An Exploratory-Descriptive Study on the Impact of COVID-19 on Teaching and Learning: The Experiences of Student Nurses in the Rural-Based Historically Disadvantaged University of South Africa.

Covid-19 has disrupted normal working conditions as people were not allowed to assemble in one place. There is a limit that is placed on the number of people congregating in public areas, and these measures also affect the education system worldwide. The purpose of the study was to explore nursing students' experiences in a historically disadvantaged rural-based university on the impact of Covid-19 on teaching and learning. The study employed an exploratory-descriptive qualitative design among nursing students who were purposively sampled to participate in the study. A qualitative self-administered open-ended online google form was used to collect data. Thematic analysis was employed for this study. All ethical measures were respected during this study. Interviews were conducted with 68 participants, including 12 undergraduate second-year students, 7 third-year students, and 49 fourth-year students. A total of 51 females and 17 males participated in this study. The study yielded several themes, including participants' expression of their experiences related to teaching and learning during the national lockdown, participants' views on the impact of COVID-19 on teaching and learning/research, and Participants suggested sustainable strategies to promote teaching and learning during the national lockdown. In conclusion, the role of preceptors in all clinical areas should be strengthened to improve clinical teaching and learning. The researchers recommend strengthening collaboration among university lecturers for sharing ideas and finding innovative solutions appropriate for handling any pandemic that threatens teaching and learning processes.

Unexpected Learning Opportunities for Nursing Students.

ABSTRACT: Restrictions on groups and public gatherings during the COVID-19 pandemic have limited in-person learning experiences for nursing students. But the crisis has also led to unanticipated opportunities. In this article, we describe how participation in vaccination clinics at our university offered students occasions for experiential learning that aren't normally part of nursing education. Volunteering at these clinics allowed our students to practice important skills while participating in efforts to help mitigate the spread of the virus.

Adapting to Racial Trends in the U.S. Population.

Nurse leaders call for more diversity in nursing school students and faculty.

Examining the racial and ethnic diversity of associate degree in nursing programs by type of institution in the US, 2012-2018.

BACKGROUND: Increasing nursing workforce diversity is essential to quality health care. Associate Degree in Nursing (ADN) programs are a primary path to becoming a registered nurse and an important source of nursing diversity. PURPOSE: To examine how the number of graduates and racial/ethnic student composition of ADN programs have changed since the Institute of Medicine's recommendation to increase the percentage of bachelor's-prepared nurses to 80%. METHODS: Using data from the Integrated Postsecondary Education System, we analyzed the number of graduates and racial/ethnic composition of ADN programs across public, private not-for-profit, and private for-profit institutions, and financial aid awarded by type of institution from 2012-2018. DISCUSSION: Racial/ethnic diversity among ADN programs grew from 2012-2018. Although private for-profits proportionally demonstrated greater ADN student diversity and provided financial aid institutionally to a higher percentage of students, public schools contributed the most to the number and racial/ethnic diversity of ADN graduates. CONCLUSION: Given concerns regarding private for-profits, promoting public institutions may be the most effective strategy to enhance diversity among ADN nurses.

Opportunities in Chaos: Leveraging Innovation to Create a New Reality in Nursing Education.

The impact of the global coronavirus disease-2019 (COVID-19) pandemic has triggered changes in nursing education at a pace not previously experienced in academia. Academic nursing leaders have been faced with challenges of balancing the impact of the pandemic responses in the face-to-face classroom, laboratory, and clinical learning, ensuring the safety of the college community, and supporting alternative educational delivery formats with assurance that desired learning outcomes and demanded professional competencies are attained. The challenge faced by these leaders is unprecedented. However, there is opportunity in crisis for leaders. This article details how the leadership at one institution leveraged transformational change theory to support faculty, staff, and students during this time of rapid change. Additionally, the article discusses the use of transformational change theory and the ongoing institutional commitment to meeting curricular goals and objectives while maintaining a commitment to being student focused.

Mentoring to engage diverse undergraduate nursing students in honors research.

BACKGROUND: A diverse workforce is necessary to reflect our communities and impact the health disparities of our increasingly diverse populations. Students from ethnic minority and socioeconomically disadvantaged backgrounds face many challenges and barriers to their academic success. Faculty must try new ways of supporting the engagement of this student population to positively affect quality outcomes for the entire community. METHODS: High-performing students were recruited from undergraduate research courses to participate in a study to determine how honors research mentoring programs affect the engagement of undergraduate nursing students from ethnic minority and socioeconomically disadvantaged backgrounds. FINDINGS: Study participants who were mentored for 3 years had a retention rate of 98%, compared to a rate of 73% in the year before the start of the mentoring initiative with faculty. NCLEX (National Council Licensure Examination)-RN pass rates were 95% for those in the mentoring program, compared to 84% for those not mentored. Of the students completing the program and passing the NCLEX-RN, 100% are employed in the local community. CONCLUSIONS: A competent and diverse nursing workforce is a priority for eliminating health disparities in rural and underserved communities. Supporting ethnic minority and socioeconomically disadvantaged students is valuable to bridging this gap and positively influencing our communities.

Exploring the Contextual Factors Surrounding the Recruitment and Retention of Men in a Baccalaureate Nursing Program.

Men continue to be significantly underrepresented within the nursing profession, making up less than 10% of the Canadian nursing workforce. While studies have explored the challenges faced by men in nursing, fewer studies have explored the recruitment and retention barriers experienced by male nursing students. The purpose of this study was to explore the recruitment and retention of male nursing students currently enrolled in an undergraduate baccalaureate nursing program. Snowball sampling was used to recruit male nursing students (n = 17) to participate in focus groups where they shared what factors affected their decision to enter a nursing program and what experiences contributed to their decision to remain in the nursing program. The results of this research can contribute to the development of strategies to recruit and retain men in nursing and ultimately have the effect of diversifying the nursing profession.

Assessing Nursing Students' Perceptions of the QSEN Competencies: A Systematic Review of the Literature With Implications for Academic Programs.

BACKGROUND: Nurses are in key positions in the healthcare system to provide, monitor, and manage the care delivered to their patients. In 2005, the Quality and Safety Education for Nurses (QSEN) initiative was launched to redefine quality and safety competencies for pre-licensure nursing education. It is imperative that nurses are graduating with the full spectrum of the QSEN competencies to practice in today's healthcare environments. AIMS: The purpose of this systematic review was to evaluate the research about student nurses' perceptions of their abilities to perform the six QSEN competencies and to determine the effect of integrating the QSEN content in their courses, clinical placements, or simulation experiences. METHOD: A systematic review of the literature was conducted to retrieve published studies from CINAHL, PubMed, Web of Science, and ERIC using the search terms of Quality and Safety Education for Nurses, QSEN, QSEN competencies, nursing student, and student nurse. The studies that were included in this review were assessed by both authors independently using standardized critical appraisal tools. RESULTS: Seven studies met the inclusion criteria: four descriptive, one quasi-experimental, and two mixed-methods designs. Overall, pre-licensure nursing students perceived patient-centered care as the most discussed and quality improvement as the competency least reviewed in their curricula. Students reported to be most prepared to perform patient-centered care skills and least prepared to perform quality improvement skills. LINKING EVIDENCE TO ACTION: Revisiting the integration of the quality improvement competency into nursing curricula can increase nursing students' understanding of this QSEN competency. More research with sufficiently powered sample sizes, valid and reliable tools measuring outcomes of interventional studies, and attention to quality and rigor is needed to assess graduating students' understanding of the QSEN competencies.

Promoting civility in nursing practice using systems thinking: Evidence-based teaching strategies for nurse educators.

There is a critical need for nurse educators to promote civility in nursing practice using systems thinking to promote quality and safety and improve patient outcomes by preventing undue patient harm. In this article, evidence is synthesized in order that readers can recognize, respond and manage workplace incivility. Systems thinking is introduced as a best practice solution for advancing a civil workplace culture. The author-created Systems Awareness Model, adapted for civility awareness, guides nurse educators with evidence-based strategies for teaching nurses the essential skills to promoting a civility culture within health systems. The strategies can be used by nurse educators in practice to interface workplace application. Proposed examples of evaluation methods are aligned with the teaching strategies. The purpose of this article is to provide nurse educators in practice with evidence-based teaching strategies and evaluation methods to address incivility in health care using a systems thinking perspective.

A Literature Review of Nursing Extern Program Outcomes.

This literature review gathers in one place recent published literature on extern programs. Fourteen extern articles published between 2009 and 2019 were identified, and program information was extracted. Student benefits were increased in confidence, clinical skills, and learning the nursing environment. Organizational benefits were reduced orientation, reduced recruitment costs, and hiring nurses that were a good fit with the organization. For a healthcare organization, extern programs may ease the shortage of available registered nurses.

Care of the Spirit: Effects of an Interdisciplinary Undergraduate End-of-Life Course on Knowledge, Competence, and Response Empathy.

The purpose of this pilot was to identify the effects of a 4-credit interdisciplinary undergraduate course focused on communication strategies to enhance spiritual care at the end of life. The course provided students with opportunities to enhance their ability to communicate empathically with individuals facing the end of life. Evidence-based content focused on ways to live each day with hope and gratitude, strengthen relationships, create a legacy, and find meaning and purpose in life and death. Narayanasamy's (1999) Actioning Spirituality and Spiritual Care Education and Training in Nursing model guided project development. The study used a prospective, pretest/posttest design. Participants included undergraduate students (n = 34) from nursing, premedicine, athletic training, business, economics, and religious studies at a Midwest liberal arts college. Statistically significant differences were found in students' attitudes toward and knowledge of spirituality/spiritual care (P < .0001, Cohen's d = 0.59), spiritual care competence (P < .0001, Cohen's d = 0.79), and level of response empathy through role play (P < .0001, Cohen's d = 0.92). Many students referred to this course as "life changing" and "healing." As our students go out into the community, they may intimately touch the lives and hearts of future patients, family, and friends who face the end of life with their compassionate words.

The Future of Nursing Education: Multidisciplinary Community-Engaged Research for Undergraduate Nursing Students.

BACKGROUND: Undergraduate nursing students with research experience are more likely to pursue graduate education. Community-engaged research mentoring facilitates not only this process but also student engagement in topics such as cultural relevance and community partnerships. METHOD: Two cohorts of undergraduate students participated in a novel yearlong multidisciplinary mentored research experience based in a predominantly Black community. A qualitative, descriptive study using semistructured interviews was conducted with undergraduate students to describe effects of a multidisciplinary, community-engaged mentored research experience on cultural sensitivity, acquisition of research skills, and intent to pursue graduate study. RESULTS: Both cohorts of students demonstrated cultural sensitivity, acquired basic research skills, and had favorable attitudes toward or a definitive plan to pursue graduate education influenced by their participation in the mentored research experience. CONCLUSION: This approach may represent a viable strategy for increasing the number of graduate-prepared nurses and reducing health disparities via the provision of culturally competent care. [J Nurs Educ. 2020;59(6):341-344.].

Educational Program to Increase Substance Use Disorder Knowledge and Decrease Stigma in First-Year Nursing Students.

PURPOSE: The opioid epidemic in the United States is changing the population nurses serve. Stigma and bias among healthcare providers towards patients with substance use disorder occurs across disciplines and negatively impacts the care provided to this population. We sought to assess the knowledge and perceptions of first-year nursing students at a large college of nursing towards those with opioid use disorder and to provide an educational intervention with the goals of decreasing bias, increasing substance use disorder knowledge, and increasing the understanding of multi-pronged treatment strategies. DESIGN: The program consisted of an interactive two-hour presentation based on the disease model of addiction. METHODS: First year nursing students from a large urban college were administered a pre- and post-presentation survey designed to evaluate their perceptions towards those with opioid use disorder. RESULTS: Thematic analysis indicated stigma and bias was present in some first-year nursing students towards those with opioid use disorder. Results from a summary t-test showed a significant increase in the mean scores from pre- to post-test (t = -2.224, df 429, p = .027). CONCLUSIONS: Our project results indicate that knowledge and bias towards those with substance use disorder can be changed with education, which may improve the delivery of healthcare to this vulnerable population. CLINICAL IMPLICATIONS: Since bias and stigma negatively impact care provided by clinicians, presentations such as this one can not only provide education on evidence based practices, but may change the attitudes of future providers, improving the quality of healthcare delivered to this vulnerable population.

Integrating Mental Health Nursing in the Prelicensure Nursing Curriculum.

BACKGROUND: Learning to care for patients with mental health concerns is an important part of nursing school. Teaching mental health concepts across the nursing curriculum, rather than in just one course, prepares students for meeting the mental health needs of all clients. This article describes the integration of mental health concepts throughout an accelerated bachelor of science in nursing program. METHOD: Faculty developed an innovative approach to integrate mental health throughout the curriculum in lieu of a stand-alone course. RESULTS: Quantitative metrics remained consistent when comparing cohorts before and after the integration of mental health. However, students did not recognize mental health content within the program. CONCLUSION: Integrating mental health concepts in the prelicensure nursing curriculum enables students to learn and understand how to care for clients with mental health concerns in any clinical setting. [J Nurs Educ. 2020;59(7):405-408.].

Moral dilemmas involving anthropological and ethical dimensions in healthcare curriculum.

BACKGROUND: Currently a variety of novel scenarios have appeared within nursing practice such as confidentiality of a patient victim of abuse, justice in insolvent patients, poorly informed consent delivery, non-satisfactory medicine outputs, or the possibility to reject a recommended treatment. These scenarios presuppose skills that are not usually acquired during the degree. Thus, the implementation of teaching approaches that promote the acquisition of these skills in the nursing curriculum is increasingly relevant. OBJECTIVE: The article analyzes an academic model which integrates in the curriculum a series of specific theoretical concepts together with practical skills to acquire the basic ethic assessment competency. RESEARCH DESIGN: The project includes designing two subjects, General Anthropology and Ethics-Bioethics, with an applied approach in the nursing curriculum. The sequential structure of the curriculum in both subjects is constituted by three learning domains (theoretical, practical, and communicative) with different educational strategies. ETHICAL CONSIDERATIONS: No significant ethical considerations as this is a discussion paper. FINDINGS: The model was structured from the anthropology's concepts and decision-making process, applied to real situations. The structure of the three domains theoretical-practical-communicative is present in each session. DISCUSSION: It is observed that theoretical domain fosters the capacity for critical analysis and subsequent ability to judge diverse situations. The practical domain reflected two significant difficulties: students' resistance to internalizing moral problems and the tendency to superficial criticism. The communicative domain has frequently shown that the conflicting points are in the principles to be applied. CONCLUSION: We conclude that this design achieves its objectives and may provide future nursing professionals with ethical competences especially useful in healthcare practice. The three domains of the presented scheme are associated with the same process used in decision making at individual levels, where the exercise of clinical prudence acquires particular relevance.

Giving undergraduate nursing students international experiences: Issues and strategies.

Educational institutions began international student placements or exchanges in earnest in the 1990s, with varying degrees of success. Although nursing education in a number of countries has embraced giving undergraduate students the opportunity of international experiences, this is still not the norm in many countries, nor within all nursing schools within a country. In our rapidly globalizing world, it is critical that students are given opportunities internationally to be better prepared for practice, to achieve a global mindset, and to take their place as future global citizens through international experiences. Evidence from the literature shows positive effects on nurses having had international experiences to broaden their horizons, examine other cultures, grow their cultural competence, share and gain knowledge with others, and build their capacity for future practice in an increasingly globalized world. Our focus here is on providing students with short-term undergraduate exchanges or placements in international settings, and encouragement for nursing institutions to develop international partnerships that are sustainable. Some implications for nurse educators and other staff involved in international exchanges are also considered.

From Education to Practice: Incorporating Quality Improvement Projects Into a Baccalaureate Nursing Curriculum.

The accelerated pace of change in health care and the call for a radical transformation in prelicensure nursing education will require changes in baccalaureate nursing programs to ensure nurses are adequately prepared for practice. At one Midwestern university, academic nurse educators developed an innovative multilevel interprofessional and intradisciplinary education opportunity using a Lean Healthcare quality improvement (QI) process to improve systems, strengthen academic-practice partnerships, and bridge the education-to-practice gap. During one 16-week semester, one group of sophomore and junior clinical nursing students worked collaboratively with personnel at a local health care organization on a QI project on sequential compression devices. The students identified practice barriers related to sequential compression device compliance when medication prophylaxis was contraindicated. Using a Lean QI framework, the students developed and implemented a comprehensive, evidence-based venous thromboembolism prophylaxis policy, including tools and strategies for educating employees and patients.

Effects of a Simulation With Team-Based Learning on Knowledge, Team Performance, and Teamwork for Nursing Students.

Simulation and team-based learning are reported as useful strategies in nursing education. However, empirical evidence on the effects of participating in an integrated course of team-based learning and simulation is limited. The aim of this study was to identify the effects of a nursing simulation program with team-based learning on knowledge, team performance, and teamwork among Korean nursing students. A one-group pretest-posttest design was used. Fourth-year students (N = 229) participated in a 32-hour nursing simulation program with team-based learning. Each of the three sessions of the program involved a 3-hour task training with video-assisted learning and skills performance assessment, 1-hour team-based learning, and 4-hour simulation session with a high-fidelity simulator. In addition to the knowledge test and performance assessment, participants completed a self-administered questionnaire on teamwork. Participants achieved higher scores in the Group Readiness Assurance Test than they did in the Individual Readiness Assurance Test. The posttest scores on team performance and teamwork were significantly higher than their pretest scores. The simulation with team-based learning induced favorable effects on participants' knowledge, performance, and teamwork. A curricular integration of simulation program with team-based learning is consistent with achieving outcomes-based learning in nursing education.

Should we use preceptorships in undergraduate nursing education?

BACKGROUND: Clinical learning experiences are the cornerstone of undergraduate nursing education as they allow students to apply theory to practice and help them develop as competent practitioners who are prepared for the realities of diverse, complex, and ever-changing practice environments. PROBLEM: The traditional clinical teaching model, where small groups of students work with educators who are on-site facilitating learning, has numerous issues and thus there have been calls for reform. This Creative Controversy focuses on one reform option, the alternative clinical teaching model of preceptorships, which has gained popularity in recent years. APPROACH: Current evidence surrounding preceptorships in undergraduate education was examined and critiqued. CONCLUSION: Despite their popularity, there is a lack of robust evidence surrounding preceptorships and the motivations for using this model remain questionable. Future study is needed so preceptorships are implemented according to evidence-based teaching practices and not clouded by inappropriate motivations. The author challenges readers to question their practices and work to positively contribute to the science and practice of nursing education.