Empowerment of nursing students in the United Kingdom and Japan: a cross-cultural study

The effect of combined training (theoretical-practical) of palliative care on perceived self-efficacy of nursing students

BACKGROUND

Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students.

METHODS

This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics.

RESULTS

The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05).

CONCLUSION

Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.

Critical Incident Techniques and Reflection in Nursing and Health Professions Education: Systematic Narrative Review

BACKGROUND

The terms critical incident technique and reflection are widely used but often not fully explained, resulting in ambiguity.

PURPOSE

The aims of this review were to map and describe existing approaches to recording or using critical incidents and reflection in nursing and health professions literature over the last decade; identify challenges, facilitating factors, strengths, and weaknesses; and discuss relevance for nursing education.

METHODS

A systematic narrative review was undertaken. MEDLINE and the Cumulative Index to Nursing and Allied Health Literature were searched using MeSH terms, returning 223 articles (2006-2017). After exclusions, 41 were reviewed.

RESULTS

Articles were categorized into 3 areas: descriptions of the development of an original tool or model, critical incidents or reflection on events used as a learning tool, and personal reflections on critical incidents.

CONCLUSIONS

Benefits have been identified in all areas. More attention is needed to the pedagogy of reflection and the role of educators in reflection.

A Japanese version of the stressors in nursing students (SINS) scale

OBJECTIVES

To translate and study the factor structure of a Japanese version of the Stressors in Nursing Students scale.

METHODS

The Stressors in Nursing Students scale was translated into Japanese and administered to a large cohort (N = 1298) of female Japanese nursing students across five universities and across all four years of the nursing programme. The data were analysed using exploratory factor analysis.

RESULTS

Exploratory factor analysis revealed four factors: 'Clinical'; 'Conflict and confidence'; 'Education'; and 'Free time'. The relationship between the total score on the Stressors in Nursing Students scale and the demographic aspects of the sample was weak but there was a significant increase in the perception of stressors between first and second year students.

CONCLUSIONS

There were similarities and differences between the perception of stressors by nursing students in Japan compared with, for example, the United Kingdom and China mainland. While a four-factor structure was found here, the distribution of items in the Stressors in Nursing Students scale differed from previous studies in the United Kingdom and China with the 'Free time' factor being unique to this study. Stress is an issue for nursing students and is related to the specific stressors they encounter in the process of their work and study. Findings can inform the development of strategies to reduce such stressors among nursing students in multiple, global contexts.

Graduating nurses' self-efficacy in palliative care practice: An exploratory study

BACKGROUND

Educational institutions and the health care industry agree that graduates from professional programs need to be "work ready" and capable of delivering competent and confident nursing care. One measure of program success is the student's self-efficacy in meeting expected graduate capabilities. In this study student's self-efficacy is related to palliative care graduate capabilities.

AIM

To explore graduating Bachelor of Nursing Science (BNSc) students' self-efficacy in caring for palliative care patients.

DESIGN

A qualitative design using semi-structured face-to-face interviews.

SETTING

A regional Australian university.

PARTICIPANTS

A purposive sample of 10 students in their final semester of study in a Bachelor of Nursing Science degree program.

METHOD

Semi-structured face-to-face interviews were conducted. Interview questions were informed by published palliative care graduate capabilities. Interview data were transcribed verbatim and coded by capability. The coded data were then analysed to determine evidence of self-efficacy in caring for palliative care patients.

RESULTS

All participants had experiences in caring for palliative care patients. However, the responses did not consistently reflect high degrees of self-efficacy in four documented palliative care graduate capabilities required to care for persons with a life-limiting illness.

CONCLUSIONS

The findings support others that have identified gaps between curriculum and health care industry requirements in terms of students' beliefs about their empowerment to deliver nursing care as graduates. Education interventions and approaches to program evaluation require further development to better support students' growth of self-efficacy in undertaking their graduate roles.

An exploration of Operating Department Practice students' experiences of placement support during their first perioperative clinical placement

BACKGROUND

National and International research shows student anxiety and stress levels are high during times of clinical practice, especially during initial placement allocations. Current literature stresses the importance of preparing students for clinical placements but it is not clear what information students require to adequately prepare them. This study explored Operating Department Practice students' experiences during their first placement.

METHODS

A focus group approach was used to explore the experiences of Operating Department Practice students immediately following their first clinical placements. Following pilot study work a small focus group study was conducted. Data were analysed thematically providing a large amount of in-depth rich data.

FINDINGS

Three main themes were identified; information, placement and learning experience. Students highlighted inconsistencies in their mentoring, exacerbated by inaccurate information provided by the university. Students felt confused as a result.

CONCLUSION

It was found important for students to feel welcomed and supported by the mentoring processes in order to foster a sense of belonging. Information given by the university should be accurate and effective. This can only be achieved by closer collaboration between the university and practice providers.

Factors influencing student nurse decisions to report poor practice witnessed while on placement

BACKGROUND

While it is commonly accepted that nursing care is generally of a good standard, it would be naïve to think that this is always the case. Over recent years, concern about aspects of the quality of some nursing care has grown. In tandem with this, there is recognition that nurses do not always report poor practice. As future registrants, student nurses have a role to play in changing this culture. We know, however, relatively little about the factors that influence student decisions on whether or not to report. In the absence of a more nuanced understanding of this issue, we run the risk of assuming students will speak out simply because we say they should.

OBJECTIVES

To explore influences on student decisions about whether or not to report poor clinical practice, which is a result of deliberate action and which is witnessed while on placement.

METHODS

Qualitative interviews were conducted with thirteen pre-registration nursing students from the UK. Participants included both adult and mental health nurses with an age range from 20 to 47. Data were analysed to identify key themes. Category integrity and fit with data were confirmed by a team member following initial analysis.

RESULTS

Four themes. The first of these, 'I had no choice' described the personal and ethical drivers which influenced students to report. 'Consequences for self' and 'Living with ambiguity' provide an account of why some students struggle to report, while 'Being prepared' summarised arguments both for and against reporting concerns.

CONCLUSION

While there is a drive to promote openness in health care settings and an expectation that staff will raise concerns the reality is that the decision to do this can be very difficult. This is the case for some student nurses. Our results suggest ways in which educationalists might intervene to support students who witness poor practice to report.

Empowerment an essential ingredient in the clinical environment: a review of the literature

Empowerment is an important concept worthy of attention in healthcare. The merits of empowerment are irrefutable including benefits to the organisation and to the individual nurse. Empowered nurses contribute to the clinical learning environment in a positive way. There is a dearth of literature on how or indeed if nursing students are empowered. The process of empowering registered staff/nursing students is not clear. Ward environment and culture are important contributors to patient care, patient safety and staff well-being. It is therefore necessary to address how empowerment can contribute positively to improving the environment in which care is provided.

Attitudes Toward and Justification for Wife Abuse Among Syrian Medical and Nursing Students

Purpose:

To explore the perceptions of and attitudes toward violence and beliefs of contextual justification of wife abuse among Syrian medical and nursing students.

Design and Method:

A descriptive, cross-sectional design was used. The Perceptions of and Attitudes toward Wife Abuse Questionnaire was used to collect data from a convenience sample of 621 medical and nursing students from three public universities in Syria.

Results:

Only 18.4% of the students had positive attitudes toward interpersonal violence reflecting low tolerance to wife beating and use of physical force for problem solving and child discipline, and 16.1% did not justify wife beating. Medical, older, female students, from urban areas, with more educated parents, and those who did not experience violence or witness violence between their parents had significantly more positive attitudes toward wife abuse and significantly less justification of wife beating ( p < .05).

Conclusion and Implications:

Education about violence against women of future medical and nursing students is the responsibility of medical and nursing educators and health policy makers, who have to acknowledge the influence of the sociocultural factors in shaping student’s attitudes toward wife abuse and develop strategies to enhance these attitudes at the early stages of professional preparation.

'With a bit of tweaking…we could be great'. An exploratory study of the perceptions of students on working with older people in a preregistration BSc (Hons) Nursing course

BACKGROUND

With ageing demographics, it is important that nurse education curriculum can prepare students to work with older people.

AIMS AND OBJECTIVES

To explore students' perceptions of working with older people and the extent to which their preregistration curriculum is preparing them for this role.

DESIGN

A qualitative research design, incorporating focus groups in data collection.

METHODS

Four focus groups were held in January 2011, involving a total of 32 students undertaking a preregistration BSc (Hons) nursing degree course.

RESULTS

An overt focus in the preregistration curriculum on acute and critical care and perceived deficits in care of older people content left some students feeling underprepared to work with older people and to challenge ritualistic practice. Clinical placement experience and mentor support appeared to be influencing students' decisions about whether they would consider working with older people in the future.

CONCLUSION

Education providers should ensure that students are adequately prepared to work with older people and that students are supported when they observe poor practice. A finding that observation of ritualistic practice could prompt some students to consider working with older people, warrants further research. Implications for practice. Nurse educators should evaluate the content and delivery of their preregistration courses to ensure that the prerequisite knowledge, skills and attitudes required to work with older people are accorded appropriate value and attention.

Nurses' perceived work-related empowerment in Lithuanian context

STUDY'S RATIONALE: Empowerment is widely used within the nursing literature in different countries, but perceived empowerment of Lithuanian nurses has not been studied before. There is a lack of research which has analysed nurses' views and feelings of empowerment.

AIMS AND OBJECTIVES

The aim of this study was to describe the perception of Lithuanian nurses' work-related empowerment. The study describes how empowered the nurses felt in their work and how background factors were related to empowerment.

ETHICAL ISSUES

The permission to use the questionnaire was given by copyright holders. The questionnaire was approved by the Ethics Committee. RESEARCH METHODS AND INSTRUMENT: The data were collected using a structured questionnaire comprised of two parts: the background questions and the Work Empowerment Questionnaire divided into three areas: verbal, behavioural, and outcome empowerment. The data were analysed statistically using SPSS, and Microsoft Excel programs. The descriptive statistics, non-parametric tests and Spearman correlations were conducted. The sample consisted of 212 participants.

RESULTS

The nurses experienced strong general empowerment (mean 7.9; max 10.0). They were more confident in their abilities to perform actions related to behavioural (mean 8.3) and verbal (mean 8.0) empowerment, and less confident in outcome (mean 7.3) empowerment. All aspects of empowerment were closely related to each other (p ≤ 0.001). Several significant relations were found between the aspects of empowerment and the background variables.

STUDY LIMITATIONS

The Work Empowerment Questionnaire used in the study was originally developed in Canada. Differences in language, culture, health care organizations, and nursing practice may affect the validity of translated questionnaire in Baltic context.

CONCLUSIONS

To prepare nurses for roles in which they may successfully exercise the power to create change, they need experience the process of empowerment during their education, and experience later supportive management.

Inconsistent use of the critical incident technique in nursing research

AIM

This paper is a critique of the use of critical incident technique in nursing and a demonstration of how its development has resulted in inconsistency and confusion.

BACKGROUND

Critical incident technique is used globally by nurse researchers to explore a plethora of nursing issues. Its main strengths are flexibility and adaptability, but its popularity has resulted in ambiguity and confusion.

DATA SOURCES

A search of the CINAHL database for the period 1956-2007 was performed using the search terms critical incident technique and nursing. Together with hand searching, this produced a total of 59 papers. The papers were analysed according to country of origin, research topic, sample size, data collection method, inclusion/exclusion criteria, data analysis and terminology. We then categorized the results of this analysis depending on similarities and differences in the papers.

DISCUSSION

We focus on two areas: methodology and terminology. From a methodological perspective critical incident technique has become inconsistent and in relation to terminology, the diverse language associated with the technique has created confusion. Moreover, issues of rigour may be compromised as a result of this inconsistency. A great deal of inconsistency has been created by nurse researchers' attempts to advance critical incident technique. This has led to confusion, which is not helpful for advancing nursing knowledge.

CONCLUSION

While embracing the continued development of critical incident technique, we advocate a standardized approach to its use. Unless nurse researchers are alert to the methodological and terminological inconsistencies in use of the critical incident technique, it risks becoming an interminable quagmire through which navigation will be impossible.

Power and empowerment in nursing: a fourth theoretical approach

AIM

This paper is a discussion of the use of poststructuralism as a means of exploring power and empowerment in nursing.

BACKGROUND

Power and empowerment are well-researched areas of nursing practice, but the issue of how to empower nurses and patients continues to cause debate. Power and empowerment are complex issues and other researchers have provided some clarity by proposing three theoretical approaches: critical social theory, organizational theory and social psychological theory. We support their work and propose an additional poststructural approach as a means of analyzing power and empowerment in nursing.

DISCUSSION

The concept of power in nursing may be critiqued by drawing on the work of Michel Foucault and paying particular attention to two areas: disciplinary power and knowledge/power relationships. Foucault's contention was that behaviour is standardized through disciplinary power and that power and knowledge are intertwined. Nurses who seek an understanding of empowerment must first grasp such workings as hierarchical observation, normalizing judgement, the examination, and power/knowledge relationships, and that cognizance of such issues can promote nursing practice that is empowering. They need to adopt a more critical stance to understanding power and empowerment in nursing, and one way of fostering such criticism is to view nursing practice through a poststructural lens.

CONCLUSION

A poststructural approach merits a place alongside other approaches to understanding power and empowerment in nursing.