Baccalaureate Minority Nursing Students Perceived Barriers and Facilitators to Clinical Education Practices: An Integrative Review

Linguistically responsive learning and teaching for non-native speakers in undergraduate nursing education: a scoping review protocol

INTRODUCTION

Non-native-speaking nursing students as well as faculty, preceptors and mentors face specific issues related to language in undergraduate nursing education. A better understanding of the language experiences, needs, requirements, assessments and support activities will guide linguistically responsive learning and teaching and will direct future curriculum development. This scoping review aims to examine and map the extent of literature related to linguistically responsive learning and teaching for non-native speakers in undergraduate nursing education and to describe the lived experiences, barriers and facilitators, language needs, assessment tools and supportive interventions.

METHODS AND ANALYSIS

This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). In May 2023, a preliminary search was conducted. The comprehensive search will include MEDLINE (PubMed), CINAHL (EBSCO), ERIC (EBSCO) and MLA (EBSCO). OpenGrey (DANS) and reference lists of the included articles will be searched for grey literature and additional articles. Two independent reviewers will screen titles and abstracts, then review the full texts of articles. Data will be extracted using a data extraction form and will be presented in figures, tables and narrative syntheses, in line with the review questions. This review will include articles that describe the experiences of non-native-speaking nursing students, faculty or preceptors in undergraduate nursing education and clinical practice environment. Articles that report on language requirements, needs and assessment tools will also be considered as well as articles reporting on supportive activities and interventions within the study programmes. Articles related to exchange students or programmes will be excluded.

ETHICS AND DISSEMINATION

No ethical approval is required. The findings of the review will be disseminated through peer-review publication as well as oral and poster presentations at scientific conferences.

Minority Student Perspectives of Barriers, Supports, and Christian Virtues in an Undergraduate Christian Nursing Program

ABSTRACT

Diversity and inclusion are critical priorities in nursing education programs. Literature has focused on minority student experiences of barriers and supports-but not through a Christian worldview. This qualitative study using a phenomenological-hermenuetic approach gave voice to the experiences of 15 self-identified minority student graduates from a Christian baccalaureate nursing program. Data analysis revealed opportunities for growth in providing a supportive climate within the program and how Christian virtues of hospitality, humility, and reconciliation can be employed to achieve this goal.

Perspectives of Ethnically and Racially Diverse Nurse Faculty on the Success of Ethnically and Racially Diverse Nursing Students

BACKGROUND

Ethnically and racially diverse (ERD) nursing students experience unique challenges in the educational environment. Existing research on perspectives of ERD nurse faculty, with emphasis on their perceptions of the factors that support the academic success of ERD nursing students is limited.

PURPOSE

The purpose of this study was to explore factors that contribute to the success of ERD nursing students as perceived by ERD nurse faculty.

METHODS

This qualitative study was conducted utilizing a focused ethnography design and methodology, with the theoretical underpinning of Critical Race Theory.

RESULTS

Twelve themes emerged relating to support, resources, relationships, faculty hiring practices, program structure, instructional content, flexibility, and culture of the educational environment.

CONCLUSIONS

The perspectives of ERD nurse faculty provide an essential body of information that program administrators, faculty, and staff can utilize to positively impact the academic success of ERD nursing students.

Predictors of attrition and program dismissal in a nursing major

BACKGROUND

Increasing the representation of nurses and other health professionals from minority populations is one way to address health disparities. The purpose of this study was to investigate nursing admission criteria that predicted first, second, third semester attrition and program dismissal.

METHOD

A retrospective secondary data analysis was conducted on existing student records spanning from 2016 to 2020 in one BSN program from a Hispanic-serving institution to gain an understanding about program attrition and dismissal. A total of n = 349 student records were included in the analysis.

RESULTS

Pre-nursing science GPA, pre-nursing college GPA, and reading ability were found significant predictors for attrition and dismissal, respectively.

CONCLUSIONS

Aptitudes in the sciences and in reading should be emphasized in pre-nursing to enhance student success in nursing. Findings from this study could inform administrators in postsecondary and in secondary education about establishing infrastructures for at-risk students to better prepare the latter for a nursing major.

Modeling the social determinants of resilience in health professions students: impact on psychological adjustment

Stressors inherent to training and stemming from the learning environment are associated with high rates of burnout, depression, and mental health problems in health professions students (HPS). There is evidence that disadvantaged or stigmatized groups are particularly affected. These problems not only impact students after graduation but may also have detrimental effects on patient outcomes. Resilience, conceptualized as the process of adapting well in the face of adversity, has inspired an increasing number of interventions aimed at addressing those problems in HPS. These interventions have mostly targeted individual students and their psychological traits while ignoring social and structural factors that may enhance or undermine individual resilience. To address this gap in the literature, the authors reviewed the evidence for psychosocial determinants of resilience and proposed a model inspired by the social determinants of health literature and the "upstream-downstream" metaphor. In this theoretical paper, the authors propose that upstream determinants such adverse childhood experiences and socioeconomic and sociodemographic markers of disadvantage have a direct effect on psychological adjustment and an indirect effect mediated by resilience. Additionally, the authors propose that the institutional downstream drivers of learning environment, social support, and sense of belonging moderate the direct and indirect effects of the upstream determinants on psychological adjustment. Future research should test these hypotheses and gather evidence that may guide the development of interventions. The authors present their model as part of a comprehensive response to recent calls to action to address diversity, equity and inclusion in health professions education.

A Mentoring Initiative for Students at Historically Black Colleges and Universities: One Strategy to Increase Nursing Workforce Diversity and Advance Health Equity

This article addresses low retention and graduation rates among historically marginalized students in nursing programs at Historically Black Colleges and Universities (HBCUs). Mentoring is a proven success strategy to support systems for historically marginalized students, helping them navigate challenges, improving academic outcomes, and increasing the diversity of the nursing workforce. The article highlights the mentoring initiative of AARP's Center for Health Equity through Nursing and the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and the Robert Wood Johnson Foundation, and the outcomes of this collaboration. The paper details the implementation of a mentoring initiative to enhance graduation rates and National Council Licensure Examination (NCLEX) success among historically marginalized students and emphasizes collaboration among institutions and organizations, as well as strategies for funding, mentor recruitment, and NCLEX preparation. Recommendations include promoting robust mentoring programs, preparing mentors, and conducting further research on the effects of mentoring on student outcomes in HBCUs.

Linguistic Modification When Developing Case Studies: An Integrative Review

BACKGROUND

Students from culturally and linguistically diverse backgrounds experience language barriers that influence their progression through nursing programs. Linguistic modification is a strategy that eliminates unnecessary wording and cultural bias to improve learning outcomes for students from diverse backgrounds. This integrative review adds to the knowledge of best practices in linguistic modification that can be applied to designing case studies for nursing students with diverse backgrounds.

METHOD

A comprehensive review of the literature was conducted in scholarly scientific databases from 2002 to the present.

RESULTS

Twenty-three articles discussed linguistic modification or summarized previous literature. Only four research studies were found pertaining to linguistic modification for culturally and linguistically diverse nursing students. Faculty and student practices that ameliorated language barriers were identified.

CONCLUSION

The use of linguistic modification throughout a nursing curriculum creates an inclusive learning environment. Further research is needed on linguistic modification in nursing education. [J Nurs Educ. 2023;62(9):495-501.].

Perspectives and corrective processes: Evaluating social justice in a nursing PhD program

Efforts to integrate tenets of social justice into PhD nursing programs are long-standing but have intensified in the past few years in response to civil unrest, threats to human rights, and health inequities exacerbated during the COVID-19 pandemic. In this paper, we present an overview of our School of Nursing's efforts and processes to evaluate and ensure that social justice principles were reflected throughout the PhD program. Components of this initiative included (a) forming a Social Justice Taskforce, (b) conducting listening sessions with alumni and currently enrolled PhD students to understand student experiences, (c) surveying PhD students to aid in prioritization of recommendations for improvement, and (d) convening key stakeholders to connect student priority areas to institutional programs and practices. Lessons learned through these activities highlighted the importance of gaining the perspective of diverse constituents and stakeholders, acknowledging areas for improvement, engaging students in transformative action, and partnering with faculty, staff, and leaders in solution development as we work to eliminate systemic injustices in PhD nursing education.

Barriers and facilitators to recruitment and retention of underrepresented racial and ethnic minoritized students to PhD programs in nursing: A qualitative descriptive study

BACKGROUND

There is a global shortage of Doctor of Philosophy (PhD)-trained nurses, which is amplified among underrepresented racial and ethnic groups who are minoritized.

PURPOSE

This study explores barriers and facilitators to recruiting under-represented racial-ethnic group who are minoritized (UREM) PhD nursing students, defined as African American, Black, American Indian, Alaskan Native, or Hispanic/Latinx.

METHODS

Using a qualitative descriptive design, interviews of 23 UREM PhD nursing students were analyzed with conventional content analysis.

DISCUSSION

Barriers to recruitment and retention included identifying students interested in a PhD, organizational culture of programs, student mental health, and lack of social support. Facilitators for recruitment and retention included less discrimination and microaggressions experienced by students, faculty from groups who are minoritized representation, and strong family support. These findings had implications for recruitment and retention and PhD programs in nursing can focus on the above key areas to better recuit and retain UREM students.

CONCLUSION

Allocating funding to culturally tailored mental health resources, student scholarships, and increasing UREM members of faculty within PhD programs.

Barriers and opportunities for promoting health professions careers among African American students in the Midwest

The purpose of our study is to examine the barriers and facilitators for urban African American students interested in pursuing health professions careers in the Midwest. In our analysis of the key informant interviews and focus groups, we identified four barriers (lack of preparation, lack of funding, lack of support/isolation, and perceived discrimination) and three facilitators (early preparation, support/mentorship, funding). We provide recommendations for how to leverage these facilitators and address the barriers to increase the representation of African Americans in the healthcare workforce. Novel future directions for this work should include comprehensive interventions tailored to URM students that span the health professions education pipeline and begin as early as elementary school. Interventions that engage mentors should take place at high school, undergraduate, and graduate health professions school levels.

Differential Grading of Reflective Writing Between Clinical Instructors and Faculty Type

BACKGROUND

It is important for instructors to give equivalent grades for comparable student performances on an assignment. Students complain of differential grading, especially when multiple instructors grade a course assignment.

METHOD

This descriptive comparative study examined clinical instructor-assigned grades for reflective thinking and writing components. Grades for 480 critical reflective papers by 80 undergraduate nursing students were assessed for differences between clinical group instructors and part-time versus full-time instructors.

RESULTS

Despite evidence of comparable student performance on the assignment across both groups, grades differed among the 10 instructors on both components. Grades differed between part-time and full-time faculty on reflective thinking but not writing, with part-time faculty grading reflective thinking higher than full-time faculty.

CONCLUSION

Differential grading was identified between clinical instructors and type of faculty. The merit of multiple instructors grading a single course assignment warrants reconsideration. Enhanced grading training is recommended for part-time instructors who are expected to grade written assignments. [J Nurs Educ. 2023;62(2):101-104.].

Prelicensure Nursing Students’ Reflections on Institutional Response to the 2020 COVID-19 Crisis

The study aimed to describe how prelicensure student nurses perceive academic support and their institutions’ response during the 2020 COVID-19 crisis. The shift to online learning caused by the COVID-19 pandemic disrupted every aspect of higher education, including pre-licensure nursing students. Prelicensure nursing education is one of the most stressful programs in higher education. In a period of great uncertainty, it becomes essential to explore how prelicensure nursing students perceive academic support from their institutions. A qualitative descriptive design was employed for the study. Thematic analysis was used to analyze data obtained from 16 semi-structured interviews. Six themes resulted from the data: Disorganization leading to chaos; technology and technical challenges; stress and frustration; am I prepared to be a nurse?; not having money; mental health matters. This study validates the experiences of nursing students. Students’ obstacles during the pandemic should be identified and mitigated to promote learning and academic success.

Clinical placements as a challenging opportunity in midwifery education: A qualitative study

AIM

The aim of this qualitative study was to explore some of the existing statuses of clinical education and examine the strengths and weaknesses of the clinical faculty programme.

DESIGN

A qualitative study.

METHODS

This qualitative study was designed through the directed content analysis approach, which was completed according to the Context, Input, Process, and Product evaluation model. The purposeful sampling method of maximum variation was employed to select 33 participants, and the data were collected through in-depth individual interviews and focus group discussion.

RESULTS

After the interview transcripts were analysed, the participants' opinions of the clinical faculty programme and the relevant challenges, dimensions and factors were classified into four categories and sixteen subcategories. The categories were compiled in the CIPP evaluation model, including context, input, process and product. Based on the content analysis results, appropriate planning was recommended for teaching effective clinical skills to students.

Examining Whiteness in Obstetric and Pediatric Simulations: A Content Analysis

BACKGROUND

Whiteness is a systemic construct that functions to make itself invisible and prevent its racialization. Whiteness informs the nursing profession on all levels and impacts how nurses learn, relate to, and perpetuate whiteness through structural, curricular, interpersonal, and ideological means. The aim of this study was to use an antiracist framework to analyze manifestations of whiteness in select prelicensure obstetric and pediatric clinical simulation scenarios at a large midwestern college of nursing.

METHODS

Nine prelicensure nursing simulations were analyzed for themes using qualitative content analysis.

RESULTS

Two themes related to whiteness emerged from the data-normalizing whiteness in assessment and othering.

CONCLUSION

Applying an antiracist framework in clinical nursing education can assist educators and students to see the embedded whiteness and racism in the curriculum and begin to address it. Additional analysis is needed to explore nurse educators and student perceptions of whiteness in simulations. [J Nurs Educ. 2021;60(12):690-696.].

The Dotson Bridge and Mentoring Program: A Diversity Success Story

BACKGROUND

Even though the Institute of Medicine released a report on the importance of ethnic diversity in the health care workforce to reduce health disparities, there has been little progress in increasing diversity in nursing.

PROBLEM

Nationally, health care systems do not have adequate representation of Black/African American, Asian, and Latino RNs.

APPROACH

The Dotson Bridge and Mentoring Program is an innovative mentoring program for African American, Latino, Asian, and Native American (ALANA) students.

CONCLUSION

Mentoring programs that support ALANA students can lead to an increase in retention, graduation, and NCLEX pass rates and should be an integral part of nursing programs. The outcomes of the program included improving the course pass rates from 50% to 92%, improving the first-time NCLEX pass rate from 74% to 94% and decreasing the attrition rate from 23% to 1%.

Developing a Social Determinants of Learning™ Framework: A Case Study

Supplemental digital content is available in the text.

AIM

The aim of the study was to propose a framework, social determinants of learning™ (SDOL™), an actionable model to address learning disparities and expand learning opportunities to support nursing student diversity, equity, and inclusion.

BACKGROUND

There is significant growth in the racial and ethnic diversity across students at all levels of higher education, mirroring the growing diversity of the US population. Yet, lower rates of persistence and higher attrition rates among these student groups continue.

METHOD

The authors established six socially imposed forces, causative domains, as foundational to the SDOL framework. Key attributes of each domain were identified through a literature search. A case study illustrates an initial study of interventions targeting specific domains of the framework aimed toward student success.

CONCLUSION

Equitable education for all has far-reaching implications across nursing education and higher education in general. Further development and testing of the SDOL framework will support the goal of equitable education for all.

A survey of midwifery graduates' opinions about midwifery education in Iran: a cross-sectional study

BACKGROUND

Attaining high-quality education requires continuous evaluation and revision of the curriculum. The view of the graduate students can provide valuable insight into the necessary evaluations and revisions. Therefore, this study aimed to evaluate the opinions of midwifery graduates about midwifery education in Iran METHODS: This was a descriptive cross-sectional study and the research data were collected through a census sampling procedure from all (82) midwifery graduates of the Nursing and Midwifery School of Shiraz University of Medical Sciences between 2018 and 2020. The data collection instrument was a validated researcher-made questionnaire derived from the Graduation Questionnaire (GQ) developed by the Association of American Medical Colleges (AAMC). The data were then analyzed using SPSS 22.

RESULTS

In this study, about 62% of the graduates were satisfied with the quality of the midwifery education they had received during the four-year program. Moreover, 61% of the graduates maintained that theoretical courses were well-integrated with the clinical experience they needed. The quality of the internships in different wards and departments was also evaluated from the viewpoints of the graduates, and the results indicated that they were relatively satisfied with their internship experiences. However, only 40% of the graduates were satisfied with the quality of their clinical evaluation, since they faced the most significant challenges in the clinical and maternity wards (47%) with the midwifery staff and gynecology residents and found the quality of facilities in the clinical program to be lacking. According to the participants, the quality of teaching was not good for some courses such as biochemistry and microbiology.

CONCLUSION

It seems that the midwifery curriculum needs to be constantly revised, aiming to improve student satisfaction with their midwifery education. Some effective measures in this regard are employing experienced professors, developing cooperation between midwifery instructors and clinical departments, and trying to improve the educational environment. Attention to the improvement of facilities and equipment and agreement between the content of the theoretical education and practical topics are also recommended to improve the quality of midwifery education.

A Nurse Educator's Perspective About Institutional Racism and White Supremacy in Nursing Education

In the United States, nursing education programs at mostly white institutions are led by faculty that are 80% white. This absence of diversity is a symptom of systemic racism and white supremacy, reinforced through built systems of inequity and economic constraints that influence accessibility of nursing education programs. White cultural norms drive standards of professionalism and assimilation within nursing education programs. These standards are formulated from white cultural supremacy and contribute to the unconscious biases of nursing faculty. It is necessary to examine these biases to reduce potential and realized inequities for students of color in current nursing education programs. Challenging and changing these cultural norms can contribute to the dismantling of systemic racism and white supremacy in nursing education and the profession of nursing, thereby increasing the diversity of the professional workforce.

The Lived Experience of Stress in Latinx Nursing Students: Implications for Recruitment and Retention

BACKGROUND

Health leadership groups have identified a need for more culturally competent nurses as a means to reduce health disparities. Nurses who identify as minorities are more likely to practice in underserved areas with minority populations, leading to more effective, culturally competent care. Despite efforts to increase the number of minority students graduating from nursing programs, the number remains disproportionately low and little is known about the specific experiences of the stressors experienced by these students.

METHOD

This qualitative phenomenological study used focus group interviews to explore the lived experiences of stress in Latinx prelicensure nursing students.

RESULTS

Five main themes emerged: Stress of Coursework, School-Life Balance, Navigating Uncharted Territory, Feeling Unsupported, and Staying the Course.

CONCLUSION

Findings help paint a picture of the experiences of Latinx students. Understanding the experiences of stress in Latinx nursing students can help to improve nursing recruitment and retainment efforts, which will increase the number of culturally competent nurses and ultimately help to reduce health disparities within the Latinx community. [J Nurs Educ. 2021;61(1):6-12.].

An evaluation of the Veterans Health Administration National Nursing Education Initiative

BACKGROUND

Since 1999, the Veterans Health Administration's (VHA) National Nursing Education Initiative (NNEI) has provided 16,294 scholarships for registered nurses to attain baccalaureate and advanced nursing degrees.

PURPOSE

The goal of this evaluation was to determine factors that enhanced or hindered a scholarship recipient in the completion of their degree and service obligation.

METHODS

A regression analysis was performed to identify predictors of degree completion for 10,043 participants in 162 VHA facilities.

FINDINGS

Significant predictor variables for degree completion were intended occupation, entry degree, gender, age, and year entering the program. Eighty-six percent (86.7%) of participants completed the degree requirement. Of those who completed their degree, 97% completed the service obligation.

DISCUSSION

As recruitment and retention initiative, NNEI scholarships are poised to address the VHA nursing staffing shortages as well as build a highly qualified nursing workforce capable of providing the best care to our Nation's Veterans.

Accent bias: A barrier to Black African-born nurses seeking managerial and faculty positions in the United States

The purpose of this study was to examine the perceptions of Black African-born nurses (BABN) with non-native accents regarding their nursing career advancement in the United States. Data were collected using individual interviews. Fifteen nurses originally from three sub-Saharan African countries were included in the study. The findings were reported under six themes: perceived low level of intelligence, not suitable to lead, making fun of/belittling, prejudging without evidence, downgrading, and accent modification. The finding indicated that participants believed that their race and accent influenced their professional nursing opportunities. These results are relevant to BABNs, nurse educators, and healthcare organization leaders. BABNs are capable of participating in nursing leadership and education despite their non-native accent.

Outsiders in Nursing - Voices of Black African Born Nurses & Students in the US: An Integrative Review

Purpose:

The purpose of this integrative review was to describe the experience of being outsiders in nursing as described by Black African Born Nurses and Student Nurses (BABN&SN) in the U.S., give voice to their experiences in U.S. academia and healthcare settings, discuss the implications of the BABN&SN othering on the U.S. healthcare systems, and offer recommendations to address the issues based on the literature.

Methods:

An integrative review approach discussed by Whittemore and Knafl was utilized to review literature from nursing journal published from 2008 to 2019.

Results:

Major findings include collegial/peer isolation and loneliness; racism and discrimination, unwelcoming environment, silencing of voices, personal resilience, and sense of belonging. The results of this review indicate that BABN&SN experience in U.S. nursing contribute to harrowing periods of feeling like ‘an outsider.’

Conclusions:

BABN&SN are integral part of the U.S. nursing workforce and the healthcare system. Academic and work environments that support all nurses and students, despite their perceived differences, are essential to promoting an inclusive environment. Understanding the relational pattern that guides the BABN&SN socialization into nursing is vital to developing targeted support especially when entering the clinical practice environment.

Development and Validation of a Marginality Index for Nursing Students

AIM

The purpose of this study was to develop a marginality tool that speaks specifically to the domain of nursing education.

BACKGROUND

Minority nursing students in the United States have consistently reported feelings associated with the process of marginalization. Given the dearth of instruments that measure marginality directly, the concept has not been sufficiently investigated in nursing students METHOD: The Englund Marginality Index (EMI) was administered to 323 nursing students currently enrolled in a baccalaureate nursing program in Wisconsin. A psychometric evaluation of the index was performed.

RESULTS

The EMI consists of 19 items and explained 70 percent of the variance. Cronbach's α coefficient for the instrument was .90. Test-retest correlation was strong at r = .92, a strong support for the temporal stability of the instrument.

CONCLUSION

The findings from this study demonstrate that the EMI is a valid and reliable measure of marginality.

Nursing workforce diversity: Promising educational practices

BACKGROUND

Nursing workforce diversity is a national priority for providing culturally competent care and contributing to improved health equity. While nurses from underrepresented populations are increasing in the nursing workforce, the distribution of nurses in the United States is still not representative of the population.

PURPOSE

The purpose of this paper is to describe the current state of workforce diversity in Western states and identify promising practices from programs located in Arizona, California, Colorado, and Oregon that are focused on improving nursing workforce diversity.

METHODS

Four innovative programs to address nursing workforce diversity are presented. Each project has unique situations and approaches to improving admission, retention, and graduation of students underrepresented in nursing. Similar approaches each project used include holistic admission review, academic and student support, financial support, and mentoring.

CONCLUSIONS

These projects contribute to knowledge development related to improving nursing workforce diversity for other colleges, universities, and states to consider. Improving nursing workforce diversity is a priority issue that could lead, through collective impact, to resolving health inequities nationally.

Exploring the experiences of being an ethnic minority student within undergraduate nurse education: a qualitative study

BACKGROUND

Students studying in a country where another language is spoken face multiple challenges including their ability to fully integrate with peers and academic pressures in trying to obtain an undergraduate nursing degree. The aim of the study was to explore the lived experiences of students, from varying cultural and ethnic backgrounds, undertaking an undergraduate nursing degree.

METHODS

The study adopted a qualitative design and eight individual semi-structured interviews were conducted. The interviews were analysed using manifest content analysis according to Graneheim and Lundman.

RESULTS

Students reported feelings of isolation and the lack of opportunities to integrate with native students within academia and practice. The need for personal support was a crucial factor that was independent of gender and students reported challenges related to both language and culture during the programme.

CONCLUSIONS

Suggestions arising from this study includes appropriate support systems within academia and practice. It is imperative that universities and practice settings promote and integrate cultural awareness within academia and practice in meeting the needs of students and providing culturally appropriate nursing care, thereby providing opportunities for all students to become competent and professional practitioners.

The Lived Experience of Nursing Students with Culturally and Linguistically Diverse (CALD) Backgrounds in Italy: A Descriptive Phenomenological Study

Introduction: In recent decades, Italy has been exposed to significant migrant flows resulting from political and economic instability in neighbouring countries. As a result, there has been an increased amount of cultural and linguistic diversity (CALD) among nursing students. The aim of this study was to explore the experience of CALD nursing students as lived in the Italian nursing programmes. Method: A descriptive phenomenological method was used in 2017 with the involvement of a purposeful sample of 21 CALD nursing students in five Italian Bachelor of Nursing Science campuses. Data were collected using semistructured interviews; the subsequent content analysis was conducted by two independent researchers. Results: CALD nursing students reported having lived a transformative experience based on seven themes, from “living in the middle, between belonging and detachment” to “acquiring cultural awareness and cultural sensitivity.” Discussion: Dealing with linguistic and cultural differences can affected CALD students’ academic success, but also encourages them to develop awareness and cultural sensitivity by influencing their peers and the environment of the nursing programme. Therefore, having CALD students is a great value for nursing programmes. Nursing programmes should embody the values of cultural sensitivity and acceptance, including them as a nursing care value and as a concrete strategy to support CALD students. They should also develop strategies to promote the knowledge and responsibilities of nurses among CALD students and increase cultural sensitivity among faculty members at different levels.

Baccalaureate Nursing Education Experiences of African-Born Nurses in the United States

BACKGROUND

African-born nurses are valuable members of the U.S. nursing workforce. The majority begin their nursing education in community colleges and practice as licensed practical nurses/vocational nurses (LPN/VNs) and RNs before obtaining their Bachelor of Science in Nursing (BSN) degree. For African-born nursing students, the environment of 4-year institutions, although exciting and promising, may be overwhelming and challenging.

METHOD

In this qualitative descriptive study, 25 African-born nurses who graduated from accredited RN-to-BSN programs over a period of 5 years were interviewed. Qualitative content analysis was used to analyze the data.

RESULTS

Several factors including flexible curricular designs and helpful campus resources supported students' educational experiences. Factors such as financial difficulties and difficult work-family-school balances challenged them.

CONCLUSION

The BSN curriculum is especially rigorous and demanding for foreign-born minority students. Such programs must provide appropriate resources to support students who are new to U.S. education system. [J Nurs Educ. 2019;58(5):281-289.].

Life at the Margins: Marginality and Race in Undergraduate Students and Faculty

The United States has become increasingly diverse, but this same rise in diversity is not reflected in the nursing profession. The purpose of this study was to investigate the relationship between marginality and minority status for nursing students in two states with very different racial/ethnic minority profiles. Marginality was measured using the Koci Marginality Index. When comparing students by geographical region, there were statistically significant differences between the two groups with regard to the marginality subconcepts of intermediacy, differentiation, power, secrecy, voice, liminality, and reflectiveness. Data were also collected from nurse faculty at each of the universities in Texas and Wisconsin. Findings suggest that there are significant differences between the two faculty samples with regard to advising, tutoring, and mentoring activities, as well as referral of minority students to campus resources. Marginalization is a complicated, deeply entrenched issue that continues to significantly impact minority nursing students across the nation.

Differences in Gender-related Profile Characteristics, Perceptions, and Outcomes of Accelerated Second Degree Nursing Students

BACKGROUND

The New Careers in Nursing (NCIN) program provided scholarships and other supports to accelerated degree students at 130 nursing schools and collected data from the scholars at three time-points.

PURPOSE

The NCIN database was analyzed to identify gender-based differences in scholars' profile characteristics, program experiences, and post-graduation outcomes.

METHOD

An adaptation of Jeffreys's Nursing Universal Retention and Success Model guided the analysis. Gender differences were assessed after multiplicity adjustments for false positive rates.

RESULTS

Differences based on gender were found for profile characteristics, student affective factors, academic factors, professional integration factors, environmental factors, as well as academic, psychological and NCIN program outcomes. Results suggest that males were influenced by economic factors more than females when choosing nursing as a career. They had fewer concerns about financial aspects associated with being a student again yet secured employment sooner after graduation than female scholars. They did not view support services as important as did female students. They expressed confidence in their leadership competence more than their female counterparts.

CONCLUSION

Efforts are needed to better understand and address the nuanced gender-based perceptions and needs of nursing students who are male.

Exploring Self-Perceptions of Anxiety among Nursing Students in the Clinical Setting and Select Demographics

Clinical learning experiences are essential in nursing education but they are often anxiety provoking for learners. Understanding the factors associated with the anxiety levels of nursing students in clinical placements has become more complex over the years with increasing heterogeneity within the nursing population. A correlational study was conducted to examine the relationships between nursing students’ self-perceived anxiety levels, as measured by the State-Trait Anxiety Inventory (STAI), and the students’ age, gender, previous employment, and previous education. The findings revealed that nursing students have a higher than average level of anxiety and that male nursing students reported higher levels of anxiety compared to female nursing students. No significant correlations were found between age, previous education, previous employment, and self-perceived anxiety levels. Findings from this study provide an opportunity for discussion by nursing educators and identify a need for future research and practice.

Challenges of PhD Graduated Nurses for Role Acceptance as a Clinical Educator: A Qualitative Study

Introduction: Clinical education is the core component of nursing education. PhD graduated nurses who are faculty members can play a main role in clinical instruction. However, there is not clear understanding about the challenges which they may encounter for accepting their role as clinical educator. The aim of this study was to explore the challenges of role acceptance by PhD aduated nurses who are faculty members.

Methods: In this qualitative exploratory study a total of 13 participants (8 PhD graduated in nursing, 3 head of departments of nursing, one educational vice chancellor of nursing school, and one nurse) were selected by purposive sampling method. Data were collected by semi-structured, face to face interview and analyzed by conventional content analysis approach developed by Graneheim and Lundman.

Results: The main theme emerged from data analysis was "identity threat". This theme had five categories including expectations beyond ability, lack of staff’s rely on the performance of PhD graduated nurses, poor clinical competencies, doubtfulness, and obligation.

Conclusion: PhD graduated nurses experienced some worries about their role as clinical educators and argued that they have not been prepared for their role. Therefore, policy makers and authorities of nursing schools should support PhD graduated nurses for accepting their new roles as clinical educators. Moreover, some changes in nursing PhD curriculum is needed to improve the clinical competencies of PhD graduated and prepare them for their role as a clinical educator.