Advancing health equity in prelicensure nursing curricula: Findings from a critical review.

Nurses play a crucial role in reducing health disparities and advancing health equity for individuals and communities. The future nursing workforce relies on their nursing education to prepare them to promote health equity. Nursing educators prepare students through a variety of andragogical learning strategies in the classroom and in clinical experiences and by intentionally updating and revising curricular content to address knowledge and competency gaps. This critical review aimed to determine the extent to which health equity concepts are explicitly present in prelicensure undergraduate nursing curricula globally. Of 434 articles screened, 22 articles describing 20 studies met inclusion criteria. Frequency and quantity of health equity content, concepts and topics, teaching strategies, evaluation strategies, and the overall extent of integration varied widely. Notably, only two articles described overall well-integrated explicit health equity content, and there was little attention to whether students transfer this learning into practice. A focus on individualism rather than population and community was noted, highlighting the presence of whiteness in nursing. Results from this review confirm that nursing education has room to improve with respect to health equity in the curricula.

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.

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.].

Does Every Student Count! in Your State? Update on the National School Nurse Dataset.

The NASN launched a new data initiative in 2018 called: The National School Health Data Set: Every Student Counts! The initiative includes three distinct foci or prongs. This article reports on the progress of states participating in Every Student Counts! For more information on NASN's initiative and to learn how school nurses can join the data revolution, go to http://nasn.org/everystudentcounts .

Teaching-service integration: building the educational workshop in healthcare / Integración enseñanza-servicio: construyendo el taller pedagógico en salud / Integração ensino-serviço: construindo o ateliê pedagógico em saúde

ABSTRACT Objective: To identify the pedagogical strategies and the elements that determine the construction of the educational workshop in healthcare at the teaching-service integration process. Method: Collective case study with qualitative approach. The cases consisted of two undergraduate courses in nursing. Thirty-one interviews were conducted with healthcare professionals, professors and students, in addition to participant observation in seven basic health units (UBS) that received the students interviewed. Results: The following analytical categories emerged: teaching-service integration: articulating idealized situations with real situations; pedagogical workshop in health: development of collective pedagogical actions; reflection on the experiences in the pedagogical workshop in health: articulating the knowledge of the work world with the teaching world. Final Consideration: Despite the integration difficulties between teaching and service, we can conclude that their encounter generates a fertile field for the development of the educational workshop in healthcare. To this end, the agreement of the strategies presented in the constitution of the workshop is necessary.

RESUMEN Objetivo: Conocer las estrategias pedagógicas y los elementos que determinan la construcción del taller pedagógico en salud en el proceso de integración enseñanza-servicio. Método: Estudio de caso colectivo con abordaje cualitativo. Los casos fueron dos cursos de graduación en enfermería. Se realizaron 31 entrevistas con profesionales de salud, docentes y discentes, además de observación participante en siete unidades básicas de salud (UBS) que recibieron a los estudiantes entrevistados. Resultados: emergieron las siguientes categorías analíticas: integración enseñanza-servicio: articulando situaciones idealizadas con situaciones reales; el taller pedagógico en salud: desarrollo de acciones pedagógicas colectivas; reflexión sobre lo vivido en el taller pedagógico en salud: articulando el conocimiento del mundo del trabajo con el mundo de la enseñanza. Consideraciones Finales: A pesar de las dificultades de integración entre enseñanza y servicio, se puede concluir que el encuentro de estos genera un campo fértil para el desarrollo del taller pedagógico en salud. Para ello, es necesario pactar las estrategias presentadas en la constitución del taller.

RESUMO Objetivo: Conhecer as estratégias pedagógicas e os elementos que determinam a construção do ateliê pedagógico em saúde no processo de integração ensino-serviço. Método: Estudo de caso coletivo com abordagem qualitativa. Os casos foram dois cursos de graduação em enfermagem. Foram realizadas 31 entrevistas com profissionais de saúde, docentes e discentes, além de observação participante em sete unidades básicas de saúde (UBS) que receberam os estudantes entrevistados. Resultados: Emergiram as seguintes categorias analíticas: integração ensino-serviço: articulando situações idealizadas com situações reais; o ateliê pedagógico em saúde: desenvolvimento de ações pedagógicas coletivas; reflexão sobre o vivido no ateliê pedagógico em saúde: articulando o conhecimento do mundo do trabalho com o mundo do ensino. Considerações Finais: Apesar das dificuldades de integração entre ensino e serviço, pode-se concluir que o encontro destes gera um campo fértil para o desenvolvimento do ateliê pedagógico em saúde. Para tal, é necessária a pactuação das estratégias apresentadas na constituição do ateliê.

Social barriers experienced by female Saudi nursing students while studying nursing: A phenomenological study.

Saudi Arabia has a shortage of Saudi nurses in the workforce, particularly with limited numbers of local female nurses. Social factors may influence views towards the discipline of nursing thus influencing interest of local females choosing to undetake nursing studies. The aim of this paper is to explore the lived experiences of Saudi female nursing students regarding the social barriers encountered related to studying nursing. Hermeneutic phenomenology guided by Van Manen underpinned the study. In-depth, semi-structured interviews were conducted, and data thematically analysed. Eight female nursing students from one university nursing school in Saudi Arabia participated. Two main themes emerged, the first, 'dealing with social factors', describes the range of social issues encountered by students. The second theme, 'social support', describes support needs and strategies used by students as they faced social issues. This study demonstrates that Saudi female nursing students could generally overcome social difficulties they confronted, particularly when they received viable social support to encourage them in their studies. Therefore, it is important to understand the social factors and experiences that may act as barriers to students completing their nursing studies. This can help in the recruitment and retention of nursing students and design of supportive programs to facilitate their studies.

Transforming nursing curricula for a global community.

With nurses and midwives providing the majority of health care globally, nursing education in all countries must prepare students for broader responsibilities to move the agenda forward for equitable care and universal health coverage. Columbia University School of Nursing developed and implemented a vibrant approach to curriculum transformation that included a new didactic course followed by a program of global clinical experiences to expand students' learning environments in global health. Program planning included defining learning objectives, mobilizing support within the school, establishing new sites, recruiting and preparing students, overseeing of students with host institutions, and evaluating the program. A total of twenty-four students were placed over five sites for a six-week credit-bearing global clinical experience. Students had varied clinical experiences with new understandings of the reality of health disparities. Host sites expressed a commitment to have students return in the next year, and all students stated that they would chose a global experience again. This innovation provides a transformative addition to nursing education with a deepened understanding of health disparities and nursing roles in different health systems. It strengthens the school's network of nursing and midwifery educators and opens doors for new exchanges.

Nursing and Global Health: social determinants of health in the training of nurses.

OBJECTIVE: To evaluate to which extent nursing professors understand how social determinants of health impact on health, and whether the topic is addressed in nursing undergraduate education in Brazil. METHOD: This is a methodological study carried out with 222 nursing faculty members from Brazilian higher education institutions. The answers of the domain "Social and environmental determinants of health", concerning a questionnaire on "Core Competencies in Global Health", were analyzed. RESULTS: Most professors have over 10 years of experience in nursing higher education. A large part of the participants strongly agreed or agreed on the importance of college subjects related to the above-mentioned topic for the education of the nurses. CONCLUSION: The professors in this study agreed that social and environmental health determinants must be taught in Nursing school, since it is necessary that nurses value this knowledge, slowly making it a part of the curriculum framework.

Development of a context specific accreditation assessment tool for affirming quality midwifery education in Bangladesh.

OBJECTIVE: using the International Confederation of Midwives (ICM) Global Standards for Midwifery Education as a conceptual framework, the aim of this study was to explore and describe important 'must haves' for inclusion in a context-specific accreditation assessment tool in Bangladesh. DESIGN: A questionnaire study was conducted using a Likert rating scale and 111 closed-response single items on adherence to accreditation-related statements, ending with an open-ended question. The ICM Global Standards guided data collection, deductive content analysis and description of the quantitative results. SETTING: twenty-five public institutes/colleges (out of 38 in Bangladesh), covering seven out of eight geographical divisions in the country. PARTICIPANTS: one hundred and twenty-three nursing educators teaching the 3-year diploma midwifery education programme. FINDINGS: this study provides insight into the development of a context-specific accreditation assessment tool for Bangladesh. Important components to be included in this accreditation tool are presented under the following categories and domains: 'organization and administration', 'midwifery faculty', 'student body', 'curriculum content', 'resources, facilities and services' and 'assessment strategies'. The identified components were a prerequisite to ensure that midwifery students achieve the intended learning outcomes of the midwifery curriculum, and hence contribute to a strong midwifery workforce. The components further ensure well-prepared teachers and a standardized curriculum supported at policy level to enable effective deployment of professional midwives in the existing health system. KEY CONCLUSIONS: as part of developing an accreditation assessment tool, it is imperative to build ownership and capacity when translating the ICM Global Standards for Midwifery Education into the national context. IMPLICATIONS FOR PRACTICE: this initiative can be used as lessons learned from Bangladesh to develop a context-specific accreditation assessment tool in line with national priorities, supporting the development of national policies.

The validation of the Supervision of Thesis Questionnaire (STQ).

BACKGROUND: The supervision process is characterized by differences between the supervisors' and the students' expectations before the start of writing a bachelor thesis as well as after its completion. A review of the literature did not reveal any scientifically tested questionnaire for evaluating nursing students' expectations of the supervision process when writing a bachelor thesis. OBJECTIVES: The aim of the study was to determine the construct validity and internal consistency reliability of a questionnaire for measuring nursing students' expectations of the bachelor thesis supervision process. DESIGN & METHODS: The study had a developmental and methodological design carried out in four steps including construct validity and internal consistency reliability statistical procedures: construction of the items, assessment of face validity, data collection and data analysis. SETTINGS & PARTICIPANTS: This study was conducted at a university in southern Sweden, where students on the "Nursing student thesis, 15 ECTS" course were consecutively selected for participation. Of the 512 questionnaires distributed, 327 were returned, a response rate of 64%. RESULTS: Five factors with a total variance of 74% and good communalities, ≥0.64, were extracted from the 10-item STQ. The internal consistency of the 10 items was 0.68. The five factors were labelled: The nature of the supervision process, The supervisor's role as a coach, The students' progression to self-support, The interaction between students and supervisor and supervisor competence. CONCLUSIONS: A didactic, useful and secure questionnaire measuring nursing students' expectations of the bachelor thesis supervision process based on three main forms of supervision was created.

Addressing Social Determinants of Health Through Advocacy.

The social determinants of health (SDOH) are receiving increased attention due to their influence on health disparities, health outcomes, and overall quality of life. Nurse leaders must take an active role in advocating for strategies that address these important issues. The purpose of this descriptive study was to explore nurses' knowledge, attitudes, and behaviors related to SDOH. A sample of 107 registered nurses completed the SDOH survey. Findings revealed that nurses experience personal discomfort and anticipate patient discomfort related to addressing the SDOH in their practice. They also voice a lack of skill, lack of time, and a dependency on other professionals to address these issues. The findings highlight the need for nurse leaders to advocate for nurses and those they care for through policy development, collaboration, and education. Based on the findings of this study, multiple strategies for nurse leaders serving as advocates are presented.

Drawing on antiracist approaches toward a critical antidiscriminatory pedagogy for nursing.

Although nursing has a unique contribution to advancing social justice in health care practices and education, and although social justice has been claimed as a core value of nursing, there is little guidance regarding how to enact social justice in nursing practice and education. In this paper, we propose a critical antidiscriminatory pedagogy (CADP) for nursing as a promising path in this direction. We argue that because discrimination is inherent to the production and maintenance of inequities and injustices, adopting a CADP offers opportunities for students and practicing nurses to develop their capacity to counteract racism and other forms of individual and systemic discrimination in health care, and thus promote social justice. The CADP we propose has the following features: it is grounded in a critical intersectional perspective of discrimination, it aims at fostering transformative learning, and it involves a praxis-oriented critical consciousness. A CADP challenges the liberal individualist paradigm that dominates much of western-based health care, and the culturalist and racializing processes prevalent in nursing education. It also situates nursing practice as responsive to health inequities. Thus, a CADP is a promising way to translate social justice into nursing practice and education through transformative learning.

Nursing and Global Health: social determinants of health in the training of nurses / Enfermería y Salud Global: determinantes sociales de salud en la preparación de enfermeros / Enfermagem e Saúde Global: determinantes sociais de saúde no preparo de enfermeiros

ABSTRACT Objective: To evaluate to which extent nursing professors understand how social determinants of health impact on health, and whether the topic is addressed in nursing undergraduate education in Brazil. Method: This is a methodological study carried out with 222 nursing faculty members from Brazilian higher education institutions. The answers of the domain "Social and environmental determinants of health", concerning a questionnaire on "Core Competencies in Global Health", were analyzed. Results: Most professors have over 10 years of experience in nursing higher education. A large part of the participants strongly agreed or agreed on the importance of college subjects related to the above-mentioned topic for the education of the nurses. Conclusion: The professors in this study agreed that social and environmental health determinants must be taught in Nursing school, since it is necessary that nurses value this knowledge, slowly making it a part of the curriculum framework.

RESUMEN Objetivos: Evaluar en qué grado una muestra de docentes de enfermería entiende que los determinantes sociales de salud afectan la salud, y si el tema es abordado en la enseñanza de grado de enfermería en Brasil. Método: Estudio metodológico realizado con 222 docentes de escuelas de enfermería brasileñas. Fueron analizadas las respuestas del dominio "Determinantes sociales y ambientales de salud", referente al cuestionario "Competencias Básicas Esenciales de Salud Global". Resultados: En su mayoría, los docentes presentaron tiempo de actuación en enseñanza superior de enfermería superior a 10 años. Entre los participantes, gran parte concordó totalmente o concordó sobre la importancia de contenidos relacionados al tema en la formación de enfermeros. Conclusión: Los docentes concordaron en que los determinantes sociales y ambientales de salud deben ser dictados en los cursos de enfermería, toda vez que resulta fundamental que la enfermería valore este conocimiento y lo introduzca gradualmente en su grilla curricular.

RESUMO Objetivo: Avaliar em que grau uma amostra de docentes de enfermagem entende que os determinantes sociais de saúde afetam a saúde e se o tema é abordado no ensino de graduação em enfermagem no Brasil. Método: Estudo metodológico realizado com 222 docentes de escolas de enfermagem brasileiras. Foram analisadas as respostas do domínio "Determinantes sociais e ambientais de saúde" referente ao questionário "Competências Básicas Essenciais de Saúde Global". Resultados: Em sua maioria, os docentes apresentaram tempo de atuação no ensino superior de enfermagem acima de 10 anos. Dentre os participantes, grande parte concordou totalmente ou concordou sobre a relevância dos conteúdos relacionados ao tema para a formação de enfermeiros. Conclusão: Neste estudo, os docentes concordaram que os determinantes sociais e ambientais de saúde devem ser ministrados nos cursos de enfermagem, uma vez que é fundamental que a enfermagem valorize esse conhecimento e o introduza gradativamente em sua grade curricular.

Advancing Health Equity Through Student Empowerment and Professional Success: A Statewide Approach.

BACKGROUND: A lack of diversity in the nursing workforce nationally has been identified by Oregon state leaders as a factor contributing to health inequity. METHOD: The goal of Advancing Health Equity Through Student Empowerment and Professional Success (HealthE STEPS) is to graduate nursing students from disadvantaged backgrounds to improve health equity within their communities. A comprehensive plan of evidence-based strategies was developed based on social determinants of health and addresses academic socialization, learning support, financial resources, networking, curriculum development, and campus culture. RESULTS: Ninety undergraduate nursing students participated in the program during a 2-year period. Retention of participants was 97% with graduation rates of 94%. First-time licensure pass rates were 82% and 96% of participating graduates employed in a medically underserved community. CONCLUSION: This comprehensive innovative program of evidence-based strategies addresses health equity by developing a diverse nursing workforce to practice in medically underserved communities. [J Nurs Educ. 2016;55(6):316-322.].

Does State Legislation Improve Nursing Workforce Diversity?

A health-care workforce representative of our nation's diversity is a health and research priority. Although racial and ethnic minorities represent 37% of Americans, they comprise only 16% of the nursing workforce. The purpose of this study was to examine the effect of state legislation on minority recruitment to nursing. Using data from the National Conference of State Legislatures, American Association of Colleges of Nursing, and U.S. census, we compared minority enrollment in baccalaureate nursing programs of states (Texas, Virginia, Michigan, California, Florida, Connecticut, and Arkansas) before and 3 years after enacting legislation with geographically adjacent states without legislation. Data were analyzed using descriptive and chi-square statistics. Following legislation, Arkansas (13.8%-24.5%), California (3.3%-5.4%), and Michigan (8.0%-10.0%) significantly increased enrollment of Blacks, and Florida (11.8%-15.4%) and Texas (11.2%-13.9%) significantly increased enrollment of Hispanic baccalaureate nursing students. States that tied legislation to funding, encouragement, and reimbursement had larger enrollment gains and greater minority representation.

Baccalaureate nursing education: has it delivered? A retrospective critique.

Despite political support for the baccalaureate degree as entry to practice, historical concerns over nursing education - the value of education versus service, professional versus vocational identity and theoretical versus practical knowledge - persist. The authors challenge the notion of a "two-tiered" nursing system and call for a nationwide curriculum review to help the profession adapt to the changing needs of the Canadian healthcare system.

Factors influencing nursing career choices and choice of study program.

In advance of a recruitment campaign, Israeli first-year nursing students of all ethnicities were surveyed to elucidate what factors had influenced them to make nursing their career and what sort of training track they preferred. The responses made it clear that different factors influence different groups differently. There were noticeable differences by gender, age, and ethnicity. Overall, training institutions were chosen for their closeness to the student's home but other factors also operated among particular groups, such as institutional prestige and flexible entry criteria. There was a blatant preference for academic, particularly university-sited, programs over diploma programs.

Physical fitness in pre-registration nursing students.

BACKGROUND: Nurses are ideally placed to deliver health promotion interventions, including physical fitness, however evidence suggests that nurses themselves are failing to engage in healthy lifestyles; this in turn making them less likely to promote health. It would appear that some nurses are allowing their own values, beliefs and behaviours to hinder this role. We propose these nurses are in breach of the Nursing and Midwifery (NMC) code. Currently nurses self declare their fitness to practice through the NMC, however self-monitoring has been criticized for its lack of reliability. Recruitment of student nurses in the UK does not currently assess physical fitness levels in line with other professionals such as the armed forces, police or fire service. Over half the nursing workforce is now overweight or obese, with alarming levels of inactivity. Physical activity positively correlates with motivation, wellbeing, coping and positive attitude. These attributes in turn impact on employability, retention and absence. This article explores promoting health, focussing on physical activity and discusses innovative ideas to promote physical activity within the nursing Curricula.