Volume 15, Issue 1 -

The nursing profession needs leaders from across the temperament continuum. Educational environments are conducive to extroverts’ learning but can have detrimental outcomes for introverted students. Introverted nurses avoid leadership positions because they have been taught extroversion traits are needed. This study explores perceptions of seven RN-BSN students who work as nurses and self-identify as introverts. Interviews with participants were conducted to ascertain perceptions of their educational experiences including preparation for leadership positions. Four themes emerged as: (1) stop making me sick, and I will appreciate learning, (2) respect my silence, and I will eventually speak, (3) recognize my strengths, and I will grow in confidence as a leader, and (4) adapt the environment, and I will learn more. Implications for nurse educators include being mindful to avoid bias and reduce stigma, considering changes to teaching approaches to create equitable learning spaces, and respecting silence in the classroom.

Despite a wealth of information and growing diversity among nursing students, little is known about coping behaviors employed by these students or students educated in diverse environments. The aim of this integrative literature review was to examine what is known about stress, coping, measures of coping, and interventions to enhance coping, and in pre-licensure nursing students. Twenty-six peer-reviewed research articles were included. Stress, coping styles and behaviors, support, interventions, and instruments to measure coping were identified as key themes. Variations in coping were noted by gender, age, length of time in the program, and culture. Analysis of the literature illuminated the importance of support for students, and strong indications suggested educators play a pivotal role in helping students develop adaptive coping strategies. Nursing programs should consider incorporating coping instruction into the curricula.

Clinical reasoning is the cognitive process that nurses use to gather and incorporate information into a larger bank of personal knowledge. This incorporated information guides therapeutic actions, and helps determine client care. Since the process guides therapeutic actions regarding client care, failure to use the process effectively leads to poor clinical decision-making, inappropriate actions, or inaction. Because of the criticality of this process, this paper presents an analysis of the literature that reveals the current state of the science of clinical reasoning, identifies gaps in knowledge, and elucidates areas for future research. A systematic review of the databases the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Educational Resources Information Center (ERIC), PsychInfo, the Education Full Text (H.W. Wilson), and PubMed revealed 873 articles on the topic of clinical reasoning. Quality appraisal narrowed the field to 27 pieces of literature. Appendix A gives the State of the Science Coding Sheet used to identify the selections used in this research. Appendix B contains a summary of this literature. Although analysis of this literature shows that three theories exist on how to utilize most effectively the clinical reasoning process presently; a clear consistent definition is lacking. Additional research should focus on closing gaps that exist in defining the process, understanding the process, establishing linkages to non-clinical reasoning processes, and developing measures to both develop and accurately measure clinical reasoning.

Problem/Background: The ability to accurately diagnose patients based on symptom profiles is a vital yet challenging skill that Nurse Practitioners (NPs) undertake frequently. Purpose: This integrative literature review highlights a variety of evidence based, practical educational strategies that foster the development of diagnostic reasoning. Methods: An integrative literature review was conducted in order to identify original research focusing on diagnostic reasoning educational interventions. Results: Eighteen primary sources met inclusion and exclusion criteria. Results are synthesized in terms of sample and setting, methodological features, interventions, and outcomes. Interventions broadly fit into five educational themes: testing strategies, cognitive biases, simulation programs, course formats, and instructional approaches. Discussion: Interventions are simple and can be implemented in multiple educational settings. Future research should occur in populations of NP students. Validated, easy-to-use measurement tools as well as more precise diagnostic reasoning concept development should occur.

In the current healthcare environment, the healthcare industry has become increasingly focused on population health concerns. While advanced practice registered nurses (APRNs) are well prepared to contribute to population health by delivering holistic healthcare to individuals, families, groups, communities, and populations, they are not engaged in initiatives to improve population health commensurate with their numbers, education, training, experience, and role as primary care providers and essential healthcare team leaders and members. This article discusses the rationale for integrating population health into APRN curricula, one program’s approach to doing so, and preliminary lessons learned from this effort. The three main lessons learned include population health content should be integrated across the curriculum for all APRN cohorts, supplementary population health content should be considered, and opportunities for integrating didactic population health content should be included across the FNP curriculum.

Facilitating student achievement of nationally recognized entry-level-competencies in nursing leadership is a critical step in building capacity to promote patient safety, quality of care, and healthy work environments. Data for this substudy were drawn from a larger multi-phased, multi-method, cross-sectional, descriptive study conducted to inform comprehensive undergraduate curricular revision. The research question for this substudy was: what are the perceptions about undergraduate program preparation for nursing leadership? Frequencies and percentages summarized relevant quantitative data from the surveys and deductive content analysis was used to further explore the category of leadership which emerged from content analysis of qualitative data in the larger study. Key findings illustrate need for additional attention to learning experiences in conflict management, delegation and supervision of clinical teams, and advocacy. Greater collaboration between educational and clinical agencies is needed to find mutually beneficial strategies to support nursing leadership development for nursing students and new graduates.

Abstract In most schools of nursing, students rate their satisfaction with courses and teachers at the end of the semester. Low response rates on these evaluations make it difficult to interpret the results. Students were incentivized to complete their course evaluations by adding 1–2 points to one test score in the course in exchange for 85 % or higher participation by the total cohort. Ongoing monitoring and communication to students by faculty during the process was critical to motivating students to complete course evaluations. When the incentive was employed, student participation ranged from a low of 90 % to a high of 100 % response rate. The added points did not change any of the students' grades. Incentivizing students to complete course evaluations is an effective strategy to boost response rates without changing final course grades.

With the knowledge of psychoneuroimmunological responses and the known high stress levels of nursing students, as caring nurse educators, we have become ethically obligated to revise and re-vision our current nursing educational practices. Nurse educators should be motivated to create innovative and radical caring science curricular approaches, so that our nurses of the future are in turn supported in creating caring- healing sustainable bedside practices. This paper details the outcomes from an upper level yoga elective in an RN- BSN program. The course is just one within an innovative holistic-integral nursing curriculum that supports nurses in practicing self-care as a way to support their ability to create caring-healing moments and spaces for patients, implement change in the workplace, and avoid the perils of burn-out related to low stress resilience, which is so common within the nursing profession.

This Participatory Action Research (PAR) project aimed to engage students from an accelerated 'fast track' nursing program in a mentoring collaboration, using an interdisciplinary partnership intervention with a group of academics. Student participants represented the disciplines of nursing and paramedicine with a high proportion of culturally and linguistically diverse (CALD) students. Nine student mentors were recruited and paired with academics for a three-month ‘mentorship partnership’ intervention. Data from two pre-intervention workshops and a post-intervention workshop were coded in NVivo11 using thematic analysis. Drawing on social inclusion theory, a qualitative analysis explored an iteration of themes across each action cycle. Emergent themes were: 1) ‘building relationships for active engagement’, 2) ‘voicing cultural and social hierarchies’, and 3) ‘enacting collegiate community’. The study offers insights into issues for contemporary accelerated course delivery with a diverse student population and highlights future strategies to foster effective student engagement.

Abstract Background:Nursing students face the challenge of developing a comprehensive understanding of the complex role of the registered nurse across various clinical settings. Frameworks such as the “ways of knowing”, help students conceptualize and critically reflect upon important processes in their professional learning. However, the academic language used to describe frameworks can be challenging. Purpose: This manuscript has two purposes. First, to briefly describe the historical climate influencing the development of nursing as a discipline. Second, two clinical practicum scenarios in acute care and community-based care are explored with the application of Carper’s four fundamental ways of knowing in nursing (empirical, aesthetic, self-knowledge, ethical), and Chinn and Kramer’s fifth, emancipatory, knowing as foundational to developing reflexivity in clinical practice. Conclusion: These practical descriptions and concrete examples can assist students in incorporating the five ways of knowing into their reflective practice and thereby more fully develop their construct of nursing.

The purpose of the cross-sectional descriptive study was to explore and compare the students’ experiences of the clinical environment and supervision in Slovakia. Students’ clinical learning experience were measured by the valid and reliable clinical learning instrument. A higher frequency of successful supervisory experience was found in the universities which provided accredited mentor preparation programmes or courses and individualised supervisory approaches. Frequency of supervision meetings, the occupational title of a supervisor and mainly the supervision model have an association with students ‘perceptions of different domains of clinical learning environment. The duration of the placement was not related to students’ experience and perceptions of the learning environment. Slovak students reported higher score regarding the quality of nursing care or ward culture than in the supervisory relationships between students, clinical and school staff. Further studies in this field, extended to different Eastern European countries and clinical settings, may help us to understand factors affecting workplace training.

Abstract Background Empathic concern has been found to decline in health professional students. Few effective educational programs and a lack of validated scales are reported. Previous analysis of the Empathic Concern scale of the Emotional Response Questionnaire has reported both one and two latent constructs. Aim To evaluate the impact of simulation on nursing students’ empathic concern and test the psychometric properties of the Empathic Concern scale. Methods The study used a one group pre-test post-test design with a convenience sample of 460 nursing students. Empathic concern was measured pre-post simulation with the Empathic Concern scale. Factor Analysis was undertaken to investigate the structure of the scale. Results There was a statistically significant increase in Empathic Concern scores between pre-simulation 5.57 (SD = 1.04) and post-simulation 6.10 (SD = 0.95). Factor analysis of the Empathic Concern scale identified one latent dimension. Conclusion Immersive simulation may promote empathic concern. The Empathic Concern scale measured a single latent construct in this cohort.

As the development of nursing education becomes increasingly internationalized, it is tempting to focus on universal aspects of the discipline rather than explicitly emphasizing the distinct national cultures and contexts within which our profession and its educational styles and approaches have evolved. Capitalizing on an opportunity for comparative critical reflection on the relevant political, economic and social histories that have underpinned the development of nursing education in China, Brazil and Canada – three countries united by shared values about equity and access to health services – we sought to deconstruct the manner in which these forces have shaped the national differences in the way we conceptualize and deliver nursing education. On this basis, we examined the implications for the advancement of nursing education within each national context, recognizing the fundamental relevance of indepth critical reflection for optimizing nursing’s advocacy capacity within each of our national health care and policy systems.

Clinical learning experiences are essential in nursing education but they are often anxiety provoking for learners. Understanding the factors associated with the anxiety levels of nursing students in clinical placements has become more complex over the years with increasing heterogeneity within the nursing population. A correlational study was conducted to examine the relationships between nursing students’ self-perceived anxiety levels, as measured by the State-Trait Anxiety Inventory (STAI), and the students’ age, gender, previous employment, and previous education. The findings revealed that nursing students have a higher than average level of anxiety and that male nursing students reported higher levels of anxiety compared to female nursing students. No significant correlations were found between age, previous education, previous employment, and self-perceived anxiety levels. Findings from this study provide an opportunity for discussion by nursing educators and identify a need for future research and practice.

An interpretive descriptive qualitative study was conducted to explore the characteristics and outcomes of mentoring used for implementing nursing practice guidelines. We interviewed six mentees, eight mentors, and four program leaders who were involved in the Registered Nurses' Association of Ontario fellowship program in Ontario, Canada. Inductive content analysis was used and study rigor was verified using triangulation of findings and member checking. Mentors were described as accessible, dedicated, and having expertise; mentees were described as enthusiastic, self-directed, and having mixed levels of expertise. The mentoring process included building relationships, developing learning plans, and using teaching and learning activities guided by learning plans to support development of mentees. Mentoring was described as positively impacting mentoring relationships, mentees, mentors, and organizations. A central feature of this fellowship program was the learning plan used to identify mentees’ needs, guide mentoring activities, and monitor measureable outcomes.

This project is a mixed-methods systematic review on the use of simulation in pre-licensure nursing. This research question guided this review: What is the best evidence available upon which to base decisions regarding the use of simulation experiences with pre-licensure nursing students? Searches of CINAHL Plus with Full Text, MEDLINE, and ERIC were performed to identify relevant literature. These searches yielded 1220 articles. After duplicates were removed and titles and abstracts were reviewed for relevance to the inclusion criteria, the remaining 852 articles were independently assessed for quality by pairs of researchers. Forty-seven articles were retained. Findings were grouped into research using high-, medium-, and low-fidelity simulations and a group where researchers included several or all types of simulation. The conclusion is that insufficient quality research exists to guide educators in making evidence-based decisions regarding simulation. More rigorous and multi-site research is needed.

Each year, thousands of students throughout the world are required to complete one or more high-stakes tests as a measure of competency in undergraduate nursing education. Currently, the trend in nursing education is to use high-stakes tests to establish program progression policies. However, use of these tests to block student progression is of serious concern. This article describes findings of a pilot study that used a phenomenographic approach to understand senior nursing students’ experiences of completing multiple high-stakes tests for successful progression within one undergraduate nursing program. Eighteen graduating senior nursing students participated in the study via individual interviews. Students described a multitude of experiences, organized into five main categories of descriptions: high-stakes tests as a value; high-stakes tests as a stressor; high-stakes tests as a high expectation; high-stakes tests as various inconsistencies; and high-stakes tests affecting the transfer of learning. Student perspectives with high-stakes testing contributed valuable insight lacking in the current nursing education literature. Findings suggested if high-stakes tests are to be used for program progression, it is imperative for nurse educators to convene and explore strategies to support student preparation and success with testing, and develop well-defined structures of teaching and learning for the delivery of course content.

Background High fidelity human patient simulation (HF-HPS) is a teaching innovation in nursing education which may not be used to its full potential. This study seeks to understand the lived experiences of nurse faculty who are required to integrate HF-HPS into their teaching practice. Method A phenomenological methodology was used. Seventeen female nurse faculty teaching in the second year of a new collaborative bachelor of science in nursing program were interviewed about their experiences integrating mandated HF-HPS into their teaching practices. Results Six themes describing the participants’ experiences were identified: striving for self-efficacy, struggling to maintain autonomy, being part of a community of practice, adopting HF-HPS as a teaching innovation, being an advocate, and being proud. An emerging theme, being an outsider, was discussed. Conclusion This research has implications for nurse faculty and educational administrators integrating a new teaching innovation.

The aims of this study are three-fold: determine the factors that motivate nurses to pursue mental health nursing; identify the strategies that might attract nursing students and practising nurses to pursue mental health nursing as a professional career; and identify the difficulties of nurses in achieving their preferred clinical specialty. A descriptive qualitative study design with semi-structured interviews was used. Fifteen mental health nurses from rural and regional South Australia were interviewed. Interviews were transcribed verbatim, and thematic analysis was undertaken. Of the fifteen participants, thirteen were females and two were males; their average age was 50 years. The factors that motivated the participants to pursue mental health nursing were categorized as intrinsic and extrinsic. There were many strategies that might attract nursing students and nurses to the field, but the most popular suggestion was the provision of high quality meaningful clinical placements. Other strategies were to convey the personal satisfaction derived from being a mental health nurse, promote mental health nursing aggressively, and provide employment incentives. The study also highlighted the importance of addressing stigma, and greater education and support for nurses to pursue a mental health career.

Background Workplace violence has a great impact on the quality of patient care and satisfaction. This study aimed to determine the extent of violence experienced by nursing students, and its predisposing factors. Methods This was a cross-sectional study which was conducted on 150 nursing students in teaching hospitals of Ardabil University of Medical Sciences. A questionnaire form was used for data collection. Results Participants stated they were abused physically (12.7%), verbally (73.3%), racial (40.7%), and sexually (5.3%). The lack of awareness of the population about the tasks of the nursing students (40.0%) was the most important risk factor for violence against them. Conclusion The violence against nursing students is a common problem in the workplace. It is mainly caused by the lack of awareness of people from the duties of the nursing students. Therefore, it is necessary to educate the population about the responsibilities of nurses and nursing students.

Problem : Preparing health professional students for interprofessional collaborative practice, especially at a distance where provider shortages prevail remains difficult. Approach : A two-week interprofessional education (IPE) immersion experience preparing students from 11 disciplines and four universities was implemented. Week-one, using online technology, students develop/present an interprofessional careplan for a complex patient. Students then meet face-to-face to conduct group interviews with two standardized patient dyads. Week-two, students develop a website for use of the patient dyads. Websites are presented to faculty and fellow students via an online virtual meeting space. Outcomes : To date, 594 students have participated demonstrating capacity to: 1.effectively engage in interprofessional care,  2. utilize Telehealth to impact care and break down barriers of isolation, and 3. implement skills to advance healthcare. Conclusion : IPE combined with Telehealth technology provides future providers with knowledge and skills for interprofessional care regardless of geographic barriers. Next Step : Integrate more technology using mobile devices and enhance the evaluation process.

The nurse educator shortage continues without an increase in the numbers of graduate prepared nurses. Studies identified challenges in recruitment of nursing graduate students. No studies explore the experiences of nurses during graduate education. The framework used was Bandura’s self-efficacy theory. The population for this study included 15 nurse educators with a master’s or doctoral degree currently teaching in an undergraduate or graduate program in a western Canadian city. In semi-structured interviews, participants shared their experiences. Two themes emerged from the data: i) the hurdles of learning and ii) being a graduate student. The purpose of this article is to report the findings of faculty members’ experiences as graduate students. Understanding these experiences will help graduate faculty understand how graduate students develop self-efficacy throughout their graduate programs. Moreover, findings of this study will help graduate students succeed in a graduate program. Finally, issues related to recruitment and retention are addressed.

A 2015 Canadian report from the Truth and Reconciliation Commission issued two calls for action that specifically challenge nursing education programs: a call to incorporate indigenous knowledge and learning, and a call to reduce health disparities between aboriginals and non-aboriginals. These calls to action raise questions for nurse educators regarding how best to recruit, retain, and educate aboriginal nursing students. A literature review was conducted to examine issues faced by aboriginal students in nursing programs, as well as cultural competence with nurse educators working with aboriginal students. While there is some literature that addresses the need for aboriginal students to successfully complete nursing programs and thus be able to provide effective health care to aboriginal people, the emphasis is largely upon strategies. Although there are some exceptions, these have largely been ineffective. We argue the need to think about thinking in order to improve the effectiveness of these strategies within Canadian programs, as well as nursing programs abroad.

Mental illnesses, such as anxiety and depression, are top concerns among college students. Poor sleep quality intensifies the risk of mental illnesses. However, the mechanism for the associations between sleep quality and mental illnesses in college students is not well understood. Online surveys were collected with 242 undergraduate nursing students at a public university in the northeast United States. Multivariate linear regression models suggested that poor sleep quality was associated with an increased risk of symptoms of anxiety (β = 1.08, p < 0.01) and depression (β = 1.00, p < 0.01). Perceived stress mediated the association between sleep quality and symptoms of anxiety by 85.3 %, and mediated the association between sleep quality and symptoms of depression by 60.0 %. This study suggested that in addition to sleep promotion, effective interventions to identify unique stressors in nursing students and facilitate the development of appropriate coping strategies are needed to enhance their mental health and well-being.

The present study is aimed at examining the status of violence among the students of nursing, midwifery, and operating room. A self-reporting questionnaire with two sections of demographic characteristics and experience of violence was used. The data obtained were analyzed, using SPSS software. 58.7 percent of the students had a history of violence in the previous year. The maximum percentage of violence exposure belonged to the students of operating room (76.9%). The highest incidence of violence was verbal (76.4%), happened in patients’ rooms (32.9%) and was in the form of insult (75.1%). Accordingly, preventive actions are required to prevent and control violence and support students. Informing students about violence, communicative skills, reaction, and coping with violence during studying is necessary. Therefore, educational authorities and theoretical and clinical instructors should take appropriate measures in order to prevent violence and create supportive mechanisms for the students.

Cancer is one of the leading causes of death in the world. Along with increased new cases, cancer care has become increasingly complex due to advances in diagnostics and treatments, greater survival, and new models of palliative care. Nurses are a critical resource for cancer patients and their families. Their roles and responsibilities are expanding across the cancer care continuum, calling for specialized training and support. Formal education prepares nurses for entry level of practice, however, it does not provide the specialized competencies required for quality care of cancer patients. There is urgent need to align the educational system to the demands of the health care system, ease transition from formal academic systems to care settings, and to instill a philosophy of lifelong learning. We describe a model of education developed by de Souza Institute in Canada, based on the Novice to Expert specialty training framework, and its success in offering structured oncology continuing education training to nurses, from undergraduate levels to continued career development in the clinical setting. This model may have global relevance, given the challenge in managing the demand for high quality care in all disease areas and in keeping pace with the emerging advances in technologies.