Communities of reflection in nurse education programs: A qualitative multi-methods study

BACKGROUND

Nursing students often face challenges reconciling theoretical concepts with clinical realities. This study examines a novel concept 'Communities of Reflection' designed and tested to enhance coherency between theory and practice. The concept involves reflection groups comprising students, preceptors, and faculty during clinical placements.

AIM

To examine the meaning of 'Communities of Reflection' regarding the coherency between theory and practice as perceived by the involved participants.

METHOD

A qualitative multi-methods approach involved nursing students, preceptors, and faculty members who participated in 'Communities of Reflection.' Data collection methods included interviews, focus groups, written reflections, and observations.

FINDINGS

The content analysis revealed that 'Communities of Reflection' facilitate a shared engagement in nursing, fostering a deeper level of reflection. Creating a safe space and embracing vulnerability are key aspects of this shared engagement.

CONCLUSION

'Communities of Reflection' offer a valuable framework for promoting coherency between theory and practice. It appears to be crucial to students' outcomes that a well-established, equitable theory-practice partnership is the solid foundation, acknowledging that emotions can serve as a catalyst for the development of professional expertise.

Nurturing ethical insight: exploring nursing students' journey to ethical competence

BACKGROUND

Ethical competence is a key competence in nursing and the development of the competence is a central part in nursing education. During clinical studies, nursing students face ethical problems that require them to apply and develop their ethical knowledge and skills. Little is known about how ethical competence evolves during students' initial clinical placements. This study explored the development of ethical competence in first-year nursing students during their first clinical placements in nursing homes.

METHODS

This exploratory-descriptive qualitative study used focus group interviews to collect data and a phenomenological hermeneutical method for analysis. Twenty-eight first-year nursing students participated in six focus groups. The data were collected between March and April 2024 at Oslo Metropolitan University in Norway.

RESULTS

The naïve reading of the data involved an awareness of the students applying their prior knowledge, modifying their prior knowledge and developing skills that allowed them to manoeuvre ethical practices that, in some cases, appeared excellent and, in other cases, grim. The structural analysis identified three themes: (i) ethical competence forges in practice, (ii) ethical competence evolves at the intersection of knowledge and skills and (iii) ethical competence unfolds through meaningful discussions. A comprehensive understanding of the data was formulated as 'Being on a journey towards ethical competence'. This presents a metaphor illustrating that nursing students embark on a journey towards ethical competence; from their point of departure, their clinical experiences forge the essential waypoints along their path, knowledge and skills fuelling their navigation in rugged terrain towards their destination.

CONCLUSIONS

Nursing students' ethical competence evolved in intricate ways during their initial clinical period. Being informed bystanders or participants in the care of nursing home residents in situations of ethical tension may be a unique position enabling students to evaluate care options differently from those immersed in the ward culture. The findings indicate that organised professional development in nursing homes needs to focus on more reflexively driven ways of supervising students in their first clinical study period. Educational institutions need to continue and further develop reflection-based learning activities and meeting points with students and their peers during their clinical placement periods.

Empathy in Nursing Students: A Scoping Review

Purpose: Empathy is essential for nursing students as they progress through their education. To date, few review studies explored empathy in nursing students. This review examined empathy in nursing students, including how to promote empathy, factors contributing to empathy, and the evaluation of empathy. Design: The eligible population included undergraduate nursing students. The concept of interest was empathy related to nursing students. The context was undergraduate nursing programs. Eligible studies included quantitative, qualitative, and mixed-method studies. The protocol was registered in Open Science Framework (OSF). Review Methods: Joanna Briggs Institute Reviewers' Manual guided this scoping review protocol. MEDLINE with Full text (EBSCO), Scopus, ScienceDirect (Elsevier), and PubMed were used for the electronic database search. The findings were analyzed with descriptive statistics and thematic analysis. Findings: A total of 94 articles were included for analysis. Three main themes emerged: (1) approaches to promoting empathy, (2) contributing factors to empathy, and (3) evaluation of empathy. Conclusions: Empathy is cultivated in nursing in numerous ways, highlighting the need to incorporate it into the nursing curriculum. There is also controversy regarding the relationship between empathy and individual characteristics. This finding highlights the need for more effective empathy-promoting educational training that considers these personal characteristics.

Construction of an evaluation index system for undergraduate nursing teachers' curriculum humanistic competence: a Delphi study in China

BACKGROUND

The curriculum humanistic competence of nursing teachers is important to cultivate the humanistic qualities of undergraduate nursing students. However, there are no evaluation tools for the curriculum humanistic competence of undergraduate nursing teachers in China.

OBJECTIVE

To develop an index system to evaluate the curriculum humanistic competence of undergraduate nursing teachers.

DESIGN

This research conducted a Delphi study.

PARTICIPANTS

Semi-structured interviews were held with 19 experts, and Delphi rounds were conducted with 18 experts.

SETTINGS

This study was conducted in 12 universities and 4 Grade A tertiary hospitals in China.

METHODS

A literature review and semi-structured interviews were conducted to develop an initial framework. A two-round Delphi survey was employed to build the index system for undergraduate nursing teachers' curriculum humanistic competence.

RESULTS

After two rounds of consultation, the index system included 5 first-level indicators, 11 second-level indicators and 41 third-level indicators. The Cr for two rounds of consultation were 0.929 and 0.923, and Kendall's W was 0.152(P<0.001).

CONCLUSIONS

The index system for the evaluation of undergraduate nursing teachers' curriculum humanistic competence offers guidelines for undergraduate nursing teachers in China. It can be used in practice to develop high humanistic qualities in undergraduate nursing teachers.

Impact of dyadic practice on the clinical self-efficacy and empathy of nursing students

BACKGROUND

Dyadic practice of learners creates supportive learning. So far, few studies have investigated the impact of this approach on students' empathy and self-efficacy. This study aimed to investigate the effect of dyadic practice on nursing students' clinical self-efficacy and empathy.

METHODS

This study was based on a pretest-posttest randomized group from September to December 2018. All the junior nursing students (n = 44) were divided into intervention (n = 22) and control groups (n = 22) using stratified random sampling. The intervention group was trained for 6 days as student dyads, while the control group was under the supervision of an instructor and worked individually. The students' levels of empathy and self-efficacy were evaluated on the first day (pretest) and the last day (post-test) by The Self-Efficacy in Clinical Performance Scale and Mehrabian and Epstein empathy scale. The data were analyzed using the SPSS software by Fisher's exact test, Mann-Whitney test, independent t-test paired t-test, Wilcoxon signed-rank, and Analysis of covariance.

RESULTS

Dyadic practice increased empathy in the intervention group compared to the control group (P < 0.001). The adjusted mean of total empathy in the intervention group was 21.1 degrees higher than the adjusted mean of total empathy in the control group. However, no significant differences were found between the two groups in clinical self-efficacy (P = 0.762).

CONCLUSIONS

The employment of this approach seems helpful in creating an empathic atmosphere. However, further studies are required to prove the effectiveness of this method on self-efficacy.

A vulnerable journey towards professional empathy and moral courage

Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements.

The relationship between worry and comfort levels and communication skills of nursing students during pediatric clinic applications: A descriptive study

BACKGROUND

Practices of student nurses in clinical settings allow them to face the difficulties of professional practice, adapt to these environments and develop their knowledge, skills and confidence.

OBJECTIVES

The purpose of the study is to investigate the relationship between the worry and comfort levels and communication skills of nursing students during their pediatric clinic practices.

DESIGN

A descriptive study design was used.

SETTINGS

The measurement instruments were applied at the students' usual classrooms at a Turkish state university by the authors.

PARTICIPANTS

The sample of the study consisted of 145 nursing students who were in their 3rd year of study in the academic year of 2018-2019 and agreed to participate.

METHODS

The data were collected by a Questionnaire Form, the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool and the Effective Communication Skills Scale.

RESULTS

A positive and significant relationship was determined between the students' Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool, Comfort subscale scores and their Effective Communication Skills Scale, Self-Revelation, Empathy and I-Language subscale scores (p < 0.05). A positive and significant relationship was found between the students' Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool, Worry subscale scores and their Effective Communication Skills Scale, Self-Revelation, Effective Listening and I-Language subscale scores (p < 0.05).

CONCLUSION

It was concluded that there was a relationship between the worry and comfort levels of the nursing students and their communication skills during their pediatric clinic practices. Knowing about the worry and comfort levels of nursing students who take part in practices at pediatrics clinics and their effective use of communication skills will affect their statuses of coping with worry in their future professional and social experiences and may increase their clinical success.

Psychometric evaluation of undergraduate student nurses' learning perceived needs in disaster nursing: Two cross-sectional studies

BACKGROUND

Disaster nursing education is a necessity for nurses and students to improve their disaster relief competencies. Determining undergraduate student nurses' learning perceived needs for disaster nursing can help improve curricula construction. In China there is currently no valid instrument available for the evaluation of influencing factors. A disaster nursing course content system was developed using the Delphi method in 2011. However, this system was unformed and lacked psychometric evaluation.

OBJECTIVES

To adapt the disaster nursing course content system into an instrument, to evaluate its psychometric properties, and to investigate undergraduate student nurses' learning perceived needs for disaster nursing.

DESIGN, SETTINGS AND PARTICIPANTS

Two cross-sectional studies were conducted in public higher education institutions in China. In the first study, a total of 1714 undergraduate student nurses were recruited in May to October 2016; in the second study, 68 were recruited in May 2019.

METHODS

The instrument was adapted through literature review, face validity and pilot testing in preliminary studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis, parallel analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability.

RESULTS

The exploratory factor analysis and parallel analysis extracted a three-factor solution comprising 19 items that accounted for 71.69% of the total variance, including discipline introduction, skills and knowledge in disaster relief, and disaster management. The fit indices indicated a good fit. The internal consistency and test-retest reliability was good, as indicated by a Cronbach's alpha of 0.89 and an intraclass correlation coefficient of 0.87.

CONCLUSION

The Learning Needs for Disaster Nursing questionnaire exhibited good psychometric properties, thereby proving itself a valuable instrument for evaluating learning perceived needs in undergraduate student nurses.