consequences; involving increased self-confidence, self-esteem, assertiveness, adaptation, autonomy, and lifelong learning. Social Consequences; involving enhanced socialization, cultural consciousness, and social interactions. Professional Consequences; involving professional socialization, professional identity, professional ethics, link theory and practice, and professional dignity.

Conclusions:

Altogether, we concluded that the emergence of HC and its positive and remarkable consequences in nursing knowledge helps the personal, social, and professional development in nursing.

"I Felt Alienated in the Operating Room": A Phenomenological Qualitative Study

PURPOSE

To investigate the clinical practice experiences of nursing students in the operating room and to evaluate these experiences in terms of professional socialization.

DESIGN

This study was designed as a qualitative study based on Heidegger's hermeneutic phenomenological approach.

METHODS

The study was conducted with second-year nursing students who attended the operating room (OR) as an observer for 10 hours as part of the Surgical Nursing course. The study data were collected with a semistructured interview form on the day following this restricted and limited experience. This form included items that questioned the students' experiences of how they perceived the clinical experience and how they were ultimately affected. The data were analyzed using van Manen's thematic analysis.

FINDINGS

The study was conducted with nine students, including four males and five females. The ages of the students ranged between 19 and 21 years. Two themes and seven subthemes were determined as a result of the data analysis. The themes of the study were (1) short and difficult experience and (2) very important for professional socialization.

CONCLUSIONS

The study provided important information about nursing students' experiences regarding the effect of OR practice on their professional socialization. It was understood that the students perceived OR practice as a short and difficult experience, felt worthless and alienated, and realized that there was no empathy in the OR. Additionally, they stated that the team members did their job very well and that they felt the importance of being the best. Moreover, they found OR practice important for guiding one's career goals, professional socialization, and gaining a professional identity.

Conceptions of clinical learning among stakeholders involved in undergraduate nursing education: a phenomenographic study

BACKGROUND

To prepare nursing students to become critical, autonomous members of the workforce, an agreement among stakeholders on how this can be achieved in the clinical setting is needed. However, a critical discussion of the clinical learning process in relation to actual and desirable outcomes is lacking in the nursing education literature. This study aimed to map conceptions of the desired process and outcomes of clinical learning among stakeholders involved in undergraduate clinical nursing education.

METHODS

Twenty-five semi-structured interviews about their understanding of clinical learning were conducted with nursing students, supervisors, clinical educators and higher education institute professionals involved in clinical nursing education in a Dutch academic medical center. Data were analyzed using a phenomenographic approach.

RESULTS

Four conceptions were identified: clinical learning as a process to 1) meet curricular demands, 2) learn to deliberately deliver patient care, 3) learn to deliver patient care within the larger (healthcare) context, and 4) become a continuously developing professional. Conceptions 3 and 4 represented a broader, more inclusive perspective on clinical learning than conception 1 and 2. Conceptions were distinguished by five dimensions: role of guidelines from the school; learning opportunities, focus of supervisor; focus of reflection; desirable outcomes of clinical learning.

CONCLUSIONS

Those directly involved in clinical learning in nursing may have qualitatively different understandings of its desired nature and outcomes. Two patterns across conceptions could be discerned: a) a shift in focus from learning as following standards, to following an individualized learning trajectory and b) a shift in focus from increasing patient load, to understanding oneself and the patient within the healthcare context. To prepare nursing students for the future workforce, a flexible, social form of self-regulated learning is warranted, as well as an understanding of one's own role within the healthcare system and a critical attitude towards healthcare. Schools and hospitals should collaborate to integrate these values in the curriculum. The current study adds different ways of applying self-regulated learning as a relevant dimension in understanding clinical learning to the literature. Through the phenomenographic approach we identified conceptions that can be a basis for training and policy development.

A conceptual framework of student professionalization for health professional education and research

OBJECTIVES

To present a conceptual framework of student professionalization for health professional education and research.

METHODS

Synthesis and discussion of a program of research on competency-based education.

RESULTS

Competency-based education relies on active, situation-based group learning strategies to prepare students to become health professionals who are connected to patient and population needs. Professionalization is understood as a dynamic process of imagining, becoming, and being a member of a health profession. It rests on the evolution of three interrelated dimensions: professional competencies, professional culture, and professional identity. Professionalization occurs throughout students' encounters with meaningful learning experiences that involve three core components: the roles students experience in situations bounded within specific contexts. Educational practices conducive to professionalization include active learning, reflection, and feedback.

CONCLUSIONS

This conceptual framework drives a research agenda aimed at understanding how students become health professional and how learning experiences involving action, reflection, and feedback foster that process and the advancement of professional practices.

Ambivalence of Professional Socialization in Social and Educational Professions

The factors that promote successful professional socialization have become a primary focus of study through the expansion of higher education. The structural changes in the labor market of post-socialist countries such as Hungary over the last three decades have presented a challenge to the training areas of social and educational professions. In Hungary, these professions are not very attractive, the degrees have a low profitability, and the working people already face great challenges when looking for a job. Our research question is whether the traditionally theoretical character of higher education is able to keep up with the dynamic changes in the reality of the labor market. By interviewing 20 professionals about their professional experience and career plans, we tried to answer the questions about the low attractiveness and low retention rate of these professions. We compared the careers of bachelor’s graduates with degrees in social work, youth work, and education. The qualitative analysis showed that professionals whose training included more field exercises and supervision were more successful. They had increased their professional and social capital, and these helped them to integrate into the labor market.

Professional socialization: an analytical definition

Professional socialization is defined as a process through which a person becomes a legitimate member of a professional society. This will have a great impact on an individual’s professional conduct and morality. The aim of this study was to clarify this concept and reduce the ambiguities around it.

This was a qualitative research through which the concept of professional socialization was analyzed using Walker and Avant’s eight-step approach. The review of literature for this concept was done using electronic database without any time limitation. The overall search produced about 780 articles, and after reviewing these articles, 21 were selected purposefully.

Based on concept analysis, we propose the following analytical definition: Professional socialization is a nonlinear, continuous, interactive, transformative, personal, psychosocial and self-reinforcing process that is formed through internalization of the specific culture of a professional community, and can be affected by individual, organizational and interactional factors. This definition is in accordance with the interactionism perspective. Existence of a particular profession and getting involved in a community of practice are the antecedents of this process, and formation of professional identity and professional development are its consequences. A case model, as well as borderline and related cases, has been introduced for this concept. The results of this study can be used to design useful educational interventions to conduct and facilitate the process.