Pursuing Success in a Hybrid PhD Nursing Program.

BACKGROUND: Little is known about hybrid PhD nursing students' experiences. METHOD: The purpose of this study was to describe and analyze the experiences of PhD nursing students in a hybrid program using a convergent mixed methods design. Recent nursing PhD alumni (n = 18), and current PhD students (n = 4) were recruited at a research-intensive university in the southwestern United States. RESULTS: Four metainferences were identified: (1) the facilitator of faculty as both advisors and mentors; (2) the facilitator of peers as support, motivation, and a source of advice that preceded advisors; (3) the barrier of receiving conflicting feedback from advisory and dissertation committees; and (4) the barrier of not understanding the PhD student process. CONCLUSION: Peer support is fundamental for hybrid PhD nursing student success; conflicting feedback and not understanding the process are significant barriers. Strategies are recommended to mitigate barriers to facilitate hybrid PhD nursing students' success. [J Nurs Educ. 2024;63(5):328-331.].

Incorporating a Psychiatric Telehealth Simulation in a Family Nurse Practitioner Curriculum.

The prevalence of mental health disorders in primary care is high and challenges related to the COVID pandemic warrant further training of the family nurse practitioner. A telehealth simulation learning experience that included common primary care diagnoses in mental health-general anxiety, depression, and substance use disorder-was incorporated into a non-clinical behavioral health course. Formative evaluation provided by licensed nurse practitioners confirmed the need for improving interviewing techniques, engaging clients, and promoting safety among this population. Students' confidence during the encounter was measured using the Simulation Effectiveness Tool. Findings suggest a simulation learning experience is an effective resource for training nurse practitioner students to treat mental health disorders.

Clinical Inquiry and Problem Identification.

This is the second article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making. It builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to http://links.lww.com/AJN/A133). This follow-up series will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey.

Qualitative comparative analysis of learning engagement among Chinese part-time master's students in nursing.

BACKGROUND: Graduate nursing education plays an important role in the development of an innovative nation. Such education benefits the health of the community by cultivating competent and highly skilled nurses who can provide safe and quality nursing care. The number of students pursuing nursing degrees in China is insufficient, to meet the social demand for advanced practice nurses. The part-time Master of Nursing Specialist program for students offers flexible learning options for working nurses. However, the relatively low level of learning engagement exhibited by this group has raised concerns among policy-makers and nursing educators. An in-depth study of the factors affecting the learning engagement of part-time Master of Nursing Specialist postgraduates, especially with regard to their combined effect, is expected to provide a basis for improving the level of learning engagement among such students. METHODS: This study used ability-motivation-opportunity-theory and fuzzy-set qualitative comparative analysis to analyze the relationships between five conditions (i.e., supportive campus environment, supportive work environment, student-faculty interaction, research motivation and time management ability) and learning engagement by reference to data collected from a sample of 225 part-time Master of Nursing Specialist students who were enrolled in China. RESULTS: The fuzzy-set qualitative comparative analysis results indicated that individual examples of these antecedent conditions were insufficient to influence learning engagement. In contrast, three combinations of the five conditions led to high levels of learning engagement, and substitutability and complementarity were observed among the various elements in the configuration. CONCLUSIONS: Research motivation, student-faculty interaction, a supportive work environment and time management are factors that can influence part-time postgraduates' learning engagement. Supervisors can enhance their research skills and expertise, hospitals can establish supportive environments for students, and students can strengthen their research motivation and time management abilities.

An Effective Academic Medical Center-Based Strategy to Enhance Diversity Among Nurse Researchers.

The Connell-Jones Endowed Chair Diversity Nursing Research Scholars Program was created to promote engagement in nursing research and scholarship among nurses of color. Preliminary evaluation suggests that the program was widely beneficial, resulting in enrollment in doctoral education for some. Establishing opportunities that promote exposure and participation in nursing research and scholarship among nurses of color helps cultivate cohorts of diverse nurses armed to address health disparities through the advancement of nursing knowledge.

Why Pursue a Doctorate? Findings From a Study of Doctorally Prepared RNs in an Integrated Healthcare System.

OBJECTIVE: The aim of this study was to examine the motivations and perceptions of RNs with completed doctorates in an integrated healthcare system. BACKGROUND: Historically, PhD preparation was the primary doctorate available for nurses, preparing them to conduct research and hold leadership positions. The recent growth of Doctor of Nursing Practice (DNP) programs that focus on either advanced clinical practice or executive competencies has significant implications for the future of nursing in practice settings. METHODS: A 30-item survey was sent to all 93 RNs at a healthcare system who have completed doctorates. RESULTS: A response rate of 71% found DNPs outnumber PhDs 3 to 1. PhDs are significantly more likely to perceive concrete benefits associated with their degrees, and DNPs are more likely to report that their degrees have not made a difference in their jobs. CONCLUSIONS: Leaders in practice and education must collaborate to ensure that both DNPs and PhDs are engaged in positions that use their highest level of competence in any setting.

Doctoral Nursing Education: Year 1 Survival Tips.

The inaugural year of a doctoral nursing program is a challenging transition from a clinical practitioner to a scholarly expert. Drawing on personal and peer experiences, we offer a comprehensive guide for thriving in this transformative period. Covering crucial aspects such as work-life balance, time management, research skills, and self-care, we offer insights to empower future doctoral nursing students, equipping them to confidently navigate the challenges and emerge as successful scholars in the field. [J Contin Educ Nurs. 2024;55(4):157-160.].

Assessment of nursing faculty retirement projections.

BACKGROUND: Nursing faculty retirement is a critical factor contributing to the nursing faculty shortage. PURPOSE: To assess the accuracy of projections on 2016 to 2025 nursing faculty retirements made in a previous study by Fang and Kesten (2017). METHODS: The 2016 to 2022 full-time nursing faculty data collected by American Association of Colleges of Nursing were used to examine the accuracy of the retirement projections for the same years. DISCUSSION: The study found that the mean age of full-time nursing faculty decreased for the first time; the number of faculty retirees and their age distributions projected by Fang and Kesten (2017) were accurate; there was a larger loss of nursing faculty at senior ranks to retirements than was anticipated; nursing faculty aged 50 to 59 in 2015 have made significant progress in doctoral attainment, senior rank, and graduate-level teaching by 2022, but they were still underrepresented in senior ranks compared to the 2016 to 2022 retirees; and for nursing faculty with a PhD degree, their growth was slower than their loss to retirements. CONCLUSION: The findings demonstrate the usefulness of the specific methods for faculty retirement projections. The decline in the mean age of nursing faculty is a positive sign that there is an increased recruitment of younger nurses into academia. The increase in the number of younger nurses entering academia with Doctor of Nursing Practice (DNP)-degree preparation can be leveraged through PhD-DNP collaboration to prepare practice-ready nursing graduates who contribute to health care improvements. Nursing schools need to implement innovative strategies to mentor younger faculty for their successful succession.

National evaluation of DNP students' use of the PICOT method for formulating clinical questions.

BACKGROUND: The intent of the PICOT (i.e., Population, Intervention, Comparison, Outcome, Time) method is to formulate focused clinical questions to facilitate the discovery of relevant evidence through systematic searching, with the components of the question serving as the foundation for the search. Doctor of Nursing Practice (DNP) graduates use evidence-based practices to institute changes in their organizations' systems and policies, thereby yielding positive effects on both patient and system outcomes. Given that the clinical question is the foundation of the evidence-based practice process, DNP graduates' competence in the PICOT method needs to be better understood. AIMS: This analysis aimed to describe how DNP students used the PICOT method to ask clinical questions in their DNP projects. METHODS: Project questions were retrieved from a subset (n = 129, 60.56%) of an existing national random sample of publicly available DNP projects spanning the years 2010 to 2021 from Commission on Collegiate Nursing Education-accredited schools (n = 213). Project questions using the PICOT method were further evaluated with a scoring system of 0 = no and 1 = yes for missing elements, formatting, directional outcome, and project purpose. Possible scores ranged from 0 to 8, with higher scores indicating more errors. Discussion among five researchers, until agreement was achieved, yielded consensus. RESULTS: Although the PICOT method was project author-identified in 66 (31.0%) projects, only four (6%) followed the PICOT method. All 66 (100%) were intervention questions. There were 2.74 (SD 1.55) mean errors, ranging from 0 to 6. No questions were missing P or O. Specific errors included missing I 3 (4.5%) or missing C 37 (56%), poor formatting 34 (51.5%), directional outcome 44 (66.7%), and project purpose 38 (57.6%). Thirty-three (50%) of the questions were missing T; however, T is not used for searching, so researchers recalculated the mean error without T (M = 2.24, SD = 1.28, range 0-5). LINKING EVIDENCE TO ACTION: Gaps in the accurate use of the PICOT method to construct clinical questions can lead to biased searches, inaccurate clinical problem identification, and, when used as the project purpose, jumping to non-evidence-based solutions. Academic faculty and clinical educators can mitigate these skewed outcomes and enhance their impact on quality outcomes by helping DNP-prepared nurses shore up this foundational skill.

The effects of using a flipped classroom pedagogy in nursing anesthesia education: a program evaluation.

BACKGROUND: The flipped classroom (FC) pedagogy improves undergraduate student proficiency and satisfaction. However, its effectiveness has not been demonstrated in nursing anesthesia education. OBJECTIVES: Pre- and post-FC tests and course evaluations were retrospectively compared to determine if FC was an effective pedagogy for a nursing anesthesia program (NAP). METHODS: The design of the study was a retrospective program evaluation. Two groups were compared with 59 students in the pre-FC group taught via traditional lecture and 61 students in the post-FC group taught with FC. Answers to the same 167 test questions were compared using an independent t-test and five course evaluation questions were statistically compared using NPAR1WAY procedure with the Wilcoxon option to determine if significant differences existed between the two nursing anesthesia student cohorts. RESULTS: The post-FC students exhibited a significant 4 % increase in test scores and expressed increased satisfaction compared to their pre-FC counterparts. CONCLUSIONS: This retrospective program evaluation showed that student proficiency and satisfaction improved between the groups after changing to the FC pedagogy. However, research is needed to determine the true value of using FC in nursing anesthesia education. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: The flipped classroom model can be beneficial in graduate nursing education with our ever-changing student population.

[Nursing skill levels and implementation of Advanced Nursing Practice in Austria: A cross-sectional study]. / Pflegerische Qualifikationsniveaus und Umsetzung von Aufgaben für eine Advanced Nursing Practice in Österreich.

Nursing skill levels and implementation of Advanced Nursing Practice in Austria: A cross-sectional study Abstract: Background: New fields of practice are emerging under the concept of "Advanced Nursing Practice" (ANP) that offer specialised care provided by nurses who hold master's degrees. In Austria, nurses are currently being trained as Advanced Practice Nurses (APN). Aim: The project aimed to investigate which advanced nursing practice tasks according to the Hamric model are undertaken by nurses at different levels of qualification in Austria. Methods: Certified nurses did participate in a cross-sectional survey through an online questionnaire based on the Role Delineation Model and tailored to the Austrian context. The tasks were assigned based on the Hamric model and were tested and evaluated descriptively according to the qualification level through factor analysis. Results: Completed data was available from 105 participants, among them 80% with undergraduate education, 20% with a master's degree. A tendency in the results showed that the level of qualification was related to the activities carried out. The higher the academic degree, the more activities were performed in the field of leadership. The central ANP-competencies, research and education, are rather weak among all respondents. Conclusion: The results show that activities corresponding to the competencies of an ANP are performed by a heterogeneous group of nurses. Conditions and a standardized understanding of ANP need to be established in order to offer a professional practice that matches the competency profile.

New Graduate Nurse Transition into Rural Home: A Case Study.

The global shortage of nurses and high attrition rates for newly graduated nurses along with the shifting demand for home care has created a critical need for retention strategies that address the specific challenges of rural settings. The effectiveness of structured transition or mentoring programs are primarily studied in acute care settings, making it difficult to translate to the unique context of rural home care nursing. The complexities of the independent nature of home care nursing practice and limited resources to address transition shock make it difficult to successfully transition newly graduated nurses to rural home care. A case study supports mentorship facilitation as a readily available, effective strategy that can overcome the challenges of rural home care settings. A comparative analysis will link Duchscher's (2008) transition shock theory to mentorship as an effective strategy for supporting NGNs' transition in home care nursing. Recommendations offer rural care leaders practical strategies bundled with mentorship to optimize the successful transition and retention of newly graduated nurses in their workplaces.

Improving New Graduate Nurse Retention With a Transition to Emergency Nursing Practice Program.

INTRODUCTION: Emergency department turnover rates increased at Sentara Northern Virginia Medical Center. Most applicants were new graduate registered nurses. A strength, weakness, opportunity, threat analysis revealed 3 weaknesses regarding new graduate registered nurses in emergency departments. Transition to practice program was necessary, new graduate registered nurse competency needed to progress rapidly, and retention rates needed improvement. METHODS: The emergency department registered nurse transition to practice pathway was created to address these challenges. Retention statistics were garnered through new graduate registered nurses length of employment. Improving retention rates at Sentara Northern Virginia Medical Center led to expansion of the program to the other 11 hospitals in the system. Self-report surveys were created later to evaluate the new graduate registered nursess' satisfaction with the program and perception of clinical confidence. RESULTS: Using the emergency department registered nurse transition to practice pathway, turnover rates at Sentara Northern Virginia Medical Center dropped from 46% to 5.1%. Post expansion, the overall program retention rates were 96% at 6 months, and 86% at 1 year. The 2-year retention rate prior to COVID-19 was 82%, afterward, it dropped to 65%. Most surveyed new graduate registered nurses had a confidence level of 25% or less on the first day. After their 17-week orientation, 54% reported confidence levels had risen to 75%. Within 6 months, 81% reported 75% confidence, at 1 year, 87% reported levels between 75% and 100%, and at 2 years, 100% reported a confidence level between 75% and 100%. DISCUSSION: This development of the emergency department registered nurse transition to practice pathway resulted in improved emergency department registered nurse retention and confidence. Savings from reduced turnover and reduced temporary labor staffing were achieved with this program. Implementation takes careful resource management, ongoing analysis, and research to validate return on investment.

Expert-Type Content Validity Applications to Doctor of Nursing Practice Projects.

Background: Developing rigorous doctor of nursing practice (DNP) projects continues to challenge faculty and doctoral students. To address project rigor, expert content validity methods have been applied to clinical projects. Students implement expert content validity processes to literature-based project components. Objectives: The objectives of this study are to describe some of the developmental phases of DNP projects during the courses of one DNP program and to explore one strategy for increasing the rigor of DNP projects, review details on expert-type content validity methods, and examine literature for projects implementing an alternate application of expert-type content validity and scoring approaches to components of DNP projects. Methods: Expert content validity methods are described for DNP projects, such as guidelines, teaching plans, support groups, and algorithms. They are used to judge components generated from initial content analysis strategies. Types of expert panelists and descriptions of scoring ranks on project components are presented to represent different expert content validity strategies. Results The steps are presented to support expert content validity processes. Conclusions: DNP projects challenge faculty and students to create systematically constructed quality improvement projects on important and interesting clinical problems. The expert context validity process is one approach of enhancing project rigor. Implications for Nursing: An outline offers steps to establish expert content validity for translational DNP projects.

New Graduate Nurses' Experiences by Generation in South Korea: A Qualitative Meta-Synthesis.

BACKGROUND: As the nursing organization environment evolves into one in which several generations work together, there are concerns about generational differences leading to conflicts. PURPOSE: A synthesis of qualitative studies was used to gain insight into the experiences and perceptions of new nurses working in South Korean hospitals and identify generational differences between nurses of Generations X and Y. METHODS: Eight databases were searched systematically for qualitative studies published up to June 2020. The Critical Appraisal Skills Programme Checklist for Qualitative Research was used to evaluate the quality of the retrieved studies, and the data were synthesized thematically using the Thomas and Harden method. RESULTS: Of the 2,482 studies retrieved, 19 were included in this meta-synthesis. The experience of new nurses were presented in the three analytical themes of work experience, interpersonal relationships, and adaptation, from which eight descriptive themes were derived: (a) dissatisfied with own work performance, (b) negative feedback on work outcomes, (c) irregular daily life, (d) colleagues who help adapt to work life or make work life harder, (e) feelings of sympathy toward peers, (f) disrespectful patients or caregivers, (g) effective reactions, and (h) ineffective reactions. Although the new nurses from Generations X and Y reported similar experiences during their first year of nursing, differences were found in their values and tendencies regarding work and interpersonal relationships. Compared with new Generation X nurses, new Generation Y nurses placed more value on the meaning of individual work contributions, intimacy with colleagues, and appropriate feedback. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study support nursing administrators implementing strategies that both acknowledge and reduce the impact of generational category on nursing teams. Furthermore, emphasizing communication and acknowledging ongoing change as generations progress may strengthen bonds that lead nurses to value each other and their work.

The DNP project: Two decades of impact.

ABSTRACT: Twenty years ago, pioneer Doctor of Nursing Practice (DNP) program students completed the first DNP projects. Today, DNP projects remain a requirement for graduation. This article illustrates how the DNP project can be integrated throughout the DNP curriculum to maximize effectiveness and promote the introduction, reinforcement, and evaluation of competencies in the new American Association of Colleges of Nursing Essentials.

Everyone Is Listening: Podcasts as an Innovative Educational Approach in Graduate Level Education.

BACKGROUND: Over the past decade, graduate level nursing education has transitioned from synchronous, classroom-based models to hybrid, asynchronous models. This change has increased the amount of screen-time for graduate learners and generated the problem of screen-fatigue. To reduce screen-based learning time, faculty transitioned a didactic critical care course to a podcast-based educational format. METHOD: This pilot study used a pre-course and post-course survey to evaluate the efficacy of podcasts in delivering course content, meeting course objectives, and understanding learners' perceptions of podcasts in education. RESULTS: Pre-course and post-course survey data demonstrated that podcasts successfully met course objectives and provided content that was equally or more engaging than screen-based lectures. CONCLUSION: Podcasts can be successfully incorporated into a didactic course as a content delivery modality and are an innovative strategy for engaging adult learners in an asynchronous, distance-friendly format while continuing to meet educational objectives. [J Nurs Educ. 2024;63(5):335-337.].

Improved professional competencies and leadership in PhD-prepared nurses and doctoral students after participating in the cross-national and web-based Nurse-Lead program.

BACKGROUND: Doctor of Philosophy (PhD)-prepared nurses are expected to exercise leadership in their various roles. Therefore, European nurse scholars developed a cross-national web-based Nursing Leadership and Mentoring Educational (Nurse-Lead) program. PURPOSE: To evaluate changes in leadership practices, professional and research competencies as well as career development of PhD-prepared nurses and doctoral nursing students after participation in the Nurse-Lead program. METHODS: A pre-post-test evaluation was conducted. Surveys addressed leadership, professional and research competencies, and career development. Quantitative data were analyzed with descriptive statistics and paired sample t-tests. Content analysis was used for qualitative data. DISCUSSION: The 30 participants showed significant improvements in all leadership practices, professional competencies, and most research competencies. Participants reported increased confidence in decision-making, taking on new responsibilities, and becoming more visible within research teams. CONCLUSION: Web-based, international leadership and mentoring programs are promising tools for the leadership and professional development of PhD-prepared nurses and doctoral nursing students.