Are men treated differently in clinical placements during nursing studies? A cross-sectional study

AIM AND OBJECTIVE

To explore the perceptions of nursing students regarding the treatment of men in nursing during their clinical placement.

BACKGROUND

Negative placement experiences of men who are nursing students is a risk factor for student attrition. Hence, exploring gender disparity in treatment during placement from both men and women studying nursing will contribute to improving student experience and reducing attrition.

DESIGN

Survey capturing both quantitative and qualitative data.

METHODS

Nursing students were surveyed between July and September 2021 across 16 Schools of Nursing in Australia. In addition to the Clinical Learning Environment Inventory (CLEI-19), an open-ended question explored if men received different treatment during clinical placement.

RESULTS

Those who expressed difference in treatment of men were less satisfied with their clinical learning experience (p < .001). Of the 486 (39.6%) who responded to the open-ended question, 152 (31%) indicated a difference in the treatment of men, reporting that men received: (a) better (39%); (b) different, not exclusively better or worse (19%); and (c) worse (42%) treatment from either the clinical facilitator or ward staff. While both men and women perceived gender differences in the treatment of men during placement, men were more likely to report worse treatment.

CONCLUSION

Despite the advances achieved in recruiting men in nursing, negative experiences during clinical placement are characterised by stereotypes, prejudice and discrimination, adversely impact retention.

RELEVANCE TO CLINICAL PRACTICE

Nurse educators need to recognise specific support students require during placement regardless of gender. Our findings reinforce the adverse impacts of inequitable treatment on both men and women nursing students on learning, clinical performance, morale and ultimately on retention in the nursing workforce. Addressing gender stereotyping and discrimination in the undergraduate nursing program is an important step in promoting diversity and inclusivity in the nursing workforce.

Leveraging university-industry partnerships to optimise postgraduate nursing education

BACKGROUND

Industry and higher education sectors devote considerable, but independent resources to deliver postgraduate nursing education. This leads to duplication, uncertainty among students, and critical gaps in nursing education. Establishing and sustaining meaningful partnerships between invested university and industry stakeholders can strengthen workforce capability and improve patient care.

METHODS

To evaluate the feasibility and effectiveness of using a University-Industry Integration Framework to develop a postgraduate nursing education program. Prospective mixed methods cohort study (STROBE). A co-design approach, using an established University-Industry Integration Framework, leveraged expert stakeholder partnerships to contextualise knowledge and service need for developing a postgraduate education program for cancer care nurses.

RESULTS

All participants (n = 46) were 100% satisfied with the online resources, support, and communication processes applied. Qualitative data generated three major analytical interpretations (reciprocity, flexible adaptations, authentic learning), highlighting the experiences and connections and how the partnership evolved. Program participants (n = 15) undertook a six-week cancer education program with eight responding to the survey with overwhelming satisfaction (100%), increasing their knowledge and skills. While barriers were evident, three quarters (n = 6) indicated these were addressed and enabled progress in the program. However, 63% (n = 5) were not satisfied with the program workload.

CONCLUSIONS

University and industry partners can apply the University-Industry Integration Framework and deliver a successful postgraduate education program for cancer care services. Within a co-design partnership it is possible to develop strategies and processes to overcome barriers and deliver a program for mutual benefit. The culmination of this successful education program has enhanced collaborations between partners and likely will sustain the offering of future co-design endeavours.

Development and psychometric testing of the gender misconceptions of men in nursing (GEMINI) scale among nursing students

BACKGROUND

Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career.

OBJECTIVE

To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale.

DESIGN

Cross-sectional survey.

METHODS

Pre-registration nursing students enrolled in undergraduate nursing programs across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing.

RESULTS

Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: a) identified nursing as their first career choice (p = 0.002); b) were in their final year of program enrolment (p = 0.016); and c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions.

CONCLUSION

The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students.

IMPACT STATEMENT

Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.

Effectiveness of using simulation in the development of clinical reasoning in undergraduate nursing students: A systematic review

AIM/OBJECTIVE

This systematic review examines the effectiveness of undergraduate nursing students' using simulation to acquire clinical reasoning.

BACKGROUND

Use of simulation to positively impact practice outcomes is an established method in nursing education. Clinical reasoning is a graduate capability that contributes to safe practice, so developing clinical reasoning requires explicit scaffolding in undergraduate contexts. While research has primarily evaluated specific clinical reasoning frameworks, variability in clinical reasoning definitions has obscured simulation efficacy for clinical reasoning acquisition.

DESIGN

This review uses the Joanna Briggs Institute Systematic Reviews approach.

METHODS

An electronic database search was conducted to identify studies published from May 2009 to January 2020 using a three-step search strategy. Selected papers were assessed by at least two independent reviewers for inclusion criteria, methodological validity, and data extraction. Ten studies using quasi-experimental designs involving 1532 students were included.

RESULTS

Evidence regarding the effectiveness of simulation for undergraduate nursing students' acquisition of clinical reasoning was limited but of high quality. Review results showed no statistically significant gains in clinical reasoning with a single simulation exposure. Two emerging concepts, situation awareness and teamwork support the enhancement of clinical reasoning within simulation. In order to draw future conclusions on the efficacy of simulation to develop clinical reasoning, more research is warranted.

CONCLUSIONS

New insights about team-based simulations and situation awareness were identified as integral for development of clinical reasoning in the context of simulation. More consistent use of terminology in the context of simulation research is also recommended.

Building safety cultures at the frontline: An emancipatory Practice Development approach for strengthening nursing surveillance on an acute care ward

AIM

To evaluate an emancipatory Practice Development approach for strengthening nursing surveillance on a single medical-surgical ward.

BACKGROUND

Registered nurses keep patients safe in acute care settings through the complex process of nursing surveillance. Our interest was understanding how frontline teams can build safety cultures that enable proactive nursing surveillance in acute care wards.

DESIGN

A year-long emancipatory Practice Development project.

METHODS

A collaborative relationship was established around a shared interest of nursing surveillance capacity and researcher embedded on a medical-surgical ward. Critical analysis of workplace observations and reflection with staff generated key sites for collective action. Ward engagement was supported by creative Practice Development methods including holistic facilitation, critical reflection and action learning. An action learning set was established with a group of clinical nurses, facilitating practitioner-led change initiatives which strengthened nursing surveillance and workplace learning. Evaluation supported an iterative approach, building on what worked in an acute care context. Immersive researcher evaluation, drawing on multiple data sources, generated an analysis of how ward nursing surveillance capacity can be strengthened. COREQ criteria guided reporting.

RESULTS

The ward moved through a turbulent and transformative process of resistance and retreat towards a new learning culture where nursing surveillance was visible and valued. Staff developed and sustained innovations including the 'My MET Call series', a 'Shared GCS initiative', an enhanced 'Team Safety Huddle', and staff-led Practice Development workshops. These new practices affirmed nurses' agency, asserted nurses' clinical knowledge, positioned nurses to participate in team decision-making and humanised care.

CONCLUSION

Working collaboratively with frontline staff enabled bottom-up sustainable innovation to strengthen nursing surveillance capacity where it mattered most, at the point of care.

RELEVANCE TO CLINICAL PRACTICE

Emancipatory Practice Development enables the profound impact of small-scale, microsystem level practice transformation. It is an accessible methodology for clinical teams to develop effective workplace cultures.

Developing a postgraduate professional education framework for emergency nursing: a co-design approach

Background

Hospital and university service providers invest significant but separate resources into preparing registered nurses to work in the emergency department setting. This results in the duplication of both curricula and resource investment in the health and higher education sectors. This paper describes an evidence-based co-designed study with clinical-academic stakeholders from hospital and university settings.

Methods

The study was informed by evidence-based co-design, using emergency nursing as an exemplar. Eighteen hours of co-design workshops were completed with 21 key clinical-academic stakeholders from hospital and university settings.

Results

Outcomes were matrices synchronising professional and regulatory imperatives of postgraduate nursing coursework; mutually-shaped curriculum content, teaching approaches and assessment strategies relevant for postgraduate education; a new University-Industry Academic Integration Framework; five agreed guiding principles of postgraduate curriculum development for university-industry curriculum co-design; and a Graduate Certificate of Emergency Nursing curriculum exemplar.

Conclusion

Industry-academic service provider co-design can increase the relevance of postgraduate specialist courses in nursing, strengthening the nexus between both entities to advance learning and employability. The study developed strategies and exemplars for future use in any mutually determined academic-industry education partnership.

Engaging students in a community of learning: Renegotiating the learning environment

Promoting student engagement in a student led environment can be challenging. This article reports on the process of design, implementation and evaluation of a student led learning approach in a small group tutorial environment in a three year Bachelor of Nursing program at an Australian university. The research employed three phases of data collection. The first phase explored student perceptions of learning and engagement in tutorials. The results informed the development of a web based learning resource. Phase two centred on implementation of a community of learning approach where students were supported to lead tutorial learning with peers. The final phase constituted an evaluation of the new approach. Findings suggest that students have the capacity to lead and engage in a community of learning and to assume greater ownership and responsibility where scaffolding is provided. Nonetheless, an ongoing whole of course approach to pedagogical change would better support this form of teaching and learning innovation.

The experience of agency nurses working in a London teaching hospital

This Husserlian phenomenological study explored the lived experience of eight full-time agency nurses working in the environment of intensive care in London, United Kingdom. In-depth interviews were used to ascertain the participants' experiences of full-time agency nursing in intensive care. Colaizzi's [Colaizzi P. Psychological research as the phenomenologist views it. In: Vale R, King M, editors. Existential-phenomenological alternatives for psychology. London: Oxford University Press; 1978, p. 48-71] method of data analysis was utilised. Thematic analysis identified three cluster themes: the shared experience of lacking confidence; the shared experience of deskilling; and the shared experience of feelings of isolation. The theme of the shared experience of lacking confidence identified the importance of support and understanding of agency nurses' needs in the ICU. The theme of the shared experience of deskilling illuminated participants concern at not having the opportunity to care for patients of higher acuity. The theme of the shared experience of feelings of isolation highlighted that often participants did not feel they "belonged to a team". Study findings suggest the need to include: the implementation of protocols within the clinical setting; the provision of performance feedback to agency nurses; and the consideration of ongoing structured professional development and education for ICU agency nurses.