Graduate nurses' learning trajectories and experiences of problem based learning: a focused ethnography study

Using unfolding case studies to develop critical thinking for Graduate Entry Nursing students: an educational design research study

BACKGROUND

Graduate Entry Nursing (GEN) programmes have been introduced as another entry point to nurse registration. In the development of a new GEN programme, a problem-based approach to learning was used to develop critical thinking and clinical reasoning skills of motivated and academically capable students.

OBJECTIVE

To explore and evaluate the design and delivery of course material delivered to GEN students embedded in authentic learning pedagogy from the perspectives of both GEN students and academic staff using an unfolding case study approach.

METHODS

An educational design research approach was used to explore the learning experiences of GEN students using an unfolding case study approach situated in experiential pedagogy and the teaching experiences of the academics who designed it. Data were collected through semi-structured interviews with students once they had finished the course and weekly reflective diary recordings by academic staff throughout implementation. Thematic analysis was used to analyse the data.

FINDINGS

Student reflections highlighted that this cohort had insight into how they learned and were comfortable voicing their needs to academic staff. While the unfolding case studies were not liked by all participants, for some it offered a unique learning opportunity; particularly when scaffolded with podcasts, simulation labs, tutorials and clinical placements. Staff reflections primarily aligned with student experiences.

CONCLUSION

The gaps highlighted in the delivery of the course suggest that a blended pedagogical approach to graduate entry nurse education is required. Specifically, GEN students are aware of the learning needs and are happy to express these to academic staff, thus suggesting that engaging with a co-design curriculum approach will benefit future cohorts.

Effects of Problem-Based Learning Strategies on Undergraduate Nursing Students' Self-Evaluation of Their Core Competencies: A Longitudinal Cohort Study

To respond to patients' increasing demands and strengthen nursing professionals' capabilities, nursing students are expected to develop problem-solving skills before they enter the workforce. Problem-based learning (PBL) is expected to provide effective simulation scenarios and realistic clinical conditions to help students achieve those learning goals. This article aims to explore the effects of PBL strategies on nursing students' self-evaluation of core competencies. This longitudinal cohort survey study evaluated 322 nursing students attending Chung Shan Medical University, Taiwan, in 2013 and 2014, where PBL teaching strategies are used in all four undergraduate years from freshman to senior. Based on their undergraduate academic levels, students were categorized into three groups- one-year PBL exposure, two-year PBL exposure, and three-year exposure. A core competency questionnaire was administered twice to ask participants to self-assess five professional competencies: learning attitude, problem identification, information analysis, execution, and life-long learning. The results showed that students with the longest exposure to PBL (Group 3) had higher self-evaluated scores for all core competencies than the other groups, except for the execution competency. The mean total competency score increased by 0.12 points between the pre-and-test. In addition, the mean score increased significantly more in Group 3 than in Groups 1 and 2. These trends were consistent for the information analysis, execution, and life-long learning competencies. In conclusion, the changes in the self-evaluated scores between groups indicate PBL strategies effectively improve nursing students' core competencies. The longest exposure group reported higher self-evaluated core competency scores than the other groups, especially for the information analysis, execution, and life-long learning competencies.

English as a Foreign Language Teachers' Well-Being, Their Apprehension, and Stress: The Mediating Role of Hope and Optimism

Studies have shown that teachers' wellbeing has a positive effect on teachers' learning quality and learners' performance. Nevertheless, teaching is a stressful and exhausting profession at all academic level with special difficulties about the nature of language education. Tension and fear are still classic challenges in learning, though the concepts such as hope and optimism are core issues in assisting teachers to feel happy during instruction and work longer. The present review makes efforts to provide the most current confirmation on the interface of hope and optimism with educational issues since they are progressively documented as significant emotional capitals for educational success, job growth, and presentation. It is worth mentioning that the current review of research can benefit educational administrations, and other stakeholders and officials in the educational community to contemplate the functions of constructive emotions in the process of learning to decrease and even diminish stress and apprehension that consequently lead to flourishing.

Nursing students' experiences of what influences achievement of learning outcomes in a problem-based learning context: A qualitative descriptive study

Aim

This study aimed to describe nursing students' experiences of what facilitate or impede the achievement of learning outcomes in PBL‐based nursing education.

Design

A qualitative descriptive design was used.

Methods

Data were collected from individual semi‐structured interviews with 18 undergraduate nursing students in Sweden and were analysed using Burnard's qualitative content analysis.

Results

The results were organized into three categories: (a) understanding of the required level of knowledge depth (b) tutor's engagement and (c) student base group interactions. These categories represent essential components of PBL that could either facilitate or impede students' achievement of learning outcomes in nursing education. To improve the students' opportunities to achieve the learning outcomes, proper introduction of and a continuous education on PBL as a pedagogical method provided both to students and tutors should be considered important.

Degree in Nursing: education through problem-based learning

OBJECTIVE

To describe how undergraduate courses in Nursing are using the problem-based learning (PBL).

METHOD

Integrative literature review, from searches in the databases Education Resources Information Center (ERIC), Latin American and Caribbean Health Sciences Literature (Lilacs), and PubMed, from 2010 to 2015. 36 articles were analyzed.

RESULTS

A teaching method used in all continents, the PBL enables improvement of the critical thinking, autonomy, motivation for learning, active search attitude, ability to work in teams, and problem-solving. Difficulties and challenges relate to the training of students and teachers to understand the principles of the method.

FINAL CONSIDERATIONS

The benefits of PBL coincide with the needs of nursing training, but its applicability demands constant review in seeking to develop the skills necessary for this training.

Learning for Transdisciplinary Leadership: Why Skilled Scholars Coming Together Is Not Enough

Transdisciplinary research is an emerging new normal for many scientists in applied research fields, including One Health, planetary health, and sustainability. However, simply bringing highly skilled students (and faculty members) together to generate real-world solutions and policy recommendations for complex problems often fails to consistently create the desired results in transdisciplinary settings. Our research goal was to improve understanding and applications of transdisciplinary learning processes within a One Health graduate education program. This qualitative study analyzes 5 years of action research data, identifying four transdisciplinary leadership skills and four conditions required for consistent skill development. Combining Vygotsky's theory of proximal development with identified transdisciplinary skills, we explain why educational scaffolding is needed to enable more successful design and delivery of transdisciplinary learning, particularly in One Health educational programs.

Problem-Based Learning for Didactic Presentation to Baccalaureate Nursing Students

Nursing judgment is an essential component in the delivery of safe, quality patient care. Nurses must have the knowledge and skills to question authority, make judgments, substantiate evidence, and advocate for the patient. Traditional pedagogy in content-laden courses remains primarily lecture based. Incorporating active strategies to strengthen professional practice is essential. A pilot study assessed senior baccalaureate nursing students' perceptions of problem-based learning (PBL) and their readiness for self-directed learning. In addition, the authors analyzed the relationship between readiness for self-directed learning and course content mastery using PBL. Students completed the Self-directed Learning Readiness Scale, the Problem-Based Learning Environment Inventory, and course content mastery exams. Students reported positive experiences with PBL and readiness for self-directed learning. Readiness for self-directed learning and 2 of 5 exam scores were inversely, significantly related. Students' perceptions of their readiness for self-directed learning did not always correspond with course content mastery. Specifically, some students who perceived themselves as ready for self-directed learning did not perform well on course content exams. This inverse relationship has not been reported by other researchers and brings an interesting perspective to student perceptions and actual performance. Four themes emerged from students' narrative responses: Prepared Me for Real Life Professional Situations, Stimulated My Critical Thinking, Promoted Independent Problem Solving, and Supported Learning Retention. PBL as a pedagogical approach provides opportunities for nursing students to explore their professional independence while attempting to master content.

Factors influencing orthopedic nurses’ pain management: A focused ethnography

Aim: The aim of this study was to explore the factors influencing orthopedic surgery nurses’ decisions to administer pro re nata (PRN) opioid analgesia for postoperative pain.

Background: Fast-track surgery programs reduce length of stay by identifying and addressing factors causing patients to remain in hospital, including pain (H. Kehlet, Lancet. 2013;381:9878(9878)). The management of acute pain is an important component of quality care for patients after total knee arthroplasty.

Methods: The study used a qualitative design of focused ethnography. Ten nurses working on an orthopedic surgery unit at a large urban hospital in western Canada participated in semistructured interviews that used a patient vignette to examine factors that influenced participants’ pain management in the context of fast-track surgery. Interviews were transcribed and analyzed using thematic analysis and constant comparison.

Findings: Nurses described a complex clinical environment where the interplay of several factors informed decisions to administer PRN opioid analgesia. The unit’s culture and physical space influenced nurses’ assessments of pain and their decisions whether to treat pain with PRN opioids. Each nurse’s self-concept affected pain management decisions because of perceived importance of pain control and perceived duty to provide analgesics. The subjectivity of pain added another layer of complexity as nurses responded to the patient’s expression of pain from within the milieu of the unit culture and their unique self-concept.

Conclusion: Understanding the complexity of factors that influence nurses’ postoperative pain management provides clinical nurses and nursing leaders with directions for future education and research, guided by the goal of continued improvement in pain management in the challenging setting of fast-track surgeries.

Improving competencies in evidence-based dementia care: Results from a pilot study on a novel inter-professional training course (the KOMPIDEM project)

OBJECTIVE

In order to address well-known challenges in dementia care, an inter-professional course was developed to improve medical students' and nursing students' competencies in the provision of evidence-based care for people with dementia. The course comprises lectures, problem-based learning (PbL) tutorials and visitations to care facilities. A pilot study was conducted to evaluate the acceptance and feasibility of the inter-professional course.

METHODOLOGY

Alongside preliminary implementation of the newly developed course, a pre-post survey was carried out involving all participating students. The questionnaire contained standardized and open-ended questions on participants' views regarding the quality and relevance of several course components and characteristics. The data were analyzed by means of descriptive statistics.

RESULTS

When the course was offered the first time, multiple barriers became evident, leading to premature course termination and subsequent revision of the curriculum. When the revised course was offered, 10 medical students and 8 nursing students participated. The course proved feasible, and the median overall quality was rated as "2" (IQR 2-3) at a rating scale ranging from 1 (very good) to 6 (inadequate). Following aspects were most frequently judged positively: the course's inter-professional scope, the visitations to care facilities and the PbL tutorials. Potential for improvement was particularly noted with regard to a more distinct focus on well-defined, mainly practical learning outcomes. There were no indications of systematic between-group differences in the medical and nursing students' perceptions of the course program.

CONCLUSIONS

The results confirmed the feasibility of the inter-professional course on dementia care and the relevance of its inter-professional scope. However, to ensure sustainable course implementation in the long term, further program adaptations based on current findings and further evaluation studies focusing on objective parameters of the process and outcome quality are required.

Not just ticking all the boxes. Problem based learning and mental health nursing. A review

BACKGROUND

The practice and policy of mental health nursing are changing. Integration of health and social care, an increased emphasis on wellness and recovery and greater expectation of involvement from both service users and carers require competence in both group and interpersonal working. The active and dynamic processes of problem based learning provide the ideal environment to achieve proficiency in these skills.

OBJECTIVES

The aim of this review was to understand those programme elements that best support the delivery of a problem based learning module.

DATA SOURCES

This study utilised a standard module evaluation.

REVIEW METHODS

A systematic analysis of completed module evaluations allowed key themes to be established.

RESULTS

Problem based learning helps develop the skills and attributes that mental health nursing need in an increasing collaborative and wellness focused practice environment. Successful integration of PBL is more likely to occur when student centred approaches are already incorporated within a programme. Creating the right conditions for learning are key to successful facilitation of PBL groups.

CONCLUSIONS

Successful implementation of PBL requires identification of relevance to practice by students, a programme approach that is compatible with the aims and philosophy of PBL and a form of facilitation that encourages development of student autonomy.

Learning to create new solutions together: A focus group study exploring interprofessional innovation in midwifery education

Undergraduate students can learn how to be innovative in partnerships with health care institutions and private enterprises. This study portrays how a three phase innovation model was applied in an interprofessional health education context at a Danish university college. The aim of the study was to explore midwifery, nutrition and health as well physiotherapy students' perceptions of participating in a real-life innovation project situated in antenatal care. A total of eighteen students participated in five focus group interviews. Thematic analysis was used to interpret data findings. Data analysis revealed three themes: 'Navigating in uncertainty', 'Being part of a team' and 'Impact of project learning'. Students found project learning to be the most relevant with regards to their clinical practice. Furthermore, study findings suggest that innovation is promoted by teamwork, interprofessional participation, mentor support and external partnerships.