Faculty-student interactions and the student-perceived climate for caring

Transition shock among nursing interns and its relationship with patient safety attitudes, professional identity and climate of caring: a cross-sectional study

BACKGROUND

Nursing interns often experience lots of challenges during their clinical nursing internships, which can adversely affect career decisions and result in a squandering of nursing education resources. Patient safety attitudes, professional identity and climate of caring may affect nursing interns' clinical experience. However, more evidence is requested to validate these relationships for nursing educators to develop effective education programs and facilitate interns' successful transition.

METHODS

This was a cross-sectional study, which used a convenience sampling method to recruit 387 nursing interns during December 2022 to April 2023 in university affiliated hospital in Hunan province, China. Data were collected using standardized scales. Spearman correlation and multiple regression analysis were employed to examine the relationship between transition shock, patient safety attitudes, professional identity, and climate of caring.

RESULTS

Nursing interns experienced transition shock at a moderate level and the highest levels of transition shock in response to overwhelming practicum workloads, with the second being related to the conflict between theory and practice. Transition shock was negatively correlated with patient safety attitudes, professional identity and climate of caring among nursing interns.

CONCLUSIONS

Nursing managers and educators need to value the transition shock experienced by nursing interns. Our study suggests that developing a strong sense of professional identity and a positive attitude toward patient safety can be effective in reducing the level of transition shock among nursing interns. In addition, a caring climate within the nursing unit can significantly enhance the overall experience of nursing interns. This can be achieved by enhancing the support of clinical mentors, providing patient safety-focused education, and facilitating team communication among nurses.

Perceptions matter: faculty caring, campus racial climate and academic performance

AIM

Examine the influence of students' perception of faculty caring on academic performance and the moderating role of students' perceptions of campus racial climate.

BACKGROUND

There is limited knowledge on how students' perceptions of faculty caring, campus racial climate and academic performance are linked. Understanding this nexus is crucial to improving nursing education.

DESIGN

Secondary analysis of a cross-sectional data obtained from seven undergraduate nursing programs in Texas, USA.

METHOD

Data were from 385 students enrolled in Medical-Surgical 1 over three semesters (March 2010-December 2010). Six sets of factor analytic scores derived from 31 original perceptions of faculty caring items served as predictors; one set of scores derived from seven original perceptions of campus racial climate items served as moderating variable in a regression model. Numeric grade was the outcome variable.

RESULTS/FINDINGS

Perception of faculty having a positive outlook/compassion had an enhancing effect on performance. As students' perceptions of campus racial climate became increasingly discriminating, the positive association between perceptions of faculty's trust in students' judgment and academic performance became increasingly strong.

CONCLUSION

Results highlight ways by which students' perception of micro-level social reality (dyadic interaction) might interact with their perception of meso-level social reality (social environment) to influence their academic performance.

Insight into error hiding: exploration of nursing students' achievement goal orientations

An estimated 50% of medication errors go unreported, and error hiding is costly to hospitals and patients. This study explored one issue that may facilitate error hiding. Descriptive statistics were used to examine nursing students' achievement goal orientations in a high-fidelity simulation course. Results indicated that although this sample of nursing students held high mastery goal orientations, they also held moderate levels of performance-approach and performance-avoidance goal orientations. These goal orientations indicate that this sample is at high risk for error hiding, which places the benefits that are typically gleaned from a strong mastery orientation at risk. Understanding variables, such as goal orientation, that can be addressed in nursing education to reduce error hiding is an area of research that needs to be further explored. This article discusses the study results and evidence-based instructional practices for this sample's achievement goal orientation profile.

Nursing Students' Perceptions of Instructor Caring: An Instrument Based on Watson's Theory of Transpersonal Caring

This study describes the development and testing of an instrument to measure nursing students' perceptions of instructor caring. Originally, 69 statements about instructors' caring behaviors, based on Watson's 10 carative factors, were created with Dr. Jean Watson. The Nursing Students' Perceptions of Instructor Caring (NSPIC) instrument uses a 6-point Likert scale for students' responses to the statements. After pretesting the instrument with a small group of nursing students, the NSPIC was tested with 133 baccalaureate nursing students. Based on item analysis, factor analysis, and student comments, the number of statements were reduced to 31. Psychometric testing revealed that the NSPIC is internally consistent (alpha = 0.97) and contains five subscales. Convergent validity was established between the NSPIC and a semantic differential scale of students' perceptions of instructor caring. Predictive validity was assessed with Coates Caring Efficacy Scale. Although the NSPIC is in its early stages of development, its psychometric properties indicate that it is a valid and reliable measure of nursing students' perceptions of instructor caring.

Student-teacher connection: a place of possibility

AIM

This paper expands the understanding of student-teacher connection and offers direction for educators in supporting connection as a place of possibility.

BACKGROUND

The evolution of a humanistic paradigm in nursing education is evident in research exploring student-teacher relationships. Connection is described within humanistic student-teacher relationships, reported as part of experiences of students, educators and clinicians within emancipatory curricula, and emerged as a central metaphor in a metasynthesis of caring in nursing education. Additionally, student-teacher connection in clinical nursing education has been reported as creating positive outcomes for students' learning experiences and professional socialization.

DISCUSSION

In this paper, student-teacher connection is envisioned as having a value beyond these tangible outcomes - a value that arises from the essence of connection itself. The qualities inherent in the essence of connection - knowing, trust, respect and mutuality - create a transformative space in which students are affirmed, gain insight into their potential, and grow toward fulfilling personal and professional capacities: student-teacher connection emerges as a place of possibility. The possibilities that exist for students and teachers in a connected relationship are exemplified as connection is proposed as a cornerstone in supporting students at risk of failing a clinical nursing course.

CONCLUSION

Acknowledging student-teacher connection as a place of possibility highlights the importance of student-teacher relationship to students' learning and raises implications for preparation and evaluation of educators, and educational practice within the international nursing arena. Of note is the need for the preparation of educators to include a focus of developing relational competence as well as evaluation processes that consider the teacher-in-relationship. Regardless of the educational setting, educators are challenged to consider their beliefs and actions and the influence these exert on relationships with students. Further research exploring specific possibilities within connection is required.

The Phenomenon of Caring

Using a phenomenologic approach, this study uncovered themes related to the perception of nurse educators' role in caring. The themes discovered were intuitive discovery, supportive guidance, respect, promoting independence, and shared success. Discussion of the themes indicated potential outcome divergence. Also noted were differences in what students/orientees and nurse educators believe to be caring behaviors related to independence and rescue strategies. Nursing educators, regardless of employment situation, are encouraged to use these findings to better understand their role perceptions by students and orientees.

Faculty Support and Student Retention

A study was conducted to explore the relationship between nursing students' perceived faculty support and nursing student retention. The 458 associate degree nursing students who participated were categorized according to their persistence-those who had persisted continuously throughout a nursing program, those who had withdrawn voluntarily at some time during a program, and those who had been required to withdraw because of academic failure. Perceived faculty support was measured by scores on the Perceived Faculty Support Scale, an instrument developed by the researcher for this study. A factor analysis of the instrument revealed two factors-psychological support, directed at promoting a sense of competency and self-worth, and functional support, directed at the achievement of tasks to reach the goals of persistence and academic success. Analysis of variance revealed persistence group differences in perceived faculty support. Students who reported greater perceived faculty support were more likely to persist throughout a nursing program than students who withdrew either voluntarily or because of academic failure. To promote retention of nursing students, faculty need to provide the caring atmosphere of a mentoring relationship and direct assistance to facilitate student learning.

Student--teacher connection in clinical nursing education

BACKGROUND

The trend toward humanistic nursing education has called for a transformed student-teacher relationship that fosters learning and growth of students and teachers. Although such a relationship has been claimed to form the basis for student-teacher connection and to be a positive influence on students' learning outcomes, there is a paucity of research exploring these claims. Neither the nature of student-teacher connection nor the processes by which it occurs have been described.

AIMS

A research study was undertaken to explore and describe undergraduate nursing students' experiences of connection within the student-teacher relationship and the effects of student-teacher connection on students' learning experiences in clinical nursing education.

RESEARCH DESIGN

The qualitative research approach of interpretive description was chosen for this study. Unstructured interviews and a focus group were used to collect data from eight undergraduate nursing students. Data were analysed using the process of constant comparative analysis, and revealed four interrelated major categories that formed a description of the students' experience of student-teacher connection.

FINDINGS

This article presents part of the findings of this study. After describing the nature of student-teacher connection, the discussion focuses on the influence of teachers and other factors on the formation of student-teacher connection. Relevance is given to this discussion by describing the outcomes of connection for students' clinical learning experiences.

Relationships among student and graduate caring ability and professional school climate

This study represents the second phase in a longitudinal study of the development of caring ability in registered nurses. A nationwide sample of female graduates of US baccalaureate nursing programs was resurveyed 3 years after the phase-one survey taken during nursing school. The purpose of the study was to continue an evaluation of several variables contributing to the development of professional caring ability. Previously validated instruments were used to measure caring ability (Caring Ability Inventory), maternal and paternal care (Parental Bonding Instrument), and the caring climate of the respective nursing schools (Charles F. Kettering Ltd. School Climate Profile). Although parental bonding scores remained unchanged from the initial survey, caring ability scores significantly increased after entry into practice (paired student's t test, P < .001). The strongest predictor of postgraduate caring ability was student caring ability scores (r = .58, P < .001). When student caring ability scores were excluded as a potential predictor during stepwise multiple regression analysis, school climate scores were the strongest predictor of postgraduate caring ability (r = .17, P < .05). This suggests that development of professional caring ability is related to caring school environments. Furthermore, caring ability as a student predicts further development of caring ability after entry into practice.

Hospital nurses' perceptions of the ethical climate of their work setting

PURPOSE

To develop an instrument to measure how hospital nurses perceive the ethical climate of their work setting and to evaluate its psychometric properties. A way to measure ethical climate can help nurses understand the work setting influences on their practice and can be used to diagnose areas for organizational change as well as to evaluate effectiveness of organizational interventions.

DESIGN

Descriptive. Instrument developed was the Hospital Ethical Climate Survey (HECS). Sampled were 360 RNs (48% response rate) employed in clinical practice at two acute-care hospitals in one U.S. midwestern city. The nurses completed a questionnaire in 1993-1994 consisting of items developed to assess their perceptions of ethical climate, along with the 43-item Integrity Audit, a social desirability scale, and a demographic inventory.

METHODS

Construct validity was assessed by confirmatory factor analysis (CFA) using the LISREL 7 statistical program.

RESULTS

The final CFA model consisted of 26 variables in five factors, which were organized according to the relationships of nurses with peers, patients, managers, hospital, and physicians. Internal consistency reliability, using Cronbach's alpha, for the final 26-item instrument was 0.91 (range 0.68 to 0.92) for the subscales.

CONCLUSIONS

The Hospital Ethical Climate Survey has acceptable initial reliability and validity.

Development of an Instrument to Measure Caring Peer Group Interactions

The purpose of this study was to develop psychometric properties of the Peer Group Caring Interaction Scale (PGCIS) designed to measure caring during informal peer interactions as experienced by undergraduate nursing students. The PGCIS has two subscales that address caring peer behaviors and interactional events during which students assist their peers in the resolution of specific needs. PGCIS psychometric properties were developed using data from 873 junior students enrolled at 87 BSN schools of nursing. Internal consistency reliability was demonstrated for the 9-item Caring Behaviors and the 7-item Giving Assistance subscales with a coefficient alpha of .91 for each. Findings from an exploratory factor analysis supported the two subscale structure of the PGCIS. The PGCIS scores correlated positively with scores on the Intimacy subscale of the Organization Climate Description Questionnaire (OCDQ) and the Peer Group Interaction Scale and inversely with scores on the OCDQ Disengagement subscale. The findings from this study provide beginning support for the PCGIS as a valid and reliable approach to the measurement of caring in academic settings. Additional studies are recommended to continue the psychometric evaluation of this instrument.

Teaching caring within the context of health

Changes in the delivery of healthcare have created an environment viewed as uncaring to both the patient and healthcare providers. Thus teaching concepts of health and caring becomes a priority for nurse educators. The authors discuss how caring can be taught in the context of health. Specifically, they describe a teaching method which was aimed at sensitizing students to Allen's model of health and Watson's carative factors.

Mentoring and self-efficacy for advanced nursing practice: a philosophical approach for nurse practitioner preceptors

Nurse practitioners (NPs), frequently called upon by graduate schools of nursing to be preceptors for NP students, are asked to play an active role in the socialization of these students as capable primary care providers. Much is expected of the preceptor in the typical short-term clinical preceptorship with little guidance available to her or him. A mentoring model of clinical education, while representing a longer-term commitment for preceptors than usual precepting arrangements, may ultimately be a more effective model for student learning and more satisfying for the preceptor than currently practiced models. Eastern philosophical principles, very much in harmony with valued nursing approaches to relationships, can provide a framework for examining mentoring as a strategy for promotion of self-efficacy for advanced practice that can be of benefit to both the NP preceptor and the NP neophyte.

Evaluation of a school climate instrument for assessing affective objectives in health professional education

A conceptual framework for the study of school climate and development of professional caring ability is proposed that is compatible with research on learning environment and socialization. Student input characteristics were measured demographically and through use of previously validated scales from the Parental Bonding Instrument; student outcome characteristics were measured on the Caring Ability Inventory for which considerable empirical validity evidence exists. The primary focus of this evaluation addressed reliability and validity of an instrument designed to assess learning environment that had not previously been used in postsecondary education. Four abbreviated School Climate scales were studied: Respect, Trust, Morale, and Caring. Source data were obtained from the initial phase of a longitudinal study of baccalaureate nursing students throughout the United States. Factor analysis, score reliability, and item-total correlation results indicate the School Climate instrument has indicate the School Climate instrument has theoretical and practical utility for program evaluation and improvement in health professional education.

The lived experiences of students in nursing: voices of caring speak of the tact of teaching

The purpose of this phenomenological, Heideggerian hermeneutical study was to describe the lived experiences of 23 undergraduate nursing students in relation to their perceptions of "caring" experiences in their nursing programs. Data were collected by the primary investigators at a statewide nursing convention, with students relating stories of critical student experiences related to caring. Themes related to caring experiences included "caring as offering," "leaps ahead caring," and "creating a caring place." A recurrent pattern of "power inherent in teaching" was identified across student narratives, suggesting the need to study how teachers can use the tact of teaching to empower students. Implications drawn from the data suggest the need to explore how nursing students' learning is shaped by caring interactions with nurse clinicians and other health professionals as well as with nursing faculty.

The Preceptor Model of Clinical Instruction: The Lived Experiences of Students, Preceptors, and Faculty-of-Record

The preceptor model of clinical instruction will become increasingly popular due to the cost of undergraduate education, the scholarly demands of research and teaching, and an interest in developing new partnerships among students, clinicians, and teachers. It is quite timely, therefore, that nurse researchers reveal the nature and utility of this instructional model prior to its widespread use. To that end, hermeneutic interviews (N = 31) were conducted with senior-level undergraduate nursing students (n = 10), staff nurse preceptors (n = 11), and master's and PhD-prepared faculty-of-record (n = 10). Employing interpretive phenomenology, the authors identified common meanings, relational themes, and a constitutive pattern designated learning nursing thinking. An examination of this pattern and its associated themes may help identify those teaching practices that should be extended and those that should be altered.

Creating a caring community in nursing education

In response to the call to reclaim caring in nursing, an associate of science in nursing degree program recently incorporated a curriculum that emphasizes the teaching and learning of caring. To accomplish this goal, caring groups composed of nursing faculty and students were established. The caring group experience involved the creation of a safe place in which nursing students and faculty could engage each other in a reciprocal dialogue of sharing and support. This article reports the findings of a qualitative study designed to discover and describe the lived experience of being in a caring group from the perspective of nursing students. Participants reported being more aware of the meaning and importance of caring in their personal and professional lives, being more accepting of others, and valuing caring and self-care more. They also expressed an intention to recreate the caring group experience in future practice settings. Conclusions from this study address the pedagogical measures necessary to sustain care and caring as the essence of nursing.

Affirming Cultural Diversity: A Pathways Model for Nursing Faculty

This article presents a model for affirming the diversity of backgrounds, learning styles, and career aspirations for students in baccalaureate and graduate nursing education. The theoretical model, known as Pathways, is developed with a travel analogy and begins by acknowledging the diversity of educational preparation and socialization experienced by students from various cultural, economic, and ethnic backgrounds. Learning styles and needs of these students are addressed through assessment and interventions that are individualized and serve as maps and guides through the professional learning sequence and into future professional careers. The model is useful for planning and evaluating expanded services for a broad spectrum of students. The focus of this article is on the preparation of faculty as mentors for students with disadvantaged backgrounds.

Guiding dialogue in the transformation of teacher-student relationships

The National League for Nursing at its 1989 biennial convention resolved that nursing curricula be revised to reflect enriched caring practices through egalitarian teacher-student and teacher-to-teacher relationships that reflect cooperation and a sense of community. The distribution of power relationships between student and teacher, teacher and teacher, and teacher and administrator must be reconceptualized and realized before any significant change in nursing education's curriculum can occur. Revising curricula to incorporate such a change in teacher-student relationships begins with dialogue with teachers that is authentic. Authentic dialogue will cause examination and reexamination of assumptions and ideologies about teacher-student relationships.

Nursing Students' Perspectives: Experiences of Caring and Not-So-Caring Interactions with Faculty

The purpose of this study was to describe the meaning of baccalaureate nursing students' lived experience of caring and not-so-caring interactions with faculty. The research questions explored the phenomenon of being cared-for or not-cared-for by asking, "What does being cared-for by faculty mean to baccalaureate nursing students?" Students were also asked to describe not-so caring interactions with faculty. Seventeen baccalaureate nursing students at a private liberal arts college and 15 baccalaureate nursing students at a public university were interviewed. Transcripts of the tape-recorded interviews were analyzed using Giorgi's technique. After reflection upon the content of the interviews, significant statements were identified, meaning units were developed, and themes were extracted which were then abstracted into categories of Recognition, Connection, and Confirmation/Affirmation. Finally, general structural descriptions of phenomena of a caring and of a not-so-caring interaction were constructed. Implications for teaching, research, and practice are described.

Narrative Pedagogy: Rethinking Nursing Education

Narrative pedagogy is an interpretive approach to teaching and learning that is being used to foster educational reform. As it pertains to nursing education, narrative pedagogy is an approach to thinking about teaching and learning that evolves from the lived experiences of teachers, clinicians, and students. In this article, the author reviews the philosophical underpinnings of narrative pedagogy, provides examples of how narrative pedagogy can be used to rethink the teaching of nursing knowledge and practice, and discusses the strengths and limitations of narrative pedagogy as an alternative approach to teaching and learning.

The new paradigm: concepts and application in community health nursing

The central role of community health nursing in future health care delivery systems is undisputed. The abilities and characteristics of nurses who will practice in those systems depends to a large extent on their learning experiences in basic nursing programs. Educators are being asked to prepare skilled, compassionate scholar-clinicians to provide care for the complex needs of clients, despite already packed curricula. The curricular changes cannot be additive; learning must be designed to empower students to become nurses who are both skilled and compassionate. Certain faculty attitudes and behaviors are essential to this new educational paradigm and student activities and assignments must foster confident effective practice.

Clinical psychology students' perceptions of an academic climate for caring

There is a general consensus that caring is an important personal attribute of helping professionals. One way for educational institutions to develop a caring attitude in students is to provide an academic climate for caring. A total of 45 doctoral students in a clinical psychology program were asked to list specific faculty-student and student-student interactions which they believed reflected a caring attitude towards others. Components of this student-perceived climate for caring include mutual respect and support, personal interest, and informal socialization.