Supporting student nurse professionalisation: the role of the clinical teacher

Mock court: a valuable tool to teach legal procedures to undergraduate medical students

BACKGROUND

Teaching through role-plays is a preferred modality when certain behaviours or skills need to be taught. They provide a risk-free environment that simulates a real-life scenario. For a clinician, appearance in a Court of Law as an expert witness is a part of his/her legal obligation.

OBJECTIVE

To explore the utility of Mock Court as an additional teaching tool for undergraduate medical students, in understanding and familiarizing with legal procedures, specifically the courtroom procedures.

METHODOLOGY

We conducted Mock Court sessions with the students playing various roles, following which feedback was collected from the students, teachers and guest assessors. The data was statistically analysed by comparison of frequencies and paired t-test (pre- and post-session comparison).

RESULTS

The study revealed a positive effect of the Mock Court sessions on the students, based on their increased confidence, motivation and a better grasp of legal procedures. There was a statistically significant (p < 0.001) improvement in the understanding of specific aspects of courtroom procedures after the session.

CONCLUSION

The authors recommend the active implementation of Mock Court as a teaching aid for undergraduate medical students, and the use of PDSA (Deming) cycle as a tool for quality-checks and self-improvement in subsequent sessions.

"Safety Means Everything": An ethnographic methodology to explore the formation of professional identity in nursing students

AIM

The aim of this qualitative study is to explore how various conditions within educational contexts impact nursing students' experiences of becoming professional nurses and how these conditions affect their agency and the formation of their professional identities.

BACKGROUND

Nursing education is essential to becoming professional and competent in caring for patients. A strong professional identity in nursing contributes to better patient outcomes and improves the well-being, retention, and recruitment of practitioners in the health care system. At the same time, research indicates that development of a professional identity during education is challenging and needs further investigation.

DESIGN

The qualitative research design draws on the theoretical and methodological framework of critical psychology practice research. The practice research design and close collaboration with users ensure the continuous development and implementation of theory and practice.

METHODS

The data used in this study originated from ethnographic fieldwork, which involved following two nursing students through their final clinical placement training at the Geriatric Department of a university hospital in Denmark. Additionally, nursing students in two classes were observed as part of their nursing education practice at a university college from April to July 2022. The participant observational design, combined with in-situ interviewing, facilitated a comprehensive understanding of the students' engagement in social practices and interactions within the context of nursing education.

RESULTS

Our results show how the conditions of nursing students' everyday lives have a critical impact on their self-understanding and journey to becoming competent and professional nurses. Three main themes emerged from the analysis: (1) Perception of safety, (2) Motivation for learning in different communities of practice, and (3) The meaning of learning culture and role models.

CONCLUSION

The development of nursing students into professionals is profoundly influenced by factors affecting their ontological safety that are deeply embedded in socio-cultural and educational contexts. The results underscore the need to foster ontological safety in nursing education. Creating safe, participatory, and supportive learning environments is essential to the holistic development of students into caring, competent nurses. Educators and stakeholders must remember their crucial role in this context and focus on establishing these environments to facilitate students' sense of belonging in the nursing profession.

TWEETABLE ABSTRACT

The development of professional identity in nursing starts with safety. Ontological Safety in learning environments ensures competent and professional nurses. #NursingEducation#Safety#ProfessionalIdentity.

Professional identity and preparedness for hospital practice among undergraduate nursing students: A cross-sectional study

BACKGROUND

Professional identity is a crucial characteristic that undergraduate nursing students must possess to ensure effective and safe clinical practice. It has been identified as a factor influencing nursing student retention and their intention to remain in the nursing profession. However, the influential factors that impact the development of professional identity among nursing students currently are not well known.

OBJECTIVES

To identify factors determining professional identity among undergraduate nursing students and to confirm the relationship between nursing students' professional identity and their preparedness for hospital practice.

DESIGN

A cross-sectional study.

SETTINGS

The largest public nursing college in Oman.

PARTICIPANTS

180 full-time undergraduate nursing students in their third and fourth years who had completed at least one clinical course.

METHODS

Students completed validated, self-administered paper questionnaires through convenience sampling, including professional identity and preparedness for hospital practice scales.

RESULTS

The mean total score for professional identity was 63.3 (SD = 10.5), indicating a moderate level of professional identity. The findings showed a low level of preparedness for hospital practice among nursing students, with, a mean total score of 165.8 out of 246 (SD = 30.4). We found a significant positive association between professional identity and preparedness for hospital practice (r = 0.43, p < 0.001), the number of clinical courses taken (r = 0.15, p = 0.041), enrolment in fourth-year clinical courses (H (4) = 19.9, p = 0.001), grade (H (3) = 7.8, p = 0.049) and the selection of nursing profession as the first choice (H (3) = 28.0, p = 0.05).

CONCLUSIONS

The study has implications for identifying students with lower readiness for hospital practice and providing them with the necessary training. Nursing educators should prioritize reinforcing professional identity among students who have chosen nursing as a secondary option or have a lower grade. This can be achieved by promoting a positive nursing image and fostering a supportive clinical learning environment.

Professional nurses supporting learners during professional socialisation in Limpopo province

Background

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

Aim

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

Setting

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

Methods

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

Results

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

Conclusion

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

Contribution

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

Improving cultural humility in physical therapy students: What is faculty's role?

BACKGROUND

Clinician bias contributes to health disparities; therefore, educational standards and professional expectations incorporate cultural humility. Vague standards and numerous pedagogical methods make implementing an effective and uniform curriculum challenging. Classroom and clinical faculty's attitudes and behaviors are pivotal; however, evidence on roles beyond instruction is lacking.

PURPOSE

This study explored physical therapy (PT) students' perceptions of faculty's role in improving their cultural humility.

METHODS

This study was rooted in a phenomenological approach that incorporated elements of both descriptive and interpretive phenomenology. Thirteen first-year PT students participated in one-on-one interviews which underwent reflexive thematic analysis.

RESULTS

Reflexive thematic analysis generated two hundred-ninety codes, six categories, and one overarching theme. Dissonance emerged between students' perceptions of faculty's role and the explicit and implicit curriculum.

CONCLUSION

Explicit messaging from classroom instruction and implicit messaging from clinical encounters and unspoken attitudes, values, and behaviors were disparate. Faculty role modeling, diversity, cultural awareness, and perceived comfort interacting with a diverse patient population improved students' self-confidence and cultural humility. Professional development including field experience with a cognitive apprenticeship approach, and standardized, discipline-specific cultural humility competencies may provide uniform and clear guidelines.

Live experience of nursing students with internship program: A phenomenological study

BACKGROUND AND AIM

The internship is a program for transition of nursing students to the clinical setting. This study was conducted to describe and interpret the experiences of nursing students from the internship program.

MATERIALS AND METHODS

This was an interpretative phenomenological study following Van Menen's approach in six steps. Twelve nursing students were selected from 12 different universities in Iran from April to August 2020. Data was collected through 15 in-depth interviews (three supplementary interviews) over the course of 25-90 min and verbatim transcriptions. Data were analyzed with MAXQDA version 10 software. The researcher used four Guba and Lincoln criteria to obtain a rigorous study.

RESULTS

In this study, three main themes and eight subthemes were extracted. The main themes included "professional identity development," "moving toward professional self-efficacy," and "developing coping strategies for workplace adversities." The subthemes were "promoting the cognition of profession," "acceptance among colleagues as a nurse," "accepting professional roles," "self-awareness of weaknesses in patient care," "self-reliance," "advancing clinical skills," "adopting effective coping strategies," and "avoiding tension in clinical settings."

CONCLUSION

Nursing internship students have experienced moving toward professionalization with professional identity and self-efficacy development, and they succeeded in clinical challenges by learning coping approaches.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

AIM

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

DESIGN

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

RESULTS

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

CONCLUSION

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

Comparison of the effectiveness of the electronic portfolio and online discussion forum methods in teaching professional belonging and ethical behaviors to nursing students: a randomized controlled trial

BACKGROUND

Nursing is a profession that has had many ethical aspects and understanding professional belonging and ethics as a deep and complex process is one of the basic concepts in this field. This study aimed to compare the effectiveness of training professional belonging and ethical behaviors in two methods: electronic portfolio and online discussion forum in nursing students.

METHODS

This study is a single-blinded randomized-controlled trial (RCT) with two parallel intervention groups and a third control group. The sample size was 90 selected by block randomization method. The educational contents of professional belonging and ethical behaviors were presented to the participants in two ways: electronic portfolio and online discussion forum. Demographic information form, professional belonging questionnaire, and ethical behaviors questionnaire were applied to collect data. Data were analyzed using SPSS version 24 software. Respectively mean, standard deviation and repeated measured, analysis of variance tests was used in descriptive and analytic statistic. (P value < 0.05).

RESULTS

Comparison of the mean score of professional belonging and ethical behavior in the three stages of pretest, immediately after the test and four weeks after the test in all three groups was significant (P < 0.001). The control group had a higher mean score of professional belonging immediately after the test (108.18 ± 48.9) compared to the other two groups. Also, the online discussion forum group had a higher mean score on ethical behavior in four weeks after the test (104.2 ± 0.8) compared to the other two groups.

CONCLUSION

Training based on two methods of the electronic portfolio and online discussion forum increases and enhances the level of ethical behaviors in students. Therefore, the implementation of such methods of training can be useful in improving, promoting, and learning ethical behaviors in nursing students. On the other hand, training based on the two methods had a negative impact on professional belonging. Therefore, it is suggested that future studies be conducted with a greater focus on areas of professional belonging.

TRIAL REGISTRATION

This research has been registered in Iranian Clinical Trial Registration Center (IRCT) with registration number "IRCT20180612040063N1" and registration date "16/07/2018".

Study of Nightingale's nursing professionalism: a survey of nurses and nursing students in China

Background

Nursing professionalism is highly significant to the development of nursing. Florence Nightingale was the founder and leader of modern nursing, and Nightingale’s nursing professionalism has a significant impact on nursing in China and all over the world. In the new era, a new understanding of Nightingale’s nursing professionalism should be developed, and its positive role in nursing reshaped.

Methods

A total of 1,557 nurses and nursing students from 27 provincial administrative regions of China were surveyed using a customized questionnaire. Their recognitions of Nightingale’s nursing professionalism were evaluated based on scores, and statistical differences between and within the groups were analyzed using an Analysis of Variance (ANOVA). The elements of Nightingale’s nursing professionalism were extracted by the exploratory factor method and a principal component analysis.

Results

The Cronbach’s α of the questionnaire was 0.965, and the two groups did not differ significantly (p > 0.05). Based on the standard that the cumulative contribution rate of common factor should be > 85%, three common factors of Nightingale’s nursing professionalism, including professional emotion, professional ability and professional ethics, were extracted based on the Scree plot.

Conclusions

This study aimed to explore the connotation of Nightingale’s nursing professionalism. Our survey indicates that Nightingale’s nursing professionalism is highly recognized by nurses and nursing students in China. Its connotation includes professional emotion, ability and ethics. Nursing education and nursing management should fully utilize the leading role of Nightingale and guide the professional behaviors of nurses to be consistent with Nightingale’s nursing professionalism, thus, improving the degree of nurse professionalism.

Changes in professional commitment of undergraduate nurse students before and after internship: a longitudinal study

BACKGROUND

Experiencing internship shapes nursing students' professional commitment and aggravates its changes. However, few studies have been investigated how this changes empirically.

OBJECTIVES

The aims of this study are to investigate (a) what are the changes of professional commitment of nursing students before and after the internship? (b) Which of multiple independent variables is the strongest predictor?

METHODS

A longitudinal study was conducted with 996 senior undergraduate nursing students (ready to enter clinical practice) in the China universities. The survey was conducted in the spring of 2015 and autumn of 2016. The data were collected by a paper-and-pencil questionnaire. The instruments used included Professional Commitment Scale and Perceived Stress Scale. Analysis of paired t-test and linear regression analysis were performed on the data.

RESULTS

Nursing students showed lower professional commitment (2.79 ± 0.36) than they were (2.92 ± 0.36) before internship. Socio-demographic variables, pre-internship professional commitment and stress perceived during internship predicted 40.1% of the variance in the post-internship commitment.

DISCUSSION

These data summarize the nursing students' professional commitment changes and the main influential factors that contribute to post-internship professional commitment of undergraduate nursing student. The findings are timely, which indicate that senior nursing students' professional commitment can be increased by enhancing pre-internship commitment and reducing students' stress levels during internship.

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

Background

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

Objectives

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

Method

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

Results

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

Conclusion

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

Oblikovanje modela medpoklicnega sodelovanja medicinskih sester na področju zagotavljanja farmacevtske skrbi

Uvod: Medpoklicno sodelovanje medicinskih sester pri zagotavljanju farmacevtske skrbi je pomembno z vidika zagotavljanja kakovosti zdravstvene oskrbe pacienta. Vendar pa vključevanje medicinskih sester v farmacevtsko skrb odpira tudi številna vprašanja, povezana z njihovim izobraževanjem ter posledično posedovanjem kompetenc za njihovo učinkovito vlogo pri zagotavljanju farmacevtske skrbi. Cilj raziskave je bil ugotoviti stališča zdravnikov, farmacevtov in medicinskih sester do vloge slednjih v medpoklicnem sodelovanju na področju farmacevtske skrbi v Sloveniji.Metode: Uporabljena je bila deskriptivna interpretativna metoda. V namenski kvotni vzorec je bilo vključenih 24 oseb: osem zdravnikov, osem farmacevtov in osem medicinskih sester. Podatki so bili zbrani z delno strukturiranimi intervjuji. Pridobljene podatke smo analizirali s pomočjo metode analize vsebine.Rezultati: Raziskava je razkrila, da medicinske sestre že sedaj opravljajo del nalog na področju farmacevtske skrbi in svojo vlogo vidijo tudi v nadaljnjih prizadevanjih za medpoklicno sodelovanje. Ugotovitve sicer kažejo, da zdravniki in farmacevti niso naklonjeni morebitnim profesionalnim kompetencam medicinskih sester, ki vključujejo področje zagotavljanja farmacevtske skrbi. Ob tem izpostavljajo zlasti znanje, ki ga po njihovem mnenju medicinskim sestram primanjkuje. Rešitev vidijo v vpeljevanju dodatnih izobraževanj s področja farmakologije. Medicinske sestre menijo, da so v okviru zagotavljanja farmacevtske skrbi zapostavljene oziroma neenakopravne.Diskusija in zaključek: Medpoklicno sodelovanje v okviru zagotavljanja farmacevtske skrbi je zelo pomembno in ima lahko pozitiven vpliv na rezultate zdravljenja, vendar morajo medicinske sestre pridobiti ustrezna dodatna znanja in posledično kompetence, se kontinuirano izobraževati, imeti vidnejšo vlogo v kliničnih raziskavah ter ne nazadnje v teh prizadevanjih tudi same prevzemati dejavnejšo vlogo.

Influences of nursing students' career planning, internship experience, and other factors on professional identity

BACKGROUND AND OBJECTIVE

Nursing professional identity is an important factor in the development of nursing education and clinical practice. Career-planning curriculums enable students to learn relevant knowledge and skills in a targeted manner, in addition to achieve career targets. Assessment and analysis of the present situation of Chinese nursing students' career planning and professional identity may provide an important guidance for the improvement of teaching content and quality of the career-planning curriculum. This study aimed to describe nursing students' professional identity, and to find out influences of nursing students' career planning, internship experience, and other factors on professional identity.

METHODS

A descriptive cross-sectional research method was employed to conduct a questionnaire on 453 full-time junior and senior undergraduate nursing students in China in December 2019.

RESULTS

The average score for nursing students' professional identity was 101.42, which is at a moderately low-level. There was a significantly positive correlation between the level of nursing students' career planning and professional identity (r = 0.529, P < 0.01). Nursing students' professional identity was also influenced by grade, age, acceptance of career-planning curriculums, and other factors.

CONCLUSION

The results indicated that the level of professional identity in nursing students is closely associated with their career planning. One strategy to improve this situation is to motivate universities to pay further attention to the effectiveness of career-planning curriculums and, to improve the quality of teaching and guidance system.

Faculty and nursing staff experiences and perceptions of nursing students' clinical placements in residential aged care facilities: a qualitative systematic review protocol

OBJECTIVE

The objective of this review is to synthesize evidence on the experiences and perceptions of faculty and staff nurses toward nursing students' clinical placements in residential aged care facilities.

INTRODUCTION

Nursing education plays an important role in preparing students to provide quality care to older adults. Recent reports suggest that nursing programs across the globe are championing the integration of content on the care of older adults into their curricula as well as recognizing the value of clinical placements that focus exclusively on care for older adults, such as in residential aged care facilities. Student experiences in residential aged care facilities can play a significant role in helping shape professional identity as well as how the setting is viewed. Student interactions with nursing faculty and staff in the residential care learning environment are both recognized as being influential in this process. This review seeks to explore faculty and staff experiences and perceptions of nursing student placements in such facilities.

INCLUSION CRITERIA

This review will consider qualitative studies that address the experiences and perceptions of faculty and staff nurses who work with nursing students in residential aged care facilities. Studies published in English and from 1995 onward will be sought.

METHODS

Two reviewers will independently appraise studies and extract qualitative data using the JBI standardized critical appraisal and extraction instruments. Findings from the review will be categorized according to similarity in meaning, and categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings.

Challenges and facilitators of professional socialization: A systematic review

AIMS

This current study aimed to present a review of the challenges and facilitators of professional socialization among undergraduate nursing students.

DESIGN

Systematic review.

METHODS

A literature search was conducted in Embase, Google Scholar, PubMed and Scopus in April and May 2018 for studies published in the English language. Four thousand three hundred fifty-two articles were retrieved. We conducted further screening for full-text articles after discarding duplicates and irrelevant studies. Finally, eight studies were included. The Joanna Briggs appraisal tools were used to appraise and evaluate study quality. The PRISMA guidelines were followed and a narrative synthesis used for data analysis.

RESULTS

Challenges and facilitators of professional socialization were identified and categorized into two major themes. Under each theme, results were grouped into three sub-themes: professional, personal and educational challenges/facilitators.

[From clinical practice to nursing research: Auto-ethnography as a tool for analyzing the researcher’s identity transitions]

The scientific legitimacy of nursing research depends on its adherence to different scientific criteria. Despite the lack of consensus on predetermined criteria, reflexivity is widely discussed as a strategy to establish rigour in qualitative research. Unfortunately, with the exception of tools such as the reflexive journal, little is said about how reflexivity can be completed. Several recent studies suggest the relevance of autoethnography to support the reflexive approach of nurse researchers. Inspired by the findings of an autoethnography and a narrative literature review, this article examines how this approach can contribute to the reflexivity of the nurse researcher. Autoethnography seems particularly adapted to the professional and academic context in which many nurses evolve. As a reflective tool, autoethnography can promote the development of the researcher's self-awareness, provide analytical tools to help better understand the influence of previous experiences on the relationship to research and report on the transition between different professional identities. In order to contribute to the debate on the use of autoethnography in qualitative research, central elements to this approach are discussed.

Socialization of nurses in the Family Health Strategy: contributions to professional identity

ABSTRACT Objective: To verify how socialization of nurses in the Family Health Strategy (FHS) influences their professional identity. Method: Exploratory, descriptive research, whose theoretical-methodological framework was dialectical hermeneutics, anchored in the premises of the Sociology of Professions. Data were collected through semi-structured interviews with 27 nurses from the FHS of the city of São Paulo. The resulting empirical material was subjected to Discourse Analysis. Results: The choice for Nursing was influenced by previous knowledge of the profession and by the affinity with care. Socialization was not limited to what was absorbed, including the search for an individual professional identity and collective sharing. Final considerations: Nursing care is built in daily practice, mobilizing the nurse for an action that includes herself, the relationship with the other and the conditions in which the work is performed, opening the opportunity for identity reconstruction, consistent with the concreteness of the work.

Peer support systems and professional identity of student nurses undertaking a UK learning disability nursing programme

This practitioner based action research examines the implementation of the peer assisted study scheme (PASS) and individual peer mentoring in a cohort of first year undergraduate nursing students. It arose out of the desire of a small number of students in one UK university to transfer from the learning (intellectual) disabilities nursing field to other fields. The number of learning disabilities nurses is falling in England, and nursing shortages and student nurse retention generally is an international concern. The peer support was evaluated by 21 completed questionnaires. All the students had found the sessions they attended useful. Four themes emerged from the study. Students reported gains in knowledge around academic skills, placements and their chosen field of nursing; students felt more confident as a result of attending the sessions; students felt supported, and the importance of the peer mentor's interpersonal skills was highlighted; and finally students had valued meeting other students in their chosen field. These findings are discussed with reference to relevant literature.

Professional Socialization: A Grounded Theory of the Clinical Reasoning Processes That RNs and LPNs Use to Recognize Delirium

Delirium is an acute disorder of attention and cognition. It affects half of older adults in acute care settings and is a cause of increasing mortality and costs. Registered nurses (RNs) and licensed practical nurses (LPNs) frequently fail to recognize delirium. The goals of this research were to identify the reasoning processes that RNs and LPNs use to recognize delirium, to compare their reasoning processes, and to generate a theory that explains their clinical reasoning processes. Theoretical sampling was employed to elicit data from 28 participants using grounded theory methodology. Theoretical coding culminated in the emergence of Professional Socialization as the substantive theory. Professional Socialization emerged from participants' responses and was based on two social processes, specifically reasoning to uncover and reasoning to report. Professional Socialization makes explicit the similarities and variations in the clinical reasoning processes between RNs and LPNs and highlights their main concerns when interacting with delirious patients.

Studying the old masters of nursing: A critical student experience for developing nursing identity

In the past professional identity in nursing was inculcated in students alongside institutional pride. A strong sense of professional identity is key to staff retention and recruitment and key to the delivery of quality nursing care. With the wholesale transfer of pre-registration nursing education to the third level sector, however, the reality is that students now divide their affiliations between university and healthcare institutions and professional identity development may be stymied. For this reason, there is need to explore alternative means of developing professional identity. Exposure to nursing history may counteract this tendency. Based on adult nursing students' reflections of a visit to the Florence Nightingale Museum, we discuss the potential of this activity in aiding development of critical professional identity.

Graduate-Assistant Athletic Trainers' Perceptions of Professional Socialization in the Collegiate Setting: Part I

CONTEXT

Many newly credentialed athletic trainers (ATs) pursue graduate assistantships, which allow them to gain experience while being supervised by an experienced AT. The graduate-assistant (GA) ATs' perception of their socialization process into the collegiate setting is unknown.

OBJECTIVE

To explore the professional socialization of GAs in the collegiate setting.

DESIGN

Qualitative study.

SETTING

Phone interviews.

PATIENTS OR OTHER PARTICIPANTS

A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 6) participated.

DATA COLLECTION AND ANALYSIS

Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review.

RESULTS

Four themes emerged: (1) role identity, (2) initial entry into role, (3) maturation, and (4) success. Before beginning their role, participants envisioned the assistantship as a way to gain independent experience while being mentored. They perceived themselves as the primary care providers for their athletic teams. Those who were immediately immersed into clinical practice adapted to their role quickly despite experiencing stress initially. Participants felt that a formal orientation process and a policies and procedures manual would have alleviated some of the initial stress. The GAs matured as they practiced clinically and developed confidence as they gained experience. Personal attributes, experience, and peer and supervisor support contributed to perceived success as GAs. Factors that hindered perceived success were lack of confidence, an unsupportive environment, and long hours.

CONCLUSIONS

When looking for graduate assistantships, ATs should seek a position that allows them to practice independently and provides didactic educational opportunities while aligning with their athletic training philosophies.

Graduate-Assistant Athletic Trainers' Perceptions of the Supervisor's Role in Professional Socialization: Part II

CONTEXT

Many new athletic trainers (ATs) obtain graduate-assistant (GA) positions to gain more experience and professional development while being mentored by a veteran AT; however, GA ATs' perceptions of the supervisor's role in professional development are unknown.

OBJECTIVE

To explore the supervisor's role in the professional development of GAs in the collegiate setting.

DESIGN

Qualitative study.

SETTING

Phone interviews.

PATIENTS OR OTHER PARTICIPANTS

A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 5).

DATA COLLECTION AND ANALYSIS

Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review.

RESULTS

Three themes emerged: (1) GAs' expectations of supervisors, (2) professional development, and (3) mentoring and support. Participants expected their supervisors to provide mentorship, support, and feedback to help them improve their athletic training skills, but they also realized supervisors were busy with patient care responsibilities. Most participants felt their supervisors were available, but others believed their supervisors were too busy to provide support and feedback. Participants felt their supervisors provided professional development by teaching them new skills and socializing them into the profession. Furthermore, they thought their supervisors provided mentorship professionally, personally, and clinically. Supervisors supported the participants by standing behind them in clinical decisions and having open-door policies.

CONCLUSIONS

The graduate assistantship allows new ATs to gain experience while pursuing professional development, mentorship, and support from a supervisor. The extent of development is highly dependent on the supervisor, but most supervisors mentor GAs. When looking for graduate assistantships, future GAs should seek positions in which supervisors actively provide mentoring and professional development.

An exploration of role model influence on adult nursing students' professional development: A phenomenological research study

Patients' expectations of being cared for by a nurse who is caring, competent, and professional are particularly pertinent in current health and social care practice. The current drive for NHS values-based recruitment serves to strengthen this. How nursing students' development of professionalism is shaped is not fully known, though it is acknowledged that their practice experience strongly shapes behaviour. This study (in 2013-14) explored twelve adult nursing students' lived experiences of role modelling through an interpretive phenomenological analysis approach, aiming to understand the impact on their development as professional practitioners. Clinical nurses influenced student development consistently. Some students reported that their experiences allowed them to learn how not to behave in practice; a productive learning experience despite content. Students also felt senior staff influence on their development to be strong, citing 'leading by example.' The impact of patients on student professional development was also a key finding. Through analysing information gained, identifying and educating practice-based mentors who are ready, willing, and able to role model professional attributes appear crucial to developing professionalism in nursing students. Those involved in nurse education, whether service providers or universities, may wish to acknowledge the influence of clinical nurse behaviour observed by students both independent of and in direct relation to care delivery and the impact on student nurse professional development. A corollary relates to how students should be guided and briefed/debriefed to work with a staff to ensure their exposure to a variety of practice behaviours.

Nursing students’ perceptions of faculty members’ ethical/unethical attitudes

Background:

Through education, individuals acquire knowledge, skill and attitudes that facilitate professional socialization; it involves intellectual, emotional and psychomotor skill development. Teachers are role models for behaviour modification and value development.

Objective:

To examine students’ perceptions of faculty members’ ethical and unethical attitudes during interactions in undergraduate nursing.

Research design:

This descriptive study consisted of two phases. In Phase I, we developed an instrument, which was administered to nursing students to assess validity and reliability. Exploratory factor analysis yielded 32 items. Cronbach’s α was 0.83, and test–retest reliability was good. In Phase II, a 32-item version of the instrument was administered to nursing students from another university.

Participants and research context:

Participants included 219 nursing students from one university in Phase I and 196 from another university in Phase II. The study was conducted at the universities attended by the participants.

Ethical considerations:

Ethical approval was granted by the institutions involved, and all participants provided informed consent.

Findings:

In Phase I, the instrument demonstrated good psychometric properties for measuring nursing students’ perceptions of faculty members’ ethical and unethical behaviours. In Phase II, students considered certain professional and personal qualities, including respecting confidentiality and students’ private lives and assuming an impartial stance during interactions in the classroom, examinations, or clinical practice, ethical. They considered using obscene examples or unprofessional speech during teaching, selling textbooks in class, using university facilities for personal interests, engaging in romantic relationships with students, and humiliating students in front of patients or staff in clinical settings unethical.

Conclusion:

Results of this study suggest that nurse educators should be aware of their critical role in the teaching–learning process, and they must scrutinize their attitudes towards students from an ethical point of view.

Exploring commitment, professional identity, and support for student nurses

Problems with the recruitment and retention of nurses globally mean that insight into the factors that might increase retention in qualified staff and students is crucial. Despite clear links between work commitment and retention, there is little research exploring commitment in student nurses and midwives. This paper reports the findings of a qualitative study designed to provide insight into commitment using semi-structured interviews conducted with nine pre-registration students and a qualitative survey completed by 171 pre-registration students. Thematic analysis of the data emphasised the impact of placement experiences on commitment via interpersonal relationships. Students typically emphasised their professional identity as the basis for commitment, although many participants also highlighted a lack of acceptance by qualified practitioners, which reduced it. There was evidence that suggested that practitioner workload may impact the student experience due to challenges in making sufficient time to provide support. Implications for retention strategies are discussed.

Attitudes toward clinical practice in undergraduate nursing students: A Q methodology study

BACKGROUND

Clinical practice (CP) provides an opportunity to directly apply nursing theories learned in class to practice, with the aim of improving nursing knowledge and skills. Nursing students' perspectives about CP can be diverse.

OBJECTIVE

To identify nursing students' attitudes toward CP.

DESIGN

Q-methodology, an integration of quantitative and qualitative methods, was used.

PARTICIPANTS

A convenience P-sample consisting of 43 second-year undergraduate nursing students.

METHODS

Forty-three selected Q-statements from each of the 43 participants (P-sample) were classified into the shape of a normal distribution using a 9-point bipolar scale. The collected data were analyzed using the pc-QUANL program.

RESULTS

Two discrete factors emerged. Factor I comprised a querulous attitude with a critical perspective. Factor II comprised an enthusiastic attitude with a future-oriented perspective.

CONCLUSION

The subjective viewpoints of the two identified factors can be applied in planning effective CP for nursing students.

Core professional nursing values of baccalaureate nursing students who are men

BACKGROUND

The perceptions of core professional nursing values of men in baccalaureate nursing programs are poorly understood.

OBJECTIVE

The study purpose was to understand and interpret the meaning of core professional nursing values to male baccalaureate nursing students.

RESEARCH DESIGN AND CONTEXT

One-to-one interviews were conducted with male nursing students from a public university in the Midwest, following interpretive phenomenology.

ETHICAL CONSIDERATIONS

Measures to protect participants included obtaining Institutional Review Board approval, obtaining signed informed consent, and maintaining confidentiality.

FINDINGS

The study revealed five themes and several subthemes under an overarching finding of caring. Acquisition of professional nursing values began prior to the nursing program and continued to varying degrees throughout the program.

DISCUSSION

Several implications are offered for nursing education, nursing practice, research, and public policy. These include identification of common values, teaching-learning strategies, inclusive environments, teamwork, and conflict resolution.

CONCLUSION

Caring was revealed using a metaphor of a puzzle.

Nursing identity and patient-centredness in scholarly health services research: a computational text analysis of PubMed abstracts 1986-2013

BACKGROUND

The most important and contested element of nursing identity may be the patient-centredness of nursing, though this concept is not well-treated in the nursing identity literature. More conceptually-based mapping of nursing identity constructs are needed to help nurses shape their identity. The field of computational text analytics offers new opportunities to scrutinise how growing disciplines such as health services research construct nursing identity. This paper maps the conceptual content of scholarly health services research in PubMed as it relates to the patient-centeredness of nursing.

METHODS

Computational text analytics software was used to analyse all health services abstracts in the database PubMed since 1986. Abstracts were treated as indicative of the content of health services research. The database PubMed was searched for all research papers using the term "service" or "services" in the abstract or keywords for the period 01/01/1986 to 30/06/2013. A total of 234,926 abstracts were obtained. Leximancer software was used in 1) mapping of 4,144,458 instances of 107 concepts; 2) analysis of 106 paired concept co-occurrences for the nursing concept; and 3) sentiment analysis of the nursing concept versus patient, family and community concepts, and clinical concepts.

RESULTS

Nursing is constructed within quality assurance or service implementation or workforce development concepts. It is relatively disconnected from patient, family or community care concepts.

CONCLUSIONS

For those who agree that patient-centredness should be a part of nursing identity in practice, this study suggests that there is a need for development of health services research into both the nature of the caring construct in nursing identity and its expression in practice. More fundamentally, the study raises questions about whether health services research cultures even value the politically popular idea of nurses as patient-centred caregivers and whether they should.

Supervising athletic trainers' perceptions of professional socialization of graduate assistant athletic trainers in the collegiate setting

CONTEXT

Many newly credentialed athletic trainers gain initial employment as graduate assistants (GAs) in the collegiate setting, yet their socialization into their role is unknown. Exploring the socialization process of GAs in the collegiate setting could provide insight into how that process occurs.

OBJECTIVE

To explore the professional socialization of GAs in the collegiate setting to determine how GAs are socialized and developed as athletic trainers.

DESIGN

Qualitative study.

SETTING

Individual phone interviews.

PATIENTS OR OTHER PARTICIPANTS

Athletic trainers (N = 21) who had supervised GAs in the collegiate setting for a minimum of 8 years (16 men [76%], 5 women [24%]; years of supervision experience = 14.6 ± 6.6).

DATA COLLECTION AND ANALYSIS

Data were collected via phone interviews, which were recorded and transcribed verbatim. Data were analyzed by a 4-person consensus team with a consensual qualitative-research design. The team independently coded the data and compared ideas until a consensus was reached, and a codebook was created. Trustworthiness was established through member checks and multianalyst triangulation.

RESULTS

Four themes emerged: (1) role orientation, (2) professional development and support, (3) role expectations, and (4) success. Role orientation occurred both formally (eg, review of policies and procedures) and informally (eg, immediate role immersion). Professional development and support consisted of the supervisor mentoring and intervening when appropriate. Role expectations included decision-making ability, independent practice, and professionalism; however, supervisors often expected GAs to function as experienced, full-time staff. Success of the GAs depended on their adaptability and on the proper selection of GAs by supervisors.

CONCLUSIONS

Supervisors socialize GAs into the collegiate setting by providing orientation, professional development, mentoring, and intervention when necessary. Supervisors are encouraged to use these socialization tactics to enhance the professional development of GAs in the collegiate setting.

'My mentor kicked a dying woman's bed…' analysing UK nursing students' 'most memorable' professionalism dilemmas

AIM

To provide depth and breadth in the analysis of nursing students' written narratives of 'most memorable' professionalism dilemmas.

BACKGROUND

While nursing students are taught professionalism through formal curricula, they commonly experience workplace-based professionalism dilemmas. Although non-UK studies have begun to explore students' lived experiences of dilemmas, they lack detail about when and where dilemmas occur, who is involved, what students do and why and how students feel.

DESIGN

Online survey of healthcare students including 294 nursing students from 15 UK nursing schools.

METHOD

Nursing students provided a written narrative of their most memorable dilemma (December 2011-March 2012) as part of a survey examining the impact of professionalism dilemmas on moral distress. We conducted thematic and discourse analysis of all narratives and narrative analysis of one exemplar.

FINDINGS

The most common themes were patient care dilemmas by healthcare personnel or students, student abuse and consent dilemmas. Of the dilemmas, 49·6% occurred over 6 months previously, 76·2% occurred in hospitals and 51·9% of perpetrators were nurses. 79·3% of students reported acting in the face of their dilemma. Of the narratives, 88·4% contained negative emotion talk and numerous significant relationships existed between types of emotion talk and dilemmas. Our narrative analysis demonstrates the impact of dilemma experiences through emotion talk and more subtle devices like metaphor.

CONCLUSION

Findings extend previous research with nursing and medical students. Nurse educators should help students construct emotionally coherent narratives to make sense of their experiences, actions and identities and to better prepare them for future professionalism dilemmas.

Role modeling in undergraduate nursing education: an integrative literature review

The transition of nursing education from the hospital setting to the university sector over recent decades has opened dialog about who is guiding the development of nursing students' professional identity. In addition, there is ongoing debate over real or perceived gaps between nursing student learning in the university and the clinical area, how this translates into professional behaviors and how well students make the transition between the two settings. This paper presents the findings of an integrative literature review into the topic of role modeling in undergraduate nursing education. This review was conducted to identify and appraise research findings about role modeling of professional behaviors for undergraduate nursing students. Literature reviewed from 2000 onwards assesses what is currently known about role modeling of undergraduate nursing students. A systematic search of the databases of CINAHL, Scopus and PubMed from 2000 onwards resulted in the selection of 33 articles for deeper analysis. Two clear themes emerged from the literature, the first relating to nurse clinicians as role models for students during clinical placements and the second relating to nurse academics as role models in the academic setting. Findings from this integrative literature review show an imbalance in the recognition of the role modeling of professional behaviors in the clinical versus the academic setting. Nurses in academic settings have more contact with the students over their period of study and as such, the significance of nurse academics as student role models requires further investigation.

A Guest in the House: Nursing Instructors’ Experiences of the Moral Distress Felt by Students during Inpatient Psychiatric Clinical Rotations

Significant research has been done on the impact of moral distress among nurses, particularly in acute and intensive care settings. However, little research to date has investigated the experiences that nursing students have with moral distress. Additionally, there is a dearth of research on the role of nursing instructors’ perceptions of their responsibilities to their students when encountering morally distressing situations. This manuscript describes a qualitative study conducted with eight mental health nursing instructors who acknowledged a responsibility for helping students deal with moral distress and ethical issues, but who also struggled with ways to do so. Additionally, instructors expressed frustration with their “guest” status on inpatient psychiatric units and their powerlessness to effect moral change in a medical model of psychiatric care.

Measuring student nurse professional socialisation: the development and implementation of a new instrument

The role of the clinical teacher is poorly understood, particularly the role they play in supporting the professional socialisation of student nurses. In part this lack of understanding is due to the inadequacy of existing tools to measure the phenomenon. This paper reports on the development and trial of a tool that attempts to illuminate the effects this role has on the development of the newest members of the profession. Selected results of the trial with Australian undergraduate Bachelor of Nursing students and their Clinical Teachers demonstrate that Clinical Teachers are important adjunct socialising agents particularly for mature students and students who enter the profession for altruistic reasons. Further, female Clinical Teachers indicate that they are more involved in certain aspects of student professionalisation than their male counterparts. The development of the tool followed interviews with Clinical Teachers and graduates from 2 universities. The tool trial then used a multi-site cohort study design, with N=196 students (from 3 universities) and N=58 Clinical Teachers (from 2 universities).