Registered nurses' perceptions of educational preparation for professional work and development in their profession

ICU nurse preceptors' perceptions of benefits, rewards, supports and commitment to the preceptor role: A mixed-methods study

This paper explores Intensive Care nurses' perceptions of benefits, rewards, supports and their commitment to the role of preceptor. A questionnaire, consisting of Likert-scales and open-ended questions was used to collect data during October 2018. Preceptors were committed to their role. Correlations were found between preceptors' perceptions of benefits or rewards and commitment to the role (p = 0.003, r² = 0.39) and perceptions of support and commitment to the role (p = .001, r² = 0.46). Altruistic benefits were perceived to be of the greatest importance. Participants who recognised the importance of preceptorship for the organisation were more likely to be committed to the role. Eighty-three percent of respondents reported a lack of consistency in allocation to work with their preceptee. Qualitative results elucidated themes of helping, personal professional development, the opportunity to teach, and organisational improvement. Supports as barriers and enablers to successful preceptorship were discussed in terms of peer and leadership support, role preparation, the logistics of the environment, role conflict, and consistency of allocation to work in a preceptorship dyad. Commitment to the preceptor role may be increased by highlighting organisational benefits of preceptorship, increasing consistency of contact between preceptorship dyads, and increasing access to supports and preparation.

Developing a self-checklist of staff development behavior for associate nurse unit managers using the Delphi method

The most significant influence on nurses' professional growth is through work under direct guidance in clinical settings. Associate nurse unit managers perform direct patient care with the staff, as well as assist management work of nurse unit managers. They can be excellent role models for the staff. We examined their behaviors that help promote staff development, aimed to identify effective behaviors, and created a self-checklist to evaluate them. We created 53 items to assess staff development behaviors, which were evaluated via a Delphi survey with 252 experts and a questionnaire survey with 124 associate nurse unit managers in Japan to evaluate whether the created item was appropriate. The results of the Delphi survey showed an agreement rate of over 90%, and associate nurse unit managers showed an acceptance rate of 82.6-99.2% for 40 of 53 items. Consequently, we created 40-item self-checklist of staff development behaviors for associate nurse unit managers with adequate validity. This checklist would be helpful for them to promote staff development while working in clinical settings and would contribute to enhancing the quality of nursing.

Who Wants To Be a Nurse? Understanding Emirati Female Students' Knowledge and Attitudes About Nursing as a Career

AIM

The aim of this study was to increase understanding of female high school students' intentions to pursue a nursing career. The objective is to explore theories on attitudinal research and propose a research model that examines the relationship between attitude, knowledge, and impact on intention to pursue a nursing career.

BACKGROUND

There is a paucity of research on understanding the reasons for the shortage of local nurses in the United Arab Emirates.

METHOD

Data were collected from 157 female high school students. The research model was empirically tested using standard procedures.

RESULTS

Findings support some of the proposed direct and interactional effects. Attitude is a predictor of intention of high school students to pursue a nursing profession. The interaction effect of attitude and knowledge significantly predicts intention.

CONCLUSION

The study calls for further investigation on the effects of attitude and knowledge on students' intention to pursue a nursing career and bring about changes in thinking.

Graduated nurses' experiences with baccalaureate thesis writing: A qualitative study

This study explores the perceptions of newly graduated nurses regarding the baccalaureate thesis (BT) writing process. A qualitative approach with content analysis was adopted. Thirteen newly graduated nurses participated in the study. The inclusion criterion was having completed the BT during their university education as nurses within 3 years of the study. Information was obtained through semistructured interviews. Data collection began in June 2018 and ended in March 2019, once saturation of information was reached. Three major categories were identified: the beginning of the process, the advantages of Baccalaureate thesis writing, and the teacher's role. The participants expressed that their training focused on a synthetic and particular type of writing that is necessary for clinical scenarios but not suitable for scientific academic texts. Additionally, reflective diaries were described as a powerful writing practice during their studies. Participants conceive the realization of the baccalaureate thesis as a difficult process, especially as regards selecting, synthesizing, and writing about the available information, processes that they indicated generate anxiety. Academic writing skills should be specifically included in the nursing curriculum.

Final year pre-registration student nurses perceptions of which taught theoretical knowledge is important for practice

This research illuminates the perceptions of eighteen final year undergraduate pre-registration student nurses, to understand what theoretical knowledge was perceived to be useful during their pre-registration nursing education, and what was not. The research adopted a qualitative phenomenological approach, and utilised a sample size of eighteen final year student nurses as the data source. The data collection method consisted of semi-structured interviews and the study took place at a Higher Education Institution within the North West of England approved to provide pre-registration nurse education. Participants provided their data during their final year of their undergraduate pre-registration nursing programme, via semi-structured, digitally recorded interviews, which were transcribed verbatim. The transcribed interviews were then analysed using Interpretive Phenomenological Analysis. The findings generated three themes, these were; important knowledge to learn for everyday practice, irrelevant for my future role, and, can we have some more? Findings demonstrate what aspects of the taught curriculum student nurses perceive to be of use to their practice, and why they perceive this to be the case. This affects how student nurses approach their learning during their nursing education. In addition it was clear what participants perceived was not useful for their practice and why this was the case. Additionally, participants offered suggestions of what they would also like adding to their curriculum, and provided insights for what they would like adding to the curriculum, which can be used for enhancing this. This is useful when developing future curricula to understand which aspects student nurses learn in a deep and superficial way. This can provide a useful insight for to ensure that patient care is not compromised.

Introductory anatomy and physiology in an undergraduate nursing curriculum

Using an educational data mining approach, first-year academic achievement of undergraduate nursing students, which included two compulsory courses in introductory human anatomy and physiology, was compared with achievement in a final semester course that transitioned students into the workplace. We hypothesized that students could be grouped according to their first-year academic achievement using a two-step cluster analysis method and that grades achieved in the human anatomy and physiology courses would be strong predictors of overall achievement. One cohort that graduated in 2014 (n = 105) and one that graduated in 2015 (n = 94) were analyzed separately, and for both cohorts, two groups were identified, these being "high achievers" (HIGH) and "low achievers" (LOW). Consistently, the anatomy and physiology courses were the strongest predictors of group assignment, such that a good grade in these was much more likely to put a student into a high-achieving group. Students in the HIGH groups also scored higher in the Transition to Nursing course when compared with students in the LOW groups. The higher predictor importance of the anatomy and physiology courses suggested that if a first-year grade-point average was calculated for students, an increased weighting should be attributed to these courses. Identifying high-achieving students based on first-year academic scores may be a useful method to predict future academic performance.

Graduate nurse experiences of support: A review

The first year of practice as a nurse is recognized as stressful. Graduate nurses (GNs) report gaps in their education, reality shock, burnout and other negative experiences that influence their intentions to remain in nursing.

OBJECTIVES

The aim of this literature review was to gain a greater understanding of the experiences of GNs.

REVIEW METHODS

It included thirty-six articles that focused on GNs and their transition to nursing, as part of a graduate nurse program (GNP), from 2005 to present.

RESULT

The review identified three main themes that influence the transition from student to registered nurse. These themes included, 1) feeling stressed and overwhelmed by nursing responsibilities, 2) the amount of support from senior nurses and 3) the importance of feedback on their performance as nurses.

CONCLUSIONS

Further research that is focused on the support and feedback provided to new nurses is needed.

Attitude to the subject of chemistry in undergraduate nursing students at Fiji National University and Federation University, Australia

Attitude to the subject of chemistry was quantified in first-year undergraduate nursing students, at two geographically distinct universities. A purpose-designed diagnostic instrument (ASCI) was given to students at Federation University, Australia (n= 114), and at Fiji National University, Fiji (n=160). Affective and cognitive sub-scales within ASCI showed reasonable internal consistency. Cronbach's alpha for the cognitive sub-scale was 0.786 and 0.630, and 0.787 and 0.788 for affective sub-scale for the Federation University and Fiji National University students, respectively. Mean (SD) score for the cognitive sub-scale was 10.5 (5.6) and 15.2 (4.1) for students at Federation University and Fiji National University, respectively (P<0.001, t-test). Mean (SD) score for the affective sub-scale was 13.1 (5.1) and 20.7 (4.3) for students at Federation University and Fiji National University, respectively (P < 0.001, t-test). An exploratory factor analysis (n=274) confirmed a two-factor solution consistent with affective and cognitive sub-scales, each with good internal consistency. Quantifying attitude to chemistry in undergraduate nursing students using ASCI may have utility in assessing the impact of novel teaching strategies used in the education of nursing students in areas of bioscience and chemistry. However, geographically distinct populations of undergraduate nurses may show very different attitudes to chemistry.

Development and validation of a new tool measuring nurses self-reported professional competence--the nurse professional competence (NPC) Scale

OBJECTIVES

To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines.

DESIGN

A methodological study including construction of a new scale and evaluation of its psychometric properties.

PARTICIPANTS AND SETTINGS

1086 newly graduated nurse students from 11 universities/university colleges.

RESULTS

The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: "Nursing care", "Value-based nursing care", "Medical/technical care", "Teaching/learning and support", "Documentation and information technology", "Legislation in nursing and safety planning", "Leadership in and development of nursing care" and "Education and supervision of staff/students". All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: "Patient-related nursing" and "Nursing care organisation and development". In addition, evidence of known-group validity for the NPC Scale was obtained.

CONCLUSIONS

The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses.

Writing a bachelor thesis generates transferable knowledge and skills useable in nursing practice

Generic skills or transferable skills have been discussed in terms of whether or not skills learned in one context can be transferred into another context. The current study was aimed to explore nurses' self-perceptions of the knowledge and skills they had obtained while writing a Bachelor's thesis in nursing education, their experience of the extent of transfer and utilization in their current work. Responding nurses (N=42) had all worked from 1 to 1.5 years after their final examination and had completed a questionnaire that was structured with open-ended questions. Only five nurses reported that they were unable to use any of the knowledge and skills they had obtained from writing a thesis. A majority of the nurses (37/42) could give many examples of the practical application of the skills and knowledge they had obtained. Our findings indicate that writing a thesis as part of an undergraduate degree program plays a major role in the acquisition and development of knowledge and skills which can subsequently be transferred into and utilized in nursing practice.

How do new BSN nurses perceive their nursing education?

OBJECTIVE

The goal was to determine if new bachelor's of science in nursing (BSN) nurses perceived their education to be relevant for the current demands of the profession.

METHODS

The design was nonexperimental, descriptive survey research. Data were gathered using a researcher-designed mailed survey. Addresses for survey participants, RNs who had graduated with a BSN within 2 years prior to June 2012, were obtained from the North Carolina State Board of Nursing.

RESULTS

This study found that new graduates in the sample perceived their academic preparation to be adequate for transitioning into professional practice; however, new graduates wish they'd had more opportunities to practice clinical skills while in nursing school. Respondents also perceived that some health assessment content included in nursing programs may not typically be useful in entry-level nursing practice.

CONCLUSIONS

Because a large percentage of the sample perceived they'd had inadequate clinical practice time, new nurses might not feel completely competent with practice-related skills. Employers should take this into consideration when structuring orientation programs. Additionally, the curricula planners for BSN programs might creatively and strategically consider ways to increase or improve the clinical practice opportunities for nursing students.

The experiences of undergraduate Assistants in Nursing (AIN)

BACKGROUND

University academic timelines and a shortage of clinical placements available for students have created challenges for universities to provide maximum clinical exposure and preparation for practise. A State-run health system in Australia developed an incentive whereby students are actively recruited to work as Assistants in Nursing (AINs) whilst completing their undergraduate nursing programme, enabling them to enhance clinical skills learned during university. There have been no previous studies that reflect their experiences.

AIM

This study aimed to explore and describe experiences of undergraduate AINs in the nursing workforce.

METHOD

Semi-structured interviews were used to obtain in-depth accounts of the undergraduate AIN experience. Six participants who were employed at various healthcare facilities around the Sydney metropolitan area comprised the sample. Interviews were digitally recorded and transcribed verbatim. Data were thematically analysed.

FINDINGS

Three main themes emerged from the data: becoming part of the team, understanding the scope of the AIN role, and working outside your comfort zone.

CONCLUSION

Findings can add to international discussions in the literature related to the training and education of ancillary nursing staff. Furthermore findings provide insights into some of the challenges faced by tertiary institutions in preparing students for the clinical work environment. Whilst the employment of undergraduate AIN's can be an effective strategy, the lack of formalised guidelines to inform those working with undergraduate AINs may hinder the full potential of their employment.

Impact of the Bologna process in Bachelor nursing programmes: The Swedish case

The higher education reform in Europe known as the "Bologna Process" implies further harmonisation and integration of nursing programmes into the higher education system. This study explores this process in Sweden, where the development of nursing education into an undergraduate programme started in 1977. The aim of this study was to analyse characteristics of the major subject and its relationship to other subject areas, such as medical sciences and social sciences, in Bachelor level nursing programmes in Sweden following initial implementation of the Bologna process. A constructivist approach and descriptive content analysis were employed to analyse the 2008 nursing curricula and syllabi of 27 undergraduate programmes at 26 Swedish universities and university colleges. The results revealed variation in terms and concepts used for the major subject as well as its scientific foundation, demarcation between the major subject and other subjects included in the study programmes and its relationship to the profession. These variations are linked to the variety of research orientations under debate in the Scandinavian countries: Nursing Science and Caring Science; representing different knowledge domains, focus, challenges and visions for the discipline. Potential implications of basing curricula on a major subject other than Nursing Science in a Bachelor level nursing programme are highlighted.

What is provided and what the registered nurse needs--bioscience learning through the pre-registration curriculum

Registered nurses undertaking programmes of study to become non-medical prescribers appear to have limited biological science knowledge. A case study was undertaken to determine whether the nurses entering Prescriber programmes considered studies in bioscience in their pre-registration nursing courses had been sufficient, linked to practice, and had prepared them for their roles as registered nurses. The literature identifies a continuing trend amongst nursing students describing a lack of sufficient bioscience in initial nurse education; there is limited literature on the views of experienced registered nurses. The participants in this study were 42 registered nurses from adult and mental health nursing, community and inpatient services. The results obtained from questionnaires and interviews are described. Questionnaire analysis identified that 57.1% of participants indicated bioscience in their pre-registration nursing programme had been limited and 40.5% stated the bioscience content had not prepared them for their roles on registration. Those reporting extensive coverage of bioscience were all aged over 41 years and had qualified before 1995. Greatest coverage of bioscience in pre-registration programmes was reported in relation to anatomy and physiology, with relatively limited coverage of microbiology, pharmacology or biochemistry. Respondents considered all five topics to be important. Interviews supported the questionnaire findings.

Improvement in the nursing care quality in general surgery wards: Iranian nurses' perceptions

Improving care quality is one of the duties of almost all health service providers. Although it is of much significance to identify the factors influencing nursing care quality in specific clinical settings, a few studies have been conducted to improve our knowledge in this regard. This study aimed to determine Iranian nurses' perceptions of the factors influencing quality of nursing care in general surgery wards. A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 15 nurses working in general surgery wards of two educational hospitals. The following themes and subthemes emerged from the analysis: 'beyond daily routine tasks', 'cooperation and the promotion of effective relationship' and 'updating education'. The second theme consisted of two subthemes: 'relationship among care team members' and 'communication between nurses, patients and relatives'. Providing qualified nursing care in Iran is complicated contextually and is somehow controversial. The study participants believed that in this context, proper delivery of appropriate nursing care is difficult for nurses owing to the barriers mentioned. Therefore, as a primitive action health care policy makers and managers are required to bring sensible changes into health care system through legislating suitable rules to guarantee the quality of nursing cares.

Preceptoring nursing students: registered nurses' perceptions of nursing students' preparation and study approaches in clinical education

Preceptorship influences Registered Nurses' (RNs) daily work to different degrees depending on nursing students' knowledge, and willingness to learn. Consequently, it is of the utmost importance to investigate how RNs assess nursing students in clinical education. The aim of this study was to describe RNs' perceptions of nursing students' preparation and study approaches at hospital workplaces, and to explore relationships between RNs' perceptions and their personal/clinical characteristics. A cross-sectional design was used. In 2006, 142 of 196 RNs at a Swedish hospital answered a questionnaire (response rate 72.5%). The majority of RNs (63-84%) rated students' study approaches highly and thought students comprehended the outcomes of learning. Fewer (45-49%), rated students as having adequate theoretical knowledge highly and were of the opinion that they had acquired knowledge about the unit. Statistically, non specialist nurses rated significantly higher compared with specialist nurses. Significant positive correlations were found between the RNs' perceptions of nursing students and their interest in preceptoring. The extent to which preparation programmes, established in collaboration between a university and a hospital, had improved preceptors and nursing students was not graded. Further descriptive and intervention studies are therefore needed.

Knowledge use in nursing practice: the importance of practical understanding and personal involvement

Understanding knowledge use in everyday nursing practice is important to the improvement of educational preparation and quality in health care. This paper reports registered nurses' experiences in different parts of the Norwegian health care system. The aim of the study was to elucidate nurses' experiences of knowledge use in work situations. Eleven nurses, each with two to three years of experiences after graduation, participated in both in-depth interviews and focus group interviews in 2006. A qualitative hermeneutic approach, inspired by Gadamer's philosophy, guided the research process and the analysis and interpretation of the transcribed interview-texts. Experiences related to coping with frequent changes and complexity in work situations were captured in this study. The participants emphasised that knowledge use is connected to their ability to get involved in and assess particular situations, and so is their skill in integrating situational experiences into their existing knowledge framework. A challenge in nursing education is as follows: for students to understand these interpretive modes of knowledge use and to develop personal abilities, they should have access to and be active participants in certain health care situations, and they should have the opportunity to reflect on acting personally in professional relationships.

National survey of psychiatric mental health advanced practice nursing: the adequacy of educational preparation: voices of our graduates

BACKGROUND

Little is known about the fit between practice and graduate education from the perspective of psychiatric mental health advanced practice registered nurses (PMH APRNs).

OBJECTIVE

With the purpose of addressing this gap in our knowledge, an e-mail survey that was sent to certified PMH APRNs included a query "Did your program prepare you for your role?" and an open-ended follow-up question: "Please explain how your graduate program did not prepare you adequately for your role?"

DESIGN

Descriptive survey.

RESULTS

Although 70% of respondents reported satisfaction with their educational programs, content analysis of the comments indicated that the most pressing concerns related to instructional content about psychopharmacology, the practice of prescribing and psychiatric diagnosing, and that there was a perception of a disconnect between the role they were prepared for and their role in the present-day world of work.

CONCLUSIONS

The findings reinforce the need for the PMH nursing specialty to further define the optimal methods for preparing APRNs for the full scope of psychiatric services they are licensed to provide as the size of the PMH APRN workforce increases.

The subject of pedagogy from theory to practice--the view of newly registered nurses

The aim was to describe, from the newly registered nurses' perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital. Two categories emerged in the analyses. The first category was "Pedagogical methods in theory" with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was "Pedagogical methods in everyday clinical practice" with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.

Discrimination of educational outcomes between differing levels of critical care programmes by selected stakeholders in Australia: a mixed-method approach

OBJECTIVE

This study was designed to prioritise educational outcomes for three levels of postgraduate speciality critical care nursing programmes.

BACKGROUND

Postgraduate speciality education has proliferated within Australia over the past 20 years. However, there is little agreement regarding the expected characteristics, or relevant priorities, of these characteristics of graduates successfully completing these programmes of study.

METHOD

This study used a mixed-method approach comprising two phases. Initially a survey was mailed to volunteers between March and June 2005 to obtain priorities in educational outcomes for graduates of critical care programmes. This was followed by a stakeholder focus group in May 2006 to refine expected outcomes.

RESULTS

Survey respondents rated educational outcomes that described professional and legal aspects of practice to ensure safe patient care as highest priority for programme graduates. Although most educational outcome statements were considered important for graduates from all levels of courses, increasing levels of practice was described for increasingly higher levels of programmes from Graduate Certificate to Masters Degree.

CONCLUSION

This study provides an emerging description of the priorities of critical care nursing programmes, with priority given to professional and legal aspects of practice. Further delineation of priorities is necessary to inform ongoing educational development.