Swedish nursing students' experience of aspects important for their learning process and their ability to handle the complexity of the nursing degree program

Development of nursing students' professional identity in different mentoring approaches during clinical training: A quasi-experimental study

BACKGROUND

The professional identity (PI) of nursing students' is essential for high quality performance and safe healthcare. Clinical training plays a key role in the development of professional identity during nursing studies.

AIM

The aim of this study was to investigate the impact of individual and group mentoring approaches on the development of PI during clinical training, as well as the influence of the order in which these approaches are applied, and the effect of time on the development of PI.

DESIGN

This study used a quasi-experimental design.

SETTINGS

The study was conducted at the Department of Health Studies in Croatia.

PARTICIPANTS

The 119 first, second, and third year ungraduate nursing students.

METHODS

Students were divided into two groups. Each group performed clinical training in group and individual mentoring approaches, but in different order. The Professional Identity Five Factor Scale (PIFFS) was used to measure PI levels at four different time points: immediately before and after the first and second rounds of clinical exercises.

RESULTS

Both groups of students, achieved approximately average results in all three dimensions of the PI. There was no statistically significant main effect of the group/individual mentoring approach on the dimensions of knowledge (P = 0.471), experience (P = 0.865) or perception of role model and professional future (P = 0.565). The levels of the dimensions knowledge (P = 0.001), experience (P = 0.001) or perception of the role model and professional future (P = 0.002) differed in four measurement points, which indicates a general increase in all three PI dimensions.

CONCLUSIONS

During the performance of the clinical training, the level of PI increased. The group mentoring approach has an immediate effect on increasing knowledge, but this effect diminishes over time. In terms of experience, both mentoring approaches have similar reinforcing effects. However, the individual approach seems to be more suitable for improving the perception of role models and the professional future.

Mentoring Support Quality in Group and Individual Mentoring Approaches during Nursing Clinical Training: A Quasi-Experimental Study

Clinical training is an essential element in nursing education, the outcomes of which are directly related to the quality of mentoring support. This quasi-experimental study aimed to examine whether the group or individual form of the mentoring approach used and the order of application of the mentoring approach contribute to the quality of mentoring support provided to students. The study comprised two measurement points with 130 nursing students, divided into two groups with different orders of application of the mentoring approach. The validated Mentoring Support Quality Evaluation Questionnaire (MSEQ) was used. Students in both groups rated the quality of mentoring support as higher following an individual mentoring approach. A significant interaction was found between the mentoring approach used and the order in which the mentoring approaches were applied (p = 0.002). The individual mentoring approach contributed significantly to a higher quality of mentoring support after the second round of clinical training (p = 0.021), while after the first round, the difference between the group and individual approaches was not as clear. The results suggest that not only the form of the mentoring approach but also the sequence of changes in the mentoring approach should be planned when implementing clinical training.

Barriers and Solutions to the Gap between Theory and Practice in Nursing Services: A Systematic Review of Qualitative Evidence

Background. The phenomenon of theory‐practice gap has endured within the field of nursing from the era of Florence Nightingale until today, persistently manifesting negative consequences within the profession by accentuating the dichotomy between theoretical understanding and the practical dimensions of nursing. This prevalent issue necessitates comprehensive examination to unveil all the circumstances and variables that fuel the gap, along with exploring viable resolutions to bridge these divides. Objective. To identify, summarize, and synthesize literature on the causes leading to theory‐practice gaps and solutions in nursing profession. Methods. MEDLINE, PubMed, Scopus, CINAHL, EMCARE, ERIC, and Ovid were searched from 2012 to December 2022. Eligible reviews addressed causes of the theory to practice gap in nursing. Extracted data from included reviews were synthesized using guidelines for meta‐synthesis along with the JBI Critical Appraisal Checklist for qualitative research. Result. The analysis of studies yielded 22 significant findings, subsequently categorized into six thematic areas based on their contextual similarity. Following this, a meta‐aggregation process combined these categories, generating two synthesized findings: (1) barriers for the gap and (2) facilitators for the gap. Barriers for the gap had three subcategories: “clinical life challenges,” “misconception of clinical nursing,” and “lack of collaboration between universities and clinical settings.” The second synthesis was “Facilitators for the gap” which had two subcategories: “create clinically culture‐based content” and “develop clinically based curriculum.” Conclusion. This review provides a comprehensive summary of the current understanding of barriers and facilitators influencing the theory‐practice gap in the field of nursing. To effectively reduce this gap in nursing care, stakeholders such as regulatory bodies, healthcare professionals, and academic institutions must take into account various contextual factors while recognizing the ever‐evolving nature of the healthcare environment.

Students' learning in clinical practice - a scoping review of characteristics of research in the Nordic countries

RATIONALE

The complex nature of student learning in clinical practice calls for a comprehensive pedagogical framework on how to create optimal learning affordances.

PURPOSE

The purpose of this study was to describe characteristics of conducted research regarding investigated research questions, distribution of different health care student groups, and employed methodological approaches.

METHODS

A scoping review was chosen to capture the multifaceted characteristics in the field of learning in clinical practice. Funded local projects were analysed to provide significant core concepts for the literature search. A systematic search and review of articles published 2000-2019 in the Nordic countries was conducted according to PRISMA- ScR (23). The search was made in Medline (OVID), SveMed+ and CINAHL and resulted in 3126 articles. After screening of the titles and abstracts 988 articles were included for further review. The abstracts of all these articles were reviewed against established inclusion and exclusion criteria and 391 articles were included. Characteristics of purposes and research questions were analysed with a qualitative content approach resulting in identified subject areas including significant categories. Health care student groups and methodological approaches were also identified.

RESULTS

Subjects predominating the research were organisation of clinical practice, supervision, and students' experience followed by interprofessional learning and learning environment. Co-operation, university-clinical setting, and patients' role were investigated to a small extent. Sparsely occurring subjects were also specific learning outcomes and evidence-based knowledge. Nursing students were involved in 74% of the studies, medical students in 20%, and other professions around 8%. Qualitative approaches were most common.

CONCLUSION

Health care students' learning in clinical practice has been researched to a large extent within the Nordic countries and important subject areas are well represented. The research displays a great potential to extract and describe factors to create a pedagogical framework with significant meaning to support students' learning.

The extraordinary makes the ordinary visible - nursing students' experiences of their learning in clinical practice during COVID-19: a qualitative study

BACKGROUND

The COVID-19 crisis had a significant impact on health care and nursing education as a large part of it is carried out in clinical practice. However, it is not known how the learning situations during the pandemic affected students' learning. To deepen the understanding of students' learning, learning theories within a constructive paradigm is used as a framework for this study. The purpose of the study was to explore nursing students´ perceptions of their learning in clinical practice during COVID-19.

METHODS

In this interpretative qualitative study, seven focus group discussions were conducted with 21 nursing students at different stages of the nursing programme, all of whom performed clinical practice during the outbreak of COVID-19. The analysis of the discussions was performed with interpretative content analysis related to theoretical assumptions about learning.

RESULTS

The learning situation was characterised by chaos and confusion affecting both the students' opportunities to learn and what they learned. Despite the uncertainty the students appreciated having experienced this unique situation, which contributed to valuable learning. Things otherwise taken for granted or not encountered before became visible. The learning processes were characterised by complexity and challenges that hindered or stimulated learning. It depended on the student's approach and the management of the clinical education. Concerns about one´s own and relatives' health, and not being able to finish studies, also affected learning. The students learned about important measures during a pandemic regarding hygiene, care organisation, communication, and the multifaceted role of the nurse.

CONCLUSION

Unpredictable situations such as a pandemic can lead to unique learning since "the extraordinary makes the ordinary visible". The students learned things additional to the formal learning outcomes, and the experiences strengthened their will to become nurses. Challenges due to a crisis can become important driving forces for learning, if not experienced as overwhelming. Some students felt they received space for own initiatives and responsibility while others felt lost and abandoned. Preparing for a crisis means preparing for an unknown future. Students therefore need to experience dilemmas and uncertain situations and reflect in a safe environment.

Learning in the Third Room-A Way to Develop Praxis by Embracing Differences Between Theoretical and Practical Knowledge

Contradictions between theory and practice are well known in nursing. To this end, this article discusses a learning strategy that might facilitate the capture of the dialectic between theory and practice, equally valid components of a nurse's competence, giving the 2 forms of knowledge equal relevance. Using a virtual platform (ie, the "third room") decreases the power order between different forms of knowledge. Nurses, students, and teachers all contribute to a seminar using nonhierarchical structures and concepts to capture the knowledge that enables to learn the praxis of nursing.

Sources of the knowledge-practice gap in nursing: Lessons from an integrative review

BACKGROUND

The ultimate value of learning lies in the transfer of knowledge to real-life settings. The gap between knowledge and practice can be described as the disconnection between acquired knowledge, the skills learned in nursing school, and those skills needed to practice safely and independently. This is a concerning issue that needs to be investigated deeply to address all the circumstances and factors contributing to the gap.

OBJECTIVES

To reveal the full range of factors leading to the knowledge-practice gap in nursing by means of a thorough survey of the most recent evidence and updates.

METHODS

An integrative review design was selected. Three data bases (MEDLINE, CINAHL Plus and ERIC) were searched electronically for research articles from 2009 up to June 2020 on the gap between knowledge and practice. The 406 articles that appeared were appraised for inclusion or exclusion using the JBI Critical Appraisal Checklist for qualitative research.

RESULT

Eight qualitative studies were included in the review, which identified three major themes and subthemes. The first theme is personal factors, with the following subthemes: internal motivation, learning style and attitude. The second theme is educational structure, with the following subthemes: clinical instructor role, preceptor effect and curriculum. The third theme is organisational characteristics, with the following subthemes: resources, clinical setting features and staffing.

CONCLUSION

The review revealed that the knowledge-practice gap has deep roots in multiple factors. Considering all dimensions of these factors is the key to bridging the knowledge-practice gap.

'They just came with the medication dispenser'- a qualitative study of elderly service users' involvement and welfare technology in public home care services

BACKGROUND

Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people's involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users' experience of user involvement in the implementation and everyday use of welfare technology in public home care services.

METHOD

This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis.

RESULTS

Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible.

CONCLUSION

The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

Learning about user participation among nursing students: A qualitative study

BACKGROUND

User participation is an important aspect of nursing, especially within a rehabilitation setting where the emphasis is on the patient's ability to become as independent as possible. It is also decreed by law that students should learn about user participation. Furthermore, to achieve good nursing skills it is important for the students to understand "the what" and to reflect on "the how" regarding user participation.

OBJECTIVES

The aim of the study was to explore how students learn to apply user participation in a context of rehabilitation.

DESIGN AND METHOD

The design of the study is qualitative. Content analysis was adopted, and both inductive and deductive approaches were used. The informants were nursing students in the second and third years of the bachelor's degree at a university in Norway. Most of the students were in community health services, but some of them performed their internship at hospitals. Two focus groups with 11 students were conducted. In addition, the data also consist of 28 written reflections and 31 written work requirements in relation to rehabilitation. The students from the focus groups and the written work requirement were in practice in community health services. In the written reflections it was 14 students who had their internship at hospital and 14 students in community health services.

RESULTS

The main categories of the study are barriers to learning, dialogue as a tool and reflection as essential. The students learn to use check lists and focus on organizational planning, which might be a barrier to learning. Dialogue is important to improve the students' learning. Students need to reflect on user participation together with their supervisor to learn to be confident in encountering users, which indicates that reflection is essential.

CONCLUSION

The major findings indicate that students lack competence og user participation and that their supervisors seldom talk about it with them. Also, it should be compulsory reflection notes about user participation in the student's internships. Teachers at universities must inform supervisors and develop courses about mentorship and user participation. This may be a step forward to overcome theory-practice gap.

Nurse Students' Thoughts on a Sustainable Professional Life as Nurses: A Qualitative Study

INTRODUCTION

In a global context of an increasing and aging population, along with environmental changes, nurses play an important role in relieving suffering among vulnerable people and groups in society. Sustainability in nursing contributes to sustainable development through providing an environment that is not detrimental to/protects present and future generations' opportunities for good health. There is a global shortage of nurses, and it has been shown that, locally, every fifth newly graduated nurse considers leaving their new profession five years after graduation. The aim was to describe how nursing students' thought about a sustainable professional life as nurses before their graduation.

MATERIALS AND METHODS

A qualitative design with a written data set was used, and a thematic analysis was performed. One hundred five students (80 women and 25 men) in semester six out of six of the nursing education program participated.

RESULTS

The analysis resulted in three themes: 1) to have an ethical foundation that guides the individual nurse in protecting the nursing care and developing the nursing care for their patients; 2) to be in a listening, reflexive and supportive workplace enabling a professional nurse to continuously grow and learn and 3) to be a proud professional nurse with integrity, not risking with their own health or personal professional development.

CONCLUSION

The nursing students describe their thoughts on the requirements for having a sustainable professional life as nurses as having a strong inner ethical compass to help guide, protect and develop the nursing care for the patients. In addition, it requires a workplace with a reflexive and supporting culture. However, the nursing students also put their own health and the opportunities for professional growth at the top of their priorities, and if these conditions are lacking, they will switch to another workplace.

Work-integrated learning as a pedagogical tool to integrate theory and practice in nursing education - An integrative literature review

It can be challenging for nursing students to navigate between theory and practice and to implement theoretical knowledge in real work situations and vice-versa. Work-integrated learning can support the students by enabling them to combine theoretical studies with practical work experience during their clinical placement. The aim of this integrative literature review was to identify models for the integration of theory and practice during clinical placements in nursing education by using work-integrated learning. Sixteen articles were found and analyzed using an integrative review method. Three themes were identified: 1) Supervisor support to enable students to develop a professional identity 2) Variety of modalities for teaching and 3) Collaboration between academic lecturers and clinical supervisors aimed at integrating theoretical and practical knowledge. Work-integrated learning enables students to integrate theory and practice, develop skills for knowledge-in-practice and prepares them for working life. It also supports the sharing of experiences between various healthcare professionals. This review identified a need for further research on work-integrated learning as a method for enhancing nursing students' workplace learning.

Changes in nursing students' expectations of nursing clinical faculties' competences: A longitudinal, mixed methods study

BACKGROUND

Changes in nursing students' expectations of their clinical nursing faculty competences over the course of time are an insufficiently researched phenomenon.

OBJECTIVES

To explore what competences BSc nursing students expect from their clinical faculties during their clinical training, and whether their expectations changed during their three-year studies. Furthermore, to survey factors which influenced their expectations and whether the fulfilment levels of their expectations influenced their feelings, learning, and behaviour.

DESIGN

A two-phase, mixed-methods design was used.

SETTINGS

The Higher Nursing Education Institution in Osijek, Croatia, European Union.

PARTICIPANTS

A cohort of 34 BSc nursing students, who were followed over the course of their three-year studies.

METHODS

In Phase I, in each year, prior to their clinical training, participants responded to the same modified Nursing Clinical Teacher Effectiveness Inventory questionnaire about their expectations of clinical faculties' competences (52 items representing six categories of competences). In Phase II, seven days after their graduation, participants wrote reflections on the aforementioned expectations during their studies.

RESULTS

The results show that Clinical faculties' evaluation of student was the category in which participants had the highest expectations in all three years. Results of Wilcoxon signed rank test indicate a significant increase of participants' expectations in all categories of clinical nursing faculties' competences during their study. Participants' reflections confirm these results and indicate that actual competences of clinical faculties and behaviour have the most significant effects on the change in these expectations. Participants reported that expectations, if fulfilled, facilitate their learning and motivation for better performance.

CONCLUSIONS

BSc nursing students' expectations of clinical nursing faculty competences represent an important concept, as they obviously determine the quality of faculty practice. Hence, they should be considered in the preparation, implementation, and evaluation phase of this vital part of nursing education.

A square peg in a round hole: Theory-practice gap from the lens of Filipino student nurses

Previous studies suggest that theory-practice gap has remained to be a formidable task and a challenge to the nursing profession. While efforts to understand the nature and dynamics of theory-practice gap have been undertaken across the globe, a dearth in literature exists in the context of a developing country like the Philippines. Seemingly, no research has ventured yet to explore the theory-practice gap experiences of Filipino student nurses. Hence, the major intent of this qualitative investigation is to describe and capture how theory-practice gap is viewed by a select group of senior nursing students (n=10) in a comprehensive university in the Philippines. From the thickness and richness of the descriptions of the field text gathered in this study, an interesting conceptualization labeled as the Theory-Practice Gap Deficit Triad which consists of (a) structural, (b) pedagogical, and (c) relational deficits was emerged. Interestingly, the said model describes a clear intersection of the various concerns and dilemmas encountered by student nurses in their clinical exposures. Findings of this paper are valuable inputs to nursing educators, practitioners, and administrators in initiating realignment efforts geared toward developing nurses whose knowledge, skills and attitudes are responsive to the ever changing professional practice landscape.

The shift from a medical to a nursing orientation: A comparison of Swedish nursing students' expectations when entering the nursing degree programme in 2003 and 2013

BACKGROUND

The focus of education in nursing has changed over time with a decreased focus on biomedicine and an increased focus on nursing science. It is therefore important to investigate whether these changes are also reflected in the students' conceptions and expectations of the programme over time.

OBJECTIVES

The aim of the study was to describe and compare two cohorts of students entering the nursing programme with 10year in between (2003 and 2013), regarding their demographic background, reasons for wanting to become a registered nurse, expectations of the programme and perceptions of the nursing profession.

DESIGN AND SETTING

The study was a descriptive cross-sectional cohort study carried out at a university in southern Sweden.

PARTICIPANTS

In all, 177 nursing students participated in the study, 89 from the 2003 cohort and 88 from the 2013 cohort.

METHODS

Data were collected at the start of the programme using a questionnaire consisting of predefined and open-ended questions. The responses were statistically analysed and compared.

RESULTS

The students' reasons for wanting to become a registered nurse remained stable over the 10-year period. The main reason stated by the students in both cohort was humanitarian, i. e wanting to help others. The students' expectations regarding both the programme and the nursing profession had, however, changed significantly from a biomedical to a nursing orientation in the 10-year perspective.

CONCLUSIONS

The change in the students' preconceptions of the nursing education towards increasing importance of nursing science indicates the beginning of a paradigm shift.

Students' experiences of learning in relation to didactic strategies during the first year of a nursing programme: a qualitative study

BACKGROUND

In university undergraduate nursing programmes, didactic strategies that enable students to learn nursing skills, solve problems and develop reflective and critical thinking and practice are needed. The aim of this study was to explore how different didactic strategies support nursing students' experiences of learning during the first year of a reconstructed nursing curriculum.

METHODS

This study employed a qualitative approach. The data were gathered through written narratives that were analysed using qualitative content analysis.

RESULTS

Nursing students' experiences of learning through different didactic strategies, were evident in the text. These perspectives were organised into the following themes: To focus on the patient perspective and paying more attention to others, Learning from discussions and reflections on one's own learning, Training for the professional role and becoming more courage, and Gaining insights into nursing and increasing one's self-awareness. The education increased the students' self-awareness, which helped them to pay greater attention to patients and their relative. During the learning process, the students became more courageous, reflected and discovered their shortcomings.

CONCLUSION

Stated didactic strategies supported a broad base of knowledge on nursing and the professional role of nurses. Educators are challenged to strengthen meaningful learning in nursing and to facilitate the progression of nursing programmes.