Why do nursing students not want to work in geriatric care? A national questionnaire survey

Approximately half of the nursing students confirmed their willingness to participate in caring for older people: a systematic review and meta-analysis

BACKGROUND

Global population aging poses a significant global challenge, necessitating an increased demand for proficient caregivers specialized in elderly care. In our study, a systematic review and meta-analysis were conducted to synthesize the evidence concerning nursing students' willingness to participate in caring for older people.

METHODS

Eligibility criteria focused on cross-sectional studies involving nursing students' willingness to participate in caring for older people and were reported in English or Chinese. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WANFANG databases were searched from inception until July 24, 2022. The methodological quality assessment in the included studies was evaluated using the AHRQ instrument. The pooled effects of the nursing students' willingness to participate in caring for older people were computed using a random-effects model. Funnel plots and Egger's test were employed to evaluate publication bias. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was conducted to verify the robustness of the meta-analysis findings. All statistical tests were conducted with Stata 16.0 software.

RESULTS

A total of 68 studies of medium or high quality met the eligibility criteria, involving 30,328 nursing students. The rate of nursing students' willingness to participate in caring for older people was 49.0% (95% CI = 46-53%, I2 = 98.1%, P = 0.000). The results of meta-regression analysis showed that the following four predictor variables were significantly associated with nursing students' willingness to participate in caring for older people: experience of living with and caring for older people, nursing as their first choice and their year-level in education, respectively. Subgroup analyses for these four predictor variables revealed the following pooled estimates of nursing students' willingness: having experience of living with older people (0.54, 95% CI = 0.46-0.62) vs. no such experience (0.38, 95% CI = 0.30-0.46), having experience of caring for older people (0.55, 95% CI = 0.48-0.63) vs. no such experience (0.38, 95% CI = 0.30-0.46), nursing as their first choice (0.54, 95% CI = 0.51-0.58) vs. not their first choice (0.44, 95% CI = 0.35-0.53), being in the first year of nursing education (0.44, 95% CI = 0.34-0.55), second year (0.45, 95% CI = 0.34-0.56), and third and fourth year (0.62, 95% CI = 0.53-0.71).

CONCLUSION

The study found that approximately half of the nursing students confirmed their willingness to participate in caring for older people.The present study can serve as a resource for policymakers to increase the willingness of nursing students to participate in caring for older people.

Developing a comprehensive curriculum program for nurse practitioners delivering primary care in the long-term care setting

In the Long-Term Care (LTC) setting, comprehensive primary care is often provided by Nurse Practitioners (NPs). NPs are uniquely positioned to meet the evolving primary care needs of LTC residents. However, caring for this population requires additional education and training due to its special considerations. To meet the learning needs of NPs entering the LTC workplace, a Certificate Program was designed to enhance primary care competencies within the LTC setting. The aim of the program is to increase knowledge, capacity, and confidence of NPs to deliver quality, evidence-based, integrated, and interprofessional primary care to LTC residents. This curriculum is anticipated to address the growing need for LTC services and improve the delivery of high-quality primary care.

Nursing Students' Perceptions on a Pain Management E- Learning Module: An Exploratory Quantitative Study

BACKGROUND

Nursing students are graduating ill-prepared to assess and manage pain in older adults. To address this gap, we developed an e-learning module on the topic.

AIM

To examine nursing students' perceptions on a pain management e-learning module focused on older adults.

METHODS

Utilizing an exploratory quantitative design, we assessed nursing students' perceptions of the e-learning module. We used a feedback survey (four 5-point, Likert-type items) and one open-ended question to assess students' perceptions. Descriptive statistics were used to summarize students' perceptions and demographic characteristics. Responses to the open-ended question were content analyzed.

RESULTS

A total of 181 of 249 students completed the module, of whom two-thirds were female. Students perceived that the module enhanced their knowledge, confidence, and perception in working with older people. Students also found the method of instruction interactive and enjoyable.

CONCLUSIONS

The e-learning module on pain management was viewed by nursing students to be helpful and its interactive method of learning improved their knowledge, confidence, and perceptions of working with older adults in pain.

Starting a university gerontology research laboratory: Experiences from researchers in public health and psychology

Although founding and directing an independent research laboratory is often expected of faculty at American universities, there are several barriers to successful completion of this important task. There is little guidance in the literature regarding exactly how to go about starting a research laboratory. The guidance that exists for faculty often focuses on running research labs in the "hard sciences," such as biomedical science and engineering, leaving social and behavioral scientists out of such considerations. Additionally, smaller or teaching-focused universities often have little infrastructure or support for starting a research lab, so faculty at these institutions may not know where to begin. These barriers are significant concerns for junior faculty, who are often unprepared for the realities and challenges of starting a successful research lab while obtaining other milestones required for promotion and tenure. We present two examples of recently-formed gerontology research laboratories begun by junior faculty, one in the psychology department of a research university and one in public health at a teaching-focused university. Our case studies present the reader with specific examples, lessons learned, and guidance for starting their own gerontology research laboratory in higher education, whether as a physical or virtual space, as well as recommendations on maintaining its functioning during a global pandemic.

"The supreme discipline of Nursing"-A qualitative content analysis of nurses' opinions on caring for people eighty years of age and older

Introduction

Nurses often experience stress and feel under time pressure when working with older people, increasing their job dissatisfaction. Especially people 80 years of age and older often require more complex and a greater measure of care, as the risk of care dependency is higher in this age group. This study was conducted to collect nurses' experiences and opinions regarding the care of people 80 years of age and older, as well as to learn more about how nurses perceive this care.

Method

We analysed narratives collected in an Austrian nationwide, cross-sectional online study to investigate nurses' attitudes towards people 80 years of age and older and their perceptions regarding their care (N = 1197). Data were collected from May-October 2021 by using a convenience sampling method. In total, 149 participants filled in the free text field; these texts were analysed using a qualitative content analysis method.

Results

Three main themes emerged from the analysis of the nurses' narratives: (1) 'opinions on people in need of care', (2) 'reputation of nursing profession', and (3) 'criticism of current nursing practice'. Most narratives were assigned to the subthemes 'positive opinions on nursing', 'ideal image of nursing', and 'shortage of staff'.

Conclusion

Nurses considered their work with people aged 80 years and older to be meaningful and important, but they criticised working conditions which need to be improved. This could be achieved by offering further education and increasing nursing staff. Further research is needed to investigate nurses' needs and wishes regarding the care of people aged 80 years and older.

The influence of prior work experience in aged care on nursing students' views on aged care nursing: A systematic review

BACKGROUND

Nursing students' experiences during clinical training in aged care placements is a well-studied topic. However, there is less research on the connection between nursing students' prior experiences as assistants in nursing (AIN) and their perception of aged care nursing.

AIM

The aim of this study was to identify and synthesize undergraduate nursing students' experiences as working as AIN in aged care settings.

METHOD

A systematic review was carried out by searching the CINAHL, Scopus, Medline and Medic databases, supplemented by manual searches. The searches focused on peer-reviewed scientific empirical research articles published in English, with a 10-year date limitation. The data were analysed by the qualitative content method.

RESULTS

The review identified 11 articles, which showed that nursing students' prior work experience shifts their perceptions of older adults' care. The findings were organized under four major themes. Through their employment as AIN, (1) nursing students' ability to reflect and develop skills needed in clinical work strengthened, (2) they became aware of the independent role of the nurse, (3) they feel part of the workplace community and (4) they recognized their feelings and views about aged care as a career.

CONCLUSION

Students' work experience in aged care helps them to observe aged care settings as a unique set up and nursing comprehensively from the perspective of an older adult's care needs and they can observe the dynamics of a workplace community. They can see many positive features in working in aged care and assess their experience with positive descriptions.

Impact of interprofessional geriatric teamwork on students' perceptions of older persons and collaborative practice

Health professions programs lack sufficient exposure to geriatric education in curricula. The Seniors Assisting in Geriatric Education (SAGE) Program exposes interprofessional (IP) teams of health professions students to older adults. To determine the impact of an interprofessional geriatric educational experience on student perceptions of team collaboration and older adults. IP teams of three or four students (n = 662) representing eight disciplines from two institutions were paired with an older adult to promote person-centered care over three semesters. Students completed two online questionnaires (pre- and post-SAGE Program, ~10 min). 136 students completed both questionnaires. Three IP collaborative practice sub-competencies under the Roles & Responsibilities and Interprofessional Communication Core Competencies increased significantly from pre- to post-SAGE Program (p ≤ 0.002). Comparison of the means for attitudes toward geriatric patients revealed statistically significant improvement in one item, Compassion (p < .002). The SAGE Program had a positive impact on IP collaborative practice and attitudes toward older people in some, but not all, areas.

Factors associated with nursing students' attitudes toward older people: A scoping review

Nursing students rate geriatric nursing poorly in career preferences, but aging populations mean more older people require access to health care. Negative attitudes held by nursing students can lead to ageism affecting the quality of care provided. The purpose of this scoping review is to summarize research findings in the published literature relating to factors associated with nursing students' attitudes toward older people, and the tools used to measure these attitudes. The Joanna Briggs Institute guide for conducting a scoping review was used. Eleven databases and search engines were searched for international peer reviewed research articles published in English between January 2000 and February 2021. Sixteen articles were included in the review. This review highlights areas for affirmative action to improve undergraduate nursing students' attitudes toward older people to prepare them to work effectively in future health care systems. Positive attitudes were associated with: senior years of study; professional values (caring, professionalism, trust); education regarding care of older adults; knowledge about aging; contact with older family members; comfort communicating with older people; and willingness to work with older people following graduation. It also identified the need for a current, nursing-specific measure of attitudes toward older people.

E-learning modules to enhance student nurses' perceptions of older people: a single group pre-post quasi-experimental study

OBJECTIVES

To examine whether e-learning activities on cognitive impairment (CI), continence and mobility (CM) and understanding and communication (UC) improve student nurses' knowledge and attitudes in the care of older adults.

METHODS

A quasi-experimental single group pre-post-test design was used. We included 299 undergraduate nursing students for the CI module, 304 for the CM module, and 313 for the UC module. We administered knowledge quizzes, Likert scales, and a feedback survey to measure student nurses' knowledge, ageist beliefs, and feedback on the modules respectively.

RESULTS

Participants demonstrated significantly more knowledge and reduced ageist attitudes following the e-learning activities.

CONCLUSIONS

Findings suggest that e-learning activities on cognitive impairment, continence and mobility, and understanding and communication improve knowledge and reduce ageist attitudes among nursing students.

The impact of care experience prior to commencing pre-registration nurse education and training: A scoping review

OBJECTIVES

Compassion in nursing and interventions to support it are of international relevance and concern. Prior care experience as a prerequisite for entry into pre-registration nurse education is suggested as a means of improving compassion. The impact of prior care experience has not been comprehensively reviewed, therefore the potential effectiveness of prior care experience as a means of improving compassion is unknown. The scoping review question was 'What is known about the impact of care experience prior to commencing pre-registration nurse education and training?' The primary objective was to scope and synthesise existing literature relating to the topic and ascertain key themes pertaining to impact. A secondary objective was to appraise literature, to contextualise findings and assess the state and stage of knowledge and research in the area.

DESIGN

The review was guided by Arksey and O'Malley's methodological framework and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist.

DATA SOURCES

Health sciences databases CINAHL, Medline and PubMed.

METHODS

Databases were searched in February 2019, updated August 2021. Data (study characteristics, findings, methodological observations) were extracted from papers meeting inclusion criteria (including peer-reviewed empirical papers with English language, electronic full-text available) and findings thematically analysed.

RESULTS

Forty-five papers from 14 countries were included. The majority (64.4 %) were published in Europe (31.1 % in the United Kingdom) between 2010 and 2021 (69 %), 60 % from 2013. Four qualitative themes (compassionate care, commitment, competence and communication) describe the impact of prior care experience, which was variable.

CONCLUSIONS

Evidence to support the effectiveness of prior care experience as a prerequisite for entry into nurse education to improve compassion, is inconsistent and insufficient. The literature displays methodological limitations and conclusions should be interpreted in light of these caveats. Recommendations are made for future research, to improve quality and comparability.

Evaluation of pharmacy student empathy scores before and after a geriatrics advanced pharmacy practice experience (APPE)

INTRODUCTION

Empathy from healthcare providers is associated with improved patient care and satisfaction, resulting in increased emphasis on empathy in pharmacy school curricula. Previous studies showed improvement in pharmacy student empathy after older adult-specific simulation activities in the didactic setting, but no such data exist for the practice environment. This study's purpose was to evaluate the impact of a geriatrics advanced pharmacy practice experience (APPE) on pharmacy student empathy toward older adults.

METHODS

All fourth-year pharmacy students in a geriatrics APPE at one of four participating sites were offered to participate in the study at the beginning of the rotation. Empathy was measured at baseline and end of the rotation using the Kiersma-Chen Empathy Scale (KCES). Wilcoxon matched-pairs signed-ranks test was used to test differences from pre- to post-rotation.

RESULTS

Fifty-four of the 110 eligible students opted to participate in the study, and 46 completed both the pre- and post-surveys. Most students were female (55.6%), and the average age was 27.3 years. Mean empathy scores for all students increased significantly by 4.89 points (z = 4.17, P < .001, d = 0.97). Specific KCES items related to handling other's feelings and viewing another person's perspective also significantly improved.

CONCLUSIONS

Empathy is a key component to professional development in healthcare students, and a geriatrics APPE provides an opportunity for students to grow this soft skill. Although further study is warranted, older adult focused rotations may be considered by schools of pharmacy to aid in preparing "graduate-ready" pharmacists.

How does geriatric nursing education program change the knowledge, attitude and working intention among undergraduate nursing students? A systematic literature review

OBJECTIVE

This review aimed to examine the changes of knowledge, attitude and working intention in nursing students after an undergraduate geriatric nursing education.

DESIGN

A systematic review of the literature.

DATA SOURCES

Five databases which included CINAHL, MEDLINE, PubMed, Scopus and Web of Science were searched for this literature review from January 2010 to October 2020.

REVIEW METHODS

The review was registered in PROSPERO registry with registration number CRD42020215703. The review examined undergraduate nursing education programs in terms of knowledge, attitude and working intention towards geriatric care among undergraduate nursing students as outcomes. We used JBI critical appraisal tools and Mixed Methods Appraisal Tool to evaluate and assess the quality of the retrieved research papers.

RESULTS

The search yielded 19 studies included in the final review, 14 of which were quantitative studies and five were qualitative studies. Four types of education programs were identified. These were type 1, a four-year undergraduate gerontology program consisting of geriatric theory and geriatric care clinical placement; type 2, stand-alone geriatric subject and geriatric clinical placement program; type 3, integrated geriatric subject and geriatric clinical placement program; type 4, solely geriatric clinical placement program. The review found that the type 2 program demonstrated the best educational outcomes in undergraduate students.

CONCLUSIONS

This review provided the most recent literature evidence pertaining to undergraduate geriatric education program and its educational outcomes. Future research should focus on the evaluating the content of each type of geriatric education program to inform the development of undergraduate geriatric nursing education.

The Association Between new Nurses' Gerontological Education, Personal Attitudes Toward Older Adults, and Intentions to Work in Gerontological Care Settings in Ontario, Canada

Background

The older adult population in Canada is increasing, and many will require care within an acute geriatric unit (AGU) or long-term care facility (LTCF). However, the nursing workforce is not growing at the same pace as the population is aging. New graduate nurses may be able to fill this gap; therefore, it is important to understand their intentions of working in gerontological care settings (i.e., AGU or LTCF).

Aim

To examine if nursing education and personal attitudes toward older adults influence newly registered nurses’(RNs) intentions to work in a gerontological care setting.

Method

Nurses (n= 1,103) who registered with the College of Nurses of Ontario for the first time in 2018 were invited to complete a questionnaire.

Results

The majority of participants (n = 181) reported a positive attitude toward older adults. However, only 14% reported an intention to work in a gerontological care setting. Participants who completed multiple geriatric focused clinical placements were more likely to report an intention to work in these settings.

Conclusion

This study provides some information regarding the attitudes and intentions of newly RNs toward a career in gerontological care settings. Further research is needed to understand nurses’ intentions regarding working in AGUs or LTCFs.

Older adults 'Have so Much to Teach Us': A qualitative study of BSN student perceptions when anticipating clinical in the nursing home

BACKGROUND

As the population of older adults is estimated to double by 2050, the growing demand for nurses to provide care to older adults will grow. Internationally, attitudes among nursing students towards caring for older adults range from negative to slightly positive.

OBJECTIVE

The purpose of this qualitative descriptive study was to examine undergraduate nursing students' thoughts, feelings and perspectives towards older adults residing in nursing homes prior to their clinical experience.

METHODS/RESULTS

Students enrolled in a clinical component of a course within a baccalaureate nursing programme were prompted to write a one-page reflection on their thoughts and feelings toward caring for older adults in a nursing home. Artefacts from 72 undergraduate students' were examined, and data saturation was obtained at 20 cases. Utilizing a one-time inquiry approach, we identified eight categories that emerged from the data: Range of emotions when anticipating clinical, building rewarding relationships with older adults, preparing for my nursing career, student pre-existing attitudes, providing the best care possible, relationships with grandparents, experience(s) in nursing homes and older adults 'have so much to teach us'. Two themes encompassed all the others: '[Older adults] have so much to teach us' and 'providing the best care possible'. A strong majority of students expressed enthusiasm for their upcoming clinical in a nursing home.

CONCLUSION

Students' attitudes were significantly more positive than those in prior studies. The results offer essential insight for nursing faculty who teach and design clinical experiences for undergraduate nursing students in nursing home facilities. Faculty should take account of their students' prior experiences, thoughts, and feelings to prepare them appropriately to care for older adults in their future nursing careers.

IMPLICATIONS FOR PRACTICE

Increasing staffing and retention of staff in nursing homes facilities remains a priority for stakeholders in long-term care of older adults. Nursing educators must continuously assess students' knowledge and attitudes assists to identify knowledge gaps and misconceptions, which must be addressed to teach student nurses how to provide high-quality, effective and culturally sensitive care to older adults. As students become more competent in caring for older adults, their desire to pursue a nursing career in gerontology care may increase. Early experiences of student nurses with older adults will prepare nursing students for their future career. Understanding students' thoughts and feelings will assist faculty in tailoring clinical orientation, designing clinical experiences and post-conference debriefings that address students' concerns. This research contributes to the knowledge of perceptions of nursing students and will assist to design educational experiences. Nursing educators who understand nursing students' attitudes toward caring for older persons can facilitate therapeutic interactions between nursing students and older adults. Designing experiences with these research results in mind may facilitate the development of positive attitudes towards caring for older adults.

Factors Affecting Attitudes towards Older People in Undergraduate Nursing Students

Background: The population of older people is increasing worldwide. The social and healthcare systems need many nurses to care for the elderly. Positive attitudes increase the preference to work with older people and improve the quality of care. This study describes attitudes towards the elderly in a sample of nursing students, and analyzes the potential factors influencing these attitudes. Methods: A cross-sectional study was carried out in nursing students during the academic course 2017–2018. Kogan’s Attitude Toward Old People Scale was used to assess student attitudes towards older people. Results: The study included 377 undergraduate nursing students, of which 75.9% were women. The mean age was 22.23 (5.69) years. Attitude proved positive, with a mean Kogan’s score of 131.04 (12.66). Women had higher scores than men, with a mean difference of 7.76 (95% CI: 4.87–10.66; p < 0.001). The male sex, age ≥ 25 years, and previous experience with institutionalized older adults worsened attitudes, while studying the subject of geriatrics, each higher course within the degree, work placements in hospitals and nursing homes, and previous experience with community older adults or with older relatives favored a more positive attitude. Participants with no interest in working with older adults yielded lower scores. Conclusions: Attitudes towards the elderly among nursing students are positive. Women have a more positive attitude. Analyzing the factors that improve attitudes in nursing students is suggested, as it may contribute to improve nursing care.

Factors affecting preregistered nurses' willingness to serve in geriatric long-term care

AIM

Rapidly ageing population leads to increased demands for long-term care. Taiwan's preparation for its ageing population focuses on engaging healthcare professionals. This study explored pre-registered nurses' current knowledge, experience in geriatric long-term care (GLTC) and willingness to serve in GLTC.

DESIGN

A cross-sectional survey design and a self-developed structured questionnaire were used.

METHODS

A probability proportionate to size sampling strategy was used to collect data from students in junior college and bachelor of nursing science programmes in Taiwan in 2017. Multiple regression was adopted to predict significant factors that influence nursing students' willingness to serve in GLTC.

RESULTS

The willingness to serve in GLTC was positively correlated with their experience of living with older adults, practicum experience, taking GLTC-related courses and interest in GLTC. Willingness to serve older/disabled patients can be enhanced through school courses and practicum experiences, indicating the importance of GLTC-related courses in the training of the professional nursing workforce.

Willingness and associated factors of working with older people among undergraduate nursing students in China: a cross-sectional study

BACKGROUND

The aging population has become a serious challenge for health care service and will lead to an increasing demand for nurses to work with older people. However, working with older people has always been an unpopular career choice among nursing students. This study aimed to further explore the willingness and associated factors of undergraduate nursing students to work with older people in China.

METHODS

A convenience sampling method was employed from May to July 2017 among undergraduate nursing students from a nursing school in Nantong China. Demographic data, the Chinese version of the Kogan's Old Person's Scale, the Chinese version of the Facts of Aging Quiz and the motivation questionnaire were used to collect data. A series of Mann-Whitney U test, Kruskal-Wallis H test, Spearman correlation test and Ordinal logistic regression analysis were applied to analyze the data.

RESULTS

Of the 853 students surveyed, 38.1 % were willing to work with older people after graduation. Expectancy, interest, attainment value, cost, prejudice, whether they like nursing profession and whether they participated in elderly-related activities were the most significant predictors of the students' willingness to work with older people.

CONCLUSIONS

Nursing students expressed a low level of willingness to work with older people upon graduation. Nursing educators have an important part in challenging students' stereotype of older people and inspire their career choice in caring for older people through both well-designed curriculum and elderly-related activities, and relevant education departments should actively optimize aged-related courses, strengthen professional ethics and gratitude education, and improve nursing students' sense of identity and mission in caring for older people, so as to improve their willingness to work with older people.

Predicting undergraduate nursing students' willingness to care for older adults: A multicenter cross-sectional study in Asia

AIM

To investigate the willingness of nursing students in Hong Kong and Mainland China to care for the elderly and to identify the factors influencing their willingness.

DESIGN

A correlational and cross-sectional design.

METHODS

A four-part self-administered questionnaire was utilized to collect data from the undergraduate nursing students in Hong Kong and Mainland China.

RESULTS

The total sample consisted of 820 nursing students, with 481 students in Hong Kong and 339 students in Mainland China. The scores of willingness to care for older people of the two groups were similar (mean score 4.68 versus 4.44), and no significant difference was observed between the students in the two regions (p = .071). A very low proportion of the nursing students in Hong Kong (7.7%) and those in Mainland China (3.6%) ranked caring for older people as their first choice of work. No salient predictors of willingness to care for older people existed for the nursing students in Mainland China.

"I learned that I am loved": Older adults and undergraduate students mutually benefit from an interprofessional service-learning health promotion program

Although benefits of service-learning and interprofessional education (IPE) have been well documented to be effective for students in gerontology, few curricula appear to integrate both aspects into a single experience for undergraduate students in public health. We discuss the development and implementation of an IPE service-learning health promotion program embedded within two different departments at a mid-sized university. Students worked in interdisciplinary teams and acquired IPE learning outcomes while they engaged in their first experiences working with diverse older adults at a low-income independent-living housing community. Twenty-five students each team-taught two sessions on nutrition, physical activity, and stress reduction techniques in a 10-week program. Qualitative and quantitative results showed significant learning outcomes from the students about the needs of the aging population and increased comfort working with seniors. Older participants in the program also reported positive health and psychological outcomes from participation. Challenges, next steps, and recommendations are also discussed.

Connecting Nursing Students and Older Adults: An Intergenerational Service-Learning Experience

BACKGROUND

Aging populations have an increased need for health care services. Nursing students are often introduced to care of older adults through a clinical experience in a skilled nursing facility, which can negatively bias a student's attitudes toward this population.

PURPOSE

The purpose of this quality improvement project was to improve the attitudes of undergraduate nursing students toward older adults.

METHOD

Students (N = 104) completed a minimum of 5 visits with an independent community-dwelling older adult. Student attitudes toward older adults were measured before and after the experience using the Polizzi Refined Aging Semantic Differential Scale. Student and older adult participants responded to satisfaction surveys.

RESULTS

Statistical and clinically significant improvements in student attitudes were noted after the service-learning intervention.

CONCLUSIONS

Nurse educators can impact the way nursing students view the older adult population by including intergenerational service-learning experiences in the curriculum.

Assessing attitudes and intention to work with older adults by American and Israeli nursing students: Adapting and testing a measure

BACKGROUND

Finding workers to care for older adults in healthcare settings has become a priority, and research identifying factors influencing a nursing student's intention to make geriatrics a career choice is needed. This calls for the development of a reliable measure of students' perceptions and attitudes.

OBJECTIVES

To determine the adaptability of Carolina Opinions on Care of Older Adults (COCOA) to assess nursing students' attitudes to older adults and their intentions to work with them in two countries.

DESIGN

Cross-sectional survey.

SETTINGS

Nursing students enrolled in an introduction to gerontological nursing course in the United States and Israel.

PARTICIPANTS

A convenience sample of 231 undergraduates pursuing a Bachelor of Science in nursing in the United States (N=122) and Israel (N=109).

METHODS

Students completed the COCOA instrument and basic demographics using an electronic platform.

RESULTS

Exploratory Factor Analysis (EFA) produced five factors explaining 59% of the variation, with the majority of the items (17, 71%) loading above 0.40 on subscales from the instrument's original structure. EFA led to the elimination of one subscale (Value of Older Adults) and the creation of a new subscale (Older versus Younger Adults) with three items. The reliability scores were good to acceptable for all subscales in both Israeli and American samples (α-Cronbach 0.80 to 0.60). Confirmatory FA supported the data's fit to the 21 items of the modified COCOA instrument (CMIN/DF=1.55, CFI=0.93, IFI=0.93, RMSEA=0.05). The analysis of model equivalence for American and Israeli samples revealed significant differences only on the Experience in Caring for Older Adults subscale.

CONCLUSIONS

The modified COCOA demonstrated good construct validity and reliability and can serve as estimation of nursing students' attitudes to older adults and their intention to make geriatrics a career choice. Future studies should further evaluate its predictive validity.

Gaining access to the field in medical ethnography: Reflections on ethical, methodological, and structural challenges in the study of long-term care facilities

The article extends the discussion on the challenges in gaining access to the field in medical ethnographic research, focusing on long-term care (LTC) facilities. Medical institutions have been documented to be difficult sites to access. The reference, however, is to the recruitment of patients as informants. The challenges of recruiting practitioners as informants have not been investigated at all. The article presents the key issues that emerged in the process of gaining social access at the sites of two LTC facilities as part of a study on care workers' identities. The main obstacles encountered during the fieldwork were organizational constraints and negotiating control over the process of recruiting the lower occupational tier of care workers with gatekeepers. The article presents the coping strategies implemented to overcome the ethical and methodological obstacles: continually reassessing the consent and cooperation of participants and developing a rapport with nurse's aides during interviews.

Nursing students' perceived value of the work environment: A discrete choice experiment

The purpose of this study was to elicit graduating undergraduate nursing students' perceived value of the work environment in aged care. Applying a cross sectional design, an electronic questionnaire was sent to 625 graduating undergraduate nursing students from three schools of nursing in Jiangsu Province, China. A discrete choice experiment questionnaire with eight choice-set questions was performed. In total, 267 nursing students (42.7%) responded to the questionnaire. We found that nursing students valued excellent working conditions the highest (OR = 3.632 [2.846~4.635]), followed by adequate formal professional development activities (OR = 2.252 [1.907~2.660]), good/excellent safety management (OR = 2.214 [1.828~2.682])/ (OR = 2.202 [1.758~2.759]), and 10% higher earnings (OR = 1.615 [1.360~1.919]). Based on these findings, the study provided information to improve the recruitment of nursing students to work with older adults. Findings suggest that students may be 44.07~73.41% more likely to choose working with older people when valued job characteristics are present.

Nursing students' willingness to work in geriatric care: An integrative review

Aims

This integrative review aims to explore the willingness of nursing students to work in geriatric care over the past 10 years and to explore the factors influencing nursing students to work in geriatric care.

Design

An integrative review.

Methods

Studies investigating nursing students’ willingness in gerontological nursing work and related influencing factors published in English in Cochrane Library, MEDLINE, Embase, PsycINFO and CINAHL between 2010–2020 were included. Data collected in April 2020.

Results

Twenty‐four studies were analysed. Most studies presented a contradictory or negative attitude about the willingness of nursing students to engage in gerontological nursing work. In most studies that rank the intention to work in nursing fields, gerontological care received the lowest or a relatively low ranking. The main factors affecting work related to gerontological nursing include prior experience caring for older adults, attitudes towards geriatrics, anxiety about ageing, clinical practice environment and living experience with older family members.

Validating Factors That Influence Student Nurse Intention Regarding Perioperative Nursing

BACKGROUND

Failure to effectively recruit Newly Graduated Nurses (NGN) to perioperative nursing in the face of an anticipated nursing shortage will adversely impact patient outcomes. Development of interventions that address the recruitment problem is hampered by lack of a comprehensive understanding of factors that influence Student Nurse Intention (SNI) regarding perioperative nursing.

PURPOSE

This descriptive quantitative study aims to test a Theory of Planned Behavior (TPB) questionnaire and validate factors that influence SNI.

METHOD

Quantitative sequence of exploratory sequential design. Item analysis, and principal component analysis of data are completed.

RESULTS

The instrument demonstrated satisfactory psychometrics. Immediate exposure or immersion, affirmation by nurse managers, and availability of positions were the most influential attitudinal, normative, and control beliefs respectively. Generational values have some influence on intention to choose perioperative nursing.

CONCLUSION

A TPB questionnaire is useful for measuring factors that influence SNI.

Factors affecting nursing students' intention to work as a geriatric nurse with older adults in Turkey: A cross-sectional study

The need for nurses specialized in geriatrics continues to increase with the aging world population. However, nurses and nursing students mostly do not consider geriatric nursing as a possible career in nursing. Therefore, understanding the factors that influence such a career preference is crucial to encourage geriatric nursing. The current study is cross-sectional and aims to investigate nursing students' intention to work as a geriatric nurse with older adults and the factors influencing those intentions. A total of 688 nursing students enrolled in the second, third, and fourth-years of the Bachelor of Nursing program in two universities were recruited. Data were collected using a questionnaire form developed by the researchers and the Kogan Attitude toward Old People Scale. Results indicated correlations between the fourth year in the program, living with older adults, taking a separate course on geriatric health, experience in providing care for older adults, and evaluating geriatric nursing as a possible career in nursing (P < 0.05). Additionally, the study demonstrated that students avert from a career in geriatric nursing due to the lack of knowledge and skills and negative experiences during internships and practice. In conclusion, nursing programs should include courses designed to focus on gerontology to improve nurse students' willingness to work with older adults.

The gerontological nurse specialist's core competencies in China: A cross-sectional study

Aim

To describe the core competencies of gerontological nurse specialists and investigate the factors that contribute to the development of core competencies.

Design

A descriptive cross‐sectional study was conducted from August 2015–March 2016.

Methods

The descriptive study of gerontological nurse specialists’ core competencies used a self‐assessment instrument with three first‐level domains (attitude, skill and knowledge) and 9 s‐level dimensions. A total of 225 gerontological nurse specialists from ten provinces in China were selected by a convenience sampling method.

Results

The average core competency score of the gerontological nurse specialists was 3.78, in the middle level(3.30–4.17/5.00). Core competency was associated with gerontological nurse specialists’ age (p = .005), professional title (p = .017), hospital level (p = .006) and passion for geriatric nursing (p = .000). The average scores of attitude, skill and knowledge were 4.45, 4.02 and 4.18, respectively. All first‐level domains were related to age (p ≤ .021) and passion for geriatric nursing (p ≤ .008); knowledge and skill were associated with professional title (p ≤ .045) and attitude and skill were associated with hospital level (p ≤ .020).

A cross-sectional study on preferred employment settings of final-year nursing students in Israel

BACKGROUND

Despite the growing demand for community nurses, their number remains relatively low. We examined perceptions of final-year nursing students regarding their preferred work setting after graduation and the factors affecting their choice.

METHODS

A cross-sectional survey using a structured questionnaire was developed specifically for this study. The questionnaire was distributed among fourth-year students from all nursing training frameworks across Israel.

RESULTS

Of 281 respondents (76.6% women, average age, 29.3 years), most (80.9%) preferred working in hospitals, while 5% preferred community settings; 14% were undecided. Students' knowledge on hospital nurses' tasks was greater compared to their knowledge on community nurses' tasks. Moreover, hospital nurses' tasks were perceived as more important than those of community nurses. The contribution of clinical placement in hospital nursing was perceived as significantly more meaningful than the contribution of clinical placement in community nursing. The vast majority of students (94.3%) stated that they would prefer to undergo a hospital nursing internship. A significant correlation was noted between students' clinical placement, the exposure to community nursing roles, and the perception of the community nurse's role: clinical placements that were perceived as a positive experience led to a more positive perception of community nurses' roles.

CONCLUSIONS

Nursing students' perception of community nursing is based upon limited information which does not reflect community nurses' actual role and work.

Effects of a person-centred and thriving-promoting intervention on nursing home staff job satisfaction: A multi-centre, non-equivalent controlled before-after study

Aim

To evaluate the effects of a person‐centred and thriving‐promoting intervention in nursing homes on staff job satisfaction, stress of conscience and the person‐centredness of care and of the environment.

Design

A multi‐centre, non‐equivalent control group, before–after trial design.

Methods

Staff (N = 341) from six nursing homes in Australia, Norway and Sweden were assigned to the intervention or the control group and both groups were evaluated before the intervention, immediately after and by 6 months follow‐up. Staff completed a questionnaire about job satisfaction (primary endpoint), stress of conscience and the person‐centredness of care and of the environment (secondary endpoints). Linear regression models were used to identify the mean scores and to analyse group differences to test the effects of the intervention.

Results

The intervention had no statistically significant effects on staff job satisfaction, level of stress of conscience or the perceived person‐centredness of care and of the environment.

Gerontological nurse teachers' abilities and influence on students' willingness in older people nursing: A cross-sectional, correlational survey

BACKGROUND

Previous studies have focused on identifying the factors hindering nursing students' interest in gerontology careers, whereas others have suggested interventions to promote students' interest in older people nursing. However, the role of a teacher is equally vital in shaping students' career preference.

OBJECTIVE

This study therefore explored students' perspectives of their gerontological nurse teachers' abilities and its association with students' willingness to work in older people nursing.

DESIGN

A cross-sectional correlation study.

SETTING

Five Universities of Applied Sciences in Finland.

PARTICIPANTS

Undergraduate nursing students (N = 243).

METHOD

A self-administered survey using the Gerontological Nurse Teacher Scale (GeNTS) and the subscale (Willingness) of the Students' Interest in Nursing Older People Scale (SINOPS). Descriptive and inferential analysis were conducted using SPSS.

RESULTS

There was a moderate positive association (R = 0.25, N = 243, p = 0.000) between students' perspectives of their gerontological nurse teachers' abilities and students' willingness to work in older people nursing. The teachers' abilities to develop gerontological nursing course most influence students' willingness in older people nursing (r = 0.26, p = 0.001), whereas their knowledge and interest in gerontology, least influenced students' willingness in older people nursing (r = 0.14, p = 0.025). Also, the teachers abilities to address students' concerns about aging, promote gerontology careers, and demonstrate leadership skills in gerontology all had a similar statistically significant moderate positive association (r = 0.23, p = 0.001) with students' willingness to work in older people nursing.

CONCLUSION

Faculty need to ensure that there is adequate personal with expertise in gerontological nursing to advocate for resources to establish a reputable gerontological nursing profile in nursing curriculum and to develop and sustain a positive attitude towards older people nursing among students and staff. A qualitative study is needed to understand the reasons behind students' ratings.

Preferences of nursing and medical students for working with older adults and people with dementia: a systematic review

BACKGROUND

A current issue in workforce planning is ensuring healthcare professionals are both competent and willing to work with older adults with complex needs. This includes dementia care, which is widely recognised as a priority. Yet research suggests that working with older people is unattractive to undergraduate healthcare students.

METHODS

The aim of this systematic review and narrative synthesis is to explore the factors related to healthcare (medical and nursing) student preferences' for working with older people and people with dementia. Searches were conducted in five databases: MEDLINE, PsycINFO, CINHAL, BNI, ERIC. Screening, data extraction and quality appraisal were conducted by two independent reviewers. A narrative, data-based convergent synthesis was conducted.

RESULTS

One thousand twenty-four papers were screened (139 full texts) and 62 papers were included for a narrative synthesis. Factors were grouped into seven categories; student characteristics, experiences of students, course characteristics, career characteristics, patient characteristics, work characteristics and the theory of planned behaviour.

CONCLUSION

Health educators should review their role in cultivating student interest in working with older adults, with consideration of student preparation and the perceived value of this work. There is a lack of evidence about the career preferences of students in relation to dementia, and this warrants further research.

The Effect of Educational Interventions on Willingness to Work with Older Adults: A Comparison of Students of Social Work and Health Professions

The study examined the effect of an educational intervention on the willingness of Israeli social work students to work with older adults, comparing them to students of nursing, speech therapy, and physiotherapy. A sample of 187 first-year students were divided into two groups: a research group (n=83) exposed to an educational intervention on ageing, and a control group (n=104) that received no intervention of any kind. Following the intervention, ageism among social work students in the research group decreased and positive behavior toward older adults increased. No significant differences were found among students of the health professions following the intervention. In addition, ageism mediated between knowledge of ageing and willingness to work with older adults.Furthermore, the higher the students assessed the contribution of the intervention, the lower their level of ageism, the more positive their behavior toward older adults, and the more willing they were to consider a career in geriatrics. The results suggest that introducing into the curriculum a variety of learning methods aimed at increasing knowledge of ageing and familiarity with the world of older adults is likely to encourage more students of social work and other therapeutic professions to work with the older population.

Undergraduate nursing students' knowledge of aging, attitudes toward and perceptions of working with older adults in Kathmandu Nepal

Objectives

This study aims to examine Nepalese undergraduate nursing students’ knowledge of aging, attitudes towards older adults and perceptions of working with older adults, and to assess differences in these outcomes by socio-demographic characteristics as well as type of nursing program.

Methods

A cross-sectional study was conducted among 385 undergraduate nursing students in six nursing colleges located in the Kathmandu Valley. Knowledge of aging, attitudes toward older adults and perceptions of working with older adults were assessed using standardized tools, the Palmore Facts on Aging Quiz, Kogan's Attitudes towards Older People Scale, and Nolan's Intent to Work with Older People Questionnaire, respectively.

Results

The mean knowledge scores on older adults and aging were relatively low; participants scored an average of 26.9 out of 50. Scores assessing attitudes towards and perceptions of working with older adults were more favorable. Compared to students pursuing a Bachelor of Science in Nursing (BSN), students pursuing a Bachelor of Nursing (BN) had a significantly higher score on the knowledge, attitudes and perception of aging scales. Linear regression analyses showed that the students’ knowledge of aging (β = 0.55; 95% CI = 0.25–0.86) and perceptions of working with older adults (β = 0.22; 95% CI = 0.05–0.38) had a significant positive association with their attitudes toward older adults.

Conclusions

Undergraduate nursing students in the Kathmandu Valley of Nepal displayed a relatively low level of knowledge, but a positive attitude towards older adults, and a positive perception of working with older adults. Observed differences in knowledge, attitude, and perception scores between students in BSN and BN programs needs further investigation; closing this gap may be important for bolstering undergraduate gerontological preparation in Nepal.

Relationship Between Gerontological Nursing Education and Attitude Toward Older People

BACKGROUND

Nursing students' attitudes toward older people affect the quality of care provided to the aging population. Although gerontological nursing has been delivered as a stand-alone course in Macao since 2008, Macao nursing students' attitudes toward older people have not been investigated.

OBJECTIVE

The purposes of this study were 1) to explore nursing students' background information and attitudes toward older people and 2) to examine the presence of relationships between these factors and gerontological nursing education in Macao, a special administrative region of China.

METHODS

A cross-sectional survey design was adopted. Nursing students in Macao were invited to complete a questionnaire to record their demographic characteristics and gerontological nursing education and measure their attitudes toward older people using Kogan's Attitudes Toward Older People (KAOP) scale.

RESULTS

Data from 377 (83.04%) nursing students who returned the questionnaire were analyzed. The students were found to have positive attitudes toward older people, with a mean KAOP score of 168.44 ± 18.38 (mean ± standard deviation). In particular, the item with the lowest mean score was "older adults have excessive demands for love" (2.5 ± 1.2), while the item with the highest mean score was "older adults need no more love than others" (6.0 ± 1.0). The results also revealed that Macao nursing students' positive attitudes toward older people were associated with having "religion," "good experience in gerontological nursing taught course," and "good experience in clinical practice with older people," which were thus considered to be the predictors of their positive attitudes toward older people.

CONCLUSION

Religion and gerontological nursing education are associated with Macao nursing students' attitudes toward older people. A longitudinal study is needed to evaluate the gradual changes in nursing students' attitudes. Nursing students' future career choices and perceptions of gerontological nursing education should be explored in a future study.

Preparing nurses and nursing students to care for older adults in lower and middle-income countries: A scoping review

BACKGROUND

The aim of this review was to examine the extent and nature of published literature on nurses' and nursing students' preparedness to care for older adults in lower and middle-income countries.

METHOD

A scoping review with 27 articles, guided by the Arksey and O'Malley (2005) framework was conducted. The following electronic databases were searched: MEDLINE, CINAHL, ERIC and SCOPUS. Grey literature using Google Scholar and ProQuest were also searched. Key search terms and subject headings such as "nursing students", "nurses", "stakeholders", "ministry of health", "readiness", "knowledge", "attitudes", "elder care", "seniors care" and "older adults" were used to identify relevant articles. Studies that reported on gerontological nursing, nursing students' and nurses' knowledge and attitudes towards older adults, and stakeholders/employers' views about nursing students' knowledge and attitudes towards older adults were included.

RESULTS

Nurses reported having moderate to insufficient knowledge in the care of older adults in the majority of the studies. Nursing students reported insufficient knowledge in the care of older adults. However, both nurses and nursing students reported positive attitudes towards the care of older adults but held misconceptions about caring for older adults. Nursing students also reported a low preference for working with older adults.

DISCUSSION AND IMPLICATIONS

The inadequate preparation of nurses and nursing students in the care of older adults means there are opportunities to enhance knowledge about health and nursing care in lower and middle-income countries and build on the positive attitudes towards older adults.

The relationship between nursing students' professional values and their attitudes towards the elderly people: A cross-sectional study

BACKGROUND

Professional values involve standards that are effective in solving problems, interacting with patients, making decisions on patient care and forming the student's attitude. Throughout the course of the nursing students' occupational education, these standards shape their attitudes, beliefs, and behaviors regarding the provision of care for individuals.

OBJECTIVE

The aim of this study was to determine the relationship between nursing students' professional values and their attitudes towards the elderly.

DESIGN

A cross-sectional research design was used in this study.

SETTINGS

This study was conducted at a university in the northeast of Turkey.

PARTICIPANTS

2nd-year (n = 93), 3rd-year (n = 101) and 4th-year (n = 81) nursing students.

METHOD

The data for the study were collected using a Personal Information Form, the Nursing Professional Values Scale- Revised (NPVS-R) and the Ageism Attitude Scale (AAS). In the data analysis, independent samples t-test, ANOVA and Spearman Correlation were used.

RESULTS

The study found that the nursing students' average total NVPS-R score was 86.4 ± 16.2 and their average total AAS score was 82.7 ± 8.8. Furthermore, a significant correlation was observed between the professional values of the students and their attitudes towards the elderly (r = 0.407, p = 0.000). A positive, moderately strong correlation was determined between the total NPVS-R scores and the 'restricted life of elderly people' and 'positive attitudes towards elderly people' sub-scales of AAS (r = 0.418, r = 0.317, p < 0.005, respectively).

CONCLUSION

The present study has demonstrated that the nursing students' professional values are associated with their attitudes towards the elderly. In the light of these results, it is suggested that professional values be taught and that courses on values be added to the curriculum in order to improve the attitudes of the students towards ageism.

Nursing Competence in Geriatric/Long Term Care Curriculum Development for Baccalaureate Nursing Programs: A Systematic Review

BACKGROUND

As facing the rapid growth of the elderly population, the demands for geriatric and long-term care are drastically increasing. Since one of the important strategies in preparation for long-term care system is to focus on the engagement of health care professionals, this paper applies a systematic approach to review the current geriatric and long term care courses in Bachelor of Science in Nursing (BSN) programs. This review assessed the impact of Geriatric Nursing (GN) and/or Long Term Care (LTC) courses on nursing students' knowledge, care intention and competence of Geriatric Long Term Care (GLTC) care to enable their nursing competence before graduation.

METHOD

Data related to the purpose of the study, research design, sample, curriculum content, teaching strategies, evaluation measurements and results were extracted. The methodological quality of all publications was included in the review.

RESULTS

Eighteen articles were eligible for analysis, including 16 quantitative and 2 qualitative studies. The review revealed that including geriatric and long term care content in undergraduate nursing curriculum could effectively enhance students' nursing competence.

CONCLUSION

GN and LTC curriculum development should offer established content on geriatric and long term care as a foundation to implement early learning experiences in the curriculum. Both theory and clinical practice of GLTC course can be developed to increase the nursing students' knowing on the elders and the disabled through the clinical placement.

The Scale on COmmunity care PErceptions (SCOPE) for nursing students: A development and psychometric validation study

The aim of this study was to develop a valid instrument to measure student nurses' perceptions of community care (SCOPE). DeVellis' staged model for instrument development and validation was used. Scale construction of SCOPE was based on existing literature. Evaluation of its psychometric properties included exploratory factor analysis and reliability analysis. After pilot-testing, 1062 bachelor nursing students from six institutions in the Netherlands (response rate 81%) took part in the study. SCOPE is a 35-item scale containing: background variables, 11 measuring the affective component, 5 measuring community care perception as a placement, 17 as a future profession, and 2 on the reasons underlying student preference. Principal axis factoring yielded two factors in the affective component scale reflecting 'enjoyment' and 'utility', two in the placement scale reflecting 'learning possibilities' and 'personal satisfaction', and four in the profession scale: 'professional development', 'collaboration', 'caregiving', and 'complexity and workload'. Cronbach's α of the complete scale was 0.892 and of the subscales 0.862, 0.696, and 0.810 respectively. SCOPE is a psychometrically sound instrument for measuring students' perceptions of community care. By determining these perceptions, it becomes possible to positively influence them with targeted curriculum redesign, eventually contributing to decreasing the workforce shortage in community nursing.

Students' Knowledge of and Interest in Older Adults: Impact of a Geriatrics Course

BACKGROUND

The number of older adults living with chronic conditions is steadily increasing, so nurses must be prepared to care for the needs of this population. However, only one third of nursing education programs include a stand-alone geriatrics course.

METHOD

A cross-sectional mixed-methods design was used to compare two cohorts of 46 nursing students. Knowledge, attitude, and interest in older adults were examined using an online survey. The control cohort did not complete the geriatric course.

RESULTS

No demographic differences were found between groups. Completing the geriatric course was not correlated with having greater aging-related knowledge. Decreased interest in working with the older adult population was found.

CONCLUSION

Findings from this cross-sectional pilot study suggest that previous experience with an aging relative was associated with better aging-related knowledge. Further research exploring students' perceptions is needed to understand the relationship between the geriatric course and attitudes toward aging. [J Nurs Educ. 2018;57(2):106-109.].

Perceptions of community care and placement preferences in first-year nursing students: A multicentre, cross-sectional study

BACKGROUND

Despite increasing shortages of highly educated community nurses, far too few nursing students choose community care. This means that a strong societal problem is emerging that desperately needs resolution.

OBJECTIVES

To acquire a solid understanding of the causes for the low popularity of community care by exploring first-year baccalaureate nursing students' perceptions of community care, their placement preferences, and the assumptions underlying these preferences.

DESIGN

A quantitative cross-sectional design.

SETTINGS

Six universities of applied sciences in the Netherlands.

PARTICIPANTS

Nursing students in the first semester of their 4-year programme (n=1058).

METHODS

Data were collected in September-December 2014. The students completed the 'Scale on Community Care Perceptions' (SCOPE), consisting of demographic data and three subscales measuring the affective component of community care perception, perceptions of a placement and a profession in community care, and students' current placement preferences. Descriptive statistics were used.

RESULTS

For a practice placement, 71.2% of first-year students prefer the general hospital and 5.4% community care, whereas 23.4% opt for another healthcare area. Students consider opportunities for advancement and enjoyable relationships with patients as most important for choosing a placement. Community care is perceived as a 'low-status-field' with many elderly patients, where students expect to find little variety in caregiving and few opportunities for advancement. Students' perceptions of the field are at odds with things they believe to be important for their placement.

CONCLUSION

Due to misconceptions, students perceive community care as offering them few challenges. Strategies to positively influence students' perceptions of community nursing are urgently required to halt the dissonance between students' preference for the hospital and society's need for highly educated community nurses.

Graduate entry students' early perceptions of their future nursing careers

Graduate entry nursing programs designed for individuals with prior degrees in other disciplines are becoming increasingly popular internationally. They provide entry into nursing for people with unique skill-sets. Yet, little is known about why these individuals choose career change into nursing and what they expect from their new careers. This component of a larger study sought to explore graduate entry nursing students' short and longer term career intentions on commencement of their courses. A cross-sectional survey was used. Descriptive frequencies were used to analyse demographic data, while summative content analysis was used with the open-ended questions. Participants were drawn from eight cohorts of commencing students from enrolled in one graduate entry masters program in Australia between 2009 and 2015. Content analysis identified three main categories: professional role, work location, and work context. Longer term responses were categorised under four categories: professional role, work location, work context and personal and professional goals. Many students had clear directions about their future nursing careers. On graduation, many envisioned working in advanced roles or in clinical specialty areas, primarily in hospital settings. However, in the longer term, there was diversity among with many envisaging work outside traditional hospital settings, and some in other health disciplines.

Workplace continuing education for nurses caring for hospitalised older people

AIMS AND OBJECTIVES

To develop, implement and evaluate a workplace continuing education programme about nursing care of hospitalised older people.

BACKGROUND

The healthcare system cannot rely solely upon nurses' prelicensure education to prepare them to meet the evolving needs of hospitalised older patients. Over the past decade, there has been a dramatic rise in the proportion of older people in hospitals, yet many nurses do not have specialised knowledge about the unique care needs of this population.

DESIGN

A multimethod pre-to post-design was employed.

METHODS

Between September 2013 and April 2014, data were collected via surveys, focus groups and interviews. Thirty-two Registered Nurses initially enrolled in the programme of which 22 completed all data points. Three managers also participated in interviews. One-way repeated-measures ANOVAs were conducted to evaluate the effect of the programme and change over time. Qualitative data were analysed using thematic analysis.

RESULTS

Survey results indicated improvements in perceptions about nursing care of older people but no changes in knowledge. Themes generated from the qualitative data focused on participants' experiences of taking part in the programme and included: (i) relevance of content and delivery mode, (ii) value of participating in the programme and (iii) continuing education in the context of acute care.

CONCLUSIONS

This study illustrated the potential role of workplace continuing education in improving care for hospitalised older people, particularly the potential to change nurses' perceptions about this population. Nurses prefer learning opportunities that are varied in delivery of educational elder-focused content and accessible at work. Organisational leaders need to consider strategies that minimise potential barriers to workplace continuing education.

IMPLICATIONS FOR PRACTICE

Workplace continuing education can play a key role in improving quality of care for hospitalized older adults and ought to be a priority for employers planning education for nurses.

The care of and communication with older people from the perspective of student nurses. A mixed method study

BACKGROUND

Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people.

OBJECTIVE

The aim of this study was to investigate student nurses' views on the care of and communication with older people.

DESIGN

A descriptive study with a mixed-method approach was conducted.

METHODS

Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015.

RESULTS

The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites.

CONCLUSIONS

Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed.

Nursing curriculums may hinder a career in gerontological nursing: An integrative review

OBJECTIVE

To investigate what prevents undergraduate nursing students from choosing gerontological nursing as a career option.

DESIGN

This study utilised an integrative literature review, which allows the inclusion of previous studies with diverse research designs to gain a broader view of the reasons why nursing students do not choose a gerontological nursing career.

METHODS

An electronic database search of CINAHL (Ebsco), Scopus and Eric elicited 251 scientific peer-reviewed empirical studies, published from 2006 to March 2016 in English. After meeting the inclusion criteria, 97 qualified for closer examination. Following exclusion, the final analysis and synthesis included 21 articles.

RESULTS

Four main themes described nursing students' contributing reasons for not selecting gerontological nursing as a career option: socio-demographic factors; experiences, perceptions and knowledge about ageing; perceptions concerning the nature or status of gerontological nursing; and theoretical studies and practical education of nursing curriculum.

CONCLUSIONS

Lack of positive experiences with older people before and during nursing students' studies led to their disinterest in gerontological nursing as a career option. The nursing curriculum also reinforces the perception of modern nursing as technical, with more emphasis on acute and critical care. The findings emphasise the need to implement an age-friendly curriculum and have nurses that specialise in gerontology to serve as mentors and role models. It is important to assist nursing students in identifying the potentials for career advancement in terms of gerontological nursing. There is also a need for nursing faculties to liaise with other stakeholders to develop or improve upon the clinical atmosphere for nursing students during gerontological nursing placement.

IMPLICATIONS FOR PRACTICE

Nursing faculties must review their curriculum to ensure that there is sufficient focus on the needs of older people within the curriculum for every student. Furthermore, respected role models who are knowledgeable and enthusiastic about issues related to older people must teach gerontological nursing courses.