Nursing students' reactions to a graphic novel: A multi-national descriptive qualitative study

BACKGROUND

Undergraduate nursing programme teaching and learning methods and content must evolve to meet the changing evidence base, healthcare context and needs of new generations of nurses. Art-based and narrative methods have been employed to help student nurses explore complex issues, including patient experiences of health and illness, person-centred care and social determinants of health. One creative visual teaching tool is the graphic novel. However, little is known about student perceptions of graphic novels and how they facilitate student nurses' reflection, engagement and learning. Gaining such an understanding may be of especial value for teaching Generation Z students who are used to interacting with complex visual imgery and prefer alternatives to text-heavy documents.

OBJECTIVE

The objective was to explore student nurses responses to Vivian, and graphic novels in general, as teaching resources in undergraduate nursing curricula in England, Sweden, and Aotearoa New Zealand.

DESIGN

A social constructionist critical framework informing a descriptive qualitative study.

SETTING AND PARTICIPANTS

Undergraduate nursing students in Sweden, England, and Aotearoa New Zealand.

METHODS

Data were collected using focus groups and semi-structured interviews. Braun & Clark's method for thematic analysis was used to analyse the data.

RESULTS

Three themes were developed: 1) reflections on clinical practice, including reflections on palliative care, holistic care for older people and communication between patients and staff; 2) graphic novels' usefulness as a teaching resource, in which students regarded them as an alternative way to learn; and 3) Vivian as a form of the graphic novel.

CONCLUSION

The graphic novel Vivian helped nursing students engage in critical reflection and with challenging theoretical concepts. It, and graphic novels in general offer an alternative to print-based texts, which may heighten their appeal to Generation Z learners.

Student nurses' experiences of workplace violence: A mixed methods systematic review and meta-analysis

OBJECTIVES

To identify the prevalence of student-directed violence on clinical placement and description of their related experience during clinical placements.

DESIGN

Mixed methods systematic review and meta-analysis conducted following Joanna Briggs Institute guidelines and reported according to Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

DATA SOURCES

CINAHL, Embase, Medline, Proquest, PsycINFO and Google Scholar.

REVIEW METHODS

Included studies were peer reviewed, published primary studies where pre-registration nursing students were surveyed about their experiences of physical, verbal, or sexual aggression, bullying or racism during clinical placement. Studies were quality assessed but not excluded based on the result. A convergent segregated approach to synthesis and integration was undertaken. Prevalence data were extracted and pooled using both random and quality effects models; separate analyses were conducted by violence type, source, and region. Qualitative data were thematically analysed.

RESULTS

14,894 student nurses from 42 studies were included across the meta-analyses. There was substantial heterogeneity in the included data. Pooled prevalence rates ranged from racism 12.2 % to bullying 58.2 %. Bullying (38.8 %) and physical aggression (10.2 %) were most perpetrated by nurses whereas sexual aggression was perpetrated mostly by patients (64.2 %) and physicians (18.6 %). Qualitative findings identified students' descriptions of reasons for, effects of, strategies for dealing with and higher education establishments' responsibilities with regards to workplace violence.

CONCLUSIONS

Student nurses commonly experience violence during their clinical placements. Given the potential debilitating physical and psychological sequelae of all forms of violence then this study further emphasises the need to use multiple strategies to prevent violence and to better equip student nurses to manage potentially violent incidents, their responses to violence, and to whistle blow or report when they are subject to violence.