Lessons learned from clinical course design in the pandemic: Pedagogical implications from a qualitative analysis.

AIMS: The purpose of this study was to examine clinical pedagogy based on experiences of changes and adaptations to clinical courses that occurred in nursing education during the pandemic. Beyond learning how to manage nursing education during a pandemic or other crisis, we uncover the lessons to be learned for overall improvement of nursing education. DESIGN: Qualitative descriptive analysis using semi-structured interview data with baccalaureate nursing students. METHODS: Data were collected in the spring of 2021 using semi-structured interview with 15 participants. Transcribed text was analysed using thematic content analysis. The COREQ checklist was used to guide our reporting. RESULTS: Three themes were identified related to course design in clinical courses for nursing students: the role and limitations of simulation, competency evaluations and career implications. Students expressed some concern over not 'finishing hours', loss of in-person clinical experiences and their reduced exposure to different clinical settings. CONCLUSION: To prepare work-ready nurses, educators need to keep in mind the trends, issues and demands of future healthcare systems. Simulation may have been a temporary measure to achieve clinical competence during the pandemic but needs to be of high-quality and cannot meet all the expected learning outcomes of clinical courses. Exposure to different patients, families and communities will ensure that the future nursing workforce has experience, socialization, competence, and desire to work in various clinical settings. Competency evaluation similarly needs to be robust and objective and consider the role and perception of hours completed. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. Participants were nursing students.

Workplace harassment: The leadership factor.

Healthcare professionals are in the business of providing care and compassion. It is ironic that healthcare has the highest rate of workplace harassment. Although harassment comes from people of various positions, its existence in healthcare fractures the intention and values that guide its mission. When mental health is compromised, mistakes happen. Healthcare professionals take the health/life of others into their care; distractions and fear from being bullied compromise that care. Health leaders are in a strategic position to address workplace harassment and bullying. Failing to do so results in complacency, jeopardizes our patients, tarnishes the organization, and damages society as a whole. It is a cost that all will pay dearly to remedy, unless it is addressed, enforced with standards, and taken to task for the better health of all.

"We talk teeth": Exploring faculty EDIA (equity, diversity, inclusivity, and access) capacity in dental education.

PURPOSE: There are increasing concerns regarding inequitable educational access and experiences for underrepresented populations in health education, prompting dental faculties to recognize EDIA (equity, diversity, inclusivity, and access) capacity as a strategic priority. Faculty members contribute to the establishment and reinforcement of institutionally engrained norms within learning settings with significant influence on the experience of students. Currently, there is limited literature on faculty EDIA capacity within dental education and minimal evidence to inform barriers to development. This study sought to explore how dental faculty members perceive their personal and institutional EDIA capacity and to identify current strengths and weaknesses of EDIA development within the institution of study and dental education. METHODS: Using a hermeneutic study design, semi-structured interviews were conducted on a convenience sampling of dental faculty members (n = 10) and a thematic, interpretative analysis was applied. RESULTS: Findings revealed six dominant themes impacting EDIA capacity. Knowledge of EDIA language, interfaculty communication, and institutional messaging are identified as weaknesses, whereas informal, community building events for EDIA development are identified as novel strengths meriting prioritization. Motivation to engage in EDIA by faculty members overall is illuminated in relation to emotionally provocative experiences. CONCLUSION: Current institutional communication of EDIA is unconsciously restricting capacity building based on hierarchical and prescribed parameters. Developing capacity in dental education requires a redirection of resources to initiatives valuing social bonding over prescribed box-checking. This study reveals a new narrative of EDIA capacity within dental education and sustainable pathways for development with high transferability to other health programs.

Perceptions of preceptors' authentic leadership and final year nursing students' self-efficacy, job satisfaction, and job performance.

BACKGROUND: Preceptors are integral to the transition process of student nurses to licensed nurses. Preceptors are leaders who could utilize authentic leadership to help foster self-awareness and positive relationships and build capacity with student nurses. PURPOSE: Investigating the relationship between perceived preceptor authentic leadership and final year nursing students' self-efficacy, job satisfaction and performance. METHODS: This correlational study used data collected from 94 pre-licensure final semester baccalaureate and licensed practical nursing students from three different schools about preceptors' authentic leadership, self-efficacy, job satisfaction and performance. Mediated multiple regression analysis was used to examine the association between perceived preceptors' authentic leadership, self-efficacy, job satisfaction and performance. RESULTS: Preceptors were perceived to demonstrate authentic leadership (M = 3.21, SD = 0.68). Students' self-efficacy increased post preceptorship (t(93) = 3.96, p < .001), and authentic leadership was associated with self-efficacy (r = 0.46, p < .001) and job satisfaction (r = 0.49, p < .001). Self-efficacy mediated the relationship between job performance and authentic leadership. CONCLUSIONS: Authentic leadership has positive implications for preceptorship and nursing students' self-efficacy, job satisfaction and performance, which could enhance nurse retention.

Clinical learning during the pandemic: Experiences of LPN-BN undergraduate nursing students.

BACKGROUND: When the COVID-19 pandemic was declared in March 2020, nursing programs made rapid decisions regarding clinical placement experiences for students. In many nursing programs, this meant ending clinical placements early, delaying clinical courses, and moving clinical courses to simulation. PURPOSE: The purpose of this study was to explore LPN-BN students' experiences in clinical courses during the COVID-19 pandemic. METHOD: A qualitative descriptive approach was employed in this study. Fifteen semi-structured conversational interviews with nursing students and recent graduates were conducted. Inductive content analysis was used to analyse the data. RESULTS: Four main concepts were identified: (1) logistics of learning; (2) shifts in clinical learning; (3) mental health matters; (4) readiness to practice. CONCLUSION: It is important to understand the experience of nursing students as this is an inordinately stressful and impressionable time for them. Insight into the student experience, will inform educators in the areas of curriculum and competency-based evaluation as well as supports for student mental health and well-being.

Effect of online versus in-person clinical experiences on nursing student's competency development: A cross-sectional, quasi-experimental design.

BACKGROUND: Clinical experience is an important component of nursing education, yet placements in agencies are hard to secure, and evaluation of outcomes challenging. The shift to virtual, online clinical courses during the pandemic created the conditions of a natural experiment. OBJECTIVES: To compare differences in outcomes between an in-person and online design for a family and community health clinical course. DESIGN: Quasi-experimental, 2-group, cross-sectional study. METHODS: Competency evaluations were reviewed from a baccalaureate nursing program in Canada from 19 students who completed an in-person clinical, and 32 students who completed an online clinical. Quantitative analysis compared competencies achieved, interest in community health nursing, and linguistic analysis of unstructured narratives using natural language processing. RESULTS: There are differences in competency evaluations for in-person versus online community clinical courses, and potential implications for future interest in community health. Natural language processing detected differences in content and psychological processes between the two groups. CONCLUSIONS: Nursing programs could apply this methodology to track impact of changes to clinical course design on achievement of competencies. There are important differences in outcomes between online and in-person clinical courses.

Factors Associated With Stress Among Second Year Student Nurses During Clinical Training in Jamaica.

The aim of this study is to determine the levels of stress among students in the Jamaican clinical setting and describe the perceived contributing factors to this stress. This cross-sectional study of 106secondyear students enrolled at 2 schools of nursing in Jamaica used a 30-item self-administered questionnaire to gather data on levels of stress and contributing factors. Participants were asked to rate the levels of stress experienced (scale: 0-5, where 5 was highest). Data were analyzed using Statistical Package for the Social Sciences® Version 19 for Windows®. The response rate was 98% (106/108), and 97.2% were females. The average age of respondents was 23.16 ± 9.01years. The majority of participants were single (78.3%) and resident in Kingston and St. Andrew (61.3%). The level of stress experienced in the clinical setting was rated 3.48 ± 1.3/5; financial difficulties (3.17 ± 1.6/5) and interactions with unit staff (3.15 ± 1.4/5) were rated the greatest contributors to stress. Students experienced fear of harming the patient (50%), and only 24% expressed consistent confidence. Except for the interactions with preceptors (P < .05), there were no differences in levels of stress between schools. Students enrolled at 2 nursing schools experienced moderately high levels of stress in the clinical environment. Financial concerns and interaction with ward staff were significant sources of stress. Collaborative strategies to address stress in the clinical areas are imperative.

Using Carl Rogers' person-centered model to explain interpersonal relationships at a school of nursing.

Faculty members are viewed as nurturers within the academic setting and may be able to influence students' behaviors through the formation of positive interpersonal relationships. Faculty members' attributes that best facilitated positive interpersonal relationships according to Carl Rogers' Person-Centered Model was studied. Students (n = 192) enrolled in a 3-year undergraduate nursing program in urban Jamaica were randomly selected to participate in this descriptive cross-sectional study. A 38-item questionnaire on interpersonal relationships with nursing faculty and students' perceptions of their teachers was utilized to collect data. Factor analysis was used to create factors of realness, prizing, and empathetic understanding. Multiple linear regression analysis on the interaction of the 3 factors and interpersonal relationship scores was performed while controlling for nursing students' study year and age. One hundred sixty-five students (mean age: 23.18 ± 4.51years; 99% female) responded. The regression model explained over 46% of the variance. Realness (ß = 0.50, P < .001) was the only significant predictor of the interpersonal relationship scores assigned by the nursing students. Of the total number of respondents, 99 students (60%) reported satisfaction with the interpersonal relationships shared with faculty. Nursing students' perception of faculty members' realness appeared to be the most significant attribute in fostering positive interpersonal relationships.