Going Domestic: Importing the Study Abroad Experience. The Development of a Multicultural New York City Study Away Program

PROBLEM

Significant off-campus domestic study away experiences have been shown to be a transformative active learning environment for students and achieve similar learning outcomes as study abroad programs.

METHODS

This manuscript describes the conception, development, and pedagogical approach of a faculty-led domestic study away experience in New York City for pre-licensure and post-licensure nursing students as an active learning strategy for developing cultural competence. Students participated in service-learning activities that illuminated the realities and challenges persons from other cultures face as they interact with health care in a culture that is not their own.

FINDINGS

In partnership with New York Cares©, students were immersed in well-established ongoing sustainable community-based projects. These experiences fostered reflective conversations between community members, student participants, and faculty regarding social factors, cultural issues and needs, and global issues and trends.

CONCLUSIONS

Through the New York study away program, students were able to broaden their perspectives about social factors and culture beyond geographic or ethnic boundaries and apply these service experiences to their nursing practice. Study away programs are an excellent strategy for nursing educators to prepare students for care of multicultural populations and for proficiency in cultural competency within the globalization of the United States.

Attrition of undergraduate nursing students at selected South African universities

BACKGROUND

The nursing profession forms the backbone of many healthcare systems. It therefore needs a consistent supply of registered nurses to deliver continuous and safe quality healthcare, and to replace the nurses leaving or retiring from the profession. Attrition actively occurs among nursing students in South Africa and threatens the future supply of registered nurses.

AIM

The aim of the study was to describe the attrition rate at selected South African universities and the factors influencing undergraduate nursing students to discontinue their nursing studies at these universities.

METHOD

A quantitative descriptive design was followed. Heads of the nursing departments at the selected universities captured data with a specifically designed questionnaire. Thereafter their former nursing students provided information via a structured telephonic interview on the reasons why they discontinued the nursing programme.

RESULTS

The study revealed that attrition of undergraduate nursing students for three intake years (2007, 2008 and 2009) at the participating universities was between 39.3% and 58.7%. Academic and financial reasons as well as poor wellness and health were the main causes for attrition. Another factor was failure to cope with the demands of the clinical environment.

CONCLUSION

Attrition might not occur immediately when a nursing student is challenged, as the student might exploit the various types of support offered. Although some nursing students do benefit from the offered support, a large number of nursing students still discontinue the undergraduate nursing programme.

Scrapping nursing student bursaries makes no sense

I'm a nursing student and have just worked 85 hours in the last 8 days. I've had 1 day off in that period of time. I've not seen my daughter in days and I can't get a paid part time job as, let's face it, I have to actually sleep.'

Barriers and enablers to retention of Aboriginal Diploma of Nursing students in Western Australia: An exploratory descriptive study

BACKGROUND

Nursing education appropriate to the learning needs of Aboriginal and Torres Strait Islander students is essential to prepare them for registration as nurses. Despite incentives to encourage the recruitment and retention of such students, a disproportionate number commence but do not finish their nursing studies.

OBJECTIVES

To describe the barriers and enablers to the retention of Aboriginal students in a Diploma of Nursing course (Enrolled/Division 2) in Western Australia.

DESIGN

An exploratory descriptive design was used.

SETTINGS

One metropolitan educational facility catering for Aboriginal people offering an 18-month course in a block release format.

PARTICIPANTS

A convenience sample of 16 students aged 18+years.

METHODS

Newly enrolled students (n=10) participated in an investigator-developed survey to explore their motivation for entering the course. Nine of these students and a further seven students who were nearing the end of their course participated in focus groups to explore their experiences of nursing education.

RESULTS

Survey respondents had a mean age of 32.7years; most were female, had nominated family as influential in the decision to enroll, and commenced with a friend. Regarding recruitment and retention, the qualitative data highlighted the importance of students': perceptions of the training organisation, characteristics, experiences of nursing education, and sources of support.

CONCLUSIONS

Strategies that develop individual's resilience and engage supportive networks can assist Aboriginal students to negotiate tertiary nursing study. Academic skills assessments supplemented with tailored educational support at entry can resource students to navigate increasingly complex course content. Flexibility throughout the course enables students to negotiate study in a context of ongoing family and financial obligations.

'I had to use food banks as I have had literally no money'

Millions of pounds have been paid to debt-ridden nursing students to prevent them from dropping out of university courses. Data exclusively obtained by Nursing Standard shows £5.2 million in discretionary funding has been handed out since 2013.

Financial pressures should not force students out of nursing

I was pleased to hear of the petition by nursing student Katherine Webb calling on the health secretary to increase the bursary for nursing students (News April 1).

HEE's planned funding cuts could lead to pre-reg courses closing

Some universities could be forced to scrap nursing and midwifery degree courses because of a proposed funding cut, academics have warned.

Creating innovative programs for the future

Although several major national mandates advocate for a better educated workforce, this push comes at a time when the competition for faculty, financial resources, advanced technology, and students remains strong. If nurse educators are seriously considering creating a new nurse program at their school, some key points are essential during the development stage. Using the innovation frameworks from the Institute of Healthcare Improvement, from the global design firm IDEO, and from Gladwell's The Tipping Point: How Little Things Can Make a Big Difference, this article examines the informal, formal, internal, and external work needed during program conceptualization, initial program exploration, resource infrastructure, support, and evaluation for an effective and innovative plan.

Becoming a nurse in Italy: a multi-method study on expenditures by families and students

Potential nursing students and their families are faced with difficult decisions regarding the amount of time and money required to complete the nursing programme and the availability of funds to cover the costs and this seems to have received little no attention to date. With the aim of describing the costs incurred by Italian nursing students and/or their families per academic year and compare cost trends incurred from 2004-05 to 2010-11, a multi-centre qualitative/quantitative study design was adopted. Italian Nursing students attending the first, second and third academic years in 2004-05 and those attending the first, second and third academic years in 2010-11 were eligible. Five hundred and six students were involved: 215 (out of 300 eligible, 71.6%) attended the bachelor's degree in nursing in 2004-05 and 291 (out of 383 eligible, 75.9%) in 2010-11. On an annual basis, the average annual expenditures increased by 12% for nursing education from 2004-05 to 2010-11. Given that qualification as a nurse requires at least three years, and considering inflation, for a student who matriculated in 2005 an average of 2485.7€ per year (7457.0€ in total) was required. Data suggest that students have modified their spending behaviour (limiting lunches at public bars, buying books and photocopies) in order to handle the rise of non-discretionary costs, such as tuition fees and the costs of attending lectures and hospital/district trainings. Policies supporting nursing education in general and for those students who are motivated but unable to undertake the course for economic reasons are urgently needed.

Creating and launching. Innovative nursing education programs: perils and pearls

Nursing's future depends on continuing to seek, create, and launch innovative nursing programs. Successful innovation can improve nursing education delivery and make optimal use of available resources while tapping into the imagination and creativity of faculty and students; in addition, it can create an optimistic environment and encourage beneficial change with the faculty and staff. Innovation has been described as an art, a process of diffusion, and a process of transforming ideas into real value. The purpose of this article is to explore the concepts surrounding innovation, steps in development of an innovation, and share pearls, perils, and lessons learned so that others can explore the process within their nursing education programs.

The cost of the objective structured clinical examination on an Italian nursing bachelor's degree course

The OSCE (Objective Structured Clinical Examination) is considered the most valid and reliable method for assessing the clinical skills of students training for health professions, but its use is limited by the related high costs. We analyzed the cost retrospectively of using an OSCE designed for second-year students (2009) in our degree course, adopting the Reznick et al. guidelines (1993), which recommend assessing both high-end costs and low-end costs. The high-end costs adopting the OSCE amounted to € 145.23 per student, while the low-end costs were € 31.51 per student. Considering the economic crisis and the cost-containment measures applied also in nursing education, strategies for further reducing costs are discussed.

Impact of the economic downturn on nursing schools

The challenges posed by the economic downturn on baccalaureate nursing schools in the southeast as it relates to their perceptions of changes in the number of applicants, acceptance rates, employer recruitment efforts, and student clinical and job placement were explored. Responses from deans and program directors indicated nursing schools are experiencing negative effects of the economic downturn in the form of graduates having difficulty finding employment, decreased recruitment efforts from prospective employers, difficulty locating clinical placements for students, and no change in faculty applicants despite an increase in undergraduate student applicants as well as graduate student applicants. These multiple factors combined could signal the death knell for programs that are ill-prepared to deal with such a crisis. Programs need to be aggressive in their efforts to draw health care recruiters as well as qualified faculty applicants to their campuses. Nursing schools must be able to clearly show why their graduates are superior to other programs' graduates when competing for both highly qualified faculty applicants and prospective student employers.

Studying + work = disaster

When Margaret recently took up her place on a nursing degree course at her local university, she calculated she would have to carry on doing some form of job to make ends meet. Margaret’s parents were already supporting her older brother through his degree, and it was not possible for the family to stretch their finances any further. So like many student nurses, Margaret took up a couple of part-time jobs; one as a barmaid in a local pub, the other as a cleaner.

Funding to attract the best

A High Quality Workforce (Department of Health (DH), 2008) reiterated the ambitions for the future of the NHS founded upon high-quality care for all patients, ensuring patient safety, effectiveness of care and a positive patient experience. The NHS is a ‘people’ organization with delivery of its services depending upon health professionals and all the support staff. It is therefore imperative that it can attract high calibre people from all sections of the population to train as health professionals.

Student bursary shake-up

The Department of Health launched its consultation on the future of funding for healthcare students. Lyn Karstadt discusses how the consultation should see an end to the long-running disparity between nursing diploma students, who receive non-means-tested bursaries, and nursing degree students, who are means-tested.

Are nursing students still a special case?

Despite the fact that many student nurses can take on extra work to get through their studies, many still receive a superior financial package to other health-care students, whose bursaries have long been means tested. But, asks Lyn Karstadt, as nursing, like midwifery, is poised to become an all-graduate profession, should nursing students still receive special financial support?

Hospitals and philanthropy as partners in funding nursing education

The current nursing shortage is complex and varies widely across the country, and remedial approaches lack adequate funding from the federal government. Lasting remedies must originate from new and different partnerships between multiple institutions with complementary missions in these markets. Hospitals as major nurse employers and foundations that leverage critical sources of financing have a vital role in partnerships. Together they promote and require new entrepreneurial skills, innovative educational strategies, and greater accountability in meeting area workforce needs.

Feasibility and outcomes of paid undergraduate student nurse positions

An Undergraduate Nurse Employment Demonstration Project (UNDP) was implemented in four Health Service Areas in British Columbia with a concurrent evaluation study. This demonstration project comprised the development and implementation of a new position in the BC healthcare system. The position enabled third- and fourth-year nursing students to be employed at their level of education. The purposes of the evaluation were to explore the feasibility and outcomes of this type of paid undergraduate student nurse employment. The three-year project and evaluation included both implementation and outcome analysis. The implementation evaluation design was descriptive and prospective, involving multiple data sources. The outcome evaluation design was quasi-experimental, with intervention and comparison groups. Learning outcomes for undergraduate nurses were increased confidence, organizational ability, competency and ability to work with a team. Workplace outcomes were increased unit morale, help with workload and improved patient care. New graduates with undergraduate nurse experience reported less time required for orientation and transition than other graduates who did not have this experience, and workplace nurses viewed these new graduates as more job-ready than other new graduates. After 21 months, new graduates with undergraduate nurse experience were less likely to move to other employment than other new graduates. Results from the four Health Service Areas indicated that the paid undergraduate nurse position was feasible and that outcomes benefited students, new graduates and workplaces. The undergraduate nurse position is now being implemented throughout all Health Service Areas in British Columbia.By 2000, concerns in British Columbia about the nursing workforce, workplace and patient safety had escalated to the point where diverse stakeholder groups were prepared to work together in new ways to prepare nursing graduates to be more job-ready, to recruit and retain new graduates and to retain existing nurses. Stakeholder groups were administrators, labour organizations, professional associations, educators and government. One idea to support job readiness and retention focussed on the feasibility of implementing cooperative education for nursing students. The effort was unsuccessful owing to lack of funding, but resulted in a review of the literature on cooperative education and other work-study programs. Cooperative education connects classroom learning with paid work experience for the purpose of enhancing students' education (Fitt and Heverly 1990; Heinemann and De Falco 1992; Ryder 1987). Reported benefits for students were improved job preparation and graduate retention (Ishida et al. 1998), additional staffing and reduction in orientation time (Cusack 1990; Ishida et al. 1998), increased practice judgment (Cusack 1990; Siedenberg 1989) and better workload management (Ross and Marriner 1985). A work-study model reported in the literature offered benefits similar to those of cooperative education, with greater flexibility in design. An example was the University of Texas Health Science Center at Houston's collaborative work-study scholarship program with local hospitals (Kee and Ryser 2001). Students in second clinical semesters were employed as unlicensed personnel by hospitals. The students, as unlicensed personnel, worked to the level of their nursing preparation. Reported benefits for students were academic credit, financial assistance, interaction with multidisciplinary teams, opportunity to refine clinical skills, understanding of nurses' roles and guaranteed interview for positions on graduation (Kee and Ryser 2001). Benefits for practice organizations were skilled help, the opportunity to recruit new nurses and increased interaction with a university nursing program. While nurse education stakeholders in British Columbia were exploring options, the concept of undergraduate student nurse employment was initiated by a group of fourth-year students at the University of Victoria who were completing the course "Nurses Influencing Change." The students were concerned about having enough practice experience to meet increasing nursing competency requirements and their survival as new graduates given workplace realities. Debt load also was a concern because extensive student practicum time limited opportunities for paid employment during the nursing education program. Students found that the idea of paid undergraduate nurse positions, based on the student employment model in Alberta, was supported by nurse leaders, many practising nurses and nursing faculty who also were concerned about meeting patient care standards and adequately preparing nursing students. In 2000, the BC Ministry of Health Services funded an Undergraduate Nurse Demonstration Project (UNDP) - one type of paid employment for undergraduate student nurses - in four Health Service Areas linked with four schools of nursing. A concurrent three-year evaluation study examined the feasibility and outcomes of the UNDP (Gamroth et al. 2004). This paper summarizes the findings of the evaluation. Evaluation Research An Undergraduate Nurse Employment Demonstration Project (UNDP) was implemented in four Health Service Areas in British Columbia with a concurrent evaluation study. This demonstration project comprised the development and implementation of a new position in the BC healthcare system. The position enabled third- and fourth-year nursing students to be employed at their level of education. The purposes of the evaluation were to explore the feasibility and outcomes of this type of paid undergraduate student nurse employment. The three-year project and evaluation included both implementation and outcome analysis. The implementation evaluation design was descriptive and prospective, involving multiple data sources. The outcome evaluation design was quasi-experimental, with intervention and comparison groups. Learning outcomes for undergraduate nurses were increased confidence, organizational ability, competency and ability to work with a team. Workplace outcomes were increased unit morale, help with workload and improved patient care. New graduates with undergraduate nurse experience reported less time required for orientation and transition than other graduates who did not have this experience, and workplace nurses viewed these new graduates as more job-ready than other new graduates. After 21 months, new graduates with undergraduate nurse experience were less likely to move to other employment than other new graduates. Results from the four Health Service Areas indicated that the paid undergraduate nurse position was feasible and that outcomes benefited students, new graduates and workplaces. The undergraduate nurse position is now being implemented throughout all Health Service Areas in British Columbia. By 2000, concerns in British Columbia about the nursing workforce, workplace and patient safety had escalated to the point where diverse stakeholder groups were prepared to work together in new ways to prepare nursing graduates to be more job-ready, to recruit and retain new graduates and to retain existing nurses. Stakeholder groups were administrators, labour organizations, professional associations, educators and government. One idea to support job readiness and retention focussed on the feasibility of implementing cooperative education for nursing students. The effort was unsuccessful owing to lack of funding, but resulted in a review of the literature on cooperative education and other work-study programs. Cooperative education connects classroom learning with paid work experience for the purpose of enhancing students' education (Fitt and Heverly 1990; Heinemann and De Falco 1992; Ryder 1987). Reported benefits for students were improved job preparation and graduate retention (Ishida et al. 1998), additional staffing and reduction in orientation time (Cusack 1990; Ishida et al. 1998), increased practice judgment (Cusack 1990; Siedenberg 1989) and better workload management (Ross and Marriner 1985). A work-study model reported in the literature offered benefits similar to those of cooperative education, with greater flexibility in design. An example was the University of Texas Health Science Center at Houston's collaborative work-study scholarship program with local hospitals (Kee and Ryser 2001). Students in second clinical semesters were employed as unlicensed personnel by hospitals. The students, as unlicensed personnel, worked to the level of their nursing preparation. Reported benefits for students were academic credit, financial assistance, interaction with multidisciplinary teams, opportunity to refine clinical skills, understanding of nurses' roles and guaranteed interview for positions on graduation (Kee and Ryser 2001). Benefits for practice organizations were skilled help, the opportunity to recruit new nurses and increased interaction with a university nursing program. While nurse education stakeholders in British Columbia were exploring options, the concept of undergraduate student nurse employment was initiated by a group of fourth-year students at the University of Victoria who were completing the course "Nurses Influencing Change." The students were concerned about having enough practice experience to meet increasing nursing competency requirements and their survival as new graduates given workplace realities. Debt load also was a concern because extensive student practicum time limited opportunities for paid employment during the nursing education program. Students found that the idea of paid undergraduate nurse positions, based on the student employment model in Alberta, was supported by nurse leaders, many practising nurses and nursing faculty who also were concerned about meeting patient care standards and adequately preparing nursing students.

Fostering Academic Success of Mexican Americans in a BSN Program: An Educational Imperative

Hispanic/Latinos are the fastest growing minority group in the U.S. and the most underrepresented in the U.S. nursing workforce. Although a body of knowledge is growing regarding factors that foster academic success of undergraduate nursing students of color, there is limited information about Hispanic students in general, and Mexican American students in particular in BSN programs. Explored in this qualitative study, were perceived influences of institutional and interpersonal factors on retention and graduation of nine Mexican American students from a predominantly White BSN program. The key findings include adequate financial assistance, maintaining bicultural relations, and experiencing authentic caring relationships from institutional agents, family, and peers as crucial factors in academic success. Recommendations for nursing faculty and administrators are offered.

An agency-financed capstone experience for graduating seniors

Capstone experiences are increasingly expected at the conclusion of undergraduate curricula. For some programs, the capstone project is a thesis or paper; for nursing, a clinical experience that synthesizes prior learning is the norm. In Kentucky, nursing programs are required to provide the opportunity for students to spend 120 hours in a clinical setting just prior to graduation. The authors evaluated an innovative approach to providing these hours during the last 7 weeks of the nursing program.

ADN to BSN: lessons from human capital theory

Currently, approximately 16% of associate degree nursing (ADN) graduates acquire baccalaureate or higher degrees. Human capital analysis demonstrated negative to minimal average returns on investment (ROI) in BSN education. Increasing the ROI may influence ADNs to pursue baccalaureate education and can be an effective strategy for meeting the projected need for BSN-prepared nurses.