Post-simulation debriefing as a stepping stone to self-reflection and increased awareness - a qualitative study

BACKGROUND

The voice of the students should be engaged in simulation curriculum development. Involving the students in the development of debriefing strategies might result in a deeper understanding of learning. However, few studies have investigated the students' perspectives on debriefing strategies. The aim of the study was to explore nursing students' perspectives on the post-simulation debriefing.

METHODS

An explorative, descriptive design with a qualitative approach was used. Data were collected in December 2017 and May 2018 through focus group interviews with undergraduate nursing students in Norway immediately after a 2-day high-fidelity simulation course in the second year of their Bachelor of Nursing degree. Data were analysed using systematic text condensation.

RESULTS

Thirty-two nursing students participated in the study. The data analysis identified two main categories. The category 'Facilitator as a catalyst for reflection' illustrated the facilitator's multifaceted and vital role in initiating and guiding the students' reflection process in the debriefing. The category 'A process towards increased awareness' encompasses the students' guided process of acquiring new insight into their professional development, and how they put parts together to see the wholeness in what was simulated.

CONCLUSIONS

This study provides knowledge to facilitators regarding nursing students' perspectives on facilitating reflection and learning during debriefing discussions. The facilitator's multifaceted role in guiding the students' reflections and their process of acquiring new insight into their professional development were identified as critical to learning during debriefing.

Raising nurse educators' awareness regarding caring pedagogical relationships' barriers to foster inclusive simulation settings: Insights from a phenomenological study

AIM

The purpose of this paper was to shed light on the main barriers to caring pedagogical relationships within simulation centers from the perspective of nursing students and offer targeted strategies to reduce these barriers.

BACKGROUND

A caring pedagogical relationship is a powerful strategy to foster students' learning within simulation settings. However, the development of this relationship could be hindered if nurse educators are not aware of its barriers. Hence, this could affect students' learning and well-being within this academic context. According to our knowledge, no previous research has addressed the question of the barriers to caring pedagogical relationships within the context of simulation.

DESIGN

This study employed a descriptive phenomenological method, entitled Relational Caring Inquiry, to collect and analyze data gathered from 19 students enrolled in an undergraduate nursing program.

RESULTS

This paper focuses on one eidos-theme that emerged from our data analysis and interpretation entitled "Educator's conscientization regarding barriers to the development of a caring pedagogical relationship". According to data analysis and interpretation, this eidos-theme was the most emphasized by research participants. It emerged from the following themes: (a) educators' dehumanizing practices, (b) disruptive and stressful academic context, (c) lack of educators' experiences and (d) educators' disinterest in students' learning.

CONCLUSIONS

Leaving caring pedagogical relationships' barriers unaddressed has shown adverse impacts on students' learning process and their mental and physical well-being. This paper brings to light the main barriers to caring pedagogical relationships and invites educators, managers and nurse leaders to be aware of these obstacles and collectively engage in humanizing nursing education. In other words, we emphasize the impact of these barriers on students' apprenticeship and suggest political actions to build caring and inclusive simulation environments.

STUDY REGISTRATION NUMBER

CERSES-19-050-D.

Perceived competence and related factors affecting the development of the clinical competence of nursing students at two university sites in Namibia: a cross-sectional study

BACKGROUND

Ensuring that nursing students graduate with the required clinical competence in nursing is a global challenge. To address this challenge, several studies have looked at various aspects of competency and competency development, however there is scanty evidence on factors affecting development of clinical competency in nursing students. Therefore the, purpose of this study was to investigate nurses' perceived competence and related factors affecting the development of clinical competence of nursing students at two university sites in Namibia.

METHODS

A cross-sectional design was utilised. Simple random sampling was applied and 272 nursing students at two university campuses in Namibia were selected. An online questionnaire was used. Data were collected between April and May, 2022, over a period of six weeks, and were analysed using Statistical Package of Social Sciences (SPSS) version 27. Chi-square and Spearman correlations were used to assess the associations and correlations, respectively, among the variables. Logistic regression was used to assess the factors associated with the development of clinical competence using a p-value < 0.05 confidence interval.

RESULTS

Forty-seven percent (47%) of the students were found to be competent while more than half (53%) were not. A Chi-square test found a statistically significant difference between students studying at different campuses and between different year levels (p =  < .05). A regression analysis showed that nursing educators' competence (β = .128; p = .36) had a positive influence on nursing students' competence levels, unlike the mode of learning (β = -.140; p = .013), which negatively predicted the development of clinical competence. No significant relationship was found between the development of clinical competence and teaching approaches, assessment, feedback, constructive alignment, theory-practice gap and reflective practice (p = ˃.05).

CONCLUSION

Educator's competence levels and the mode of learning were the two major factors that were more likely to influence the development of clinical competence among nursing students. Therefore, it is recommended that nursing training institutions prioritise the development of educators' competence and apply various modes of learning to enhance development of nursing students' competence.

Professional nurses supporting learners during professional socialisation in Limpopo province

Background

Professional nurses play a significant role in the professional socialisation of learner nurses during clinical placement. Clinical placements are areas of experiential learning as learner nurses come in contact with real-life experiences. Professional nurses are custodians of learners and need to offer them support.

Aim

The study sought to explore the role of professional nurses in supporting learner nurses during professional socialisation.

Setting

Four clinical health facilities in Limpopo province at different levels of care were purposely sampled to obtain information from different levels of care.

Methods

An ethnonursing approach and qualitative, explorative design was used. Non-probability purposive sampling was used to select 25 professional nurses. The criteria were professional nurses with 3 years of experience in professional socialisation and working in institutions accredited for clinical placement of learner nurses registered in the undergraduate programme. Data were collected through a face-to-face interview until data saturation was reached. Tesch's open coding system was used to analyse data.

Results

Professional nurses acknowledged that their responsibilities in supporting learners during professional socialisation are mentoring, teaching and being competent practitioners. Professional nurses were aware of their role in transferring ethical skills and knowledge to learners through professional socialisation.

Conclusion

The effectiveness of professional socialisation of learner nurses depends on the support offered during clinical placements.

Contribution

The study adds to the body of knowledge in nursing education and practice because when learners are offered support in the clinical areas, their learning journey will be of positive experience leading to competent practitioners.

Exploring Undergraduate Nursing Students' Perceptions on Clinical Learning Environment in the UAE: A Focus on Perceived Benefits and Challenges

Introduction

Establishing a supportive clinical environment is paramount for enhancing nursing students' engagement in clinical practice, their clinical proficiencies, and satisfaction. The increase in nursing student enrollment at the Nursing College, driven by the collaborative efforts between Abu Dhabi Health Services Company (SEHA) and universities, has given rise to concerns regarding the quality of education and clinical instruction. These concerns are primarily due to the increased student-to-instructor ratio. Furthermore, the unsupportive clinical settings and learning tensions underscore the need to understand students' learning experiences and address research gaps within the field of clinical learning in the United Arab Emirates (UAE).

Objectives

The purpose of this study is to investigate the undergraduate nursing students' perceptions of their clinical learning environment, with a focus on perceived benefits and challenges.

Methods

This study used a cross-sectional survey design. The researchers administered a five-point Likert scale questionnaire, which had been adapted and contextualized, to a convenience sample of 217 third and fourth-year nursing students who willingly participated in this study.

Results

Despite the presence of positive aspects, such as diverse clinical experiences and strong support from both clinical instructors and peers, several challenges affect the students' clinical learning. These challenges encompass disparate perceptions of supervision among staff nurses, learning tensions related to student academic workload, insufficient clinical supervision, and difficulties in finding assistance when needed.

Conclusion

There is a clear need to enhance the overall ward learning environment to optimize students' academic motivation and clinical skills. Several measures can be taken to achieve this goal, including incentivizing and reducing the workload of staff nurses, investing in the professional development of clinical instructors, promoting peer interactions and group learning, and adopting a block pattern of education in years three and four for better clinical knowledge assimilation and reduced theoretical workload.

Modernizing Bedside Clinical Instruction

Knowledge and competency gaps of new graduates can be effectively mitigated through stronger partnerships between nursing clinical instructors and bedside clinicians. Bedside clinicians can pull back the curtain on practice realities to show both the challenges and the joys. Traditional nursing faculty must learn how to strengthen and support a new way of working with bedside clinicians that includes letting go of the wheel. Changing the dynamic among nursing clinical faculty, bedside clinicians, and students is an important and essential step in nursing education and preparing new nurses to understand the realities of practice. [J Contin Educ Nurs. 2024;55(1):7-9.].

Telenursing implications for future education and practice: Nursing students' perspectives and knowledge from a course on child health

BACKGROUND

Technology advancements have altered the standard of nursing care, and education. This suggests the necessity to equip prospective nurses to provide competent care in a highly technical and digital environment via telenursing.

AIMS

The aim of this study was to assess the perceptions and knowledge of nursing students about telenursing.

METHODS

Using a descriptive cross-sectional design. A self-reported questionnaire was used. The distribution of 110 questionnaires to nursing students attending two private colleges in Jordan resulted in an 83.6% (n = 92) response rate. Descriptive and inferential statistics were applied.

RESULTS

The results showed a positive perception toward telenursing practice, as well as the difficulty in precisely defining telenursing. Age, internet usage patterns, and knowledge were all factors considered telenursing predictors. 32% of the variance was explained by the model. Telenursing would be beneficial for future nursing professionals by incorporating telenursing into the curriculum.

CONCLUSIONS

The learning environment is extends somewhat beyond the classroom, making it is necessary to integrate telenursing into education in order to redefine the future of the nursing practice.

Characteristics of effective nurse educators from Thai nursing students' perspectives

Background

Effective nurse educators will improve students' performance. Therefore, examining the characteristics of an effective nurse educator is essential, especially from nursing students' perspectives, which will provide an additional point of view to improve the teachers' quality.

Objectives

This research aimed to identify nursing students' opinions regarding the characteristics of effective nurse educators and to compare those characteristics according to age, year of study, and cumulative grade point average.

Methods

A descriptive quantitative design was used. Data were collected from 400 nursing students in Thailand using a validated questionnaire. Descriptive statistics, t-tests, and F-tests were used for data analysis.

Results

The overall mean scores of effective nurse educators' characteristics based on students' perspectives were 4.36 (SD = 0.45). Subject expertise was the most essential characteristic of the effective nurse educators (Mean = 4.45, SD = 0.47), followed by relational expertise (Mean = 4.44, SD = 0.52), personality (Mean = 4.36, SD = 0.45), and teaching-related behavior (Mean = 4.33, SD = 0.46). The results also showed that participants with different cumulative grade point averages had no different views on the characteristics of effective nurse educators (p > 0.05). However, participants of different ages and years of study had significantly different perspectives on the characteristics of effective nurse educators (p < 0.05).

Conclusion

The study offers necessary information regarding the essential characteristics of effective nurse educators. Therefore, nurse educators can use the study results to improve their desired characteristics. In addition, faculty development programs may be planned to help nurse educators improve these characteristics.

A phenomenographic study exploring the conceptions of stakeholders on their teaching and learning roles in nursing education

BACKGROUND

Nursing education involves a number of stakeholders in the teaching and learning process, and these are student nurses, lecturers, clinical instructors and nurses. The role that each of these parties play in the teaching and learning process is dependent on each other and is key to the development of competence among student nurses. However, there is scanty literature on the discourse of how these stakeholders conceptualise their roles to maximise student learning. The objective of this study was to explore the conceptions of stakeholders on their teaching and learning roles in nursing education.

METHODS

Thirty-eight semi-structured interviews and three focus group discussions were conducted with nursing students, lecturers, clinical educators at a Namibian nursing college and nurses at teaching hospitals. Phenomenographic data analysis approach was applied.

RESULTS

Four conceptions were constructed that described the level of involvement of the different parties in teaching and learning. These were initiating, supporting, becoming part of and owning the teaching and learning role. Three dimensions of variation marked the differences among the conceptions: responsibility and accountability, priorities and level of collaboration.

CONCLUSIONS

The parties involved in the teaching and learning in nursing education have qualitatively different understating of their roles and those of others. There is a pattern transcending from being at the periphery of teaching and learning to taking ownership of teaching and learning. And a movement from limited responsibility and collaboration to that of being responsible, accountable and high level of collaboration in the teaching and learning of nursing students. The conceptions in this study add more ways of enhancing collaboration between theoretical and clinical sites in nursing education, by ensuring that those involved are aware of their role and that of others and work collaboratively at the micro-level.

Clinical instruction in mental health nursing: students' perceptions of best practices

OBJECTIVES

Negative clinical educational experiences for student nurses are predictors of negative attitudes and perceptions towards mental health. In clinical education, instructors take on this important role often with little to no formal training. This study explored nursing students' perceptions of instructional best practices in mental health clinical education.

METHODS

A qualitative descriptive design was used, and 10 Canadian baccalaureate nursing (BN) students were interviewed. These students had completed a six-week practicum on an acute inpatient psychiatric unit in either their second, third or fourth year of study.

RESULTS

Through thematic analysis, three themes were identified: (1) Students valued feeling prepared at the beginning of the clinical placement. (2) Students felt empowered when instructors encouraged self-direction. (3) Students appreciated positive role modeling by their instructors.

CONCLUSIONS

Suggestions for clinical teaching strategies are made to mitigate student stress, increase confidence, and address the influence of mental health stigma on learning.

Unveiling how Clinical Nursing Education can be Improved in Northern Ghana: The Perspectives of Key Informants

Introduction

Clinical nursing education is an important component of the professional development of nursing students. Key informants such as nursing lecturers, nurse managers and clinical placement coordinators play an essential role in clinical education.

Purpose

The purpose of the study was to explore the perspectives of key informants on how the current state of clinical nursing education in Northern Ghana can be improved.

Methods

The study used an exploratory qualitative design. Sixteen participants were purposively selected and data were collected through face-to-face individual interviews. Data were analysed using framework analysis.

Findings

The study findings indicate that clinical nursing education can be improved by decreasing the overcrowding of students in the clinical setting, decreasing the theory-practice gap and providing relevant material resources in the clinical facilities. Also, nursing education institutions can improve clinical nursing education by equipping the skills laboratories, engaging an adequate number of lecturers, and carrying out clinical accompaniment.

Conclusion

There is a need to improve clinical education through collaboration between nursing education institutions and clinical facilities. Effective collaboration will ensure the planning of clinical placement to avoid overcrowding, provision of continuous professional development programmes for preceptors and improvement in clinical supervision. Also, the provision of material resources in skills laboratories and clinical facilities to enhance clinical teaching should be given priority.

COVID-19 Pandemic Impact on Nursing Student Education: Telenursing with Virtual Clinical Experiences

Introduction

The COVID-19 pandemic affected nursing students dramatically when the clinical sites and the onsite classrooms closed to physical participation. This necessitated a move to virtual classrooms and virtual clinical experiences. Some nursing schools adopted telenursing to comply with their Board of Registered Nursing direct patient care requirements. Students value the hands-on nursing in a direct care facility and clinical instructors must replicate this in a virtual setting. This article discusses telenursing and Teach-Back processes with student active engagement that facilitates learning and meets the direct care requirement. The purpose is to share best practice ideas for clinical instructors to educate when clinical settings are unavailable.

Methods

This innovation includes examples from five clinical instructors when in-person clinicals were not available due to the COVID-19 pandemic. They used virtual teaching and telenursing for nursing students which complied with clinical requirements of preconference, clinical experience, and post-conference. Telenursing combines case studies or shared documents, student collaboration, and includes a patient or patient actor via telehealth. Clinical instructors present a patient history or case study and allow students time for preparation. Socratic questioning helps students focus on determining the correct questions to ask. Telenursing call to the patient and teach-back questioning validated patient learning. Following the call, the instructor leads a post-conference debrief and students independently document the call.

Conclusion

Five clinical instructors follow the process of pre-brief, case presentation, and debrief while students develop critical thinking, strong communication skills, documentation requirements, and utilize the nursing process of assessment, diagnosis, outcome, plan, interventions, and evaluation. Students will have future opportunities to develop hands-on skills as they return to the clinical setting.

Nursing Students' Perceptions of Staff Nurse Instructors' Characteristics in a Dedicated Education Unit

BACKGROUND

The dedicated education unit is a model that has been used for clinical experiences in recent years. The importance of effective staff nurse instructors (SNIs) is paramount in nursing students' development of nursing skills and critical thinking.

PURPOSE

This study examined nursing students' perceptions of positive and negative characteristics of SNIs.

METHOD

During a 3-year period, an estimated 265 nursing students evaluated SNIs using an optional two question survey. Qualitative data were retrieved and reviewed by researchers to analyze common themes delineated by students.

RESULTS

Various themes were noted in which students identified exemplary SNI characteristics as well as barriers to learning.

CONCLUSION

Data revealed positive and negative attributes that promoted student learning by the SNIs. Areas for improvement in training of the SNIs became evident through analyzing data, which can be used by clinical faculty to improve the experiences for both students and SNIs. [J Nurs Educ. 2021;60(8):459-461.].

The characteristics of an effective clinical instructor from the perspective of nursing students: a qualitative descriptive study in Iran

Background

Clinical instructors have an important role in advancing nursing students to achieve the program objectives. Nursing student perceptions about the characteristics of an effective clinical instructors may help programs improve clinical instruction. As such, the purpose of this study was to understand the characteristics perceived by students to define an effective clinical instructor.

Methods

In this qualitative descriptive study, semi-structured interviews were conducted with undergraduate and postgraduate nursing students. The sample was purposefully selected. MAXQDA software was used for the content analysis. The codes were organized into subcategories and consolidated into categories.

Results

Data saturation was reached with twelve participants, including seven women and five men, between 21 and 36 years of age. General and special characteristics were the two main categories that emerged from the data. These categories were defined by nine subcategories including internal motivation, professional acceptability, clinical competency, teaching skill, clinical experience, values, being a faculty member, appropriate appearance, and communication skills.

Conclusions

Effective clinical instructors have a specific characteristics identified by student. The most important characteristics of effective clinical instructors were related to communication and teaching skills, internal motivation, and professional appearance. More research is necessary to determine the relationship between the characteristics, instructor competency, and student learning outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00556-9.

Clinical Teaching Effectiveness of Undergraduate Student Nurses in the United Arab Emirates

Introduction

Clinical supervision is a crucial aspect of developing nursing students' knowledge, skills, and professional attitudes. The characteristics of clinical instructors have a significant role in the progress and transition of students into their future professional roles.

Objective

The study aimed to examine the behaviors of effective clinical instructors as perceived by nursing students and faculty members in the UAE.

Methods

The study followed a cross-sectional quantitative research design to explore nursing students' and faculty members' perceptions of clinical instructors' effective behaviors that facilitate students' clinical practice. Data were collected from a convenience sample of 147 nursing students and 17 faculty members who completed an online version of the study survey at four nursing programs in the UAE.

Results

Students rated personality (M = 4.96, SD = 1.91) and teaching ability (M = 4.94, SD = 1.96) as the highest behaviors for effective clinical instructor. They perceived effective clinical instructor to be organized (M = 5.19, SD = 1.88), shows self-confidence (M = 5.16, SD = 1.84), able to answer questions (M = 5.16, SD = 1.90), emphasizes what is crucial to learn (M = 5.11, SD = 1.81), and takes responsibility for his/her actions (M = 5.11, SD = 1.90). While faculty members perceived effective clinical instructor to encourage a climate of mutual respect (M = 5.56, SD = 1.27), be approachable (M = 5.47, SD = 1.32), demonstrates clinical skill and judgment (M = 5.53, SD = 1.46), takes responsibility for his/her actions (M = 5.53, SD = 1.37), and be a good role model (M = 5.47, SD = 1.32).

Conclusion

Understanding clinical instructors' effective behaviors and supporting them during students' clinical experiences inspire a productive teaching-learning environment that is crucial to improve students' motivation, expand their learning opportunities and improve their hands-on skills.

From Clinical Practice to Academic Student Instruction: Understanding the Clinical Instructor's Perspective Using a Mixed-Methods Approach

BACKGROUND

Clinical instructors (CIs) are important to the provision of real-world experiential learning because they teach, mentor, and support students in clinical practice settings in higher education programs. CIs experience tensions that influence their retention and impact the sustainability of consistent, quality education for students.

PURPOSE

The aim of this study was to examine the experiences of being a CI and how to better support them.

METHODS

CIs in a nursing faculty at a Western Canadian university were approached to participate. Data collection included a survey (n = 17) with questions asking about the importance of and their ability to prepare, teach, and mentor nursing students in practice. Individual interviews (n = 6) and a focus group (n = 3) were conducted that asked CIs about their experiences and challenges. Analysis included descriptive statistics and thematic analysis.

RESULTS

Participants indicated feeling unprepared entering the instructor role. Key findings were the need to improve CI orientation so that it is more practical and meaningful, to increase peer support from other instructors, and to assist CIs' transition into becoming educators.

CONCLUSIONS

Understanding CIs' assessment of their needs can help institutions better support and retain them, promoting consistency and quality in practicum instruction.

Should We Be Trained to Train? Nursing Students' and Newly Qualified Nurses' Perception on Good Lecturers and Good Clinical Preceptors

Background: The reform of the Spanish higher education studies from the Bologna Declaration did not entail the necessary changes in the teaching methodologies used. The clinical preceptor emerged as the main guiding professional in the practical training of nursing students. The aim of this qualitative study was to understand fourth-year nursing students’ and newly qualified nurses’ (NQNs) perception on their lecturers’ and clinical preceptors’ effectiveness. Methods: Exploratory, descriptive qualitative study was carried out at a Spanish University. By convenience sampling and according to defined inclusion and exclusion criteria, twelve newly qualified nurses and twelve fourth-year students of the Degree in Nursing were included in order to contrast the results. A thematic analysis of data was carried out, to later be coded by two researchers. Results: Two main themes were identified: the good lecturer and the good clinical preceptor, with several subthemes in each. These included the characteristics that both should have, both in teaching, nursing and interpersonal-relation skills. Conclusions: The need of preceptorship training programs has been highlighted in our context. Educators all over the world should be properly qualified in order to train and educate competent nurses for the future.

Examination of the Structural Validity of the Clinical Learning Environment Inventory Using Exploratory Factor Analysis

Background and Purpose

This study tested the psychometrics of the Clinical Learning Environment Inventory (CLEI—actual version), a tool designed to measure the perceptions of nursing students' clinical learning. The developer of the CLEI did not report structural validity.

Method

Exploratory factor analysis (EFA) was performed using data from 311 licensure nursing students to assess the CLEI's proposed dimensions or structural validity.

Results

The Kaiser–Meyer–Olkin (KMO) test indicated acceptable sampling adequacy. Analysis of four different models, while retaining items with factor loadings >0.35, resulted in a four-factor solution with 32 items. The factors were renamed: Concern for Student Welfare (the highest weighted factor); Organized/Effective Teaching; Enjoyment of Clinical Learning; and Student Decision-Making.

Conclusions

This study suggests that the 32 item four-factor CLEI is sufficiently structurally valid and reliable for further testing.

Becoming a Transformative Nurse Educator: Finding Safety and Authenticity

The study purpose was to evaluate and strengthen this program's nursing education curriculum to better prepare and develop future nurse faculty. As the dire nursing faculty shortage increases, the transition of expert nurse clinician to novice educator is receiving more attention. In order to prepare, recruit, and retain the nursing faculty needed to meet the growing nurse shortage, understanding what nurse educators need in order to be successful is essential. Fourteen participants from four focus groups of nurse educators shared stories about their role transition. Two administrators were interviewed to determine what they identified as crucial in hiring new nurse educators. Interpretive analysis focused on identification of themes and possible paradigm cases. Themes that emerged included: a) culture of academia surprises, b) exciting "Aha!" moments, and c) Safety with a capital "S". These findings were used to strategically revise the entire nurse educator curriculum.