Lessons learned: Using a Three-Step Model of Planned Change for nursing curricular revision.

BACKGROUND: The American Association of Colleges of Nursing (AACN, 2021) introduced "The Essentials: Core Competencies for Professional Nursing Education" (Essentials) in 2021. The AACN document necessitated a change in nursing curriculums, both undergraduate and graduate. To meet the revised standards, one college of nursing within a hierarchical organization used a Three-Step Model of Planned Change to guide curricular revisions. This article presents the lessons learned from using the Three-Step Model of Planned Change, which includes barriers, strategies, and a toolkit for implementing planned change. STEP ONE-DESIRE A CHANGE: Lessons learned include embracing the unifying values of the guiding coalition to understand the motivation(s) and urgency for change. Suggested strategies include creating a cross-sectional organizational team, utilizing collaborative approaches that value members' time, and various communication methods. STEP TWO-MAKE THE CHANGE: Lessons learned include understanding the larger hierarchical structure's process requirements and time allotment for approval. Suggested strategies include establishing a repository hub for templates and shared documents, implementing various communication channels, and repurposing standing meeting times. STEP THREE-LIVE THE CHANGE: As this process is just beginning, anticipated lessons include an understanding of changes occurring circuitously within and between steps. Considerations include significant and purposeful actions to deliver the new curriculum.

Building a research-focused academic practice partnership: A stepwise approach.

The 20th century began a period of reform in nursing education and practice, with more nurses receiving advanced degrees and serving in key leadership roles throughout healthcare organizations. During this period, the transformation of the healthcare delivery system encouraged innovation and collaboration between academic nursing programs and other healthcare entities to develop partnerships based on a shared vision and goals. As a result, nurses are negotiating academic-practice partnership agreements and leading interprofessional teams to meet the needs of collaborating organizations. This article describes a stepwise approach to building a research-focused academic practice partnership, from a needs assessment to an evaluation of the partnership.

Strategies for academic nursing to advance global and planetary health: A call to action.

Nurses play a crucial role in addressing human health influenced by global forces such as pandemics, and political conflicts that displace millions; in leading efforts to promote planetary health; and in achieving the United Nations (UN) Sustainable Development Agenda. Academic nursing programs have a significant role in actualizing nursing's impact on global health (GH) and planetary health (PH). This paper describes how nursing programs can actualize their GH and PH nursing perspectives to benefit students and society, thereby increasing nursing's effectiveness and improving health outcomes in local and global settings. Numerous strategies to actualize GH and PH perspectives were derived from current literature and an assessment of eleven nursing program websites. Nursing programs may adopt program-wide strategies such as reflecting GH and PH in their mission statement; through education, in courses; and through faculty or student scholarship, policy endeavors, and/or partnerships. Now is the time to take such action, recommitting to GH and PH nursing and deepening nursing's impact. Academic nursing programs' leadership role in society, and their role in preparing nurses to lead, educate, discover, and advocate is essential for the health of populations and the planet long into the future.

The nurse-led equitable learning framework for training programs: A framework to grow, bolster and diversify the nursing and public health workforce.

BACKGROUND: Addressing threats to the nursing and public health workforce, while also strengthening the skills of current and future workers, requires programmatic solutions. Training programs should be guided by frameworks, which leverage nursing expertise and leadership, partnerships, and integrate ongoing evaluation. PURPOSE STATEMENT: This article provides a replicable framework to grow, bolster, and diversify the nursing and public health workforces, known as the Nurse-led Equitable Learning (NEL) Framework for Training Programs. The framework has been applied by several multipronged, federally funded training programs led by investigators embedded in an academic nursing institution. METHODS: The NEL framework focuses on: (1) increasing equitable access to the knowledge, skills, and competencies needed to prepare a diverse workforce to deliver effective interventions; (2) fostering academic-practice linkages and community partnerships to facilitate the deployment of newly gained knowledge and skills to address ongoing and emerging challenges in care delivery; and (3) continuously evaluating and disseminating findings to inform expansion and replication of programs. RESULTS: Ten programs using this framework have successfully leveraged $18.3 million in extramural funding to support over 1000 public health professionals and trainees. Longitudinal evaluation efforts indicate that public health workers, including nurses, are benefiting from the programs' workplace trainings, future clinicians are being rigorously trained to identify and address determinants of health to improve patient and community well-being, and educators are engaging in novel pedagogical opportunities to enhance their ability to deliver high quality public health education. CONCLUSIONS: Training programs may apply the NEL framework to ensure that the nursing and public health workforces achieve equitable, sustainable growth and deliver high quality evidence-based care.

Roadmap for integrating the AACN essentials with perioperative nursing.

Faculty members teaching in pre-licensure nursing programs are entrusted with revising nursing education to meet the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education. Colleges of nursing faculty experience difficulty establishing enough clinical sites as healthcare facilities continue to overcome staffing challenges since the start of the COVID-19 pandemic. Perioperative nursing is an underutilized area despite the potential for students to attain valuable nursing competencies and experiences in perioperative areas. An opportunity exists for faculty, regardless of having perioperative nursing experience or not, to use perioperative environments for clinical experiences in didactic and simulation courses. Our aim is to provide a roadmap for nursing faculty to include perioperative nursing in the pre-licensure nursing curriculum. Perioperative education exemplars aligned with the American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education domains are included for adoption in any college of nursing.

Educator-to-student incivility in online nursing education during COVID-19 as reported by nursing students: A descriptive cross-sectional study.

BACKGROUND: Educators' incivility in online nursing education is a serious academic issue; much of it is still unknown as it occurs in a less supervised environment. AIM: This study examined variables and differences in educator-to-student incivility in online nursing education during COVID-19, as reported by nursing students. METHODS: Utilizing the Incivility in Online Learning Environments (IOLE) online survey, a cross-sectional design was used to collect data in 2021 from a convenience sample of 163 nursing students studying in different universities in Jordan. Version 25 of the Statistical Package for the Social Sciences (SPSS) was used to generate descriptive and inferential statistics. RESULTS: As reported by nursing students, there was a low degree of incivility among nursing educators in online nursing education, 45(range 23-92), and a moderate frequency in the past 12 months, 63(range 23-92). Around 37.00 % of students thought incivility in online nursing education was a mild problem. On a scale of 0-100, 63.00 % of the students reported the level of nursing educators' civility in online nursing education ranged from 50.00 % to 70.00 % (an average of 60.00 %). Differences in students' reporting of online nursing educators' incivility and its' frequencies were significantly influenced by students' grade point averages (GPA) and genders, respectively. CONCLUSIONS: Although nursing students have a positive sense of civility among their nursing educators, incivility in online nursing education should be zero-level and disclosed and treated at its early signs.

Implementation of the São Paulo Nursing Courses Consortium for the Progress Test: experience report.

OBJECTIVE: To report the experience of implementing the São Paulo Nursing Courses Consortium for the Progress Test. METHOD: This is an experience report of the consortium's work in Progress Test preparation and application for Public Schools of Nursing in São Paulo in 2019, 2021 and 2022, with a descriptive analysis of the work process and the results obtained. RESULTS: The consortium's activities are structured into the following stages: planning; theme review; distributing and requesting questions; professor training; question elaboration; question reception; question selection; question validation; student registration; test application; analysis and dissemination of results. A total of 57.3% of enrolled students participated. There was a predominance of questions of medium difficulty and a gradual progression in the level of discrimination of the questions, with, in 2022, 82.5% being considered adequate. FINAL CONSIDERATIONS: The consortium has allowed the test to be applied interinstitutionally, with greater scope, accuracy, and quality of questions. Through this experience, it is expected to encourage progress testing in undergraduate nursing courses in other contexts.

Bridging School and Practice? Barriers to the Integration of 'Boundary Objects' for Learning and Assessment in Clinical Nursing Education.

Introduction: In clinical health professions education, portfolios, assignments and assessment standards are used to enhance learning. When these tools fulfill a bridging function between school and practice, they can be considered 'boundary objects'. In the clinical setting, these tools may be experienced as time-consuming and lacking value. This study aimed to investigate the barriers to the integration of boundary objects for learning and assessment from a Cultural-Historical Activity Theory (CHAT) perspective in clinical nursing education. Methods: Nineteen interviews and five observations were conducted with team leads, clinical educators, supervisors, students, and teachers to obtain insight into intentions and use of boundary objects for learning and assessment. Boundary objects (assessment standards, assignments, feedback/reflection/patient care/development plan templates) were collected. The data collection and thematic analysis were guided by CHAT. Results: Barriers to the integration of boundary objects included: a) conflicting requirements in clinical competency monitoring and assessment, b) different application of analytical skills, and c) incomplete integration of boundary objects for self-regulated learning into supervision practice. These barriers were amplified by the simultaneous use of boundary objects for learning and assessment. Underlying contradictions included different objectives between school and practice, and tensions between the distribution of labor in the clinical setting and school's rules. Discussion: School and practice have both convergent and divergent priorities around students' clinical learning. Boundary objects can promote continuity in learning and increase students' understanding of clinical practice. However, effective integration requires for flexible rules that allow for collaborative learning around patient care.

The effect of combined training (theoretical-practical) of palliative care on perceived self-efficacy of nursing students.

BACKGROUND: Nurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students. METHODS: This is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics. RESULTS: The mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (p<0.05). CONCLUSION: Palliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.

Cultural competence of undergraduate student nurses: a multicenter study.

OBJECTIVE: to evaluate the level of cultural competence of an undergraduate nursing students' population from four European higher education institutions. METHOD: a total of 168 nursing students from four different countries were included in our study. The study methodology involved a cross-sectional assessment of cultural competence among undergraduate nursing students from four European universities. Data collection included sociodemographic variables, as well as the following validated tools: the Intercultural Sensitivity Scale, the Cultural Competence Assessment Tool (student version) and the Cultural Awareness Scale. RESULTS: our results indicated that students demonstrated a high level of intercultural sensitivity but a moderate level of cultural competence and cultural awareness. Variations existed among students from different countries, suggesting potential differences in educational approaches. Despite expectations that higher-level students would exhibit greater cultural competence, no significant differences were found by year of study, indicating a lack of effective integration of cultural competence into nursing curricula. CONCLUSION: nurse educators should consider the students' cultural competence before designing related study programmes. Training programmes related to cultural competence should include elements which have been associated with enhanced cultural competence, including language skills, cultural encounter, and opportunities for internationalisation.

The effect of outcome-based education on clinical performance and perception of pediatric care of the third-year nursing students in Mongolia.

BACKGROUND: Mongolian government has set improvement of clinical proficiency of nursing students as one of its priorities. Nursing professionals have the sentinel role in providing healthcare services in rural areas. Outcome-based education (OBE) offers a promising pedagogical approach to actively mentally engage students to strengthen their clinical proficiencies. We implemented a pilot project with the objective of comparing students' clinical performance under OBE with our traditional didactic techniques. METHODS: The researchers implemented a non-equivalent two-armed quasi-experimental post-test-only' design approach study. The intervention arm (n = 34) received OBE pediatric training, while the control arm (n = 32) received the traditional pedagogical pediatric nursing training. Each arm of the study completed 16 hours of theory, 32 hours of clinical skills practice and 32 hours of seminars in pediatric nursing care. Data were collected using a five-section instrument, Demographic, Competency Inventory, Nursing Students' Satisfaction, Course Experience, and Objective Structured Clinical Examination. Performance and knowledge proficiencies were evaluated by applying the two-sided independent T-test. The distributions of categorical variables were assessed by Fisher's exact test or chi-squared test of significance. RESULTS: The intervention arm had higher mean score value in the competency inventory ([Formula: see text] = 238.70, SD = ± 23.07) compared to the control arm ([Formula: see text] = 222.11, SD = ± 39.94) (P = 0.04); similarly, the mean value for nursing students' satisfaction was higher for the intervention arm ([Formula: see text] = 117.87, SD = ± 15.94) compared to the control group ([Formula: see text] = 109.76, SD = ± 16.94) (P = 0.049). Additionally, the difference in the mean value for course experience questionnaire between the intervention arm ([Formula: see text] = 125.33, SD = ± 19.30) and the control arm ([Formula: see text] = 110.41, SD = ± 11.28) was statistically significant (P = 0.0001). Finally, the intervention arm had a higher mean value ([Formula: see text] = 85.40, SD = ± 6.11) for objective structural clinical examination compared to the control arm ([Formula: see text] = 81.56, SD = ± 7.01) (P = 0.023). CONCLUSION: OBE pedagogical approach offers promising benefits to improving nursing students' clinical competencies; additionally, the OBE approach seems to increase students' satisfactions with their clinical curriculum.

The effectiveness of the Escape Room as an educational methodology in the Infarction Code.

OBJECTIVE: To evaluate the efficacy of an educational intervention (escape room) in the acquisition and retention of knowledge in relation to the Infarction Code, and to compare the knowledge of other teaching methodologies related to the Infarction Code. METHODS: A pre-post study was designed without a control group. After one month of the master class on the Infarction Code given to master's degree (doctors and nurses), an educational intervention was carried out consisting of an Escape Room on the same content, with a questionnaire that collected various sociodemographic data, and a knowledge test on the Infarction Code, which was repeated immediately after the activity and at the end of 2 months after the activity, and a test of knowledge on the Infarction Code. immediately after the activity and 2 months after the master class. Likewise, after the activity, a gamified experience evaluation questionnaire (GAMEX) was completed. RESULTS: Thirty-two students received the educational intervention (12 physicians and 20 nurses), and differences were observed between medical and nursing professionals in terms of initial knowledge of simulation and gamification. After the activity, and based on the initial knowledge test, the score increased by 3.49 points, an increase that was also reflected in the test taken two months after the master class, where an increase of 2.08 points was maintained. The participants rated the experience positively, with no significant overall differences between the two professional groups. CONCLUSIONS: The nurses had greater knowledge and contact with clinical simulation, virtual reality and gamification. The escape room showed to be a valid method for the assimilation and retention of knowledge in master's degree students. Medical professionals experienced a greater degree of immersion in the activity.

Heuristics: The Teaching-Learning Journey.

In this column, the author describes a heuristic framework for teaching-learning nursing made of the humanbecoming paradigm, living the art of humanbecoming, and the humanbecoming teaching-learning model. A story helps to clarify the heuristic framework.

Benefits of the Modified Version of the Illness-Wellness Continuum Model for Nurse Education.

With rapid advancements in sciences and the expanding scope of nursing practice, faculty are challenged to connect the experiences of learners with abstract concepts of science and to cultivate clinical reasoning skills. Rationale for the adoption of the illness-wellness continuum model includes the following: (a) the relationships among illness, health, and the nursing process are relevant in many health situations, and (b) levels of wellness are steeped in holistic principles of self-care, which are consistent with educational and clinical goals. The modified version of the illness-wellness continuum model can serve as the groundwork that prepares nursing students in a constantly changing workplace.

Clinical competency of nurses trained in competency-based versus objective-based education in the Democratic Republic of the Congo: a qualitative study.

BACKGROUND: Designing competency-based education (CBE) programmes is a priority in global nursing education for better nursing care for the population. In the Democratic Republic of the Congo (DRC), object-based education (OBE) remains mainstream in pre-service nursing education programmes. Recently, the Ministry of Health developed a self-assessment tool and quantitatively compared the clinical competency of CBE- and OBE-trained nurses. This study aimed to qualitatively triangulate the results of self-evaluation by exploring perception of supervisors, incumbent CBE-, and OBE-trained nurses in comparison with the competence of the two types of nurses, and to identify influential factors or barriers to their competence in clinical settings. METHODS: A qualitative descriptive approach with conventional content analysis was applied. Twenty interviews with clinical supervisors who oversaw both CBE- and OBE-trained nurses, 22 focus group discussions (FGDs) with CBE-trained nurses, and 21 FGDs with OBA-trained nurses currently working in health facilities were conducted. Participants of the FGDs were selected from the participants of the DRC self-assessment competency comparison study where there was no statistically significance between CBE- and OBE-trained nurses in the demographic characteristics. Data were analysed in terms of the competencies identified by the Ministry of Health. RESULTS: The supervisors recognised that the CBE-trained nurses had stronger competencies in professional communication, making decisions about health problems, and engaging in professional development, but were weak in clinical skills. This study identified challenges for supervisors in assuring standardised care in health facilities with OBE- and CBE-trained nurses, as well as barriers for CBE-trained nurses as a minority in the workplace in demonstrating their competencies. CONCLUSIONS: The study results support the Ministry of Health's policy to expand CBE in pre-service education programmes but reveal that its slow implementation impedes full utilisation of the acquired competencies at health facilities. Implementation could be accelerated by strengthening cooperation among the Ministry of Health's three human resource departments, and developing and implementing a well-planned, legally binding, long-term CBE reform strategy, including an approach to the Continuing Professional Development system.