Service-Learning in Undergraduate Nursing Education: Where is the Reflection?

Advocacy for Equitable Access to Nature and Outdoor Recreation

BACKGROUND

Recent research highlights disparities in access to nature and green space, a determinant of mental and physical health. The aim of this report is to describe the process of park auditing as an innovation in nursing education.

METHOD

Teams of baccalaureate nursing students used a practice guideline and park auditing tool to examine the amenities of recreational parks and green space in an urban metroplex in the southern United States.

RESULTS

Through data collection and analysis, nursing students captured key indicators of quality and accessibility of 50 urban parks. The findings form the basis for stakeholder recommendations for advocacy to ensure equitable access to green space.

CONCLUSION

Nursing students identified priorities for advocacy to promote park improvements through community-academic-practice partnerships designed to increase outdoor recreation and nature conservation among community members. These experiences reinforced the importance of advocacy with community stakeholders to cocreate strategies for equitable access to nature. [J Nurs Educ. 2024;63(X):XXX-XXX.].

The learning outcomes of smoking cessation training in undergraduate nursing students: A systematic review

AIM

To systematically evaluate the effect of smoking cessation training on nursing students' learning outcomes.

DESIGN

This systematic review followed the PRISMA guidelines and was registered with PROSPERO (CRD42022373280).

METHODS

Ten electronic English and Chinese databases were searched to identify articles on nursing students' smoking cessation training from inception to October 2022. Medical Education Research Study Quality Instrument was used to assess the methodological quality of eligible studies.

RESULTS

Twelve moderate methodological quality studies (three randomized controlled trials and nine quasi-experimental studies) with 2114 undergraduate nursing students were included. Teaching strategies included didactic lectures, collaborative learning, blended learning and the service-learning approach. Eight studies showed that the training significantly increased nursing students' knowledge of smoking cessation (p < 0.05) and three of them showed a large effect size (Cohen's d: 0.83-1.31). Seven studies showed that training enhanced students' attitudes/motivation towards smoking cessation interventions significantly (p < 0.05) and two of them showed a large effect size (Cohen's d: 1.11-1.84). Nine studies reported that students' self-efficacy improved significantly after training (p < 0.05) and six of them showed a large effect size (Cohen's d: 0.98-2.18). Two one-group pre-post studies showed training significantly improved students' practice of 5 A's behavior (p < 0.05), with a small effect size (Cohen's d < 0.50).

CONCLUSIONS

This review showed that smoking cessation training had a positive and large effect on undergraduate nursing students' knowledge, attitudes/motivation and self-efficacy towards smoking cessation intervention, but the effect of changing the practice of 5 A's was modest. We noted that very few RCTs were done and most studies only used subjective measures. More robust experimental studies with long-term follow-up are warranted in evaluating nursing students' practice/behavior of smoking cessation intervention and patients' quitting outcomes. Blended and collaborative learning are recommended in smoking cessation education.

Nursing students' experiences of service-learning at community and hospital pharmacies in Belize: Pedagogical implications for nursing pharmacology

OBJECTIVES

Many students seem to find pharmacology learning very challenging due to the complexity and variety of drugs they have to study. The number of drugs the students have to learn, the duration of time to learn the medications, and the evolving nature of diseases demanded learning beyond the classroom walls. This study explored and described nursing students' experiences in community and hospital-based pharmacy practice sites during their service-learning and its implications for pharmacology pedagogical practices.

METHODS

Kolb's learning theory provided the framework to explore nursing students' 48-hour service-learning experiences at community/hospital-based pharmacies in Belize and its implications for pharmacology pedagogy. The study utilized two qualitative approaches, reflective journals and focus group interviews, to collect data from 46 second-year nursing students. NVivo software and coding schemes were employed to analyze the data from the interviews and reflective journals.

RESULTS

Students reported learning medications, integrating classroom pharmacological knowledge at pharmacy practice sites, acquiring and enhancing communication skills, interpreting prescriptions, dispensing medications, drug calculations, taking inventory, doing vital signs, and patient education. In addition, students reported experiencing inter-professional relationships as healthcare team members. Anxiety was a major challenge experienced by many students at the beginning of the service-learning experience.

CONCLUSIONS

This study highlights the importance of experiential learning of pharmacology amongst second year nursing students, offering the opportunity to inform and support pharmacotherapeutics educators in designing strategies for more effective teaching of medications to nursing students. It also supports the addition of pharmacy placements to the nursing curriculum' as it shows that nursing students can learn medications, skills, and teamwork from experiential pharmacy site posting. Combining classroom instruction with pharmacy experiential service learning might be an effective complement for teaching nursing pharmacology.

Nursing Students and Nurses' Recommendations Aiming at Improving the Development of the Humanistic Caring Competency

BACKGROUND

Most nursing education programs prepare their students to embody humanism and caring as it is expected by several regulatory bodies. Ensuring this embodiment in students and nurses remains a challenge because there is a lack of evidence about its progressive development through education and practice.

PURPOSE

This manuscript provides a description of nursing students' and nurses' recommendations that can foster the development of humanistic caring.

METHODS

Interpretive phenomenology was selected as the study's methodological approach. Participants (n = 26) were recruited from a French-Canadian university and an affiliated university hospital. Data was collected through individual interviews. Data analysis consisted of an adaptation of Benner's (1994) phenomenological principles that resulted in a five-stage interpretative process.

RESULTS

The following five themes emerged from the phenomenological analysis of participants' recommendations: 1) pedagogical strategies, 2) educators' approach, 3) considerations in teaching humanistic caring, 4) work overload, and 5) volunteerism and externship.

CONCLUSION

The findings suggest the existence of a challenge when using mannikins in high-fidelity simulations with the intention of developing humanistic caring. The findings also reaffirm the importance of giving concrete and realistic exemplars of humanistic caring to students in order to prevent them from making "communication" synonymous to "humanization of care".

Educational effects of community service-learning involving older adults in nursing education: An integrative review

BACKGROUND

Community service-learning is a structured experiential learning approach in which students engage in service activities in response to identified community need(s). Service-learning programmes are developed to promote understanding of societal issues and facilitates critical learning for the learners, with emphasis on learning through reflection.

OBJECTIVES

To synthesize findings from published and grey literature related to the educational effects of community service-learning involving older adults in nursing education and evaluate the quality of existing service-learning programmes.

DESIGN

Integrative review following Whittemore and Knafl's framework to analyse and synthesize a broader range of evidence.

DATA SOURCES

Six databases (PubMed, ScienceDirect, CINAHL, PsycINFO, ERIC and ProQuest) were systematically searched from inception until 30 July 2021. Reference lists of relevant studies and reviews were also assessed for eligible studies. We also searched for grey literature and dissertations in ProQuest and Google Scholar.

REVIEW METHODS

The 5-step method was used: problem identification, literature search, data evaluation, analysis, and presentation. Included studies were appraised using the Mixed Methods Appraisal Tool checklist. Service-learning programmes were evaluated using the Service-Learning Quality Assessment Tool.

RESULTS

A total of 21 studies were included. Educational benefits of service-learning in the three domains of learning (cognitive, affective and psychomotor) were identified. Nine service-learning programmes achieved adequate quality and implementation of service-learning principles, while 12 exhibited emergent quality and implementation.

CONCLUSIONS

Service-learning provides various benefits in nursing education. Existing empirical studies do not always follow established service-learning principles, and the quality of evidence is considered low. Future studies should use more rigorous methodologies and improve the reporting of research.

A Descriptive Analysis of the Experiences of Nursing Students Who Participated in an International Service-Learning Project in Haiti

BACKGROUND

Studies have demonstrated multiple benefits of international service-learning experiences in nursing education. These benefits include personal and professional growth, increased cultural sensitivity, and increased self-efficacy.

PURPOSE

The purpose of this project was to describe the experiences of nursing students engaged in an international service-learning experience in Haiti.

METHOD

A descriptive qualitative outcomes evaluation project was utilized to understand student perceptions of this experience. Nine respondents were interviewed about their experiences that took place as part of a nursing capstone course offered at a private liberal arts university in the Midwest. Interview transcripts were analyzed by the authors for common themes.

RESULTS

The six themes identified included: a desire for an international experience to better understand healthcare in a developing country; culture shock; context of poverty; excitement and a sense of "helping" amidst the chaos; feelings of increased confidence, independence, and competence; and personal and professional growth. Responses indicated students felt more confident in caring for individuals from other cultures as well as in basic nursing skills and interprofessional communication after this experience. Participants' narratives also indicated intent to serve vulnerable populations in the future.

CONCLUSIONS

The nursing students perceived increased sociocultural understanding and self-efficacy following a 10-day international service-learning experience.

In Our Own Words: Baccalaureate Nursing Students Describe Academic Service Learning Experiences

Introduction

Service learning integrates community service, didactic and student self-reflection while at the same time striving to identify and meet needs of the community partnership agencies involved. Project Descriptions. In this manuscript, two baccalaureate nursing students describe their service learning experiences while embedded in an integrated primary care community partner site for two years. In project one, students designed and conducted an educational group for mental health clients in a rural day treatment program. In project two, the student revised a diabetic clinic educational form to reduce client burden.Project management and outcomes: Projects were designed in collaboration with community partners and faculty. Project one resulted in increased knowledge of coping mechanisms in a majority of group participants. Three months after implementation of the revised form designed in project two, a majority of diabetic clients served in the clinic had A1c reductions.

Discussion

Lessons learned by students during the experiences include communication skills such as developing rapport with specific client groups, steps of change management, professional team interactions and increased civic engagement.

Conclusion

To our knowledge, this is the first manuscript wherein baccalaureate nursing students add their voice to the literature describing the benefits of academic service learning. Our next step is an online follow up 9 months post-graduation, to examine whether benefits and skills are maintained.

Using Critical Service-Learning Pedagogy to Prepare Graduate Nurses to Promote Health Equity

BACKGROUND

Despite calls from professional organizations to prepare a nursing workforce with the requisite skills to address social determinants of health (SDOH), there is little guidance for nurse educators about how to actively promote student learning of these complex issues.

METHOD

We applied a critical service-learning (CSL) pedagogy to enhance graduate public health nursing curriculum and support learner skill building in approaches to combat health disparities by addressing the underlying social conditions.

RESULTS

Course content and critical reflection activities were built incrementally across four courses and semesters to introduce and apply antioppressive frameworks, encourage students to examine their personal identities of privilege and oppression, and examine historical context and systems of power in public health settings.

CONCLUSION

CSL supports student development of structural competence and their understanding of approaches that can dismantle inequitable systems by addressing SDOH that contribute to health disparities. [J Nurs Educ. 2021;60(1):38-43.].

Teaching of infection control in undergraduate courses in health sciences: opinion of experts

OBJECTIVE

To know the perception of expert professionals in infection control and prevention on the teaching of skills for the prevention and control of infections related to health care in undergraduate courses in Health Sciences.

METHOD

We used the Delphi technique, developed in four sequential rounds. Thirty-one nurses and eight physicians participated in the study. Qualitative data were analyzed through content analysis; the quantitative ones, from the descriptive statistics.

RESULTS

The importance of the courses has had teachers with expertise in infection control and prevention added to arguments about the development of the subject in the curricula by means of a specific subject or as a transversal theme.

CONCLUSIONS

In order to cover the complexity of the elements that are interconnected for professional training, teaching must be based on pedagogical strategies that provoke reflection in students, encouraging them to develop critical thinking about their experiences.

Nursing Faculty Perceptions of Service-Learning: An Integrative Review

BACKGROUND

Nursing faculty plays a central role in facilitating service learning experiences, yet little is known about their perceptions of service-learning.

METHOD

Whit-temore's and Knafl's method for integrative review was used to analyze sources from CINAHL, ERIC, MEDLINE Complete, ProQuest LLC, and ScienceDirect.

RESULTS

Literature about nursing faculty perceptions of service-learning was scarce. Therefore, a thematic analysis was completed on 17 diverse sources regarding general faculty perceptions.

CONCLUSION

Limited research was discovered related to nursing faculty perceptions, exposing a gap in the literature. Further research may clarify the role of service-learning in nursing education. [J Nurs Educ. 2018;57(10):584-589.].

Innovative Use of Service-Learning to Enhance Baccalaureate Nursing Education

BACKGROUND

Service-learning is an established pedagogical approach to nursing education found primarily in community nursing. With changing health care landscapes, the expansion of service-learning projects throughout the nursing program provides opportunities to enrich assessment and critical thinking and amplify exposure to determinants of health.

METHOD

Implementing service-learning in foundational nursing courses allows students to be challenged with the application of complex care management within a context of caring, cultural competence, social responsibility, and self-care initiatives.

RESULTS

Integrating service-learning throughout the nursing curriculum has the potential to make positive, sustainable changes within a community, while simultaneously preparing students to view clients holistically, think critically, and develop cultural competence.

CONCLUSION

Enhancing nursing curriculum by integrating service-learning opportunities can strengthen the learning experience and foster concepts of caring, social responsibility, cultural competence, and self-care. Working with community leaders from diverse groups can lead to sustainable projects that simultaneously benefit the community and nursing education. [J Nurs Educ. 2017;56(9):560-563.].

Impact of a Required Service-Learning Curriculum on Preclinical Students

PURPOSE

The impact of brief service-learning curricula on physician assistant (PA) students is not well reported. This study explores student learning immediately and then one to 2 years after a preclinical service-learning experience through written reflections and a survey.

METHODS

The 16-hour curriculum within a behavioral science course involved community immersion and engagement with underserved clients. Reflections written by students from 3 consecutive classes were coded for major themes, and theme frequency was assessed. We then administered a survey to explore the curricular impact after students completed their clinical clerkships.

RESULTS

All students (132/132) completed the required curriculum. We identified 4 major themes from 132 reflections. The themes were (most to least frequent) self-discovery (54/132), patient focus (30/132), community resources (28/132), and patient-provider relationship (20/132). The primary attitude change (self-discovery) was student awareness of their own biases and recognition of the need for cultural humility when caring for underserved clients. In the postcurriculum survey (response 69/95), students recalled community resources as the most important learning, followed by self-discovery. Students viewed the curriculum positively and noted that the exposure increased their comfort with caring for underserved patients in their clerkships.

CONCLUSIONS

Immersion in a community-based service-learning experience with underserved clients is associated with increased self-awareness and intent to change behavior. Students perceive the experience as important for future clerkships. Preclinical service-learning curricula prepare students to care for underserved patients.

Value of Online Group Reflection After International Service-Learning Experiences: I Never Thought of That

Reflection is a widely accepted learning tool and a component of competent professional practice. An exploratory descriptive study was conducted to compare the breadth and level of reflection between students engaged in individual reflection papers and students engaged in an online group reflection discussion after an international cultural immersion service-learning program. Results indicated that students participating in the online group discussion had a higher level of reflective thinking and discussed more topics in their written reflections.

Nursing students' reflections on the learning experience of a unique mental health clinical placement

INTRODUCTION

There exists a need for innovative thinking to identify new clinical placement opportunities for nursing students. Recovery-based clinical placements for mental health nurse students remain unique and require investigation.

AIM

To examine the learning experience of Bachelor of Nursing students who undertook an innovative mental health clinical placement known as Recovery Camp.

DESIGN

This study incorporated qualitative analysis of written reflections. Using Braun and Clarke's (2006) six phases of thematic analysis the corpus of student reflections were reviewed by three members of the research team independent to each other.

FINDINGS

Four themes emerged. The theme of Pre-placement Expectations incorporates participant foci on pre-conceptions of Recovery Camp. The theme of Student Learning incorporates the ways in which participants recognised the experience of Recovery Camp influenced learning. Reflections themed under the title Placement Setting include discussion of the Recovery Camp as a clinical placement. The theme of Future Practice incorporates students' reflections on how they plan to practice as nurses as a result the learning experiences of Recovery Camp.

CONCLUSIONS

An immersive clinical placement such as Recovery Camp can influence students' perceptions of people with mental illness, have a positive impact on student learning and influence students' decisions about future practice. The learning experience of nursing students whom attend unique, recovery-orientated clinical placements can be both positive and educative.