The impact of parenting practices and family economy on psychological wellbeing and learning patterns in higher education students

BACKGROUND

There is a large literature on the significant impact of rearing factors in the psychological development of different child's learning patterns and wellbeing in elementary and secondary schools, but there is a scarcity of studies on to what extent those influences remain stable up to higher education.

OBJECTIVE

In this study, parenting practices and family status were analyzed as predictors of the different learning styles, psychological difficulties, mental health factors, and academic performance, comprising the psychosocial diversity in learning (DinL) at the university classroom.

METHODS

Using a cross-sectional design, a questionnaire was administered to a sample of 2522 students at the Complutense University of Madrid (Spain). It included a DinL scale measuring five psychological learning dimensions (coping with difficulties, effort, autonomy, Social/Physical Context, and understanding/career interest), plus several items on retrospective parenting practices, family, and sociodemographic variables. Multiple regressions and analyses of variance were conducted with the family factors as independent variables and the learning factors as dependent variables.

RESULTS

Results showed parenting variables, parents' education, and family economy as having a significant impact on psychological learning dimensions, academic performance, and especially on the students' wellbeing and mental health status, being an important contributors to explain the DinL in the university classroom.

CONCLUSION

The results bring interesting conclusions for developmental and health psychologists when working with parents aimed at fostering wellbeing and learning strategies related to academic inclusion and achievement.

The Lasater Clinical Judgment Rubric: 17 Years Later

BACKGROUND

Nearly 17 years ago, the Lasater Clinical Judgment Rubric (LCJR) was published to provide a common language and trajectory of students' development to think like a nurse.

METHOD

This article traces the uses of the LCJR from creation to the present and cites lessons learned from its use.

RESULTS

During the intervening years, the LCJR has been used effectively as a debriefing guide in simulation and as a research instrument, as well as for formative assessment. The LCJR has been translated or is in process in 19 languages besides English.

CONCLUSION

This article provides evidence of the efficacy of the LCJR and discusses important lessons learned. [J Nurs Educ. 2024;63(3):149-155.].

An integrative review of teaching strategies to support clinical judgment development in clinical education for nurses

OBJECTIVES

Historically, emphasis on task-completion and lack of intentional approaches that develop students' thinking skills have dominated clinical education. One contributing factor may be the limited literature about teaching to develop clinical reasoning and clinical judgment in the clinical environment. This integrative review accessed available literature to answer the question, What strategies are used to develop clinical judgment in the clinical education environment?

DESIGN

The Whittemore and Knafl approach framed the integrative review. The framework includes the following steps 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis, and 5) presentation.

DATASOURCES

The data bases CINAHL Plus with Full Text, OVID, and ProQuest were searched through the period of January 2000 through July of 2022.

REVIEW METHODS

The PRISMA protocol informed review and screening of the literature. Authors assessed articles for eligibility via first screening by abstract review, followed by review of the full text. Both authors reviewed the articles, assessing qualification for inclusion and evaluating the content. Data from eligible articles were analyzed and synthesized to answer the research question.

RESULTS

Of the initial 427 articles, a total of 20 articles met inclusion criteria for final analysis. Five general themes emerged for clinical judgment during clinical education. The findings identified the teaching strategies nurse educators use. Many of the teaching methods include deliberateness and intentionality in planning and implementing the strategies. In addition to evaluating clinical judgment, nurse educators guided and mentored student thinking. Finally, this review identified reported outcomes and results of the teaching strategies and methods.

CONCLUSIONS

A limited number of articles describing teaching for clinical judgment in clinical environment were found. The articles analyzed found that nurse educators used a variety of teaching strategies for the purpose of developing students' clinical judgment. More research is needed to guide best-practices in clinical education. We must move the science forward to transform and leverage clinical education more deliberately to teach thinking in practice and decision-making about patient care.

A Qualitative Inquiry Exploring Clinical Faculty Transition to a Concept-Based Curriculum

AIM

This study explores the transition process clinical faculty experience when changing to teaching in a concept-based curriculum.

BACKGROUND

Literature related to faculty support during curricular change is sparse and offers little guidance to assist clinical faculty.

METHOD

A qualitative study was conducted with participants from nursing programs in a statewide consortium. Semistructured interviews were transcribed to identify themes that linked participants' experiences to transition stages. Additional research included review of clinical assignments and observation of faculty while teaching at a clinical site.

RESULTS

Nine clinical faculty from six nursing programs participated in the study. Five themes linked to the stages of the Bridges Transition Model were identified: Collaboration, Communication, Coordination, Coherence, and Futility.

CONCLUSION

The identified themes revealed that clinical faculty varied in their transition process. These results add to the knowledge of transitional change for clinical faculty.

Creating a Learning Plan for Prelicensure Students in Primary Care Clinical Experiences

BACKGROUND

Registered nurses (RNs) working to the full scope of licensed practice can expand the capacity of the health care system and influence patient care quality. However, preparation of prelicensure nursing students to practice in primary care is particularly challenging due to curricular and practice site barriers.

APPROACH

As part of a federally funded project to expand the primary care RN workforce, learning activities to teach key concepts of primary care nursing were designed and implemented. Students studied the concepts while placed in a primary care clinical setting and debriefed in a topical, instructor-facilitated, seminar. Current and best practices in primary care were explored, compared, and contrasted.

OUTCOMES

Pre- and postsurveys revealed significant student learning related to selected primary care nursing concepts. Overall knowledge, skills, and attitudes increased significantly pre- to post-term.

CONCLUSION

Concept-based learning activities can effectively support specialty nursing education in primary and ambulatory care settings.

A National Report on Clinical Judgment Model Use in Prelicensure Nursing Curricula

AIM

This study examined US prelicensure nursing program use of clinical judgment models and teaching strategies to promote students' clinical judgment.

BACKGROUND

Growing interest in teaching clinical judgment associated with upcoming changes in NCLEX-RN testing warrants exploration of how models and teaching strategies are currently used.

METHOD

A cross-sectional survey with multiple-choice and open-ended response items was used to examine programs' use of clinical judgment educational models.

RESULTS

Of 234 participants (9 percent response rate), 27 percent reported using a model; 51 percent intended and 20 percent did not intend to start using a model. Tanner's clinical judgment model was the most used, followed by the clinical reasoning cycle. Models were used to inform design of teaching/learning strategies and facilitate clinical teaching and evaluation.

CONCLUSION

Clinical judgment model use may increase as programs prepare for changes in NCLEX-RN. Research is needed to understand how model use contributes to measurable differences in clinical judgment skill.

Twelve tips for using Facebook as a learning platform

The COVID-19 pandemic has forced health educators to adapt quickly to teaching and supporting students online. Social media platforms - of which Facebook is presently the most popular worldwide-has demonstrated its utility in facilitating online learning and fostering student support. In order for educators to get the most out of the platform, they should consider adopting a systematic and evidence-based approach. This article draws upon current literature and the authors' experiences to offer practical tips for health educators wanting to use Facebook as a learning platform and support tool for their students. We offer twelve tips, organized into prescriptive steps for creating and managing a Facebook group, and suggestions for utilizing Facebook's features to foster student learning, collaboration, communication, and socialization.

Developing Students' Clinical Reasoning Skills: A Faculty Guide

BACKGROUND

Safe patient care relies on the ability of nurses to make timely, sound clinical judgments, yet new nurse graduates are underprepared. Nurse educators must take action with teaching to develop students' clinical reasoning skills and ultimately their clinical judgment. One first step is to consider strategies that integrate clinical judgment and clinical reasoning skills into nursing curriculum.

METHOD

The literature was reviewed to uncover what is known about teaching strategies that intentionally teach clinical reasoning skills and are focused on the development of students' clinical judgment.

RESULTS

Although not exhaustive, this guide for faculty discusses first steps when considering integrating clinical reasoning and judgment into nursing curriculum, presents teaching strategies, and provides ideas for implementation within nursing curriculum.

CONCLUSION

Teaching clinical reasoning skills, using a framework, and incorporating teaching strategies such as concept-learning, high-order questioning, and reflection focused on developing clinical reasoning skills may prove useful in developing students' clinical judgment. [J Nurs Educ. 2021;60(9):485-493.].

Life Support Course for Nurses: beyond competency training

The Life Support Course for Nurses (LSCN) equips nurses with the resuscitation skills needed to be first responders in in-hospital cardiac arrests. Previous published articles on the LSCN were mainly focused on the development of the LSCN in Singapore, as well as nurses’ confidence level, defibrillation experience and outcomes, the perceived barriers faced by nurses and the usefulness of the course. This paper highlights the importance of two key learning methodologies in the LSCN: deep learning and reflection.

Moral distress in public health practice: Case studies from nursing education

Moral distress in critical care nursing has been well studied; however, there is a gap in the literature related to moral distress among nurses and nursing students practicing in the community. This paper describes moral distress experienced during participation in the Interprofessional Care Access Network, a community-based nurse-led education and practice program providing longitudinal care coordination for underserved individuals and families in rural communities and urban neighborhoods. Two case studies represent client situations resulting in moral distress for nursing faculty and students. Contributing factors include unaddressed social determinants creating barriers to health and health care; inexperience and discomfort with people living in extreme poverty; lack of access to critical services for the most vulnerable; and powerlessness to influence discriminatory systems. Strategies are described to reduce moral distress and build moral resilience among students and faculty practicing in the community. Research is needed to expand understanding of causes, interventions, and consequences of moral distress in public health nursing.

A survey of accuracy of nurses' clinical judgement of cutaneous graft-versus-host disease in Japan

AIM

We examined accuracy of nurses' clinical judgement of graft-versus-host-disease (GVHD) symptoms and related factors using Common Terminology Criteria for Adverse Events (CTCAE) for patients who developed chronic cutaneous GVHD after haematopoietic stem cell transplants.

DESIGN

Cross-sectional design using nationwide survey.

METHODS

A questionnaire survey based on Tanner's clinical judgement model to assess patients with chronic cutaneous GVHD using CTCAE was used. Free-text descriptions and statistical analyses of relationship between correct responses and demographic data were performed.

RESULTS

The rate of correct responses for main symptoms of skin GVHD was < 50%; there was no statistical significance between correct responses and demographic data, knowledge about GVHD and collaborative practice with physicians. The accuracy of cutaneous GVHD clinical judgements was not directly related to nurses' background. Educational opportunities that reinforce nurses' abilities to reflect on knowledge and experiences to interpret patient symptoms are essential for improving accuracy of clinical judgement.

Keeping the Nurse in the Nurse Practitioner: Returning to Our Disciplinary Roots of Knowing in Nursing

Nurse practitioners are a vital and growing body of primary healthcare providers. The ever-changing advancements in science and technology and the increasing complexities in health care delivery are significant factors culminating in the expanding role of nurse practitioner-led care. Nurse educators are striving to develop nurse practitioner curricula to keep pace with the increasingly sophisticated knowledge and competencies nurse practitioners must possess to render safe quality care as independent primary health care providers. However, nursing theory is losing its place as a formative foundation in nurse practitioner curricula. Multiple factors such as content-laden, competency-based, medically focused education have caused a diminishing presence of nursing theory, shrinking the philosophical basis for nursing in nurse practitioner education. The loss of the central unifying focus of the discipline and discipline-specific knowledge (nursology) risks losing the very identity that forms the basis and relevance for nurse practitioner practice. Moreover, the loss of the nurse in the nurse practitioner unmoors nurse practitioner practice from its theoretical and scientific basis, losing discipline-specific attributes that lead to higher levels of patient satisfaction and improved patient outcomes. Keeping the nurse in the nurse practitioner is a moral imperative in nurses' ethical and social contract with society. This article discusses relevant literature and offers recommendations to keep the nurse in the nurse practitioner.

Key concepts for dietetic curriculum: An observational study of Australian dietitians' perceptions

AIM

A concept-based approach to dietetic curriculum design has been proposed to prevent content overload and promote critical thinking. Fifty-six concepts were identified in a previous study. The aim of the present study was to investigate whether the dietetic profession views these concepts as representative of current practice and key for nutrition and dietetics education, and identify any new or emerging concepts.

METHODS

Accredited Practising Dietitians (APDs) were invited to participate in a self-administered online survey that included scale responses on the relevance of the 56 concepts and open-ended suggestions of additional concepts. Respondent characteristics were also collected.

RESULTS

Ninety-eight APDs completed the survey. Greater than 65% of respondents agreed/strongly agreed that all 56 concepts were relevant. There was less agreement on the concepts of acid-base balance; leadership; management; physical activity, exercise and health; quality assurance and improvement; risk; safety; stakeholder; standards; sustainability; systems and technology and health informatics. Respondents working in regional, rural and remote areas were less likely to agree that leadership was a key concept (χ²  = 4.45, P = .035). Respondents working in teaching and education were more likely to agree that sustainability was a key concept (χ²  = 7.02, P = .008). No new concepts were identified.

CONCLUSIONS

The existing 56 concepts were considered key for nutrition and dietetics education. Although the respondents to this survey view these concepts as relevant to current practice, this may not represent the entire profession. It is yet to be determined if the concepts will meet future priorities for the dietetic workforce.

An Innovative Concept-Based Learning Activity to Identify and Educate Veterans at Risk for Amputation

ABSTRACT

Nurse educators must create meaningful learning for students while addressing the needs of a rapidly changing health care system. Academic-practice partnerships help ensure that students are up-to-date on current practices while faculty and students partner to support the needs of the practice institution. To address a health care system's high amputation rates, school of nursing faculty developed a concept-based learning activity to assess and educate patients at risk for amputation. Results included increased student learning that can be applied to other practice settings and improved outcomes for the health care system.

Concept-Based Learning for Capstone Clinical Experiences in Hospital and Community Settings

BACKGROUND

Capstone clinical experiences provide opportunities for students to develop increasing competence and independence in nursing practice, as well as to focus on care that is fundamental to contemporary nursing practice.

PROBLEM

Increasingly in the United States, nursing practice is expanding to community settings, with enhanced focus on population health, whereas promoting safe practice within acute care settings remains an imperative. Student learning needs vary by the clinical setting as does delivery of clinical experiences and associated programmatic challenges. Yet, safe and effective practice is required in all environments.

APPROACH

This article describes 2 concept-based approaches to promote deep understanding of key aspects of nursing care developed to manage specific challenges in hospital and community settings. Outcomes/Conclusions: Concept-based learning activities, used to promote deeper clinical thinking and integration of theory with practice, support students to develop increased competence in care of specific patient populations in both environments.

Classroom Concepts in the Clinical Setting: Student Perceptions of Concept Cards

ABSTRACT

Concept-based curricula have been widely implemented to combat content oversaturation in undergraduate nursing education. While nursing programs have focused on changing the classroom environment, only a few have integrated conceptual learning into clinical education. This qualitative descriptive study measured student perceptions of the effectiveness of concept cards, a concept-based clinical learning activity, in maternity and medical-surgical clinical sites. Two phases of the study indicated that the use of concept cards in clinical practicum deepened and reinforced understanding of concepts and enhanced student learning in the clinical setting.

Do prelicensure nursing students' backgrounds impact what they notice and interpret about patients?

BACKGROUND

Academic educators are challenged to foster the development of clinical judgment in diverse learners. The impact of nursing students' backgrounds on clinical judgment has not previously been studied.

AIMS

SAMPLE: Prelicensure/preregistration students, representing three international English-speaking programs in 3 countries, comprised the sample (N = 532). All were enrolled in the first course in which perioperative content was taught.

DATA COLLECTION

An online learning activity was designed to elicit responses to a simulated case study of an expert nurse role model caring for an older adult patient experiencing delirium several days post-operatively.

DATA ANALYSIS

Dyads of coders did three rounds of coding. Logistic and multinomial logistic regression models used background variables to look for patterns in student responses.

FINDINGS

The data strongly suggest that background variables impact clinical judgment, however, not in interpretable patterns.

CONCLUSION

Nurse educators must acknowledge that prelicensure students' backgrounds impact their clinical judgment and assist them to learn to think like nurses.

Teaching Clinical Reasoning Piece by Piece: A Clinical Reasoning Concept-Based Learning Method

BACKGROUND

Recent discourse generates a more thorough understanding of what clinical reasoning entails. Although numerous strategies prioritize clinical reasoning development, teaching and evaluating the thinking involved in clinical reasoning remains a struggle for nurse educators, particularly regarding clinical education.

METHOD

In response, the author developed a concept-based clinical reasoning teaching method with weekly themes, lessons, and learning activities adapted from Tanner's clinical judgment model and Lasater's Clinical Judgment Rubric.

RESULTS

The method offers an organized, consistent approach to teaching and learning clinical reasoning, with multiple opportunities for student reflection, instructor guidance, and discussing clinical reasoning concepts. Clinical education became transformed for both the nurse educator and nursing students as clinical reasoning became a visible part of students' budding nursing practice.

CONCLUSION

Nurse faculty must ensure future nurses are prepared to think-inaction. The clinical reasoning teaching method offers one potential solution. [J Nurs Educ. 2018;57(12):727-735.].

From Start-up to Sustainability: A Decade of Collaboration to Shape the Future of Nursing

AIM

This article describes progress the Oregon Consortium for Nursing Education has made toward addressing the academic progression goals provided by the 2011 Institute of Medicine's Future of Nursing: Leading Change, Advancing Health report.

BACKGROUND

The history of the consortium's development is described, emphasizing the creation of an efficient and sustainable organization infrastructure that supports a shared curriculum provided through a community college/university partnership.

METHOD

Data and analysis describing progress and challenges related to supporting a shared curriculum and increasing access and affordability for nursing education across the state are presented.

RESULTS

We identified four crucial attributes of maintaining collaborative community that have been cultivated to assure the consortium continues to make progress toward reaching the Institute of Medicine's Future of Nursing goals.

CONCLUSION

Oregon Consortium for Nursing Education provides important lessons learned for other statewide consortiums to consider when developing plans for sustainability.