Experiences of nursing students providing end of life care for children and young people: A focus group study

BACKGROUND

End of life care for Children and Young People (CYP) is known to be an emotive area of practice. Previous studies involving qualified nurses have demonstrated that nurses feel they need more end-of-life care education, as well as a platform for sharing experiences and discussing them with others. Evidence relating to nursing students remains limited despite being widely acknowledged as a difficult aspect of nursing education.

AIMS

This study aims to help improve understanding of the lived experiences of children's nursing students who have cared for a patient at, during, or immediately following end-of-life. The study describes the emotions experienced by children's nursing students and explores the student nurses' perceptions of education and support needs around caring for CYP during end-of-life care.

METHODOLOGY

A qualitative inquiry methodology allowed for a pragmatic approach to design this focus group study. Nine undergraduate student children's nurses participated in two focus groups. Ethical approval was granted by the host university. Thematic data analysis using Braun and Clarke's (2019) thematic analysis was conducted.

FINDINGS

Six themes emerged from the data; Emotional practice (1), the heart of the care (2), a lasting impact (3), hierarchy of grief (4), experience, knowledge and understanding (5), and the value of support (6). End of life care for children and young people is recognised by students as a sad but important part of the job role, which can have a lasting impact and which students required improved education and support for.

IMPLICATIONS FOR PRACTICE

Improved education on end-of-life care is required. This should be introduced early, encompassing practical approaches to the varied nature of end-of-life care, normalising a range of emotions and delayed responses. Furthermore, improved support is required for both student nurses and qualified staff, who are supporting students caring for CYP at the end of life.

Developing a survey to measure nursing students' knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study

BACKGROUND

Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Canada's legislation is the first to permit Nurse Practitioners (NP) to serve as independent MAiD assessors and providers. Registered Nurses' (RN) also have important roles in MAiD that include MAiD care coordination; client and family teaching and support, MAiD procedural quality; healthcare provider and public education; and bereavement care for family. Nurses have a right under the law to conscientious objection to participating in MAiD. Therefore, it is essential to prepare nurses in their entry-level education for the practice implications and moral complexities inherent in this practice. Knowing what nursing students think about MAiD is a critical first step. Therefore, the purpose of this study was to develop a survey to measure nursing students' knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context.

METHODS

The design was a mixed-method, modified e-Delphi method that entailed item generation from the literature, item refinement through a 2 round survey of an expert faculty panel, and item validation through a cognitive focus group interview with nursing students. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

RESULTS

During phase 1, a 56-item survey was developed from existing literature that included demographic items and items designed to measure experience with death and dying (including MAiD), education and preparation, attitudes and beliefs, influences on those beliefs, and anticipated future involvement. During phase 2, an expert faculty panel reviewed, modified, and prioritized the items yielding 51 items. During phase 3, a sample of nursing students further evaluated and modified the language in the survey to aid readability and comprehension. The final survey consists of 45 items including 4 case studies.

DISCUSSION

Systematic evaluation of knowledge-to-date coupled with stakeholder perspectives supports robust survey design. This study yielded a survey to assess nursing students' attitudes toward MAiD in a Canadian context.

CONCLUSION

The survey is appropriate for use in education and research to measure knowledge and attitudes about MAiD among nurse trainees and can be a helpful step in preparing nursing students for entry-level practice.

The concept of capability in pre-registration nursing education: A scoping review

BACKGROUND

Capability in nursing education is an emerging concept that includes various requisites, which can be applied in complex or unfamiliar clinical settings. Despite growing research for practising nurses, the requisites of capability for pre-registration nursing students entering the workforce remain unclear.

OBJECTIVE

The objective was to identify the requisites that constitute capability for practice among pre-registration nursing students as well as the enablers to develop capabilities.

DESIGN

A scoping review was performed using the Joanna Briggs Institute methodology.

DATA SOURCES

Records published without date restriction were searched using MEDLINE, Embase, Emcare, CINAHL, and Scopus databases. Grey literature and reference list searching was conducted.

REVIEW METHODS

Sources explicitly reporting requisites of capability or enablers of capability development in pre-registration nursing education were eligible. All global sources written in English and available in full text were included. Data were extracted and synthesised using a specifically designed extraction tool.

RESULTS

The number of records reviewed totalled 896. Twenty-three studies met the criteria for inclusion in the synthesis. Nineteen capability requisites for practice were reported. Whilst various enablers to support development of capability requisites were reported, some challenges were also identified.

CONCLUSION

This study identified requisites of capability for practice and enablers that may support development of capability in pre-registration nursing education. This holistic set of capabilities has previously not been reported. Given the emerging nature of the concept, this collective set of requisites may not be indicative of all required capabilities of nursing students upon graduation. Efforts to develop a definitive set of requisites and explore strategies to support and enable capability development are needed to advance this concept in the pre-registration nursing education context.

Gerontological nursing competencies: A scoping review

BACKGROUND

Despite decades of advocates striving to enhance gerontological content in baccalaureate nursing programs, nurses are still graduating with inadequate knowledge and skills to work with older adults. Scholars suggest that incorporating entry-to-practice gerontological competencies could be one way to improve graduating nurses' knowledge about older adults.

AIM

To examine the state of gerontological entry to practice competencies and standards for baccalaureate-prepared nurses around the world.

DESIGN

We conducted a scoping review of the literature using the Joanna Briggs Institute (JBI) framework and followed PRISMA-ScR guidelines to report findings.

METHODS

We performed searches from inception to June 20th 2022 in Medline and EMBASE via OVID, CINAHL via EBSCOhost, Scopus, and Cochrane Library via Wiley. We conducted a search on GOOGLE for grey literature. We included literature that examined 1) baccalaureate nursing programs, 2) gerontological competencies/standards, and 3) older people/adults.

RESULTS

We found 8 literature sources, 4 of which were academic papers and 4 documents describing gerontological entry-to-practice standards and competencies from national nursing associations. Gerontological competencies highlight providing person-centered care to older people and their families across many care contexts. This care includes relational and cultural competence, exhibiting professional values and screening for potential elder abuse. Scholars in two papers relayed their experiences incorporating gerontological competencies into their curricula and two studied student nurses' gerontological competency.

CONCLUSIONS

There is interest and some progress in developing and incorporating gerontological competencies in various countries but not enough. A coordinated approach to sharing information and expertise among nations is needed to develop international gerontological competencies to facilitate improved nursing care with older adults.

Student nurses' views of participating in an intergenerational café with older people

BACKGROUND

Within the context of global ageing, older people will require health care during times in their later lives. As most nurses will care for older people across a variety of care settings, it is crucial that older people and nurses can work together in partnership. In preparation for this, it is important to develop intergenerational learning innovations for student nurses and older people. An online intergenerational discussion café was developed to provide an opportunity for older people and student nurses to meet and get to know each other.

OBJECTIVES

1) Evaluate the effectiveness of an intergenerational discussion café as a way of facilitating intergenerational learning, 2) Elicit participants' views on whether intergenerational learning had occurred.

DESIGN

Ethically approved survey research.

SETTINGS

Tertiary education institution.

PARTICIPANTS

Third year student nurses (n = 50) across three BSc Nursing pre-registration degree programmes enrolled on a shared community care module.

METHODS

Post-café, student nurses were invited via email to voluntarily participate in the research and to complete an anonymous online survey. Questionnaire return implied consent. Fifty student nurses (n = 50) participated in the post café survey. Descriptive statistical analysis of Likert scale quantitative data and thematic analysis of open-ended questions was undertaken.

RESULTS

Participants reported that the intergenerational cafés were well organised, worked well and strongly agreed that the cafés were helpful in facilitating student nurses and older people to connect socially and share views. Results also showed that participants felt they got to know a lot about older people and that they were in many ways quite similar to older people.

CONCLUSIONS

This study provides valuable information on the use of intergenerational cafés as a means of facilitating intergenerational learning. Findings indicate that it was a positive learning experience for participants.

Nursing students' processes of taking role models and being role models: A descriptive phenomenological study

BACKGROUND

Role models are frequently viewed as a means of motivating people to adopt new behaviors and inspiring them to establish ambitious targets. Role models play a significant role in the characters of individuals and can be effective in shaping their career choices, education, and identities. Within the nursing profession, role models are integral to nursing students' journey towards understanding the nursing role and professional responsibility. For this reason, it is very important for nursing students to identify role models that support the development of students growth and development.

OBJECTIVES

This study aimed to investigate the qualities of nurses who serve as role models for senior undergraduate nursing students in shaping their professional attitudes and behaviors, identify the motivations behind selecting these individuals as role models.

DESIGN

A descriptive phenomenological research method was used.

SETTINGS

The research was conducted at a state university nursing school.

PARTICIPANTS

The study was conducted with the participation of 16 senior nursing students.

METHODS

Data collected from one-on-one interviews. A thematic analysis was used to analyze the data.

RESULTS

Student nurses mostly took clinical nurses and lecturers as professional role models. They were most impressed by their role models' knowledge, strong communication skills, and respect for human beings. To imitate their role models, students were willing to work in the clinic to improve their communication and psychomotor abilities and engaged in research and inquiry in areas where they felt insufficient. However, they also reported that most clinical nurses were not positive role models. They avoided taking nurses as role models because they had low communication skills, did not guide the student, and did not value human beings.

CONCLUSIONS

The study's findings indicated that student nurses were primarily influenced by clinical nurses and viewed them as both positive and negative role models, and they aspired to emulate the qualities of the nurses they considered positive role models while actively avoiding behaviors and traits associated with those seen as negative role models. Clinical nurses, who are in contact with prospective nurses the most, have an important role in guiding them.

Protective resources against stress among student nurses: Influences of self-efficacy, emotional intelligence and conflict management styles

AIMS

This study aimed to investigate the levels of stress among French student nurses and the influence of different personal resources on their well-being and stress levels.

BACKGROUND

Student nurses have to cope with strong emotional demands, leading them to experience academic stress. Recent studies have highlighted the influence of personal resources such as self-efficacy, conflict management styles and emotional intelligence on the ability to cope with stressful situations. However, the contributions of these different factors have so far been explored separately.

DESIGN

A multicenter cross-sectional survey was performed from February to April 2022. The sample consisted of 1021 first-year student nurses from different nursing schools in France (including 890 women and 113 men), aged 18-55 years.

METHODS

Students completed an online questionnaire containing measures of well-being, Perceived Stress Scale, Occupational Stress, Generalized Self-Efficacy Scale, Emotional Intelligence and Conflict Management Styles.

RESULTS

Nearly half (40.4%) of participants reported experiencing symptoms of stress. However, they also reported a satisfactory well-being and high self-efficacy for coping with stressful situations. Multiple regression analyses revealed major contributions of self-efficacy to stress and well-being and additional mediation models showed that these contributions were partially mediated by awareness of one's own and others' emotions.

CONCLUSIONS

These findings highlight the importance of continuing to work on the construction of appropriate educational activities that are consistent with the technical and, above all, nontechnical skills of student nurses.

The influence of social media on student nurses: A systematic mixed-studies review

BACKGROUND

Social media usage has been ubiquitous and extensively integrated into the daily lives of student nurses. However, there exists a paucity of understanding regarding the influence of social media on student nurses' personal and professional development.

OBJECTIVE

To examine the influence of social media on student nurses' personal and professional values.

DESIGN

A systematic mixed-studies review.

METHODS

English language published studies were sourced from hand searches and seven electronic databases (PubMed, CINAHL, Embase, PsycINFO, ProQuest Dissertation and Theses Global, Scopus, and Web of Science) from the inception of each database to January 2023.

RESULTS

Twenty-six studies were included. Two main themes and eight subthemes were derived through thematic synthesis. The first main theme, Shaping Student Nurses into Nurses, included four subthemes: 1.1) Personal Development, 1.2) Professional Development, 1.3) Advocacy, and 1.4) Networking. The second main theme, Repercussions of Social Media Usage, included four subthemes: 2.1) Frustrations, 2.2) Discriminative Feelings, 2.3) Compulsive feelings, and 2.4) Consequences of Inappropriate Usage.

CONCLUSION

The ubiquitous utilization of social media among the current generation of student nurses, for personal, educational, and professional purposes, has precipitated transformative effects conducive to their holistic development. Notwithstanding the potential perils associated with privacy violation and inappropriate usage, educational institutions can develop pedagogical strategies and guidelines in collaboration with healthcare institutions and professionals, aimed at the incorporation of social media within the educational curricula and the prospective workplace environments of student nurses.

Effect of empathy competence on moral sensitivity in Chinese student nurses: the mediating role of emotional intelligence

BACKGROUND

Ethical issues may pose challenges to nursing students entering clinical practice. Moral sensitivity can assist them in recognising existing moral situations and then taking adequate action. Identifying the variables associated with moral sensitivity may be useful in preparing to improve nursing students' moral sensitivity.

OBJECTIVES

This study investigated empathy, emotional intelligence, and moral sensitivity in Chinese student nurses to explore the association among these three factors and to verify the mediating function of emotional intelligence in determining the connection between empathy and moral sensitivity.

DESIGN

This study used a cross-sectional correlational design.

SETTING AND PARTICIPANTS

Through convenience sampling, 239 fourth-year nursing undergraduates at a university in Western China were enrolled in this study.

METHODS

Nursing students who volunteered to participate in the study completed self-reported scales on empathy, emotional intelligence, and moral sensitivity between September and October 2022. The potential mediating effect was explored using the Process Macro and bootstrap method.

RESULTS

The nursing students' average scores were 39.62 ± 5.27 on moral sensitivity, 108.21 ± 15.49 on empathy, and 124.41 ± 13.66 on EI. Moral sensitivity was positively correlated with emotional intelligence (r = 0.454, p < 0.001) and empathy (r = 0.545, p < 0.001). Furthermore, empathy exerted a substantial direct effect on nursing students' moral sensitivity (B = 0.1424, p < 0.001). Emotional intelligence could mediate the indirect path from empathy to moral sensitivity. (B = 0.0372, p < 0.001).

CONCLUSION

Emotional intelligence mediated the association between empathy and moral sensitivity. Thus, educational activities and programmes placing an emphasis on empathy and emotional intelligence may offer an alternative way to promote moral sensitivity in Chinese student nurses.

IMPLICATIONS

Nursing educators can organise programmes to improve nursing students' emotional competence and professional values. Early exposure to clinical practice benefits nursing students a lot in terms of building interactions with patients and increasing emotional resonance. In addition, nursing educators should develop situational teaching in nursing ethics courses to help students cope with ethical issues.

The learning experiences of student nurses in the perioperative environment: An integrative literature review

OBJECTIVES

For the Student Nurse placement in the perioperative environment provides an opportunity to observe and engage in preoperative, intraoperative, and immediate postoperative care of the surgical patient. To date no synthesis of empirical studies has been undertaken to ascertain the learning impact of the perioperative experience. The objectives of this review were to identify and synthesise the literature on the learning experiences of student nurses within the perioperative environment.

DESIGN

An integrative review that followed Whittemore and Knafl's (2005) framework.

DATA SOURCES

Studies published between 2012 and 2022 were identified via a comprehensive search of the following databases: CINAHL, Medline (OVID), Medline (Pubmed), Medline (EBSCO), EMBASE, PsychINFO, ISI Web of Science and SCOPUS.

REVIEW METHODS

The review was reported in line with the Preferred Reporting for Systematic Reviews and Meta-Analysis (PRISMA). The initial search located 1475 Articles. After screening and checking for eligibility 17 articles were selected. These were critically appraised using the Critical Appraisal Skills Programme (CASP). The papers were analysed and reported in a narrative synthesis.

RESULTS

Seventeen studies met the inclusion criteria for the review. Three categories with five sub categories were identified including: Learning opportunities, Appreciation for perioperative role and intent to return and Factors influencing student learning.

CONCLUSIONS

A large variety of student learning occurs within the perioperative clinical environment. Students viewed staff nurses as positive role models in an environment that posed opportunities and challenges for student learning. Anxiety and stress in an unfamiliar environment were commonly mentioned with students offering recommendations to improve their experience.

A visual ethnographic study on nurse lecturers' enactment of compassionate care within the adult pre-registration nursing curriculum

BACKGROUND

Nurse lecturers make a valuable contribution to developing the future nursing workforce. However, how this is nurtured within nurse education requires further exploration. There is limited research exploring the experiences of nurse lecturers providing compassionate care within the adult pre-registration nursing curriculum.

OBJECTIVES

This study explores how nurse lecturers enact compassionate care within the adult pre-registration nursing curriculum. To elicit shared patterns of behaviours and use creative methods to promote a critical dialogue.

METHOD

A visual ethnographic approach was used to explore nurse lecturers' experiences at a University in England. Using purposive sampling, nine auto-driven photo-elicitation interviews took place, and five participants attended a focus group to develop individual and collaborative concept maps. A thematic approach to data analysis was employed.

FINDINGS

Five themes were identified, illustrating compassionate care as the human condition involving appropriate behaviours and competent action. Compassionate care is threaded through the curriculum using different teaching and learning approaches, requiring a culture of shared human relationships. The combination of photographs, maps and descriptions provide a unique perspective of how nurse lecturers nurture and role model compassionate care to their students.

CONCLUSION

There are many ways compassionate care is experienced, enacted and enhanced by nurse lecturers within the adult pre-registration nurse curriculum. The five main themes act as a framework to guide nursing education and nursing practice. Future research should aim to understand better how compassionate care can be nurtured within different fields of nursing.

Effects of simulation in improving the self-confidence of student nurses in clinical practice: a systematic review

BACKGROUND

Considering the positive influence of simulation from previous literature may encourage educators to regard it as a valuable teaching strategy in nursing schools. This literature review aims to investigate whether the use of simulation improves undergraduate nurses' self-confidence during clinical practice.

METHODOLOGY

This study employed a literature-based design. Five academic databases, including CINAHL, EBSCO, ProQuest, PubMed and Medline, were utilised to extract relevant studies using appropriate keywords and Boolean operators. Studies published in the last 15 years (2005-2020) were included in the search. Studies were retrieved using the Exclusion and Inclusion criteria. The Critical Appraisal Skills Programme (CASP) was used to critically appraise the studies.

RESULTS

A total of 15 primary research studies were extracted for review. Four major themes emerged from the review: Improved self-confidence to carry out clinical tasks, Increased ability to work in teams, Improved self-confidence to perform community work and Improved self-confidence in communicating with patients and team members.

CONCLUSION

Clinical simulation is a useful tool in increasing the self-confidence of nursing students to perform clinical tasks, make clinical judgements, communicate with patients and team members and improve their teamwork. To improve the quality of care received by patients, it is recommended that clinical simulations be integrated into the nursing curriculum in Saudi Arabia. Increasing the confidence of students has been shown to be associated with greater confidence in performing clinical tasks.

A mixed methods study

BACKGROUND

There is a global shortage of nurses, with particularly acute shortfall in General Practice Nursing in the United Kingdom estimated at as high as 50% vacancy rate by 2031 by some sources. There has previously been reluctance for General Practices to host student nurses on placement, but it has become imperative to increase placement capacity if practices are to be able to recruit a future workforce. Collaborative Learning in Practice is a means of organising placement learning for student nurses using a coaching model, that allows for leadership development, peer support and earlier engagement in patient care, and increases placement capacity.

METHODS

This was a mixed methods study using qualitative data from focus groups to evaluate the implementation of Collaborative Learning in Practice, and routinely collected audit data on numbers of clinic appointments to investigate the potential impact an increased capacity of student nurses might have on patient access to services. The aims of this study were: to implement and evaluate Collaborative Learning in Practice in General Practice Nursing settings; to explore issues of interprofessional learning; to explore patient access to services related to increased student nurse capacity.

RESULTS

Our qualitative data indicated the following themes as important to students and staff: Peer Support; Interprofessional Learning; and the Importance of 'own clinics' for students to see patients. The audit data indicated that having students leading their own clinics increased the clinic numbers available by approximately 20% compared to when students were not in placement.

CONCLUSIONS

This study shows that student nurses increased clinic capacity and improved access for patients. Students valued their placement, felt that they were more 'part of the team' than in other placements and consequently had a greater sense of belonging. This was multifaceted, coming in part from the welcoming practice staff, in part from the opportunities for peer support engendered by the collaborative learning in practice model, and in part from the interprofessional learning opportunities available. General Practice Nursing placements for students are important for future workforce recruitment and can help meet Quality and Outcomes Framework targets for General Practices.

Do professional nurses practice what they preach? A qualitative study on professional socialisation of student nurses in the clinical learning environment

While working alongside professional nurses, student nurses develop professional identity and learn the professional nursing role, a process known as professional socialisation. Professional nurses should model professional behaviour to be emulated by student nurses. We used a qualitative exploratory design to explore if professional nurses behave in a manner that supports professional socialisation of student nurses in a clinical learning environment. According to our observations, two main categories emerged regarding professional nurses' behaviour. The first category was unprofessional conduct with sub-categories that included disrespect, infringed patient privacy, breached confidentiality, inappropriate dress code and lack of punctuality. The second category was ward disorganisation which was related to delegating duties and structured orientation programmes for student nurses. In this study, professional nurses did not behave in a manner consistent with professional socialisation in the clinical learning environment. Student nurses may struggle to develop professional identity, leading to reduced confidence and poor patient quality care. Student nurses need to be professionally socialised in a clinical learning environment and professional nurses need to be empowered on how to carry out this process.

Mouth care: why it matters - highlighting a neglected care need

Oral health care is integral to general wellbeing, allowing people to eat, communicate verbally and socialise without discomfort or embarrassment. In relation to people being admitted to hospital, poor oral health care has been linked to longer hospital stays and increased care costs. It is also associated with an increase in hospital-acquired infections such as pneumonia and can affect nutritional intake, which is vital in supporting recovery. Assistance and encouragement with effective and daily mouth care can prevent deterioration in a patient's oral health, and yet it remains a neglected and overlooked area of care provision. Initiatives have attempted to address this neglected area of care but the pandemic and other priorities have allowed it to be lower on the healthcare agenda. Nurses, healthcare assistants and student nurses form the largest group of the healthcare workforce, providing or supervising the personal care of patients in hospitals and the community. Therefore, oral healthcare assessment and practical skills should be embedded in education and be given a strong focus and leadership to ensure that good practice is consistently implemented across all health and care settings. Mouth care really matters and should be integral to all health and care encounters. Further research and investigation into the important but neglected area of mouth care is also required.

Transformative care for people with disabilities: Empowering senior nursing students with competency based clinical education-A qualitative study of the impact

BACKGROUND

People with disabilities (PWD) constitute 26 % of the U.S. population yet no nursing schools have compulsory clinical education specific to PWD. Inadequate education and negative attitudes lead to lack of preparedness for working with PWD. To meet the needs of this highly underserved population, nursing students need training and experience in the care of PWD.

OBJECTIVE

The objective of this paper is to report three themes from the qualitative evaluation of two immersive clinical experiences with PWD for undergraduate nursing students designed to evaluate competencies for working with PWD.

DESIGN

Curriculum evaluation using qualitative methods.

METHODOLOGY

During and after the clinical experience, qualitative data (reflection papers, debriefing responses, and group interviews) were collected with a volunteer sample of senior nursing student participants of the clinical experiences with PWD. Thematic analysis was used to identify changes in students' attitudes, perceived competence, and motivation for working with PWD.

FINDINGS

Three major themes are reported in this paper: A positive shift in perspective of PWD (attitudes), impact of the experience on students' practice with PWD (comfort, confidence, awareness and motivation), and revelations from the experience (attitudes and resource awareness).

CONCLUSIONS

A comprehensive immersive clinical experience caring for PWD provides a real-world laboratory with important experiential learning activities that help students acquire and apply knowledge about the healthcare needs of PWD. Reflection activities facilitate synthesis of that knowledge. Results from this study suggest that this clinical experience can transform students' attitudes toward PWD, enhance their clinical skills, and motivate them to consider a nursing career with this highly under-served population.

Exploring the lived experience of student nurses perspective of racism within education and clinical practice: Utilising the flipped classroom

BACKGROUND

The experiential learning gained by student nurses and educators using flipped classroom principles, in conjunction with data from a subsequent study, are explored in this paper. It facilitated a deeper understanding of the 'lived experiences' of racism for Black African-Caribbean student nurses at university and within the clinical practice environment.

METHOD

The qualitative approach of 'Conversations with a purpose', using recorded focus group discussions was utilised as a pragmatic research methodology to explore perspectives of nursing students.

RESULTS

Direct and indirect racism was experienced by student nurses in both, practice, and educational environments. Common issues that arose centred on patient's refusal of care, poor support of students, discomfort or denial of staff in addressing sensitive issues, questioning of students' clinical competencies, and educators using 'otherness' (ethnicity, and related stereotypes) to emphasise limitations of certain groups of students.

DISCUSSION

The flipped classroom can be one way of creating inclusive safe spaces for discussing sensitive topics pertaining to racism, inequity, and social injustice. Nurse educators need to engage in providing awareness around these subjects, that are perceived as uncomfortable and unspoken. Without this, no significant paradigmatic shifts can be made around supporting our students in their lived experience of racism and discrimination.

Professional commitment and willingness to care for people living with HIV among undergraduate nursing students: The mediating role of empathy

BACKGROUND

As future registered nurses, undergraduate students play a vital role in integrated care for acquired immunodeficiency syndrome; hence, there is a need to examine factors that can increase their willingness to care for persons with such conditions.

OBJECTIVE

This study examined the relationship among nursing professional commitment, empathy, and willingness to care for people living with human immunodeficiency virus and acquired immunodeficiency syndrome among undergraduate student nurses, and the mediating role of empathy in this relationship.

DESIGN

Quantitative, cross-sectional design.

SETTINGS

Nursing schools from five provinces of China, including Hunan, Jiangxi, Guangxi, Henan, and Hebei.

PARTICIPANTS

A total of 747 undergraduate student nurses were recruited via cluster sampling.

METHODS

Online survey was used to collect data. Nursing Willingness Questionnaire, Professional Commitment Scale, and Jefferson Scale of Empathy were the scales used to measure the variables. Structural equation modeling was used to determine significant relationships.

RESULTS

Respondents' professional commitment and empathy demonstrated moderate positive associations with willingness to care. Empathy demonstrated a 21 % mediating effect on the effect of professional commitment and willingness to care (p < 0.05).

CONCLUSIONS

Findings highlight the enabling role of professional commitment and empathy in improving undergraduate student nurses' willingness to care for persons living with human deficiency virus. Nurse educators can help improve the impact of students' professional commitment on their willingness by using educational strategies that enhance their empathy.

Creating an interprofessional education package on patients' spiritual needs

This article outlines the experiences of a Scottish healthcare chaplain. After a student nurse expressed a dated view of chaplains, I realised it was my responsibility to refresh it. After reflection I planned, developed and implemented an interprofessional education session for nursing, midwifery and allied health professional (NMAHP) students on clinical placement. I had to develop awareness of learning theories, preferences and styles, and explore different methods of delivery. Since NMAHP students can be undergraduate, postgraduate, school leavers or career changers, the session is multi-generational and interprofessional. Attendee feedback was used to review the learning session. This package was developed and shared with my team but may be of value to other healthcare chaplains or spiritual care educators to introduce spiritual care to NMAHP students on clinical placement. It will also be a useful resource for nurses, midwives and allied health professionals to expand their understanding of the role.

Perceived sleep quality: a comparison between hospital nurses and student nurses

BACKGROUND

The prevalence of poor sleep quality is high among nurses, and affects them physically and psychologically as well as organisational functioning. However, evidence on equipping student nurses with good sleep practices that could mitigate poor sleep as they transition into the nursing workforce is lacking.

AIM

This study compared the prevalence and quality of good sleep among hospital nurses and student nurses.

METHODS

A descriptive cross-sectional study of 130 hospital nurses and 130 student nurses in Brunei was carried out. Sleep quality was assessed using the Pittsburgh Sleep Quality index. Multiple logistic regression was applied.

RESULTS

Hospital nurses were 4.29 times more likely to experience poor sleep than student nurses. Those who were overweight were 2.35 times more likely to have poor sleep quality than those with a healthy weight. Although students had significantly good sleep latency, needing less time to fall asleep, they experienced significantly more sleep disturbances, shorter sleep duration and less sleep efficiency.

CONCLUSION

The prevalence of poor sleep quality among nurses in Brunei is higher than global estimates. Stakeholders such as nursing leaders, nursing educators and healthcare policymakers should prepare student nurses and help existing nurses by formulating strategies to promote working schedules and rosters that minimise circadian disruption.

Development of a simulation placement in a pre-registration nursing programme

BACKGROUND

A 4-week simulation placement for first-year student nurses using an innovative blended approach was developed and delivered in one university. This was the first tariff-funded simulation placement in the UK for student nurses.

AIMS

To describe how this flexible simulation placement was developed, operated and adapted due to COVID-19 while exploring the student nurses' experiences and preparedness for practice.

METHODS

An anonymous online survey was undertaken and a placement evaluation was completed and compared with traditional clinical placement evaluations by previous students at the same point in their studies.

RESULTS

Students were as satisfied with the simulation placement as students who had attended real practice placements: 92% of students were satisfied with their simulated placement experience and 92% felt prepared for practice.

CONCLUSION

This simulated placement has been an acceptable replacement for traditional practice placements, particularly during the COVID-19 pandemic.

The influence of an educational intervention on nursing students' domestic violence knowledge and attitudes: a pre and post intervention study

Background

Nurses, as the largest group of health professionals, have a key role in recognising, mitigating and preventing domestic violence. However, studies demonstrating effective undergraduate educational interventions are lacking. The research aim was to compare undergraduate nursing students’ knowledge and attitudes about domestic violence before and after an educational intervention on domestic violence and explore their views on the most useful teaching strategies.

Methods

A quasi-experimental pre and post design was used to determine the impact of an educational intervention. Australian nursing students enrolled in a first-year undergraduate subject were invited to participate. The educational intervention included a 40-min pre-recorded lecture on domestic violence, and a two-hour face-to-face workshop facilitated by an expert, supported by readings. Students completed a pre- and post-intervention online anonymous survey using a validated instrument, the Inventory on Beliefs and Attitudes towards Domestic Violence. Wilcoxon signed rank tests were used to compare pre and post intervention results.

Results

Approximately 400 students completed the voluntary workshop; 198 students completed the pre survey, 176 completed the post survey and 59 (13.1%) completed both. Post intervention, participants indicated stronger agreement on 15 of 22 items. The inventory score became significantly more positive (Z = -3.196, p = .001, CI -.206—-0.067) post intervention. Of the 173 students who indicated post intervention which forms of education they found useful, 38.2% considered face-to-face tutorials to be the most useful education modality.

Conclusions

This study demonstrates the effectiveness of even a small educational intervention in changing attitudes, and creating awareness and knowledge of the context, prevalence, perpetrators, and significant associated burden of illness related to domestic violence, and nurses’ responsibility to support victims.

Mediating effects of self-directed learning on the relationship between critical thinking and problem-solving in student nurses attending online classes: A cross-sectional descriptive study

BACKGROUND

With the increased prevalence of online education due to the coronavirus 2019 pandemic and advancements in information technology, essential competencies, such as critical thinking, self-directed learning, and problem-solving ability, should be examined among student nurses taking online classes.

OBJECTIVES

Based on the findings of several studies suggesting that critical thinking does not affect problem-solving, this study aimed to examine the relationship among critical thinking, self-directed learning, and problem-solving in student nurses attending online classes, and to determine whether self-directed learning could mediate the relationship between critical thinking and problem-solving.

DESIGN

Cross-sectional, descriptive design.

SETTING

K University in South Korea.

PARTICIPANTS

In total, 138 junior and senior nursing students were enrolled.

METHODS

The critical thinking disposition scale for nursing students, self-directed learning scale, and problem-solving scale for college students were used to quantify participants' responses.

RESULTS

Our results revealed significant positive correlations among critical thinking, self-directed learning, and problem-solving. Furthermore, self-directed learning (β = 0.78, p < 0.001) had a significant mediating effect on the relationship between critical thinking and problem-solving ability (Z = 5.10, p < 0.001).

CONCLUSION

Developing and implementing appropriate self-directed learning programs are critical for improving problem-solving ability affected by critical thinking among student nurses engaged in online education.

Using an E-learning activity to enhance student nurses' understanding of cognitive impairment

BACKGROUND

Nurses often lack the knowledge and expertise to work with older people with cognitive impairment, which includes dementia, delirium and depression. This is due in part to deficits in their basic nursing education related to older people and managing the care needs of people with cognitive impairment. We developed an e-learning activity to facilitate student nurses' knowledge of cognitive impairment.

OBJECTIVES

To test if the e-learning activity could improve student nurses' knowledge of cognitive impairment and whether they would find the style of learning beneficial.

DESIGN

A quasi-experimental pre-post-test design was used to test if the cognitive impairment e-learning activity could improve student nurses' knowledge about assessing and managing the needs of older people who are experiencing cognitive impairment. A 12-item true/false quiz was completed by participants.

SETTINGS

One large Western Canadian university.

PARTICIPANTS

Second year nursing students in the four-year baccalaureate degree program, second year nursing students in the bilingual four-year baccalaureate degree program, and first year nursing students in the two-year after-degree nursing program were invited to participate. Data from 166 students were included in the analysis (n = 166).

RESULTS

Based on the results of a paired t-test (p < 0.001 and an average score increase of 1.12 out of nine), we conclude that students' knowledge about cognitive impairment in older people increased following the e-learning activity. Students also offered qualitative feedback that identified the activity as both helpful and as an enjoyable way to learn and provided suggestions for improvement.

CONCLUSIONS

This e-learning activity was effective in helping students learn about how to work with older people experiencing cognitive impairment. This mode of learning might be useful for other difficult-to-teach content areas.

Undergraduate Nurses' Attitude Change to Health Technology Implementation

The poster will report upon a longitudinal study exploring the attitudes towards the implementation of health technology into clinical and community nursing practice from the perspective of third year undergraduate students studying adult, child, mental health and learning disability nursing.

Demographic profiling of Caribbean and United Kingdom student nurses' use of social media for professional development

BACKGROUND

Most students are adept in using technology and have developed skills and confidence utilising SoMe for professional purposes. SoMe is used by both registered nurses and student nurses.

PURPOSE

The purpose of this study was to investigate the professional use of SoMe by student nurses in Trinidad and Tobago, Jamaica and the UK to guide, support and develop implementation of effective and appropriate use of SoMe for professional development.

METHODS

An online cross-sectional survey was completed by student nurses from the three countries. Data were analysed using descriptive statistics.

RESULTS

The main reason for using social media among Caribbean participants was to watch videos or short clips whereas in UK it was downloading articles. Over 75% participants of all ages believed that social media was likely to help their career. There is no social media guidance for student nurses in Trinidad and Tobago and Jamaica.

CONCLUSION

Our study demonstrated that social media is embedded in student nurses' professional development throughout their education, with some variation in their use by country. Despite the fundamental place that social media plays in student nurses' professional development, there is no national or international guidance on how student nurses should use social media for professional development.

International student nurses' use of social media for learning: A cross sectional survey

BACKGROUND

Students use social media for sharing information and connecting with their friends, also for peer support, peer learning and student engagement. Research indicates that approximately twice the number of students were using social media for educational purposes compared to academic staff and almost all students discuss academic issues on social media. However, little is known about how diverse cohorts of student nurses use social media for specific purposes at different stages of their learning.

OBJECTIVES

Identify how student nurses in each country of study use social media for learning. Identify how each generation of student nurses use social media for learning. Identify how student nurses use social media as their education progresses.

DESIGN

A cross-sectional survey.

SETTINGS

The study was undertaken across three countries Jamaica, Trinidad and Tobago and the UK.

PARTICIPANTS

Student nurses from each of the countries that consented to participate met the inclusion criteria.

METHODS

1050 student nurses across the three countries self-completed the cross-sectional survey between March and September 2019. Data was analysed using descriptive and inferential statistics.

RESULTS

WhatsApp® was the most used platform for learning amongst participants. Watching videos and downloading articles represented two-thirds of social media usage for learning. Smart phones were the most used device to access social media. Kruskal-Wallis tests were significant (≤0.001) for checking social media and messaging in lecture, use of social media for studies and classroom activities by country, generation (except classroom activities) and year of education. Use of social media for classroom activities had no significance by generation.

CONCLUSION

Country, generation and year of education are factors that influence the use of social media in student nurses' learning. These should be considered by Universities in curriculum development and in teaching and learning delivery. From a pragmatic approach, social media is available and used by a majority of student nurses and can be widely assimilated into the nursing curriculum.

"Nursing and speech and language students' perspectives of reflection as a clinical learning strategy in undergraduate healthcare education: A qualitative study"

AIM

The aim of this study was to explore nursing and speech and language students' perspectives of reflection as a clinical learning strategy during years three and four of their undergraduate education programmes.

BACKGROUND

Reflection is recognised as a core student learning activity which is widely used in undergraduate healthcare education for clinical practice. Studies indicate that structured models and frameworks do help novice students to develop the process of reflection-on-practice particularly in years one and two. However, there is limited research on healthcare students' perspectives of reflection as a clinical learning strategy in the latter years of their undergraduate healthcare education (years 3 and 4).

DESIGN

A qualitative descriptive design was used.

METHODS

Using a self-reporting method whereby students respond to a series of questions posed by the researchers, data were collected from nursing (n = 20) and speech and language students (n = 26) in one university in Ireland and analysed using thematic analysis.

RESULTS

The findings from both nursing and speech and language students were similar. Three themes identified included: description of reflection, undertaking reflection and contribution to clinical learning. Most students expressed beneficial effects of reflection for personal and professional clinical learning. Some students reported negativities to the written reflections, expressing a preference for more diverse and less structured strategies and more face-to-face reflective discussions with clinical educators.

CONCLUSIONS

Whilst the benefits of reflection for clinical practice are well versed in this study, the authors suggest that academic and clinical educators employ more diverse and innovative reflective tools for healthcare students who are at a more competent level of their undergraduate education programme. Further interprofessional research in relation to different clinical reflective strategies for healthcare students in years three and four of their undergraduate education programmes is warranted.

Supporting student nurses to develop healthy conversation skills

As advocates for health, nurses are ideally situated to deliver effective health promotion in their daily interactions with people. This work evaluates the integration of healthy conversation training, making every contact count (MECC), into a health promotion module in an undergraduate nursing degree at a higher education institute (HEI). In all, 108 students completed the online questionnaire I year after receiving healthy conversation training. 67% of students reported the regular or occasional use of healthy conversation skills and identified a wide range of scenarios where they had used the skills. 65% of students used health action planning framework in their own personal self-care. Student nurses acknowledged barriers and enablers to their use of healthy conversation skills. Having knowledgeable mentors who role modelled healthy conversations skills in their consultations was the most frequently raised factor, in addition to lack of knowledge of local resources, time and confidence. All placement settings should ensure that registered nurses, especially those undertaking mentorship responsibilities have access to healthy conversation training.

The experiences of student nurses in a pandemic: A qualitative study

Aim/objective

To record and learn from the experiences of students working on clinical placement in a pandemic.

Background

In March of 2020, final and second year student nurses in England were given the option to join the Covid-19 pandemic work-force, paid as high-level health care assistants.

Methods/design

Using qualitative methods and rapid analysis techniques, this study gathered the unique experiences of 16 final year students, from all fields of nursing at a University in the East of England, who chose to complete their final extended placement in a diverse range of clinical placements at the height of the first wave of the pandemic. Data was collected between July and September 2020.

Results

Five key themes were identified across our data: rationale for undertaking the extended placement, role tensions, caring for patients and their families, the impact on teaching and learning, and personal health and wellbeing.

Conclusions

While our participants reported largely positive experiences including a perceived heightened preparedness for qualification, their experiences provide important insights for nurse educators for the education and support of future students going into similar situations, in particular relating to welfare and support, preparation for placement, resilience, e-learning and learning on the front line.

Developing a consensus-based scoring rubric to enhance practice-based assessment of student nurses' clinical competence: A Delphi study

BACKGROUND

Concerns about reliability and validity of practice-based assessment of professional competencies are frequently reported in the literature. Difficulty in understanding competency statements or distinguishing different achievement levels has been found to be a major factor.

OBJECTIVES

To develop a consensus-based scoring rubric based on stakeholders' interpretations of level descriptors for student nurses' professional values competencies.

DESIGN

Two rounds of Classic e-Delphi.

SETTINGS

This study was conducted in a London based university using Bristol Online Survey website as a host.

PARTICIPANTS

100 stakeholders with vested interests in undergraduate pre-registration nurse education were purposefully invited to participate.

METHOD

Round one collected free-text interpretations of the United Kingdom Nursing and Midwifery Council professional values competency statements. Round two used a Likert scale questionnaire to measure the level of agreement to the level descriptor statements generated through round one. Responses were analysed through content analysis in round one and consensus measure in round two. A threshold of 70% agreement to determine consensus was set in advance.

RESULTS

In round one, 47 participants provided their interpretations of the competency statements. In round two, 51 participants completed the questionnaire. All 24 items achieved a strong consensus with 86%-100% of participants agreeing or strongly agreeing with the statements.

CONCLUSIONS

A Delphi study was successfully used to develop a consensus-based scoring rubric with clearly stated descriptors for professional values competency statements. This scoring rubric holds the potential to enhance practice-based assessment across all healthcare professional disciplines.

South African student nurses' experiences of professional nurses' role-modelling of caring

BACKGROUND

Student nurses are expected to implement a caring practice in order to become professional nurses. Caring has remained the art and science of nursing, which student nurses learn from professional nurses during clinical practice. The South African Nursing Council mandates professional nurses to teach and supervise student nurses to master the art of caring during clinical practice. Caring is taught through role-modelling of daily nursing activities.

RESEARCH PURPOSE

This study was performed to gain an understanding of South African student nurses' experiences of professional nurses' role-modelling of caring.

METHODS

Phenomenological, qualitative research. Purposive sampling of fourth-year student nurses.

DATA COLLECTION

focus groups, observations and field notes. The data were analysed using Giorgi's modified Husserlian five-step method. Ethical principles were respected.

RESULTS

Three themes were identified. Theme 1: inconsistency in the clinical environment; Theme 2: effective and ineffective role-modelling of caring and Theme 3: carelessness cascading.

CONCLUSIONS

The study facilitated an understanding of student nurses' experiences of professional nurses' role-modelling of caring. Recommendations to facilitate professional nurses' role-modelling of caring in a public hospital were formulated: Mentorship training, recognition system for professional nurses, clinical support for student nurses, open channels of communication, random nurse leader rounds, employee wellness program, workshops and positive learning environment promotion.

COVID-19 vaccination readiness among nurse faculty and student nurses

BACKGROUND

Unprecedented efforts are underway to develop COVID-19 vaccines, widely seen as critical to controlling the pandemic. Academic nursing leaders must be proactive in assuring widespread faculty and student vaccination uptake.

PURPOSE

The purpose of this study was to describe nursing faculty and student nurse factors associated with COVID-19 vaccine readiness.

METHODS

Cross-sectional online survey of nursing faculty and student nurses at a university affiliated with an academic medical center was conducted.

FINDINGS

Most full-time faculty (60%) intended to receive the vaccine; but only 45% of adjunct faculty and students reported intending to get vaccinated. The major reasons for not getting vaccinated were vaccine safety and side effects. Collectively, participants reported a low level of knowledge related to vaccine development.

DISCUSSION

As the most trusted profession, nurses will play a decisive role in counseling patients about COVID-19 risks and benefits. Findings suggest that academic nursing leaders need to consider faculty and student vaccine concerns and provide vaccine development education.

Delivering resilience training to pre-registration student nurses in partnership with a reservist military organisation: A qualitative study

BACKGROUND

Nurses need resilience to safeguard their well-being. In collaboration with a military reservist organisation the Team Series was designed to foster resilience by promoting teamwork and leadership skills in student nurses.

OBJECTIVES

To explore participants' experiences of engaging with the Team Series and the skills and knowledge acquired.

DESIGN

A qualitative design.

SETTING

A Scottish University.

PARTICIPANTS

Fourteen 3rd year pre-registration nursing students, ten academic staff and ten reservists.

METHODS

Audio-taped focus groups and interviews thematically analysed.

RESULTS

Students conceptualised resilience as clinical competence, valuing an active learning process enabling them to practice clinical and interpersonal skills, utilising a range of communication, team-building, leadership and problem-solving skills. Participation in the Team Series fostered self-awareness and self-confidence, the foundations of resilience, helping students feel more competent in coping effectively in stressful situations.

CONCLUSION

The positive impact of collaborating with a military organisation experienced in developing team-working and leadership skills is demonstrated. Learning experiences designed to promote physical and emotional resilience should be threaded throughout curricula to ensure these attributes are developed and sustained over time.

Creating safety in care: Student nurses' perspectives

Nursing is often hazardous work. Promoting safety and care requires nurses to apply knowledge, skill and creativity in patient encounters. Nurses' risk exposures are well documented, with research on student nurses' safety more limited. We studied final-year nursing students' risk perceptions using questionnaire-based vignettes involving four patient presentations on patient aggression, manipulating patient and resource risk factors. We found student nurses were most likely to ask for help and wait when managing high-risk patient aggression scenarios. Student nurses placed most importance on their own safety and patient condition in making decisions. Resource risk significantly interacted with gender, with male nurses more likely to seek help when risks were high. There is need to improve student nurse training on managing patient aggression by promoting creative approaches to problem solving and critical thinking using simulation techniques to enhance situation awareness and translate knowledge to practice.

Introduction of patient electronic medical records (EMR) into undergraduate nursing education: An integrated literature review

BACKGROUND

To prepare student nurses for clinical practice where patient electronic medical records (EMR) competence is required, nursing undergraduate curricula must provide simulation access to developing this skill set. At this stage, however, the integration of electronic documentation into the Australian undergraduate nursing curriculum has been piecemeal. Aim The aim of this integrated literature review was to identify benefits and challenges for faculty nursing staff and nursing students in relation to the integration, use and evaluation of EMR in an undergraduate nursing program.

METHODS

A systematic search of relevant peer-reviewed research and project report articles was conducted in the electronic databases. Generic qualitative thematic analysis was then undertaken with themes generated from the data itself.

RESULTS

Fifty eight articles were identified, of these 23 were found to meet the inclusion criteria. Three major themes were identified: 1) Advantages of using EMR in academic settings, 2) Identified Challenges and Limitations of EMR programs; and 3) Developing an academic EMR program and implementing EMR education program in stages. All papers acknowledged that EMR will be standard in healthcare and should be viewed as an 'essential tool' for inclusion in undergraduate nursing programs.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

There is a significant increase of electronic technology in healthcare settings, especially relating to patient documentation. Therefore, teaching the use of EMR in the simulated clinical learning environment for new healthcare providers such as nursing students is essential. The papers reviewed identified an urgent need for higher education nursing programs to support undergraduate nursing students and faculty staff to ensure EMR can be implemented effectively into the undergraduate nursing curriculum.

Does a specialised orthopaedic trauma module utilising high fidelity simulation improve student nurses' perceptions of their competence? A pilot study

BACKGROUND

Trauma is the fourth leading cause of death in the western world, and traumatic injuries are recognised as clinically challenging to care for. Orthopaedic trauma care is not standard content in pre-qualifying nursing curriculums, compounded by a dearth in specialised post-qualifying education internationally. As a result, registered nurses may not have the clinical skill set to appropriately manage patients with traumatic conditions.

AIMS

To understand pre-qualifying student nurses' perceptions of their own competence in orthopaedic trauma care and understand if utilisation high fidelity simulation improves confidence, knowledge and application of theory.

METHODOLOGY

A small-scale qualitative pilot study utilising purposive sampling, designed to inform the development of a larger longitudinal study. A 5-point likert scale questionnaire with options for qualitative comments was administered after 8 weeks of a specialised module culminating in a high-fidelity simulation and in-depth debrief session. Thematic analysis was conducted.

FINDINGS

All students found that the module improved their confidence and knowledge in their skills set. The high-fidelity simulation was found to be an effective learning environment to translate theory to practice.

CONCLUSIONS

Specialised orthopaedic trauma training is effective in improving student nurses' knowledge and perceived competence in trauma care. High fidelity simulation is a valuable teaching tool to develop student's skill sets in complex scenarios and support application of theory to practice.

A retrospective cohort study

One solution to the global nursing shortage is to increase the numbers of student nurses: clinical placements need to increase their capacity to host them. Capacity increases have previously been viewed as problematic if they increase the supervisory burden on registered nurses, and unsafe if they dilute students' supervision. The aim of this study was to assess the impact on specific patient safety measures (pressure ulcers, falls and medications errors) of having students in placement being educated in Collaborative Learning in Practice (which increases capacity) compared to when they were not. Audit data were collected from four NHS trusts in the South West of England in a retrospective cohort study. We received data on 5532 adverse events from 15 clinical areas in four NHS trusts, with 996 students on placement between January 2018 and August 2019. The risk ratio and mean differences for adverse patient events were favourable (RR = 0.9842; 95%CI 0.9604-1.008; mean difference 279, 95%CI 213-346, p = 0.01). There was no statistically significant correlation between increased student numbers and increased adverse patient events. Our data must be interpreted with caution, but we conclude that increasing capacity for student nurses in placements appears to have a positive impact on patient safety.

Conflict, confusion and inconsistencies: Pre-registration nursing students' perceptions and experiences of speaking up for patient safety

There is growing evidence demonstrating that nursing students encounter unsafe and poor clinical practice when on clinical placement. The impact on nursing students remains relatively under-explored, especially in the Australian context. This two-phased qualitative study used Interpretive Description to explore 53 pre-registration nursing students' perceptions and experiences of speaking up for patient safety. Results of the study identified students believe speaking up is the right thing to do, and their professional responsibility. The study results add to previous research by describing the dissonance students experience due to the inconsistencies between what is taught at university and performed in practice. Student's distress arises when observing nurses taking short cuts, justifying such actions and making excuses about poor practice. Students report experiencing dissonance, bewilderment and confusion and at times, anger when observing poor practice. The clinical environment culture influences students' decisions to speak up or remain silent. Understanding students' perceptions and responses will promote awareness and discussion essential to the future development of curricula and clinical support strategies that will enable students to speak up.

Co-production of an intervention to increase retention of early career nurses: Acceptability and feasibility

Co-production is a process employed to solve complex issues, recognising the expertise of all stakeholders. This paper reports on co-production undertaken by nursing students, early career nurses and researchers as part of a larger study to design an intervention to increase retention of early career nurses. Mixed methods were used to evaluate the acceptability and feasibility of the co-production process in a UK university.

Data were collected prospectively, concurrently and retrospectively via interview and questionnaire, between April 2018 and January 2019.

Twelve co-production group members completed the questionnaire and six group members and facilitators were interviewed. Students and early career nurses reported personal benefit from participating; they developed and practised transferrable communication and problem-solving skills, believed they were able to make a difference, enjoyed contributing, found benefit from using the group as a reflective space and considered that co-production produced a credible intervention.

Findings indicated co-production equipped participants to function more effectively in their nursing roles; incorporating co-production into the development of future interventions may prove beneficial. The relative novelty of this approach, and the potential application of the findings to a diverse range of geographical and organisational settings, add to the utility of the findings.

•

Co-production is acceptable and effective for designing nurse retention interventions 84.

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Co-production helped develop skills that were transferrable to the clinical area.

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Facilitators found co-production subject to competing demands and expectations.

•

Co-production should be considered to promote a credible retention interventions.

A guide to the NMC emergency standards for nurse education during the current deployment of student nurses

The Nursing and Midwifery Council (NMC) recognises the important contribution that nursing students are making to the national response to the COVID-19 pandemic. This article reports on the Greater Manchester Supervision and Delegation Framework, providing practical guidance for students and practice staff (practice supervisor/practice assessor and registered nurse) on how to support student nurses who have opted into a paid (deployed) healthcare role. The framework operationalises NMC emergency standards for Nursing and Midwifery education, enabling students to complete their pre-registration undergraduate or postgraduate nursing programme while also supporting the healthcare workforce (NMC, 2020).

Pharmacy students as educators: An interprofessional approach to insulin management education

INTRODUCTION

Student pharmacists may increase the knowledge and comfort level of student nurses and student physicians through peer-assisted teaching (PAT) on insulin management for patients with type 2 diabetes mellitus.

METHODS

Fourth-year student pharmacists completing their primary care rotation provided instruction to third-year student nurses and third-year student physicians on the selection, dosing, administration, and counseling of insulin products in type 2 diabetes. Learners were asked to complete a pre- and post-survey to determine comfort level and knowledge before and after the educational experience.

RESULTS

A total of 200 student nurses and student physicians were included in the analysis. All but two questions from the pre- to post-survey resulted in a statistically significant increase in the number of respondents who agreed or strongly agreed with the statements. In both the pre- and post-survey, >90% of participants agreed or strongly agreed that pharmacists add value to the medical team. An overwhelming majority of students indicated that this learning experience would assist them with making clinical decisions regarding insulin therapy for patients with type 2 diabetes during clinical rotations.

CONCLUSION

The education provided by student pharmacists improved knowledge and confidence in selecting, dosing, administering, and counseling on insulin products, but not with adjusting therapy. Although the student nurses and student physicians valued pharmacy prior to the study, their willingness to reach out to pharmacists increased. This study demonstrates the usefulness of PAT for collaboration between healthcare professional students for improved knowledge and confidence to ultimately enhance patient-centered care.

Upward feedback in nursing: A matter of giving, taking and asking

The educational program for nurses takes place in school and at the workplace. At the workplace, student nurses and their supervisors work together while providing the best care for their patients. In this context, it is important that both, students and supervisors, provide feedback to each other. However, it can be difficult for nursing students to provide feedback to professionals who are higher up in the hierarchy. The goal of this study is to investigate the factors that facilitate nursing students to provide so-called upward feedback and nursing supervisors to receive it. Seven focus groups of nursing students (n = 40) and two focus groups of nursing supervisors (n = 12) were organized. The qualitative data analyses of the focus group interviews and a literature study show that a feedback-friendly culture is essential in enabling upward feedback. The following aspects contribute to a feedback-friendly culture: (1) the role of the feedback receiver, (2) the role of the feedback provider, (3) relations between feedback receivers and providers and (4) the context. This study shows that nursing students and supervisors are open to provide and receive upward feedback. However more attention is needed in nursing education for the factors that facilitate this process.

An evaluation of nurses' experiences of mentoring pre-registration students

Nurse education in the UK has undergone a radical change over the past 30 years. The integration of nursing students within practice has evolved from an apprenticeship style to bespoke mentoring support. To act as mentors, registered nurses must have met stage 2 outcomes of the Nursing and Midwifery Council (NMC) Standards to Support Learning and Assessment in Practice, which clearly stipulate that mentors should have a reduced clinical commitment when supporting students, with one hour per week being protected, in addition to the 40% of time through direct or indirect supervision with their mentor/sign off mentor when facilitating a student on their final 12-week experience. However, this does not seem to be the case in reality. A qualitative study comprising six semi-structured interviews was undertaken across one health and social care trust. Data were analysed using Braun and Clarke's thematic analysis. A number of themes and subthemes were identified: engagement (barriers versus strategies), support (inclusivity versus exclusivity), and lack of recognition (strategic versus organisational). Due to the expected changes of supervising and assessing nursing students in practice, it is imperative that an innovative, collaborative and engaged approach is facilitated from all key stakeholders to ensure the sustainability of supporting and assessing students by registered nurses and the safeguarding of the public within clinical practice.

Effective interventions for preventing work related physical health complaints in nursing students and novice nurses: A systematic review

From the start of their career, nursing students and novice nurses are at risk of developing physical health problems due to high physical workload, which may lead to early exit from nursing. To provide an overview of interventions preventing physical health problems in early career, a systematic review was performed. A comprehensive search of the literature was conducted up to December 2017. Primary outcome of interest was education/work dropout. Secondary outcomes were musculoskeletal symptoms. Independent authors selected studies, appraised quality and extracted data. After screening 7111 titles and abstracts, eleven studies were included. Seven studies evaluated interventions for moving/handling training. Four evaluated other interventions. None focused on our primary outcome education/work dropout. All studies reported on physical complaints among student nurses only. Overall, risk of bias was high and clinical heterogeneity prohibited pooling of data. Intervention effects were small and inconsistent. In conclusion, evidence for the effectiveness of interventions in the nursing curricula for the prevention/treatment of physical complaints is scarce and where available conflicting. We recommend high quality research on dropout due to physical health problems, as well as on the prevention/treatment of physical complaints.

Compassionate care in the community: reflections of a student nurse

Reflecting on practice and analysing situations when compassionate care has been delivered can be a valuable way of helping student nurses develop their understanding of humanising care. This exemplar showcases a scenario when a second-year student nurse studying for a BSc (Honours) in adult nursing explored an experience while working in the community. She critically reflected on an incident highlighting a simple yet powerful example of how she helped an older couple manage an aspect of their care. This exercise helped the student to explore and understand what compassionate care means and highlighted how the value of reflection can be used to gain new insights to enhance the care of older people in her future practice in the community.

Building therapeutic connections with the acutely ill through standardised patient simulation in nurse education an evaluation study

BACKGROUND

Phenomenological empathy and sense of coherence are two researched communication approaches used to improve therapeutic connections with patients in a variety of nurse related settings. The aim of this study is to evaluate students' feedback concerning how this event has enabled that understanding, development and refinement of skill-sets in PE and SoC when managing the acutely ill during simulation.

METHODS

114 third year bachelor degree-nursing students were given the opportunity to complete an evaluation, developed for the specific purpose of this study. The evaluation contained six closed questions on a four point Likert-scale and three open questions, handed out upon completion of the standardised patient simulation of the acutely ill. Comments written in response to the open questions were analysed using manifest content analysis and closed questions using SPSS to produce descriptive frequencies.

RESULTS

100 students completed the evaluation. Student nurses', regardless of previous experience or age, indicated the need for more education and practice in phenomenological empathy and sense of coherence to enhance their ability to build therapeutic connections with the acutely ill.

CONCLUSIONS

Teaching phenomenological empathy and sense of coherence, as an integral part of standardised patient simulation is necessary to motivate student nurses ability to build therapeutic relationships with the acutely ill to enhance person centred care.

Emotions and feelings evoked in nursing students exposed to bullying behaviors in clinical settings

Background and objective

Though not fully integrated into the profession, student nurses have been exposed to and experienced bullying behaviors with limited skills to mitigate the effects of the behaviors. This qualitative study analyzed the emotions evoked due to exposure to bullying behaviors. Desired to address the question: "How do student nurses feel when they are the recipient of bullying-type behaviors?"

Methods

DESIGN: Qualitative descriptive design. SETTING: A nursing college at an urban university in the Midwestern United States; PARTICIPANTS: Matriculated students enrolled in a pre-licensure nursing program. METHODS: As part of a larger mixed informed pilot study, each participant was assigned to either the control or intervention group. Participants in the intervention group received an educational intervention focused on bullying two weeks prior to a scheduled clinical simulation. Participants in both groups each completed an individual clinical simulation during which they were exposed to bullying-type behaviors meant to replicate behaviors they may encounter in actual clinical settings. All participants were informed of their right to disenroll from the study at any point. For the health and safety of participants, individuals were provided with safeguards during the study as well as upon conclusion of their participation. Immediately following the simulation, participants completed an individual debrief interview during which they were asked to describe how the simulation made them feel. Responses were audio recorded and transcribed verbatim. Data were analyzed using a descriptive qualitative to generate thematic results.

Results

The three major themes developed included Past Bullying-like Behavior, Feelings Experienced during Simulation, and Perceptions of the Simulation. Participants reported experiencing negative emotions due to the bullying behavior exposure despite receiving an educational intervention. Harmful emotions, such as sadness, led participants to question their ability to perform simple tasks. Student nurses possess the skills and knowledge to perform routine tasks; however, when bullying behaviors target nursing students, the negative behaviors have the potential to adversely affect the whole student.

Conclusions

Further research is warranted to identify programs to aid students in overcoming the negative bullying behaviors in the clinical setting.

Care home nursing: Co-creating curricular content with student nurses

BACKGROUND

Meeting the complex care needs of an ageing population is a global issue and long term care settings, such as care homes, play an essential role. However, there is a crisis in the recruitment of registered nurses within care homes. Higher educational institutions have a critical part to play in addressing the crisis in recruitment in care homes and it is argued that student nurses can have a significant role to play in co-creating curricular content responsive to population need.

OBJECTIVE

To co-create curricular content on care home nursing with student nurses.

DESIGN

Co-creation through collaborative enquiry and a three stage thematic analysis.

SETTING

Undergraduate, preregistration nursing programme in a university in the United Kingdom.

PARTICIPANTS

Student nurses from Years One to Four undertaking a Bachelor in Nursing with Honours degree.

METHODS

Six focus groups and two one to one interviews.

RESULTS

Findings revealed predominantly negative attitudes towards care home nursing. Teaching and practice placements appeared to play a minor role in shaping students' attitudes but rather, gave the unspoken message that for the acquisition of necessary knowledge and skills, care homes were less important than other settings. Most students were initially averse to care home nursing as a career choice. During focus groups/interviews, views shifted from seeing care homes as places where you 'lose clinical skills' to places where there is 'a lot of responsibility', and also a potentially rewarding career choice. From this attitudinal shift, students made suggestions for developing better curricular content and more positive learning opportunities.

CONCLUSIONS

A co-creative framework can create a space for mutual learning between students and staff about challenges and opportunities for equipping nurses to meet the needs of ageing populations. Student nurses are open to learning about care home nursing as part of their education and keen to have a more positive exposure.

Student nurses' career intentions following placements in general practice through the advanced training practices scheme (ATPS): findings from an online survey

BACKGROUND

The demand for General Practice services in the UK, and elsewhere, is rising quickly. In part, the increasing demand is from an aging population that requires management of multiple long-term conditions. The General Practice Nurse is increasingly taking on the role. It is acknowledged that if general practice is to be able to recruit sufficient General Practice Nurses (GPNs) to meet this increasing demand in the future, new graduate nurses must be encouraged to consider general practice as a viable career option. This research is part of a review of the Advanced Training Practice Scheme (ATPS) which supported clinical placements in participating general practices.

METHODS

The aim of the study was to examine nursing students' perceptions of GP placements, and their effect upon career intentions following graduation from Sheffield Hallam University (SHU), in the UK. Interviews and an online survey were used collect data. Only the survey is reported here. The bespoke survey examined students' views of: opportunities for learning new clinical skills and consolidating existing clinical skills; the learning environment in general practice and their views on a career in general practice.

RESULTS

One thousand one hundred twenty undergraduate adult-field nursing students were contacted, with a response rate of 41% (N = 462). Ninety respondents had a placement and, 92% (N = 84) viewed practice nursing positively, and 77% (N = 70) felt that the placement had transformed their views on general practice. The opportunity to participate in the management of the various aspects of chronic disease was identified by 84% (N = 76) of the students as a key new skill they had acquired. They also reported that they valued a team ethos, control over aspects of work, and the variety of health problems they encountered.

CONCLUSION

The findings from this study demonstrate a positive experience arising from the provision of General Practice placements for nursing students. The use of 'targeted' placement schemes with appropriate support such as this may be seen as a viable way of exposing nursing students to General Practice nursing, and of encouraging new graduate nurses to consider General Practice nursing as a viable career option.