Volume 12, Issue 1 -

Think Aloud (TA), a strategy in which subjects are instructed to verbalize thoughts as they occur while completing an assigned task, was integrated into a study of clinical reasoning during high fidelity patient simulation by baccalaureate nursing students. TA methods in nursing education research with patient simulation have not previously been reported. Concurrent TA (verbalization of thoughts in short-term memory) and retrospective TA (reflective thoughts verbalized during an immediate post-simulation interview) methods facilitated the collection of rich and meaningful data. Students demonstrated distinct patterns in verbalization during concurrent TA, including public and private thoughts, narration of care, and the use of the pause to facilitate clinical reasoning. Retrospective TA data provided rich descriptions of reflection-on-action. TA provides a rich source of data regarding clinical reasoning as experienced by the baccalaureate nursing student during high fidelity patient simulation.

Background : To evaluate the effectiveness of a curriculum for achieving high levels of cultural competence, we need to be able to assess education intended to enhance cultural competency skills. We therefore translated the Cultural Awareness Scale (CAS) into Korean (CAS-K). The purpose of this study was to evaluate the cross-cultural applicability and psychometric properties of the CAS-K, specifically its reliability and validity. Methods : A cross-sectional descriptive design was used to conduct the evaluation. A convenience sample of 495 nursing students was recruited from four levels of nursing education within four universities in the city of Daejeon, South Korea. Results : This study provided beginning evidence of the validity and reliability of the CAS-K and the cross-cultural applicability of the concepts underlying this instrument. Cronbach’s alpha ranged between 0.59 and 0.86 (overall 0.89) in the tests of internal consistency. Cultural competency score prediction of the experience of travel abroad ( r =0.084) and the perceived need for cultural education ( r =0.223) suggested reasonable criterion validity. Five factors with eigenvalues >1.0 were extracted, accounting for 55.58% of the variance; two retained the same items previously identified for the CAS. Conclusion : The CAS-K demonstrated satisfactory validity and reliability in measuring cultural awareness in this sample of Korean nursing students. The revised CAS-K should be tested for its usability in curriculum evaluation and its applicability as a guide for teaching cultural awareness among groups of Korean nursing students.

Increased emphasis on the use of simulation by nursing education providers is evident world-wide. It is unclear what the implications of this initiative are for academic staff within nursing programs. Programs report a range of responses to simulation pedagogy amongst faculty ranging from enthusiasm to avoidance. This study identified a wide range of concerns encapsulating the staff themselves, their concern for students as well as organisational considerations that impact staff perceptions. Methods : Nineteen in-depth, semi-structured interviews were conducted with faculty in a school of nursing and midwifery. Thematic analysis of data was carried out. Results : This study reinforced other earlier research related to staff feelings about the introduction of a simulation program or uptake of existing equipment and facilities. This study reflects the knowledge and experience staff had of simulation and highlights the importance of ensuring all members have a collective frame of reference in order to create shared language and vision. Conclusion : This study adds to the research on staff attitudes to simulation by identifying the preconceived ideas that contribute to idea formation and relates this to the insight and self-efficacy of the faculty members.

Research has revealed the effectiveness of simulation for facilitating student development of self-efficacy, knowledge, clinical judgment, and proficiency in technical skills. This grounded theory study was conducted to describe the experience of nursing students in high-fidelity simulation and develop a model which explicates the experience of nursing students in simulation. Focus group interviews were conducted with three cohorts of students enrolled in a baccalaureate nursing program who experienced simulation four to twelve times per academic year. Five prominent themes emerged during analysis Emotional Processing; Anxiety; Making Connections; Fidelity; and Learning. The Simulation Learning Model – Student Experience (SLM-SE) was developed to illustrate the student’s multi-dimensional experience of learning through high-fidelity simulation. Findings from this study suggest that students are better equipped to learn through increasing confidence and experience, continued reflection-on action and enhanced peer-to-peer interaction. Recommendations for future research include developing strategies to optimize students’ experiences for learning in simulation.

Recognizing and responding to a cardiac arrest in the hospital setting is a high stress, high anxiety event for all healthcare providers. It requires the performance of several basic, but extremely important cardiopulmonary resuscitation (CPR) skills and response priorities. If not executed correctly and in a timely manner, a bad outcome may result. Poor retention of cardiopulmonary resuscitation skills and priorities is well documented in the literature. An integrative review of the evidence was conducted to answer the question, “Is there a more effective training method to improve nurses’ retention of CPR priorities during an in hospital cardiac arrest as compared to traditional American Heart Association training? “This review evaluated high fidelity and low fidelity simulation training, online or computer-based training and video instruction as potential teaching strategies focusing on CPR priorities. The role of deliberate practice is discussed. The strongest evidence suggests that a teaching plan employing brief, frequent, repetitive or deliberate practice used in collaboration with low fidelity or high fidelity simulation may be a potential strategy to improve nurses’ retention of CPR priorities over time.

Online learning requires higher levels of self-regulation in order to achieve optimal learning outcomes. As nursing education moves further into the blended and online learning venue, new teaching/learning strategies will be required to develop and enhance self-regulated learning skills in nursing students. The purpose of this study was to compare the effectiveness of team-based learning (TBL) with traditional instructor-led (IL) learning, on self-regulated online learning outcomes, in a blended undergraduate research and evidence-based practice course. The nonrandomized sample consisted of 98 students enrolled in the IL control group and 86 students enrolled in the TBL intervention group. The percentage of total possible online viewing time was used as the measure of self-regulated online learning activity. The TBL group demonstrated a significantly higher percentage ( p < 0.001) of self-regulated learning activities than the IL control group. The TBL group scored significantly higher on the course examinations ( p = 0.003). The findings indicate that TBL is an effective instructional strategy that can be used to achieve the essential outcomes of baccalaureate nursing education by increasing self-regulated learning capabilities in nursing students.

Nurse educators claim accountability to ensure their students are prepared to assume leadership responsibilities upon graduation. Although front-line nurse leaders and nurse executives feel new graduates are not adequately prepared to take on basic leadership roles, professional nursing organizations such as the American Nurses Association (ANA) and the Association of Colleges of Nursing (AACN) deem leadership skills are core competencies of new graduate nurses. This study includes comparison of a leadership-focused multi-patient simulation and the traditional leadership clinical experiences in a baccalaureate nursing leadership course. The results of this research show both environments contribute to student learning. There was no statistical difference in the overall score. Students perceived a statistically significant difference in communication with patients in the traditional inpatient environment. However, the students perceived a statistical significant difference in teaching–learning dyad toward simulation.

The experience of nursing students who make mistakes during clinical practice is poorly understood. The literature identifies clinical practice mistakes as a significant issue in nursing practice and education but there is very little research on the topic. This study used a grounded theory approach to explore the experience of undergraduate nursing students who had made at least one mistake in their clinical practice. What emerged is a theory that illuminates the process of how students move through the positive and negative elements of the mistake experience the core variable that emerged from the study was “living through the mistake experience.” The mistake experience was clearly a traumatic process for nursing students and students reported feeling unprepared and lacking the capability to manage the mistake experience. A number of recommendations for nursing education are proposed.

The aim of this study was to identify the learning styles and methods used by nurses to promote their professional knowledge and skills. 928 nurses from 11 hospitals across Israel completed 2 questionnaires, (1) Kolb’s Learning Style Inventory, Version 3.1. and (2) the On-The-Job Learning Styles Questionnaire for the Nursing Profession. The most common learning style was the convergent style. The other learning styles were rated in the following descending order: accommodation, assimilation, and divergence. The on-the-job learning style consistently ranked highest was experience of relevant situations. On the other hand, seeking knowledge from books, journals, television, or the Internet was ranked lowest on all the indicators examined. With respect to general and on-the-job learning styles, statistically significant differences were found between groups of nurses by: country of birth, gender, department, age, education, and role. Nurses required to take more personal responsibility for their own professional development by deepening their self-learning skills.

This study helps to quantify and describe orientation, evaluation, and integration practices pertaining to part-time clinical nursing faculty teaching in prelicensure nursing education programs. A researcher designed Web-based survey was used to collect information from a convenience sample of part-time clinical nursing faculty teaching in prelicensure nursing programs. Survey questions focused on the amount and type of orientation, evaluation, and integration practices. Descriptive statistics were used to analyze results. Respondents reported on average four hours of orientation, with close to half reporting no more than two hours. Evaluative feedback was received much more often from students than from full-time faculty. Most respondents reported receiving some degree of mentoring and that it was easy to get help from full-time faculty. Respondents reported being most informed about student evaluation procedures, grading, and the steps to take when students are not meeting course objectives, and less informed about changes to ongoing curriculum and policy.

The Nursing Students’ Clinical Stress Scale, a Likert-type survey by Whang (2002), translated from Korean into English, was used to identify perceptions of stress in baccalaureate nursing students. Data was collected from a convenience sample of baccalaureate nursing students at a Midwestern university. Students ranked their perceived stress level from clinical situations. One open-ended item asked students to describe their most stressful clinical experience. Rasch Model analysis/diagnostics were used to check the instrument for validity and reliability. Quantitative data were analyzed for descriptive statistics (means). Information from open-ended question was analyzed for themes. Qualitative themes were consistent with results from quantitative analysis and well-aligned with the literature. Students were stressed by incivility by healthcare staff and instructors, inconsistencies and time constraints. Research shows that stress can interfere with learning. It is imperative to determine causes of stress so educators can help decrease stress and improve student learning.

In the flipped classroom (FC) students view pre-recorded lectures or complete pre-class assignments to learn foundational concepts. Class time involves problem-solving and application activities that cultivate higher-level cognitive skills. A systematic, analytical literature review was conducted to explore the FC’s current state of the science within higher education. Examination of this model’s definition and measures of student performance, student and faculty perceptions revealed an ill-defined educational approach. Few studies confirmed FC effectiveness; many lacked rigorous design, randomized samples, or control of extraneous variables. Few researchers conducted longitudinal studies to determine sufficiently trends related to FC practice. This study proves relevant to nurse educators transitioning from traditional teaching paradigms to learner-centered models, and provides insight from faculty teaching across disciplines around the world. It reveals pertinent findings and identifies current knowledge gaps that call for further inquiry.

A principle-based concept analysis of student engagement was used to examine the state of the science across disciplines. Four major perspectives of philosophy of science guided analysis and provided a framework for study of interrelationships and integration of conceptual components which then resulted in formulation of a theoretical definition. Findings revealed student engagement as a dynamic reiterative process marked by positive behavioral, cognitive, and affective elements exhibited in pursuit of deep learning. This process is influenced by a broader sociocultural environment bound by contextual preconditions of self-investment, motivation, and a valuing of learning. Outcomes of student engagement include satisfaction, sense of well-being, and personal development. Findings of this analysis prove relevant to nursing education as faculty transition from traditional teaching paradigms, incorporate learner-centered strategies, and adopt innovative pedagogical methodologies. It lends support for curricula reform, development of more accurate evaluative measures, and creation of meaningful teaching-learning environments within the discipline.

Background and Objectives : High-stakes didactic testing assesses competency. Exams are stressful, and decreasing anxiety may enhance learning. Academic progression and graduation rates may result when higher levels of hopeful thinking (the belief in one’s ability to achieve desired goals), and certain achievement goal orientation (why one desires to succeed) are present. Methods : This non-experimental study engaged undergraduate nursing students via surveys to examined relationships among hopeful thinking, goal orientation, and scores on standardized high-stakes examination of students. Results : Regression analyses ( N = 151) indicated that hopeful thinking was significantly related to higher exam scores, and that performance-avoidance goal scores were significantly related to lower scores. Conclusion : The positive relationship between hopeful thinking and exam scores suggests the need to consider supporting hopeful thinking in nursing education. Additional research may explicate the relationship between performance-avoidance and scores on high-stakes exams.

Maintaining scholarship while delivering an undergraduate nursing program is a challenge for nursing faculty. In this paper, we describe an approach that involves undergraduate nursing students in a program of faculty research, which evaluates new approaches to teaching and learning. Students work with faculty to develop a research proposal, identifying specific questions and exploring relevant literature. Projects may include original data collection with faculty supervision, or secondary analysis of existing datasets. Foci have included partnership learning between nursing students and older adults, models of sustainability for a traveling health clinic, and experiences of aging. Findings and recommendations feed into the broader faculty research agenda, provide a foundation for subsequent projects, and inform further development of educational programs. Students have presented at local and national conferences and developed papers for publication based on this joint work. We describe the benefits and challenges of these partnerships, drawing upon student and faculty reflections.

In Canada, it is widely believed that nursing practice and health care will move from acute care into the community. At the same time, increasing numbers of nursing students are engaged in non-traditional clinical experiences for their community health rotation. These clinical experiences occur at agencies not organizationally affiliated with the health care system and typically do not employ registered nurses (RNs). What has yet to be established is the degree to which nursing students are actually being prepared for community health nursing roles through their community health clinical rotations. In this paper we report the findings of a mixed method study that explored the gap between desired and observed levels of competence in community health of senior nursing students and new graduates. The gap was quantified and then the nature of the gap further explored through focus groups.

Aim/Purpose : The purpose of the study was to evaluate senior students’ level of preparedness to perform and perceived importance of 22 QSEN-related skills over a three year project period. Background : The national Quality and Safety Education in Nursing (QSEN) project promotes student learning in the provision of safe, quality health care. One Midwestern nursing program attempted to address health care challenges by purposefully utilizing the QSEN competencies for curricular changes. Methods : This study collected data from students in their final semester of a baccalaureate program using the QSEN Student Evaluation Survey. Results/Findings : Students reported they were somewhat prepared to perform skills related to all six QSEN competencies. Students perceived all QSEN related skills as being as least somewhat important. Conclusions : As a result of this study, the nursing program identified areas to be developed for further growth and utilized findings to aid in curriculum revision.

Student nurses often embark on their professional careers with a lack of the knowledge and confidence necessary to navigate them successfully. An ongoing process of career planning and development (CPD) is integral to developing career resilience, one key attribute that may enable nurses to respond to and influence their ever-changing work environments with the potential outcome of increased job satisfaction and commitment to the profession. A longitudinal mixed methods study of a curriculum-based CPD program was conducted to determine the program’s effects on participating students, new graduate nurses, and faculty. This first in a series of three papers about the overall study’s components reports on undergraduate student outcomes. Findings demonstrate that the intervention group reported higher perceived career resilience than the control group, who received the standard nursing curriculum without CPD. The program offered students the tools and resources to become confident, self-directed, and active in shaping their engagement in their academic program to help achieve their career goals, whereas control group students continued to look uncertainly to others for answers and direction. The intervention group recognized the value of this particular CPD program and both groups, albeit differently, highlighted the key role that faculty played in students’ career planning.

New graduate nurses’ (NGNs) transition into the nursing workforce is characterized as stressful and challenging. Consequently, a high percentage of them leave their first place of employment or the profession entirely within one year of graduation. Nursing literature describes this complicated shift from student to registered nurse, however, limited attention has focused on strategies that could be implemented during students’ academic programs to prepare them for this difficult transition period. Therefore, a longitudinal intervention study was conducted to examine the influence of a career planning and development (CPD) program on the development of career resilience in baccalaureate nursing students and at 12 months post-graduation (NGN). The findings support including structured and progressive curriculum-based CPD opportunities in academic programs, not only for the positive outcomes that accrue to students, but also because of the benefits they extend to NGNs as they make the transition to their first professional nursing role.

As career satisfaction has been identified as a predictor of retention of nurses across all sectors, it is important that career satisfaction of both new and experienced nursing faculty is recognized in academic settings. A study of a curriculum-based career planning and development (CPD) program was conducted to determine the program’s effects on participating students, new graduate nurses, and faculty. This third in a series of three papers reports on how the CPD intervention affected faculty participants’ sense of career satisfaction and confidence in their role as career educators and coaches. Faculty who participated in the intervention CPD intervention group reported an increase in confidence in their ability to provide career coaching and education to students. They further indicated that their own career development served to enhance career satisfaction; an outcome identified as a predictor of faculty career satisfaction. Study results suggest that interventions such as the one described in this paper can have a potentially positive impact in other settings as well.