Band 8, Heft 1

Rapidly increasing enrollment in Canadian schools of nursing has triggered the development of innovative clinical placement sites. There are both opportunities and challenges inherent in the delivery of clinical nursing education in diverse community settings. As part of the Canadian Association of Schools of Nursing’s (CASN) ongoing work to assist its members and ensure baccalaureate graduates are prepared to meet the Canadian Community Health Nursing Standards of Practice at an entry-to-practice level, the CASN Sub-Committee on Public Health (funded by the Public Health Agency of Canada) conducted extensive national consultations with representatives from both academic and practice settings, as well as key national organizations. The resultant Guidelines for Quality Community Health Nursing Clinical Placements, released by CASN in 2010, aim to provide direction to Canadian schools of nursing and practice settings in addressing the challenges and opportunities arising from the changing context of community health nursing student clinical placements.

Health information technology (HIT), and specifically electronic health records (EHR), are recognized as fundamental tools for collecting, storing, retrieving, and monitoring patient care and information. However, few schools of nursing have incorporated theoretical or practical aspects of HIT competencies within the educational curriculum. The purpose of this study was to conduct a usability assessment to explore undergraduate nursing student electronic health record documentation knowledge and skill, using a patient case scenario to inform the development of an informatics-based undergraduate nursing curriculum. Three themes were identified: “Being a Novice User/Practitioner,” “Confidentiality and Security,” and “Repetition and Practice.” Integration of the EHR into nursing curriculum will allow students an EHR apprenticeship with the potential to enhance understanding and skill of nursing processes, documentation, and critical thinking. Findings will also guide teaching and learning strategies that will respond to rising expectations for competency with health information technology.

Health care in the United States is facing a crisis in providing access to quality care for those in underserved and rural regions. Advanced practice nurses are at the forefront of addressing such issues, through modalities such as health care technology. Many nursing education programs are seeking strategies for better educating students on technology utilization. Health care technology includes electronic health records, telemedicine, and clinical decision support systems. However, little focus has been placed on the role of social media in health care. This paper describes an educational workshop using standardized patients and hands-on experiences to introduce advanced practice nurses in a Doctor of Nursing Practice program to the role of social media in addressing issues inherent in the delivery of rural health care. The students explore innovative approaches for utilizing social media for patient and caregiver support as well as identify online resources that assist providers in a rural setting.

Few problems are more relevant in health care today than nurse recruitment and retention. The purpose of this study was to identify job satisfaction factors for nurse and nursing student education scholarship recipients, as well as examine the relationship of these factors to the intent to complete contractual agreements. Findings revealed that job satisfaction and a positive image of nursing were influential factors in intent to complete contractual agreements. Results may prove valuable information to recruit nursing students and increase job satisfaction.

The use of film as a teaching modality offers an opportunity for nursing students to explore the intersections of science, theory, and personal values prior to caring for clients with sexual and reproductive health (SRH) needs. Although the use of a broad range of arts and humanities modalities in the classroom is described in the literature, the use of film in relationship to teaching SRH has not been explored. Furthermore, there is a paucity of literature regarding the didactic or clinical teaching of SRH in nursing education. This article provides a framework for incorporating film as a teaching strategy into both case-based and problem-based teaching pedagogies. Reviews and discussion questions of films are provided.

Team-based learning (TBL) is an interactive teaching method promoted as an alternative to traditional lectures. TBL was implemented in four large second year classes in a baccalaureate nursing program but the implementation process was found to require much more effort than indicated in the literature. A predominant theme during the implementation phase was the importance of collegial support. Faculty workload increased significantly and they were challenged by occasional student confrontations and technological difficulties. The benefits for students included reduced attrition, reading workloads, and enhanced preparedness for classes, which allowed for more time to be spent in class discussing complex realistic nursing problems. Although TBL was not enthusiastically embraced by all of the students, the majority indicated that they liked and valued TBL, hence commitment to continuing to teach using the TBL method remains.

High stress levels in nursing students may affect memory, concentration, and problem-solving ability, and may lead to decreased learning, coping, academic performance, and retention. College students with higher levels of learned resourcefulness develop greater self-confidence, motivation, and academic persistence, and are less likely to become anxious, depressed, and frustrated, but no studies specifically involve nursing students. This explanatory correlational study used Gadzella’s Student-life Stress Inventory (SSI) and Rosenbaum’s Self Control Scale (SCS) to explore learned resourcefulness, stressors, and academic performance in 53 baccalaureate nursing students. High levels of personal and academic stressors were evident, but not significant predictors of academic performance (p = .90). Age was a significant predictor of academic performance (p = < .01) and males and African-American/Black participants had higher learned resourcefulness scores than females and Caucasians. Studies in larger, more diverse samples are necessary to validate these findings.

One goal of undergraduate nursing education is to develop competency in statistics interpretation. This competency requires adequate knowledge and skill to read and analyze the merits of research studies, quality assurance data, and patient data. The literature suggests that RNs may lack undergraduate, entry-to-practice competencies regarding statistical analysis. This review explores and critically appraises the international nursing literature concerning the pedagogy of teaching undergraduate statistics to nursing students. The following dominant three themes: (1) student and faculty characteristics, (2) conceptual framework and (3) the course characteristics of content and delivery guided our review. It was found that there is limited to no evidence concerning the pedagogy of statistics; further research is needed to establish best practices based on evidence.

Increasing diversity in the nursing workforce is a means to promote quality health care for multicultural populations. Though Aboriginal people comprise 4% of the Canadian population, Aboriginal nurses represent less than 1% of the nursing workforce. Despite isolated efforts in nursing education, Aboriginal students are neither recruited nor retained in nursing programs at a rate significant enough to close this gap. A literature review was conducted to identify the current state of knowledge on recruitment and retention of Aboriginal people in nursing education programs. Thirty six articles met inclusion criteria, and major themes were identified and organized according to characteristics of students and academic environments. Characteristics of academic environments were further segmented by secondary school, classroom, program, and university levels. With published literature in its infancy, we suggest an organizing strategy based on a decolonizing multiple intervention and evaluation approach, and commitment from Aboriginal-university partnerships, governments and the health professions.

As the demand for cultural awareness in the provision of nursing care continues to increase, nursing programs must develop creative and effective teaching strategies and curricula to address this need. The evaluation of a five year, funded, North American nursing exchange project developed and implemented by six partner universities in Canada, Mexico and the United States of America is described in this article. The project was designed to enable nursing students to increase cultural awareness, redefine their role relationships with nurses from the partner countries, and increase knowledge regarding the health care systems and role of the nurse in those countries. Findings provide evidence that teaching nursing through a prism of cultural awareness, using both a jointly taught online course and student and faculty exchanges across the three countries is an effective strategy to increase the level of cultural awareness in nursing students.

The safety and quality issues identified in the United States healthcare system have resulted in a call to transform healthcare education, preparing graduates to work in teams and within systems that promote patient safety. Responding from funding by the Robert Wood Johnson Foundation, a National Nursing Advisory Board and the American Association of Colleges of Nurses created six Quality and Safety Education for Nurses (QSEN) competencies for nursing: patient-centered care, teamwork and collaboration, evidence based practice, safety, quality improvement, and informatics. These competencies provided a systematic pedagogical structure for course redesign and content to prepare nurses to value quality and safety in caring for patients. The course redesign incorporated a wide variety of active learning modalities, simulation being an ideal education technique to implement QSEN because of the multiple levels of knowledge, skills, and attitudes that can be practiced and evaluated in each competency.

Over the past decade, online education has become common place. Critics of online education point to the possible loss of social interaction and interpersonal connections in this educational medium. Broadly, our research focus is how human to human interactions can be sustained and even enhanced in online classrooms. Specifically, this paper focuses on how one Artistic Pedagogical Technology called Photovoice (Perry & Edwards, 2010) may support these valued social interactions. Using a purposive sample of 46 graduate students in a large online university, online interactions resulting from the teaching strategy of Photovoice were analyzed for presence of authentic voice and authentic interaction. Lincoln and Guba’s (1985) authenticity criteria were adapted to evaluate Photovoice as an authentic medium. The results of this study show support for the use of Photovoice as a medium for becoming “real” or authentic to one another and as a modality of sustaining authentic interaction in the online environment.

Nursing faculty strive to educate students in a manner that prevents errors, promoting quality, patient-centered care. This endeavor is dependent upon meaningful and effective education that incorporates educational experiences reflective of the service sector. Anecdotal reports from clinical faculty and student nurses suggest that academic medication administration education may not optimally prepare students for safe entry into clinical practice. The aim of this phenomenologic qualitative research is to understand student nurse perceptions regarding teaching strategies and learning activities that prepared them for safe medication administration in acute care clinical settings. Focus group interviews resulted in two broad themes that are identified as Effective Education and Gaps in Education. Within these broad themes, findings revealed that students value faculty demonstrations, peer-learning opportunities, and repetitive practice with timely feedback. Study findings also pointed to educational gaps. Students reported needing to learn communication and conflict resolution strategies that would help them manage real-world interruptions, distractions, and computer generated alerts. Study findings recommend implementing relevant decision-support technology within academic lab learning activities.

The ever changing needs of society have created a much needed shift in health care delivery from that of hospital to community. However, the role and process of community health nursing is foreign to most nursing students as the majority of nursing curricula continue to relate experiences and examples of nursing to the more familiar role of “nurse clinician.” In contrast to undergraduate nursing programs where the use of simulation and technology has been widely adopted to emphasize the role of the nurse clinician, the use of such technology hasn’t been widely used to address the learning needs of community health nursing students. Here, we present a descriptive paper on the development of an interactive, virtual learning environment (serious game) for acquisition of community health nursing skills. The serious game primarily presents a learner-centered, experiential learning and problem-based learning approach, addressing the learning needs of today’s students.

Nursing students frequently experience disconnectedness, marginalization and antagonism during their clinical experiences. These experiences limit their ability to fully engage in the social learning that is important to the development of professional skill and identity. Current North American education models emphasize the separation between practice and education, with negative consequences for students and their learning. Re-envisioning the relationship between education and practice using Wenger’s Communities of Practice model promotes the development of mutually beneficial, capacity-building relationships where learning and growth are goals for students and staff alike. Re-creating units as learning organizations committed to learning, reflection, dialogue and quality improvement redefines the education-service relationship and changes the roles of educators and practitioners with respect to the unit learning needs. Wenger’s Communities of Practice model redefines the apprenticeship model of nursing education in ways that allow for more meaningful, effective learning relationships between clinicians, educators and students.

This research study examines learner perceptions of benefits and challenges associated with the Neighborhood (NBH), an innovative pedagogy that fosters learner engagement and integration of nursing concepts using a “virtual community” as an alternative to lecture. First-semester students from five baccalaureate nursing programs that used the NBH intervention were divided into high (N = 78) and low faculty use (N = 203) groups. Qualitative analysis revealed that the NBH intervention promoted application of concepts to real life situation was engaging and “eye-opening,” allowing students to understand health care issues from a variety of perspectives. A major challenge was busy work generated by faculty assignments unrelated to enhancing conceptual clarity. Statistical analyses indicate that benefits and challenges grow together; benefits outweigh challenges and net benefit increases with increased faculty use. This study highlights the need to provide initial and ongoing training and support to faculty at schools who adopt this intervention.

Nursing science is a topic students and faculty view with skepticism. The interchangeable terms and the need to understand the contextual nature of nursing philosophy lead to feelings of anxiety and confusion. Students question the relevance of learning nursing science in relation to practice. The analogy of a building is used to explain how nursing philosophy relates to practice. The foundation of the building forms the paradigm of the nursing domain, the outside walls represent conceptual models, the interior walls symbolize theories and the detailed décor characterizes nursing observations and practice, connecting abstract theory to concrete nursing knowledge. The analogy of interrelated concepts may help students gain an understanding of nursing science, which is essential to further knowledge development in nursing.

The purpose of this article is to report the perceptions of students regarding evaluation when placed in a rural setting for their final preceptorship course. The research question was: “What are students’ perceptions of preceptor evaluation?” Thus, a grounded theory method was employed. Twenty-three nursing students placed in rural settings for their precepted practicum experiences were interviewed regarding the evaluation process during their preceptorship experience. The core variable was that feedback is critical for students, much more so than the formal evaluation; and, that students viewed informal evaluation as meaningful and formal evaluation as superficial. The implications are that strategies are required to make students truly authentic partners in evaluation and to make evaluation a useful process in their eyes. The role of the faculty in this process must be reviewed. Feedback is key for students, thus preceptors need educational development in this area.

Self-efficacy is conceptually analyzed using the framework developed by Walker and Avant (2005). Defining attributes, antecedents and consequences of self-efficacy are identified and applied in model, borderline and related and contrary cases. Although self-efficacy has been incorporated into the work of many professions, minimal research has been conducted using this concept in clinical nursing education. By gaining a more thorough understanding of self-efficacy in relation to student learning, nurse educators and researchers can use self-efficacy in curricular planning to improve clinical nursing education.

Nursing educators are challenged to include nursing theory in all levels of curricula when faced with many influences and requirements competing for course content, placement, and credit. Some of the essential influences and content, such as quality, safety, evidence-based practice, and research methods are important. However, the critical emphasis on theory and its relationship to practice and research must be preserved. This article addresses the influences that may threaten this relationship at the baccalaureate, master’s, and doctoral levels of nursing education. Strategies are offered to ensure nurse educators continue to offer appropriate nursing theory content to advance both nursing science and practice.

Undergraduate nursing practice rotations today are quite different from what many practicing nurses experienced during their own education. This is especially true of community health practice rotations. Increasingly, non-traditional community health sites are being used as practice sites—sites such as schools, homeless shelters, non-profit agencies, and even churches. Increasingly, non-traditional practice experiences are eclipsing traditional practice experiences involving home care and public health. Why has this shift occurred, and what do these experiences offer students? Do these experiences actually prepare nursing students for clinical practice once they graduate? What does preparing the next generation of community health nurses entail?

It is important for nursing students to be exposed to critical patient care scenarios because high stress clinical situations, such as patient codes, occur unexpectedly and infrequently in the clinical setting. In addition, it is important for nursing students to be exposed to the reality of patient death in order to help them overcome fears associated with death and to develop effective coping strategies. Students may or may not have an opportunity to deal with patient codes or patient death in the clinical setting, therefore simulation labs provide students with the opportunity to practice important clinical skills and discuss emotions in a safe environment. Although there is some research on the benefits of incorporating end-of-life patient care scenarios in simulation labs, there is no research that analyzes students’ perceptions of the benefits of participating in simulated code scenarios and their emotions following patient simulated death. A pilot study was conducted to assess students’ views on the benefits of participating in simulated code scenarios in which a patient dies and the effectiveness of the debriefing session in processing emotions related to the lab experience.

Described, is a strategy session to identify how to integrate the Framework for Cultural Competence and Cultural Safety in Nursing Education (Aboriginal Nurses Association of Canada, Canadian Association of Schools of Nursing, Canadian Nurses Association) into a baccalaureate nursing program. Emphasis is placed on engaging a wider community building on faculty and institutional strengths and resources to gather a network of Elders, nurses, students, and faculty. Outlined, is the process to identify potential learning experiences, key resources for implementing the Framework, and developing an advocacy statement to influence School of Nursing (SON) and university level policy regarding commitment to the Framework, its values and principles. Written as a narrative, the information can be shared with other SONs as they move forward with their own work in cultural safety and Aboriginal nursing.

The purpose of this research was to determine the extent to which HESI tests scores improve the prediction of timely first-time nursing licensure beyond prediction based only on academic performance in the nursing curriculum. Licensure in less than 140 days post-graduation was the dependent variable used as the operational definition for first-time NCLEX-RN success. Logistic regression was used to estimate the value-added of the HESI as a predictor after controlling for measures of academic performance in the nursing curriculum (GPA in nursing courses and the presence of D or F grades in nursing-relevant courses). HESI exit exam scores substantially improved the prediction of timely licensure. Nurse educators who seek cost-effective interventions for remediation benefit from using both HESI exit scores and data on academic performance in the nursing curriculum to better identify students who are a risk of failure to achieve timely first-time licensure.

This article describes the implementation and evaluation of a program to prepare HIV Nurse Practitioners in Zambia. Thirty nurses from all nine Zambian provinces participated in this program. Data on a variety of indicators were collected at baseline and throughout the one-year program including student and supervisor assessments, student performance on pre- and post-tests, clinical and case study assessments, documentation of care in patients’ health records, and their performance on final oral and written examinations. Findings indicated that the students were able to achieve the identified competencies and that their supervisors perceived that they would be able to implement their expanded skills to improve care for patients with HIV and AIDS in Zambia. Lessons learned from this initial pilot project will be used to expand the program in order to ensure successful task-shifting to address the critical shortage of health workers in Zambia in the context of the HIV/AIDS epidemic.

Lessons learned from a faculty development program that preceded the move of a traditional PhD program in nursing to a blended learning model using online and face-to-face strategies are discussed. The majority of lessons and strategies presented are universal to any faculty development program. The lessons are organized into seven topics: Situational Leadership, Adult Learners, Just in Time Teaching, Thinking About Learning and Teaching, Lifelong Learning, Transparency and Collaboration, and Community. Our far-reaching lessons are related to the contextual nature of leadership, how to effectively design and time learning experiences for adults, the importance of open and supportive communities working for a common purpose, and how each person’s perspective shapes his or her learning experience and how the lessons learned are applied.

Educational preparation of health professionals for Palliative and End of Life Care (PEOLC) is inadequate, and nurses are no exception. In 2004, the Canadian Association of Schools of Nursing struck a Task Force to develop PEOLC competencies to address this issue. The development of national PEOLC nursing competencies involved a multi-step, emergent, interactive, and iterative process. An overarching principle guiding this process was building national consensus about the essential PEOLC specific competencies for nurses among experts in this field while simultaneously generating, revising, and refining them. There have been three stages in this iterative, multi-step process: 1) Generating a preliminary set of competencies, 2) Building a national consensus among educators and experts in the field on PEOLC specific competencies for nurses, and 3) Refining the consensus based competencies for curriculum development. Ongoing follow up work for this project is focusing on the integration of these competencies into nursing curricula.

As the complexity of health care delivery continues to increase, educators are challenged to determine educational best practices to prepare BSN students for the ambiguous clinical practice setting. Integrative, active, and student-centered curricular methods are encouraged to foster student ability to use clinical judgment for problem solving and informed clinical decision making. The proposed pedagogical model of progressive complexity in nursing education suggests gradually introducing students to complex and multi-contextual clinical scenarios through the utilization of case studies and problem-based learning activities, with the intention to transition nursing students into autonomous learners and well-prepared practitioners at the culmination of a nursing program. Exemplar curricular activities are suggested to potentiate student development of a transferable problem solving skill set and a flexible knowledge base to better prepare students for practice in future novel clinical experiences, which is a mutual goal for both educators and students.