The significance of personal learning environments (PLEs) in nursing education: Extending current conceptualizations

Enhancing professional competency in clinical procedures using head-mounted display virtual reality - a mixed method study

BACKGROUND

The maintenance of nursing professional competency is essential to ensure patients' health outcomes. With the current shortage of nursing workforce, a novel approach is necessary to refresh clinical skills and update practice.

OBJECTIVE

This study aims to examine the effectiveness of using head-mounted display virtual reality to refresh knowledge and skills and explore nurses' perceptions towards using this technology for refresher training.

DESIGN

A pre-test post-test mixed-method experimental design was employed.

RESULTS

Participants (n = 88) were registered nurses with a diploma in nursing. The intravenous therapy and subcutaneous injection procedures were implemented using head-mounted display virtual reality. The study showed significant improvement in knowledge for the procedures, cognitive absorption, online readiness, self-directed learning, and motivation for learning. In the qualitative focus group discussions, three themes were identified using thematic analyses: enjoyable way to refresh clinical knowledge; learning outside classroom and limitations in maneuver.

CONCLUSION

Using head-mounted display virtual reality is promising in refreshing clinical skills for nurses. Training and refresher courses can explore using this novel technology, which may be a viable alternative to ensure professional competence with reduced manpower and resources used by the healthcare institution.

Mid-career switch nursing students' perceptions and experiences of using immersive virtual reality for clinical skills learning: A mixed methods study

BACKGROUND

There has been an increase of mid-career professionals joining nursing. These adult students possess significant expertise in other areas and may benefit substantially in deliberate practice to acquire skills competency using immersive virtual reality (IVR) for clinical procedures before they practise in actual clinical settings.

OBJECTIVES

This study aims to (1) examine the impact of IVR clinical procedures on mid-career switch students in knowledge, game perception and user reaction; (2) to explore the mid-career switch students' perceptions and experiences in using the IVR clinical procedures.

DESIGN

A mixed methods feasibility study was used.

SETTING AND PARTICIPANTS

This study was conducted at a university in Singapore with 34 first-year mid-career switch students.

METHODS

This study is a single-group pre-test and post-test experimental study on learning clinical procedures using IVR in the home setting. The study took place from September to November 2021. Focus group discussions were conducted and analysed verbatim using thematic analysis.

RESULTS

The students demonstrated significant improvement of knowledge for subcutaneous insulin, but overall, the increase in combined scores for both intravenous therapy and subcutaneous insulin were not statistically significant. Three overarching themes included: 1) Learning and practice, 2) Challenges and barriers, and 3) Personal attributes. Most of the participants found the experiences to be engaging, relevant, and satisfying. Some reported experiencing giddiness, headache, and lack of familiarity with technologies.

CONCLUSIONS

IVR simulation can potentially be used as a supplementary learning tool to improve knowledge of clinical procedures in mid-career switch students.

A Multisite Assessment of Saudi Bachelor Nursing Students' Perceptions of Clinical Competence and Learning Environments: A Multivariate Conceptual Model Testing

Background: It is thought that students’ perceptions of educational and clinical learning environments improve the effectiveness of curricula and professional standards. It is essential to examine the educational and clinical learning environments in which nursing students learn, as well as how nursing students evaluate particular factors of these environments. Objectives: The objectives of this study were to (1) identify nursing students’ perceptions on professional competence and learning environments in the classroom and clinical settings and (2) test a hypothetical model of variables that influence and predict students’ perceptions of learning environments and professional competencies. Methods: The study employed a descriptive cross-sectional methodological design. Five hundred and eighteen undergraduate nursing students were recruited from three Saudi Arabian universities using a convenient sampling technique. Using valid and reliable self-reported questionnaires, including the Dundee Ready Educational Environment Measure (DREEM), the modified Clinical Learning Environment Inventory (CLEI), and the Nurse Professional Competence Scale-Short (NPCS-SF), data were collected. Results: Perceptions of professional competence and learning environments were positive among nursing students. With satisfactory fit indices, the final model found that students’ perceptions of clinical competence were significantly predicted by their perceptions of the clinical environment (B = 0.43, p < 0.001), students’ perceptions of university environments (B = 0.29, p < 0.001), ward type (B = 0.12, p < 0.001), and students’ year of study (B = 0.11, p < 0.001). The students’ perceptions of clinical environments were significantly predicted by their perceptions of the university environment (B = 0.31, p < 0.001), gender (B = 0.13, p < 0.001), students’ year of study (B = 0.12, p < 0.001), and ward type (B = 0.11, p < 0.001). Moreover, the students’ perceptions of the university environment were significantly predicted by gender (B = 0.11, p < 0.001) and length of training (B = 0.12, p < 0.001). Conclusions: A range of factors might influence students’ perceptions of their professional competence and learning environments. Improving the learning environments and clinical experiences of students could enhance their clinical competence. This study’s findings provide evidence for how to enhance the learning environments in the classroom and clinical settings in order to improve students’ clinical competence, which will ultimately result in better patient outcomes. It is a top priority for nursing educators all around the world to improve classroom and clinical learning settings that foster students’ learning and professional competencies.

The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals

AIMS AND OBJECTIVES

To analyse nursing students' perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals.

BACKGROUND

Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace.

DESIGN

Cross-sectional, correlational study.

METHODS

One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students' satisfaction with the clinical learning environment and learning process was measured using a 4-point Likert scale developed by the researchers. The STROBE checklist was used in this paper.

RESULTS

Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction.

CONCLUSIONS

This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies.

RELEVANCE TO CLINICAL PRACTICE

Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.

Magnet hospital attributes in nursing work environment and its relationship to nursing students' clinical learning environment and satisfaction

AIMS

To analyse nursing students' perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated.

DESIGN

This study had a cross-sectional, correlational, design.

METHODS

Data were collected using self-reported questionnaires from 180 nursing students at a university in southeast Spain between September-October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students' satisfaction with the work environment and with the clinical learning process were measured using a four-point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ² test, Mann-Whitney U test, Spearman and phi correlation were used to analyse the data.

RESULTS

Nursing students' perception of greater Magnet-like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22-0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02).

CONCLUSION

Magnet-like features at the work environment lead to superior clinical learning environment and higher students' satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation.

IMPACT

In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.

Learning With Virtual Reality in Nursing Education: Qualitative Interview Study Among Nursing Students Using the Unified Theory of Acceptance and Use of Technology Model

Background

Digital games–based learning is a method of using digital games to impart knowledge. Virtual reality (VR) programs are a practical application of this method. Due to demographic changes, the nursing profession will become increasingly important. These VR applications can be of use in training nurses for future professional challenges they may encounter. The continuous development of VR applications enables trainees to encounter simulated real life effectively and to experience increasingly concrete situations. This can be of great importance in nursing education, since 3-dimensionality enables a better visualization of many fields of activity and can prevent potential future errors. In addition to this learning effect, VR applications also bring an element of fun to learning.

Objective

The aim of this qualitative research effort is to observe the degree of acceptance of VR applications by nursing students in Germany. Various factors, including social influences, performance expectations, and effort expectations, are taken into consideration.

Methods

With a qualitative cohort study, the acceptance of nursing students towards VR applications in anatomy teaching was determined. The 12 participants were first asked to fill out a quantitative questionnaire on their sociodemographic characteristics and the extent to which they valued and liked using technology. The participants were then allowed to test the VR application themselves and were finally asked about their experience in a qualitative interview. For the collection of data and the analysis of results, the unified theory of acceptance and use of technology was used in this study.

Results

Overall, the study shows that the interviewed persons rated the VR application quite positively. The greatest influence in this was the personal attitude towards technology; the higher this affinity is, the more useful the VR application appears. Social influences can also increase the participant’s own acceptance if peers have a positive attitude towards such applications. The study shows that the trainees' motivation to learn was increased by using VR. We believe this is because each trainee could learn individually and the VR application was perceived as an enjoyable activity. Nevertheless, the cost factor of implementing VR applications in nursing training is currently still an obstacle, as not every institution has such financial capacities.

Conclusions

The extent to which the use of VR applications in the training of nursing staff is justified depends on the degree of personal acceptance. The collected results give good practice-oriented insight into the attitude of trainees towards VR. Many of the interviewed persons saw benefits in the use of VR technologies. As VR applications are constantly developing, it is necessary to conduct further studies on VR applications in nursing education and to include other possible disciplines in which these applications can be helpful.

Evaluating the learning environment of nursing students: A multisite cross-sectional study

BACKGROUND

Identifying students' experiences of the university and clinical learning environments informs quality improvement of courses.

OBJECTIVES

To investigate undergraduate nursing students' perceptions of their education environment and the facilitators and barriers to learning, during university and clinical experiences.

DESIGN

Multi-site cross-sectional survey.

SETTING

Four universities in Vietnam.

PARTICIPANTS

Undergraduate nursing students (n = 891).

METHODS

Between May and August 2016, Vietnamese versions of the Dundee Ready Education Environment Measure (Nursing) and the modified Clinical Learning Environment Inventory measured students' perceptions of university and clinical environments respectively. Two additional open-ended questions elicited perceptions of facilitators and/or barriers to clinical learning.

RESULTS

The university environment was rated as needing improvement and significant differences between universities and year of study detected. University environment mean scores were significantly higher in second year students compared with those in the third or fourth years of study. Active teaching and interpersonal relationships at university were rated positively. Overall, clinical environment scores were mid-range and second year students' mean scores were significantly higher than third or fourth years. Clinical placements greater than four weeks duration had significantly higher mean score than two week placements.

CONCLUSIONS

Evaluation of university and clinical experiences assists with identifying potential areas of interruption to nursing students' transfer of learning. In both learning environments, Vietnamese students' experiences were similar to those experienced in Western countries in that interpersonal relationships with teachers and ward staff were key factors perceived to influence learning. A notable difference in this study was the hospital environment in Vietnam had features unique to this country that interrupted students' transfer of learning. Globally it is a priority for nurse educators to facilitate both on and off campus environments that promote students' learning. Assessing these environments is a useful strategy for quality improvement of courses.

Instant messaging and nursing students' clinical learning experience

BACKGROUND

Although learning in clinical settings is a key element of nursing education, for many learners these are challenging developmental contexts often marked by isolation and a lack of belongingness. Despite the massive appropriation of mobile instant messaging (MIM) platforms and the connective properties attendant to them, very little is known about their role in and impact on nursing students' clinical learning experiences.

APPROACH AND METHODS

To address this gap, the study, which was part of a multinational research project on the use of mobile social media in health professions education in developing countries, examined the use of the instant messaging platform WhatsApp by nursing students during placements and potential associations with socio-professional indicators. The survey involved a total number of 196 nursing students from 5 schools in Oyo State, Nigeria.

RESULTS

The findings suggest that students used WhatsApp relatively frequently and they perceived that this platform strongly enhanced their communication with other students and nurses. WhatsApp use during placements was positively associated with students' maintained social capital with peer students, the development of a professional identity, placement satisfaction and with reduced feelings of isolation from professional communities. The determinants that influenced WhatsApp use during placements were perceived usefulness and perceived ease of use. No associations were found between WhatsApp use during placement and age, attitude, subjective norms and placement duration.

CONCLUSION

This study is one of the first of its kind that points to the relevance of mobile instant messaging as part of nursing students' (inter)personal learning environments in clinical settings and, particularly, in the development setting under investigation. Further research is needed to corroborate these findings, to enhance the understanding of the impact mechanisms, and to evaluate a more systematic use of MIM in clinical learning contexts.

Facilitating problem-based learning among undergraduate nursing students: A qualitative systematic review

OBJECTIVES

The purpose of this study was to identify and synthesize the best available evidence on the perspective of undergraduate nursing students on facilitating elements that contribute to their success with PBL.

DESIGN

a qualitative systematic review of the literature according to meta-aggregative methodology using the JBI SUMARI system was conducted.

DATA SOURCES

Data was collected across CINAHL, Medline, Embase, Eric, Teacher Reference Center and reference lists.

RESEARCH METHODS

Out of 378 articles, 101 were retrieved for examination and eight were retained after methodological analysis.

RESULTS

51 findings, matched with a verbatim, were extracted and aggregated in five categories: 1) in PBL, the nursing tutor models clinical reasoning and leadership skills; 2) the quality of group interactions is critical to the success of nursing students with PBL; 3) nursing students go through the process of learning with PBL; 4) through PBL, nursing students acquire skills that foster clinical reasoning; and 5) when the PBL method is used as intended, nursing students understand its purpose and process. These categories were aggregated in two syntheses worded as recommendation for practice.

CONCLUSIONS

The synthesized recommendations are: 1) tutors should be trained to effectively guide the team work of undergraduate nursing students along the PBL process in order for them to achieve its goal; and 2) nursing students should be securely introduced to PBL and experience the development of their clinical reasoning through PBL. Future research should focus on the strategies undergraduate nursing students use to succeed with PBL and the effectiveness of PBL in enhancing critical thinking and collaboration skills.