The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education

Effects of the project on enhancement of teaching skills in gerontic nursing practice of Indonesian nursing lecturer and clinical nurse preceptor

The Indonesia health care services require knowledgeable and skilled nurses as professional service providers, especially in a gerontic nursing area. Moreover, widening the gap between academic and clinical practice is also an issue, which affects the care service quality. In these circumstances, the project to enhance the educational skills of nursing lecturers and clinical nurse preceptors in gerontic nursing practice was started in 2020. Japanese nursing education experts provided guidance on the principle theory of nursing practice in basic nursing education and conducted workshops to develop nursing practice materials for 10 Indonesian trainees. The project provided 3 webinars for more than 100 Indonesian nursing lecturers and preceptors each time, 18 workshops and developed 2 virtual reality (VR) materials, 8 supervisions of the trial class and 5 lectures onsite and online. This study aimed to clarify the effects of the project evaluated in the process and its impact using a questionnaire survey and interviews conducted. The results of the questionnaire survey for students showed that 20% of their knowledge and skills in gerontic nursing, increased and the extent of understanding and satisfaction was high. Lecurers and preceptors perceived improvement in their teaching skills, especially in theoretical thinking and evidence-based teaching methods. Notably, "the evaluation from others" would be a facilitating factor of the project. The project effects were clarified and achieved the goal and objectives of the project.

Determining Self-Efficacy of Nurses Who Graduated From Distance Education Because of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

BACKGROUND

The current literature states that distance education has caused a lack of professional skills, regression of existing professional skills (Kaya & Akin Isik, 2021; Kürtüncü & Kurt, 2020), a lack of self-confidence, and feelings of inadequacy among nursing students (George et al., 2020). The current study examined the professional self-efficacy of nurses who graduated from distance education because of the coronavirus disease 2019 pandemic.

METHOD

This multicenter cross-sectional study was conducted between November 2020 and June 2022 with 164 nurses who graduated from distance education in 2020-2021 from three faculties of health sciences.

RESULTS

Professional self-efficacy of the nurses was found to be above average. Male nurses and nurses who believed distance education had a negative impact on their professional skills had significantly higher professional self-efficacy. Some nurses reported that their professional theoretical knowledge was insufficient and defined the effect of distance education on their professional skills as relatively negative.

CONCLUSION

Most of the nurses expressed that distance education had a negative effect on their professional self-efficacy and working life. [J Contin Educ Nurs. 2023;54(10):480-488.].

Practical contribution of women development army on growth monitoring and promotion service at Dembya and Gondar Zuria districts, Central Gondar Zone, North West Ethiopia: a community based mixed study

BACKGROUND

The United Nations' Sustainable Development Goal (SDG)-2 aims to eliminate child hunger or end all forms of child malnutrition by 2030. To achieve this goal the cost-effective method is the implementation of growth monitoring and promotion service with the contribution of Women Development Army (WDA) as community volunteers. However, According to the data, the program's implementation varies throughout the country and lack of evidence on the practical contribution of the WDA to enhancing child nutritional care outcomes. Therefore this study aimed to determine practical contribution of WDA and associated factors on growth monitoring and promotion service in two rural districts of central Gondar zone, Northwest Ethiopia.

METHODS

A community based mixed study was conducted from March 6 to April 7, 2022 among 615 Women Development Army. Multistage sampling technique was used to select study participants. A structured questionnaire was used to collect quantitative data and in-depth interview were used to generate qualitative information. Qualitative data were coded and grouped and discussed using identified themes. Binary logistic regression was fitted, odds ratio with 95% confidence interval was estimated to identify factors of practical contribution of WDA and qualitative data was analyzed using thematic analysis.

RESULTS

In this study practical contribution of WDA on growth monitoring was 31.4% (95% CI: 28.0-35.3%). Having GMP training (AOR = 4.2, 95%CI: 1.63, 10.58), regular community conversation (AOR = 6.0, 95%CI: 3.12, 11.54), good knowledge about GMP (AOR = 2.1, 95%CI: 1.17, 3.83) and not having regular schedule of GMP service in the area (AOR = 0.04, 95%CI: 0.02, 0.09), were statistically significantly associated with practical contribution of growth monitoring. During in-depth interview, lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were mentioned among the problems faced during growth monitoring service.

CONCLUSION

In this study, practical contribution of growth monitoring among WDA was low. GMP training regular community conversation, knowledge about GMP and regular schedule of GMP service in the local area were significantly associated for practical contribution of growth monitoring service. Lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were reasons for did not contribute effectively for GMP service. Therefore, giving training for WDA and improving community conversation at kebeles level are important to improve GM service. .

Perceptions of nurse educators and nursing students on the model for facilitating 'presence' in large class settings through reflective practices: a contextual inquiry

BACKGROUND

Nursing education starts in the classroom environment with a focus on the nurse educator-nursing student relationship. 'Presence' is defined as "a practice where the caregiver relates her/himself to the other in an attentive and dedicated way, by doing so learns to see what is at stake for the other; from desires to fear, and, in connection with this, come to understand what could be done in this particular situation and who she/he can be for the other". 'Presence' forms an integral part of the nursing profession and the value thereof should be facilitated during teaching and learning. Reflective practices may offer a teaching-learning strategy to facilitate presence in nursing students by nurse educators in large class settings. Having large classes presents challenges including from nurse educators' lack of knowledge about alternative teaching approaches; time demands for designing, implementing and testing new teaching methods; a lack of confidence in implementing new teaching approaches in the classroom; selecting and grading assessments; as well as feelings of discomfort and anxiety. A model to facilitate presence through reflective practices has already been developed and published by the present authors. The model relies on well-established steps in theory development covering concept analysis, model development and description (published in two papers by the present researchers) and model evaluation (the subject of this paper). The evaluation was carried out by a panel of experts and nursing participants.

METHODS

An explorative and descriptive qualitative design was followed. The developed model was evaluated and refined in two steps (covered in this paper). In Step 1, the model was evaluated by a panel of experts in model development, reflective practices and presence. The panel used critical reflection resulting in the refinement of the model. Step 2 involved an empirical phase where the model was evaluated by participants through participatory evaluation. Participants were selected through purposive sampling. Data collection methods included online semi-structured focus group interviews with nurse educators and virtual World Café sessions with nursing students. Content analysis was done through open coding.

RESULTS

Five themes emerged from the empirical phase, namely: Theme 1: understanding of the model; Theme 2: benefits of the model; Theme 3: limitations of the model; Theme 4: pre-existing conditions needed for successful implementation of the model; and Theme 5: recommendations for further development of the model.

CONCLUSIONS

The results produced a refined model to be implemented into the curriculums of undergraduate, postgraduate and continuous professional development programmes across nursing education institutions. This model will significantly contribute to the body of knowledge and increase nurses' awareness of presence by transforming the way they feel, think, care and act in practice, which contributes to personal and professional development.

Positive and negative aspects of psychological stress in clinical education in nursing: A scoping review

BACKGROUND

Even though clinical practice is crucial for nursing students' personal and professional development, it is recurrently associated with stress. However, stressful situations may not only elicit negative responses, but positive responses as well, and such aspects should be further investigated.

AIM

To explore the literature addressing the positive and negative aspects of stress experienced by nursing students during clinical practicum.

DESIGN

This scoping review followed the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines.

DATA SOURCES

CINAHL, MEDLINE/PubMed, PsycINFO, Web of Science, IBECS, LILACS, BDENF and two theses and dissertations repositories.

REVIEW METHODS

Searches were conducted from June to August 2022. Studies addressing the positive and negative aspects of stress experienced by nursing students during clinical practice were included regardless of the method adopted.

RESULTS

This review included 32 studies published between 1999 and 2022 in 25 countries across four continents: Africa, America, Asia, and Europe. Stress can positively influence academic performance, especially in mobilizing a search for learning and professional development and in integrating theoretical knowledge and improving clinical skills and competencies. Negatively, stress can cause biopsychosocial symptoms that compromise a student's academic performance and can cause doubts and uncertainties about the construction of their professional identity.

CONCLUSIONS

Although the negative aspects stand out over the positive ones, it is evident that both are present in the clinical practice environment. When considering stress of nursing students, educators should conduct the teaching-learning process in order to reduce the negative impact and promote the positive side of stressful situations.

Exploration of nursing students' views on the theory-practice gap in surgical nursing education and its relationship with attitudes towards the profession and evidence-based practice

AIM

The aim of this study was to explore nursing students' views on the theory-practice gap in surgical nursing education and determine its relationship with attitudes towards the profession and evidence-based practice.

BACKGROUND

In nursing education, the discrepancy between the theoretical knowledge and clinical practices is known as the "theory-practice gap". Although this problem was defined many years ago, scientific information on the subject is very limited in terms of surgical nursing.

METHOD

This descriptive-analytical and cross-sectional study was carried out in three different universities in the Black Sea Region of Türkiye. The sample consisted of 389 nursing students. The data collection was carried out in May-July 2022 through the use of the following tools: The Attitude Scale for the Nursing Profession (ASNP), the Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice (KABQ-EBP) and the researchers made form to determine students' views on the theory-practice gap. The data were analysed with Student's t-test, multiple linear regression analysis.

RESULTS

72.8% of the students stated that they thought there was a discrepancy between their theoretical surgical nursing courses and clinical practice. While the total ASNP score of students who thought that there was a discrepancy between theoretical education and clinical practice was lower than that of the other students (p = 0.002), no difference was found among the students in terms of the total KABQ-EBP score (p > 0.05). In the multiple linear regression analysis, it was determined that thinking about gap (β = -0.125, p = 0.009), gender (β = -0.134, p = 0.006), willingness to choose the profession (β = 0.150, p = 0.002) and KABQ-EBP score (β = 0.247, p < 0.001) had significant effects on nursing students' attitudes towards the profession. In the model, %12 of the total variance was explained by the variables.

CONCLUSION

The study shows that the gap between theory and practice for the surgical nursing course is a problem perceived by most students. Also, students who thought that there was a theory-practice gap for the surgical nursing course had a more negative attitude towards the profession, while their attitudes towards evidence-based nursing were not different from others. The results of this study encourage further research to gain a better understanding of the impact of the gap between theory and practice on nursing students.

Effects of Debriefing on Motivation and Reflective Thinking of Nursing Students during In-School Practicum Using a Flipped Learning Model

Debriefing and flipped learning have been determined to be useful strategies for nursing education. Recently, it has been reported that applying debriefing and flipped learning together was helpful for educational outcomes. The objective of this study was to compare learning motivation and reflective thinking before and after debriefing during nursing practicums that applied flipped learning. We implemented a quasi-experimental procedure in the form of a pretest-posttest non-equivalent control group design (1 September to 22 October 2021). The participants comprised 63 nursing students in South Korea (33 in the experimental group and 30 in the control group). Each group took part in a nursing practice class, wherein the experimental group engaged in debriefing using flipped learning, while the control group engaged only in flipped learning. We then examined academic motivation and reflective thinking in both the groups, and found that reflective thinking was significantly higher in the experimental group (53.67 ± 5.71) versus the control group (50.80 ± 4.69) (t = 2.165, p = 0.034). However, there were no differences in learning motivation between the two groups (t = 1.864, p = 0.067). In sum, this study confirmed the benefits of this new teaching approach, in which debriefing and flipped learning were integrated and incorporated into a nursing practice class. Given our promising results, this approach can be applied in various cases to strengthen the clinical practice skills of nursing students.

Exploring the Usefulness of Theory-Guided Reflection During the COVID-19 Pandemic

During 2 massive open online course sessions in 2020-2021, learners shared lived experiences during the coronavirus disease-2019 (COVID-19) pandemic within a framework of theory-guided online discussion. We analyzed 211 COVID-19-related learner narratives from online discussion boards. Themes included sharing concerns and strategies related to patients separated from loved ones, honoring strengths in self and colleagues, valuing shared support among work colleagues, realizing the importance of self-care, voicing concerns about working conditions, and recognizing the impact of theory-guided shared reflection. Themes reflected personal knowing and attributes related to the American Association of Colleges of Nursing Essentials for Nursing Education. A Supplemental Digital Content video abstract is available at http://links.lww.com/ANS/A56.

Nurses’ Knowledge, Perceived Practice, and their Associated Factors regarding Deep Venous Thrombosis (DVT) Prevention in Amhara Region Comprehensive Specialized Hospitals, Northwest Ethiopia, 2021: A Cross-Sectional Study

Introduction

Deep venous thrombosis is a preventable and treatable cause of death among hospitalized patients. Nurses' knowledge and proper assessment can play a major role in improving deep venous thrombosis prevention care.

Objective

To assess the knowledge, practice, and associated factors towards deep venous thrombosis prevention among nurses working at Amhara region hospitals.

Methods

Institutional-based cross-sectional study was conducted among nurses working at Amhara region comprehensive specialized hospitals, Northwest, Ethiopia, from April 1 to 30, 2021. A simple random sampling technique was used to select 423 samples. A structured pretested self-administered questionnaire was used to collect data. Data were entered in epi-info version 7, analyzed using SPSS version 25, and presented by frequencies, percentages, and tables. Bivariable and multivariable logistic regression was computed, and P value < 0.05 was considered to identify statistically significant factors.

Result

Good knowledge and practice of nurses towards DVT prevention were 55.6% and 48.8%, respectively. Working at the medical ward [AOR 3.175, 95% CI (1.42, 7.11)], having a BSc degree [AOR = 3.248(1.245, 8.469)], Master's degree [AOR = 3.48, 95% CI (1.22, 9.89)], obtaining a formal training about deep venous thrombosis [AOR = 1.59; 95% CI (1.03, 2.47)], and working experience of ≥11 years [AOR = 2.11; 95% CI (1.07, 4.16)] were associated with good knowledge of nurses on the prevention of deep venous thrombosis. While having good knowledge about deep venous prevention AOR = 1.75; 95% CI (1.15, 2.65)] and working experience ≥11 years [AOR = 3.44; 95% CI (1.45, 8.13)] were significantly associated with nurses' practice about deep venous thrombosis prevention.

Conclusion

Knowledge and practice of the nurses regarding the prevention of deep venous thrombosis were found to be inadequate. Therefore, providing training, creating a conducive environment for sharing of experience, and upgrading the academic status of nurses are measures to scale up the knowledge and practice of nurses regarding deep venous thrombosis prevention.

Development and psychometric evaluation of nurses' perception towards the gap between knowledge and practice

AIM

The aim of the study was to develop a survey instrument and psychometrically evaluate nurses' perceptions of the gap between knowledge and practice. Although the nursing literature has widely documented a gap between knowledge and practice, no instrument has been developed to measure this gap.

DESIGN

Psychometric analysis was done on 513 nurses working in different positions at two large hospitals in Jeddah City.

METHODS

Cronbach's alpha was used to determine the internal consistency and reliability of the research instrument, and a panel of experts evaluated the validity of the tool's content.

RESULT

The content validity index computed from expert rankings was 0.89. Factor analysis yielded four major components: knowledge, practice, environment and learning. Cronbach's alpha indicated a high level of internal consistency and reliability for the component items. The newly developed scale will facilitate measuring nurses' perceptions of the knowledge-practice gap in clinical settings.

Sources of the knowledge-practice gap in nursing: Lessons from an integrative review

BACKGROUND

The ultimate value of learning lies in the transfer of knowledge to real-life settings. The gap between knowledge and practice can be described as the disconnection between acquired knowledge, the skills learned in nursing school, and those skills needed to practice safely and independently. This is a concerning issue that needs to be investigated deeply to address all the circumstances and factors contributing to the gap.

OBJECTIVES

To reveal the full range of factors leading to the knowledge-practice gap in nursing by means of a thorough survey of the most recent evidence and updates.

METHODS

An integrative review design was selected. Three data bases (MEDLINE, CINAHL Plus and ERIC) were searched electronically for research articles from 2009 up to June 2020 on the gap between knowledge and practice. The 406 articles that appeared were appraised for inclusion or exclusion using the JBI Critical Appraisal Checklist for qualitative research.

RESULT

Eight qualitative studies were included in the review, which identified three major themes and subthemes. The first theme is personal factors, with the following subthemes: internal motivation, learning style and attitude. The second theme is educational structure, with the following subthemes: clinical instructor role, preceptor effect and curriculum. The third theme is organisational characteristics, with the following subthemes: resources, clinical setting features and staffing.

CONCLUSION

The review revealed that the knowledge-practice gap has deep roots in multiple factors. Considering all dimensions of these factors is the key to bridging the knowledge-practice gap.

Correlation Between Academic and Clinical Practice Performance of Nursing Students at a Pediatrics and Child Health Nursing Course; Mizan-Tepi University, Ethiopia

BACKGROUND

Members of the nursing profession face problems in relating knowledge with practice. However, there was no study on the correlation between academic and practice performance of pediatrics nursing in Ethiopia.

METHODS

A cross-sectional study was conducted at Mizan-Tepi University using 396 nursing students' academic and practice achievements on a pediatric nursing course. SPSS version 21.0 was used for analysis. Spearman's rho correlation (rs), one way ANOVA, independent t-test and determination coefficient (R2) were computed at p<0.05.

RESULTS

The academic performance was strongly correlated with practice performance of the 2015 (rs (394) = 0.7, p<0.001) and 2017 (rs (394) = 0.7, p<0.001) batches of regular students. However, there was a moderate correlation between academic and practice performance for the batch of 2016 regular students (rs(394) = 0.43, p<0.001). There was a moderate correlation between academic and practice performance of the 2015 (rs (394) = 0.6) and 2016 (rs (394) = 0.51, p<0.001) batches of summer students. Linear regression analysis showed that academic performance explained 17.9% to 44.1% of variability in practice performance of the regular students. The linear regression analysis also showed that academic performance explained 26.5% to 41.2% of the variability in the practice performance of summer students. Independent T-test revealed significant mean performance difference by admission type (academic (t (144.7) = 6.43, p<0.001) and practice (t (115.5) = 5.71, p<0.001)). The mean performance difference significantly varied with sex both at academic (t (394) = 3.38, p=0.001) and practice (t (394) = 4.57, p<0.001) levels.

CONCLUSION

There was a moderate to strong correlation between academic and practice performance. In addition to academic performance, variation in practice was also explained by other factors which deserve more study. Enhancing academic performance can further increase practice performance. In general, the achievements of regular and male students at pediatrics was statistically significantly higher than their counterparts. Hence, female and summer nursing students deserve extra support from nurse educators to enhance their performance.

A nursing residency program: A window into clinical judgement and clinical decision making

The purpose of this descriptive, qualitative research study was to explore a nursing residency students' perception of clinical decision making and clinical judgment as evidenced through reflective journaling. Seven Registered Nurses completed a one year Baccalaureate Degree, while concurrently participating in a nursing residency. Reflective Journals focusing on clinical incidences during the residency were analyzed using the Tanner's Model of Clinical Judgement (2006). The residency experiences were noted as temporal in nature; with three phases evident; Beginning Residency, Thresholds in Nursing Residency and Homecoming in Nursing Residency. Eight themes were identified throughout the three phases. A nursing residency is an exceptional transformative pedagogical methodology for skill/knowledge acquisition allowing for a deeper engagement in enhanced confidence, self-analysis and progression to professional socialization. In addition, reflective journaling is a viable method for the self-analysis of clinical decision making through the experience of a nursing residency.

Developing and sustaining nurses' service improvement capability: a phenomenological study

BACKGROUND

Service improvement to enhance care quality is a key nursing responsibility and developing sustainable skills and knowledge to become confident, capable service improvement practitioners is important for nurses in order to continually improve practice. How this happens is an under-researched area.

AIM

A hermeneutic, longitudinal study in Northern England aimed to better understand the service improvement lived experiences of participants as they progressed from undergraduate adult nursing students to registrants.

METHOD

Twenty year 3 student adult nurses were purposively selected to participate in individual semi-structured interviews just prior to graduation and up to 12 months post-registration. Hermeneutic circle data analysis were used.

FINDINGS

Themes identified were service improvement learning in nursing; socialisation in nursing practice; power and powerlessness in the clinical setting; and overcoming service improvement challenges. At the end of the study, participants developed seven positive adaptive behaviours to support their service improvement practice and the 'model of self-efficacy in service improvement enablement' was developed.

CONCLUSION

This study provides a model to enable student and registered nurses to develop and sustain service improvement capability.

Identifying and Overcoming Barriers for Implementing Watson's Human Caring Science

The purposes of this paper are to identify and explore ways to overcome barriers to the implementation of Watson's human caring science in Iran. A literature search was done of PubMed, Elsevier, Science Direct, Ovid, ProQuest, Web of science, and Google Scholar between 1991 and 2018 using the search terms Watson's theory, clinical nursing, nursing theory, barriers to using theory, and carative factors or processes, separately and in combination. Organizational-level, practitioner-level, and educational barriers were found, and solutions for each are explored.

Alternative mental health clinical placements: Knowledge transfer and benefits for nursing practice outside mental healthcare settings

AIM AND OBJECTIVES

To explore whether nursing student's experiences at Recovery Camp have impacted their current nursing practices.

BACKGROUND

Recently, there has been a move towards more holistic models of nursing care, which seek to break down barriers of stigmatisation and embrace the tenets of self-determination, to acknowledge people with lived experiences of mental illness and their ability to manage their recovery. In that regard, future health professionals such as nursing students will need to be educated in a manner that recognises the importance of lived experience. In this paper, we propose that Recovery Camp, an alternative clinical placement setting model, enhances clinical practice in multiple domains and is beneficial for both nursing practitioners and people with lived experiences of mental illness, as well as offering an effective nontraditional alternative to conventional clinical placement opportunities.

METHODS

This study employed a phenomenological research design, involving individual semi-structured telephone interviews. The Standards for Reporting Qualitative Research (SRQR) checklist was adhered to.

RESULTS

Three main themes were identified from the analysis: (a) engagement, (b) understanding mental health and (c) holistic care. "I definitely look at people with mental health conditions in a different light." At Recovery Camp, participants felt that they had greater opportunities for engagement with people with lived experiences, and through this engagement, their preconceptions of mental illness began to change.

CONCLUSIONS

Recovery Camp may have facilitated the transfer of knowledge that is more person-centred among nursing students, consequently impacting their current nursing practices.

RELEVANCE TO CLINICAL PRACTICE

Nurses should be equipped with mental health skills regardless of their career trajectory. While Recovery Camp represents a promising approach to facilitate knowledge transfer, further investigation will be required to determine which other factors are instrumental. This approach may have wider implications for nursing education.

Power and Resistance: Nursing Students' Experiences in Mental Health Practicums

Mental health challenges are a leading health issue, and while nurses should be well positioned to provide care to this client population, nurses are not adequately prepared for this role during their education. This qualitative narrative inquiry explored nursing students' (N = 15) experiences within their mental health practicums. Analyzed through Foucault's concept of micropower, participants' narratives illustrate that students observed nurses holding power over patients, and enacted resistance to this power in a complex interplay of empowerment and disempowerment. Study findings speak to the need for systemic shifts in mental health practice and ongoing educator support of students in mental health practicums.

Student's Experiences on Learning Therapeutic Relationship: A Narrative Inquiry

Despite the importance of the therapeutic relationship on nursing practice, the literature regarding teaching and learning therapeutic relationship is limited. This paper discussed how an undergraduate nursing student learned therapeutic relationship in an acute care setting. Narrative inquiry was applied as a research methodology. The student's reflection served as the narrative in this paper. Collaboratively, researchers conducted data analysis, common themes were drawn, and a summative narrative was presented. Based on the student's narrative, a three-dimensional model, including practical knowledge, theory, and reflection, has been created as our summative narrative. This model suggests that, to facilitate a learning process on creating therapeutic nurse-patient relationship, practical knowledge is the foundation, theory is a leading guide, and constant reflection is a learning tool which transforms learning into a reflective and meaningful experience. To promote learning on therapeutic relationship, nurse educators should emphasize the importance of both practical knowledge and theory. Constant reflection as a learning tool should be encouraged and embedded in nursing curriculum. Diverse approaches of reflection should be promoted.

Assessment of Nursing Care and Teaching: A Qualitative Approach

BACKGROUND

The reform of the Spanish higher education to adapt to the European Higher Education Area involves, among other issues, the students' participation in the curriculum assessment. The aim is to understand the insights of both nursing professionals and current undergraduate students of nursing on the connection between the knowledge acquired throughout the degree and the professional healthcare practice.

METHODS

An exploratory, descriptive qualitative study was carried out at a Spanish University. By convenience sampling, twelve nursing professionals and twelve 4th-year students of the Degree in Nursing were included. In two phases, twelve semi-structured interviews and two focus groups were conducted in order to triangulate data. A thematic analysis of data was carried out, later to be coded by two researchers.

RESULTS

Two main themes were identified: Evidence-based nursing vs. experience-based nursing, and a theory-practice gap. The topics that were specifically highlighted were the coexistence between professionals who work according to evidence and those whose work is based on experience, and the lack of connection between the training received during the degree and actual healthcare practice.

CONCLUSION

Nursing care work varies in terms of the implementation of evidence-based care. Nursing training is perceived as being affected by a theory-practice gap. To achieve the linking between nursing theory and practice, a great effort on stakeholders would be needed.

"A great stress among students" - mental health nurses' views of medication education: A qualitative descriptive study

BACKGROUND

Registered mental health nurses report dissatisfaction with the level of medication knowledge demonstrated by undergraduate nurses. However, little is known about which particular areas staff nurses are concerned about, and how they feel education can be enhanced in both academic and clinical settings.

OBJECTIVE

To investigate the views of staff nurses on the delivery of medication education to undergraduate mental health nurses.

DESIGN

A qualitative descriptive design was adopted.

METHODS

Two focus groups were held with registered nurses in two acute mental health facilities. Data were analysed using qualitative content analysis.

RESULTS

The first theme reports on the difficulties staff nurses observed with both undergraduate and newly qualified nurses around medication. It was noted that these individuals had difficulties interpreting medication charts/Kardexes, and were unable to provide medication-related education to service users. The second theme reports on strategies to enhance medication education, as recommended by participants. It was suggested that more practical education should be delivered in academic settings, with a focus on simulation and presentations from clinical staff. In the clinical settings, it was suggested that preceptors should provide education at less busy times on the ward.

CONCLUSIONS

This study gives insight into areas in which education needs to be strengthened, in order to improve the medication knowledge of undergraduate and newly qualified nurses. Further research is needed to develop evidence-based strategies to enhance this education.

BETWEEN THOSE WHO THINK AND THOSE WHO DO: PRACTICE AND THEORY IN NURSE TEACHING

ABSTRACT Objective: to identify the opinions of professors about the relationship between theory and practice in nursing. Method: descriptive analytical, qualitative study. Eighteen professors from two universities (one federal and one private) from the southern region of the country participated. Data collection took place between July and September 2014, through semi-structured interviews. Open and axial coding as proposed by Strauss and Corbin, with the help of Atlas ti® 7 software was used for data collection. Results: the following categories emerged: The centrality of the practice for teaching and The specialist x generalist dichotomy: contrasting discourses. Conclusion: the opinions of professors about theory and practice in nursing are widely conflicting. In areas considered of greater complexity, mastery of content is prefered and considered advantageous. The relationships that nurses and nursing professors maintain with knowledge influence the disconnection between theory and practice.

Communication skills: placement reflections of a children's nursing student

Reflection is a natural human activity. It is important for nursing students during practice placements when they are making sense of clinical surroundings and making decisions about care. This article uses a reflective framework to consider the placement experiences of a third-year undergraduate children's nursing student in an acute general setting, caring for an adolescent with anorexia. It focuses on the decisions made when assisting an inexperienced junior doctor during a venepuncture procedure. Reflecting on placements provides nursing students with important transferable skills to use in practice as registered nurses.

The Impact of a New Pedagogical Intervention on Nursing Students' Knowledge Acquisition in Simulation-Based Learning: A Quasi-Experimental Study

Simulation-based learning is an effective technique for teaching nursing students' skills and knowledge related to patient deterioration. This study examined students' acquisition of theoretical knowledge about symptoms, pathophysiology, and nursing actions after implementing an educational intervention during simulation-based learning. A quasi-experimental study compared theoretical knowledge among two groups of students before and after implementation of the intervention. The intervention introduced the following new components to the existing technique: a knowledge test prior to the simulation, video-recording of the performance, and introduction of a structured observation form used by students and facilitator during observation and debriefing. The intervention group had significantly higher scores on a knowledge test conducted after the simulations in comparison to the scores in the control group. In both groups scores were highest on knowledge of symptoms and lowest on knowledge of pathophysiology; the intervention group had significantly higher scores than the control group on both topics. Students' theoretical knowledge of patient deterioration may be enhanced by improving the students' prerequisites for learning and by strengthening debriefing after simulation.

Nursing Students’ Knowledge of Palliative Care at a University in Turkey

Background and Purpose:

Nursing students must acquire knowledge and skills sufficient to deliver high-quality services. Previous studies indicated that students’ palliative care knowledge was insufficient. Few studies evaluating nursing students’ palliative care opinions and skills are available in Turkey. This study aimed to determine student nurses’ knowledge of palliative care.

Methods:

This descriptive survey study included 658 students. Researchers collected the data via a 19-item questionnaire. Frequency, percentage, and mean values were used in analysis of the data.

Results:

Only 5.3% of participants correctly answered all items, while 26.3% gave correct answers in line with palliative care theoretical framework, and 5.3% gave correct responses for symptom management. Students were found to be quite lacking in palliative care knowledge.

Implications for Practice:

A content increase in the curriculum could improve students’ theoretical knowledge. In addition, students can be incorporated, as team members, into the palliative care process beginning at patient diagnosis.

Learning Situations in Nursing Education: A Concept Analysis

Background and purpose:

The nursing student requires opportunities to learn within authentic contexts so as to enable safe and competent practice. One strategy to facilitate such learning is the creation of learning situations. A lack of studies on the learning situation in nursing and other health care fields has resulted in insufficient knowledge of the characteristics of the learning situation, its antecedents, and consequences. Nurse educators need to have comprehensive and practical knowledge of the definition and characteristics of the learning situation so as to enable their students to achieve enhanced learning outcomes. The aim of this study was to clarify the concept of the learning situation as it relates to the education of nurses and improve understanding of its characteristics, antecedents, and consequences.

Methods:

The Bonis method of concept analysis, as derived from the Rodgers’ evolutionary method, provided the framework for analysis. Data collection and analysis were undertaken in two phases: “interdisciplinary” and “intra-disciplinary.” The data source was a search of the literature, encompassing nursing and allied health care professions, published from 1975 to 2016.

Results:

No agreement on the conceptual phenomenon was discovered in the international literature. The concept of a learning situation was used generally in two ways and thus classified into the themes of: “formal/informal learning situation” and “biologic/nonbiologic learning situation.” Antecedents to the creation of a learning situation included personal and environmental factors. The characteristics of a learning situation were described in terms of being complex, dynamic, and offering potential and effective learning opportunities. Consequences of the learning situation included enhancement of the students’ learning, professionalization, and socialization into the professional role.

Implication for Practice:

The nurse educator, when considering the application of the concept of a learning situation in their educational planning, must acknowledge that the application of this concept will include the student’s clinical learning experiences. More studies are required to determine factors influencing the creation of a successful learning situation from the perspectives of nurse educators and nursing students, clinical nurses and patients.

Using National Measures of Patients' Perceptions of Health Care to Design and Debrief Clinical Simulations

This article describes an innovative approach to using national measures of patients' perspectives of quality health care. Nurses from a regional simulation consortium designed and executed a simulation using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to prepare nurses to improve care and, in turn, enhance patients' perceptions of care. The consortium is currently revising the reporting mechanism to collect data about specific learning objectives based on national quality indicator benchmarks, specifically HCAHPS. This revision reflects the changing needs of health care to include quality metrics in simulation.

Experiences of nursing undergraduates on a redesigned blended communication module: A descriptive qualitative study

BACKGROUND

Education is going through accelerated changes to accommodate the needs of contemporary students. However, there are ongoing concerns regarding the quality of education in communication skills for nurses and other healthcare professionals. Many studies have been conducted to evaluate the effectiveness of a blended learning pedagogical tool in enhancing the learning of nursing undergraduates. However, little is known about students' experiences of a blended learning model for teaching communication skills.

OBJECTIVE

To explore first year nursing students' experiences of the blended learning design adopted in a communication module.

DESIGN

A descriptive qualitative design was adopted.

SETTINGS AND PARTICIPANTS

Data were collected in the form of written reflections from 74 first year nursing undergraduates who were enrolled in a university-affiliated nursing school.

METHODS

Students were asked to complete an online reflective exercise regarding an undergraduate communication module on their last day of class, and the submitted reflections were analyzed. A thematic analysis was conducted and ethics approval was obtained for this study.

RESULTS

Six overarching themes and fifteen subthemes were generated. The six overarching themes were: 1) Helpful and engaging classroom experience, 2) valuable online activities, 3) meaningful assessment, 4) appreciation for interprofessional education, 5) personal enrichment, and 6) overall feedback and recommendations.

CONCLUSIONS

The students in this study felt that the blended pedagogy communication module enhanced their learning and boosted their confidence in facing similar situations. Interprofessional education was well-accepted among students as they attained a deeper understanding on the importance of interprofessional learning and an appreciation towards other professionals. Blended pedagogy can be used in teaching communication skills to nursing students to provide a holistic and up-to-date learning experience. Future studies should consider engaging students in face-to-face interviews to obtain a deeper understanding on their experiences of a blended pedagogy incorporated communication module.

Concept mapping to promote meaningful learning, help relate theory to practice and improve learning self-efficacy in Asian mental health nursing students: A mixed-methods pilot study

OBJECTIVES

Student nurses are provided with a great deal of knowledge within university, but they can find it difficult to relate theory to nursing practice. This study aimed to test the appropriateness and feasibility of assessing Novak's concept mapping as an educational strategy to strengthen the theory-practice link, encourage meaningful learning and enhance learning self-efficacy in nursing students.

DESIGN

This pilot study utilised a mixed-methods quasi-experimental design.

SETTING

The study was conducted in a University school of Nursing in Hong Kong.

PARTICIPANTS

A total of 40 third-year pre-registration Asian mental health nursing students completed the study; 12 in the concept mapping (CM) group and 28 in the usual teaching methods (UTM) group.

METHODS

The impact of concept mapping was evaluated thorough analysis of quantitative changes in students' learning self-efficacy, analysis of the structure and contents of the concept maps (CM group), a quantitative measure of students' opinions about their reflective learning activities and content analysis of qualitative data from reflective written accounts (CM group).

RESULTS

There were no significant differences in self-reported learning self-efficacy between the two groups (p=0.38). The concept mapping helped students identify their current level of understanding, but the increased awareness may cause an initial drop in learning self-efficacy. The results highlight that most CM students were able to demonstrate meaningful learning and perceived that concept mapping was a useful reflective learning strategy to help them to link theory and practice.

CONCLUSIONS

The results provide preliminary evidence that the concept mapping approach can be useful to help mental health nursing students visualise their learning progress and encourage the integration of theoretical knowledge with clinical knowledge. Combining concept mapping data with quantitative measures and qualitative reflective journal data appears to be a useful way of assessing and understanding the effectiveness of concept mapping. Future studies should utilise a larger sample size and consider using the approach as a targeted intervention immediately before and during clinical learning placements.

Indications of comprehensiveness in the pedagogical relationship: a design to be constructed in nursing education

OBJECTIVE

To analyze how the indications of comprehensiveness translate into the teaching-learning process in a nursing undergraduate course.

METHOD

Qualitative case study carried out with professors of a Nursing Undergraduate Course. Data collection occurred through documentary analysis, non-participant observation and individual interviews. Data analysis was guided from an analytical matrix following the steps of the operative proposal.

RESULTS

Eight professors participated in the study. Some indications of comprehensiveness such as dialogue, listening, mutual respect, bonding and welcoming are present in the daily life of some professors. The indications of comprehensiveness are applied by some professors in the pedagogical relationship. The results refer to the Comprehensiveness of teaching-learning in a single and double loop model, and in this the professor and the student assume an open posture for new possibilities in the teaching-learning process.

CONCLUSION

Comprehensiveness, as it is recognized as a pedagogical principle, allows the disruption of a professor-centered teaching and advances in collective learning, enabling the professor and student to create their own design anchored in a reflective process about their practices and the reality found in the health services.

Demands on community nurse mentors: Are new models for practice necessary?

The Royal College of Nursing (RCN) Bazian report (2015a) explored international mentorship models that focus less on 1:1 mentorship than on an increased ratio of students to a mentor, and this was used to inform the RCN (2015b) mentorship recommendations document to the Nursing and Midwifery Council (NMC). The need to examine new models for mentorship and make recommendations for future practice was identified, despite the Bazian report ( RCN, 2015a ) stating that among developed countries and national regulators and professional bodies, the UK seemed to possess the most detailed policy and guidance on student nurse mentoring. The models mentioned were not community nursing-focused, as this group of nurses visits people in their own homes. The need for new community mentorship models will be examined, alongside the need to support increasing numbers of student learners in practice, as the NMC is revisiting the Standards for Learning and Assessment in Practice ( NMC, 2008 ) and has provided draft guidance of forthcoming changes for mentors inviting comments, due to be refined and published 2018. This article will examine the challenges and benefits to community nursing of adopting new models of mentorship delivery.

Effective Dementia Education and Training for the Health and Social Care Workforce: A Systematic Review of the Literature

Ensuring an informed and effective dementia workforce is of international concern; however, there remains limited understanding of how this can be achieved. This review aimed to identify features of effective dementia educational programs. Critical interpretive synthesis underpinned by Kirkpatrick's return on investment model was applied. One hundred and fifty-two papers of variable quality were included. Common features of more efficacious educational programs included the need for educational programs to be relevant to participants' role and experience, involve active face-to-face participation, underpin practice-based learning with theory, be delivered by an experienced facilitator, have a total duration of at least 8 hours with individual sessions of 90 minutes or more, support application of learning in practice, and provide a structured tool or guideline to guide care practice. Further robust research is required to develop the evidence base; however, the findings of this review have relevance for all working in workforce education.

Healthcare professionals' sources of knowledge of complementary medicine in an academic center

Background

Complementary medicine (CM) is utilized in a growing number of academic centers despite the debate concerning its value, risks and benefits. Healthcare professionals often feel uncomfortable discussing CM with patients, and little is known about their sources of knowledge in the field of CM.

Objective

To assess healthcare professionals’ sources of knowledge and attitude toward CM in an academic hospital.

Design and participants

The cross-sectional web-based survey took place from October to December 2013. A total of 4,925 healthcare professionals working at Lausanne University Hospital, Switzerland, were invited to answer the questionnaire.

Main measures

Factors influencing healthcare professionals’ opinion toward CM, knowledge and communication about CM.

Key results

The questionnaire was answered by 1,247 healthcare professionals. The three key factors influencing professionals’ opinion toward CM were personal experience, clinical experience and evidence demonstrating the physiological mechanism of CM. Personal experience was more associated with nurses’ and midwives’ opinion compared to physicians’ (80.8% vs 57.1%, OR = 3.08, [95% CI: 2.35–4.05], P<0.001 and 85.3% vs 57.1%, OR = 3.83, [95% CI: 1.95–7.53], P<0.001, respectively) as well as with professionals trained in CM compared to non-trained professionals (86.0% vs 73.2%, OR = 2.60, [95% CI: 1.92–3.53], P<0.001). Physicians relied more on randomized controlled clinical trials compared to nurses (81.3% vs 62.9%, OR = 0.43, [95% CI: 0.33–0.57], P<0.001). A majority of the respondents (82.5%) agreed that they lacked knowledge about CM and 65.0% noted that it was the patient who initially started the discussion about CM.

Conclusions

Different professionals used different strategies to forge opinions regarding CM: physicians relied more on scientific evidence, while nurses and midwives were more influenced by personal experience. Regardless of preferred information source, most respondents did not feel prepared to address patient questions regarding CM. Enhancing interprofessional education opportunities is an important strategy to help providers become empowered to discuss CM with patients. This in turn will help patients making informed decisions in their healthcare.

Factors associated with nursing students' adherence to venous blood collection practice guidelines - A cross sectional study

Venous blood specimen collection is a common procedure that nursing students perform during pre-registration courses, and training for such collections takes place on campus as well as at clinical placements. However, levels of adherence to practice guidelines are still suboptimal among both nursing students and healthcare staff. We aimed to explore nursing students' adherence to the Swedish national venous blood specimen collection practice guidelines regarding patient identification and test request management and how this adherence is related to clinical experience, capability beliefs, research use, and the perceived social climate in clinical contexts. A survey with a cross-sectional design was conducted among 305 nursing students at a medium-sized university in Sweden. Descriptive statistics and logistic regression were used for data analysis. The survey showed that 82% of the students adhered to patient identification guideline practices and 80% to test request management practices. Factors associated with correct patient identification procedures were semester and frequency of research use. Factors associated with correct test request management were previous healthcare work experience, semester, and capability beliefs regarding academic abilities and evidence-based practice. We conclude that there is a need to develop educational tools to train students in research use and evidence-based practice in order to enhance guideline practice adherence and improve patient safety.

Development of a measurement index of critical thinking in professional formation

OBJECTIVES

This research sought to construct and validate a measurement index of critical thinking (CT) in professional formation.

METHODS

Transversal, quantitative, test validation-type study. After reviewing scientific production in CT, which permitted defining the concept and its conceptual domains, a 65-item scale was constructed of closed questions on the analysis of cases evaluating CT. The scale was subjected to expert evaluation to then be applied to 53 undergraduate students (35 from nursing and 18 from sociology) to evaluate validity and reliability.

RESULTS

The 65-item scale has an explained variance of 61.3% and is comprised of five CT domains: inference, evaluation, argumentation, analysis, and interpretation. A Cronbach's alpha coefficient of 0.61 was obtained.

CONCLUSIONS

The scale proposed to assess students' CT skills converges with concepts by known authors with the CT theory and is adequate for use as a CT measurement index in professional formation.

Use of a simulation intervention to examine differences in nursing students' hand hygiene knowledge, beliefs, and behaviors

BACKGROUND

Although hand hygiene remains an essential aspect of quality care, adherence to best patient safety practices continues to pose major challenges.

OBJECTIVES

The objectives of this study are to examine hand hygiene knowledge, beliefs, practices, perceived importance and behaviors using Social Cognitive Theory and simulation-based intervention.

DESIGN

Participants were taken from a convenience sample of 131 undergraduate nursing students enrolled in a nursing fundamentals course at an urban university in the midwestern United States, and then randomly assigned to their respective groups. Using an experimental pretest-posttest design, control and intervention groups received the same lecture pertaining to hand hygiene and 3 data collection points where van de Mortel's Hand Hygiene Questionnaire (HHQ) was administered. In addition, the intervention group viewed a 6.5min video related to healthcare acquired infection and participated in 4 simulated situations requiring hand hygiene, based on World Health Organization guidelines. For all students, the hand hygiene technique was assessed through the use of Glo Germ, followed by handwashing and photography under ultraviolet light (posttest only). Image illumination was analyzed using image processing software. Microbiological sampling plates (pretest-posttest) were assessed quantitatively by colony counting.

RESULTS

Study findings did not support differences in the intervention group for the 5 hypothesized relationships. Social desirability responding and negative item confusion were found to occur with the HHQ in the student population. There was a significant difference in the UV hand photographs, with students in the afternoon having lower values than students in the morning.

CONCLUSIONS

Given the study results, there were no definitive educational recommendations to teach hand hygiene to nursing students. Future research should continue to further examine multi-focal modalities to enhance adherence to hand hygiene practices, as well as control for extraneous mediating or moderating variables found in educational settings.