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Computer-based virtual simulation in nursing is a rapidly developing field. A summary of current research could benefit nursing faculty who are incorporating this pedagogy into online teaching due to social distancing requirements. This umbrella review aimed to explore the use and effectiveness of virtual simulations in prelicensure nursing education. Our umbrella review approach was informed by The Johanna Briggs Institute guidelines. The 18 included reviews captured the experiences of over 7600 nursing students who engaged with five different virtual (screen-based) simulation modalities. Results indicated that virtual simulations can be effective in developing nursing students' knowledge and psychomotor and psychosocial skills, for example, in medication administration and communication. There was no study that showed a conclusive benefit of virtual simulations for developing clinical reasoning. Students enjoyed virtual simulations, claiming they were accessible, fun, and engaging ways to learn. Many benefits of virtual simulations and some technological challenges were identified in a mapped model. In the future, more rigorous and experimental studies are needed to confirm effects on learning outcomes. Nursing curriculum designers need to define the place and purposes of the pedagogy to ensure that knowledge and skills learned during virtual simulations can be applied to real-world, patient-centered care.
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Bacharelado em Enfermagem , Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Competência Clínica , Comunicação , Currículo , Educação em Enfermagem/métodos , Bacharelado em Enfermagem/métodos , Aprendizagem , Estudantes de Enfermagem/psicologiaRESUMO
BACKGROUND: Interprofessional education opportunities are commonly university-based and require further development during clinical practice. Many clinical contexts offer the potential for meaningful learning of both collaborative and discipline-specific practice. The emergency department (ED) demands efficient teamwork, so presents a logical location for interprofessional learning. METHODS: An interprofessional clinical placement program was implemented with the aim to enhance students' capacity and self-efficacy for collaborative practice. Fifty-five medical and nursing students participated as interdisciplinary pairs in a two-week clinical placement in the ED. Students' perceptions of the learning environment were measured pre- and post-placement with the Self-efficacy for Interprofessional Experiential Learning Scale and the Interprofessional Clinical Placement Learning Inventory was completed post-placement. Non-parametric tests were used to establish change differences. RESULTS: The Placement Learning Inventory revealed positive outcomes; the majority (16/19) agreed/agreed strongly that the placement provided sufficient learning opportunities, was interesting, and made them feel as if they belonged and most (14/19) reported they achieved the discipline specific learning objectives set by the university. Self-efficacy improved significantly (p = 0.017), showing promise for future use of the placement model Challenges were identified in the organisation and supervision of students. In the absence of additional dedicated student supervision, this model of interprofessional student pairs in the ED was challenging. CONCLUSIONS: Interprofessional clinical placements in ED are an effective clinical learning approach for final year undergraduate medicine and nursing students. Recommendations for improvements for students' clinical supervision are proposed for the placement model.
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Relações Interprofissionais , Estudantes de Enfermagem , Humanos , Aprendizagem , Aprendizagem Baseada em Problemas , Serviço Hospitalar de EmergênciaRESUMO
BACKGROUND: Virtual simulation is an interactive teaching and learning strategy used in undergraduate nursing student education, especially since the onset of the COVID-19 pandemic. Few published studies have reviewed the impact of virtual simulation as a strategy for teaching nursing students the elements of evidence-based practice. AIM: To describe types of virtual simulation that are relevant to nursing student education and examine how these modalities are applied to teach elements of evidence-based practice. METHODS: A rapid review of literature was conducted to discern the use and impact of virtual simulation. Thirty-seven studies published between 2017 and May 2021 that addressed nursing students' educational outcomes were reviewed and summarized as a narrative analysis. RESULTS: Virtual simulation and virtual reality simulation engage learners in role-plays via a computer screen or hand-held phone. Various levels of realism and immersion were apparent across different modalities and with the utilization of educational games. Most studies related to the teaching of best practice evidence-based clinical nursing topics. Twenty primary studies reported objective measures of students' improvement such as knowledge, performance, better documentation, or communication accuracy. Sixteen studies that measured knowledge identified significant knowledge gains. All studies endorsed virtual simulation as a teaching method. LINKING EVIDENCE TO ACTION: Virtual simulation approaches offer an innovative and feasible option for teaching nursing students. Such approaches should be included in undergraduate nursing curricula. While it is apparent that evidence-based practice guidelines inform the design of the virtual simulation scenarios, the effectiveness of the modality for teaching specific elements of evidence-based practice to nursing students is not yet confirmed. Nursing curricula need to include ways of teaching nursing students to search for and critically appraise trustworthy sources of knowledge for clinical practice.
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COVID-19 , Bacharelado em Enfermagem , Estudantes de Enfermagem , Currículo , Bacharelado em Enfermagem/métodos , Enfermagem Baseada em Evidências , Humanos , PandemiasRESUMO
AIMS: This paper has two aims : first, to explain the concept of empathy derived from an integrative review of contemporary nursing literature; and second, to profile a new conceptual model that can be used to inform the teaching of empathy. BACKGROUND: Empathy is fundamental to therapeutic communication and integral to quality patient care. However, the lack of agreement on the definition or conceptualisation of empathy in the nursing literature can make teaching and evaluating this skill challenging and inconsistent. DESIGN: Integrative review of literature. DATA SOURCES: Publications from January 2000 to July 2018 in Ovid Medline, Scopus, CINAHLPlus, PsycINFO, and PubMed. REVIEW METHODS: As no integrative review checklists are currently available, a PRISMA checklist was adapted to guide this review. A two-stage approach was used to explore the concept of empathy. Key definitions and attributes of empathy were identified from 11 primary studies and tabulated to allow for display and comparison. Next, the definitions and attributes of empathy drawn from a purposeful sample of 18 nursing education studies were examined, tabulated and summarised. Finally, the two samples were integrated and synthesised to form a cohesive summary, which was then illustrated with teaching and learning exemplars. RESULTS: Despite the lack of consensus on the definitions of empathy evident in the literature, recurring attributes and elements of empathy were evident, leading to the development of a new empathy model. CONCLUSION: Patterns of consistency in the attributes of empathy that emerged from the review provided the basis for a new conceptual model, termed "The Empathy Continuum." RELEVANCE TO CLINICAL PRACTICE: Each of the stages in the Empathy Continuum can be used to teach learners the meaning, attributes and application of empathy in practice. The model will be relevant to nurse educators as well as educators from other disciplines.
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Empatia , Modelos de Enfermagem , Educação em Enfermagem/métodos , HumanosRESUMO
BACKGROUND: The quality of nursing clinical placements has been found to vary. Placement evaluation tools for nursing students are available but lack contemporary reviews of clinical settings. Therefore, the aim of this study was to develop a feasible, valid and reliable clinical placement evaluation tool applicable to nursing student placements in Australia. METHODS: An exploratory mixed methods co-design project. Phase 1 included a literature review; expert rating of potential question items and Nominal Group Technique meetings with a range of stakeholders for item development. Phase 2 included on-line pilot testing of the Placement Evaluation Tool (PET) with 1263 nursing students, across all year levels at six Australian Universities and one further education college in 2019-20, to confirm validity, reliability and feasibility. RESULTS: The PET included 19-items (rated on a 5-point agreement scale) and one global satisfaction rating (a 10-point scale). Placements were generally positively rated. The total scale score (19 items) revealed a median student rating of 81 points from a maximum of 95 and a median global satisfaction rating of 9/10. Criterion validity was confirmed by item correlation: Intra-class Correlation Co-efficient ICC = .709; scale total to global score r = .722; and items to total score ranging from .609 to .832. Strong concurrent validity was demonstrated with the Clinical Learning Environment and Supervision Scale (r = .834). Internal reliability was identified and confirmed in two subscale factors: Clinical Environment (Cronbach's alpha = .94) and Learning Support (alpha = .96). Based on the short time taken to complete the survey (median 3.5 min) and students' comments, the tool was deemed applicable and feasible. CONCLUSIONS: The PET was found to be valid, reliable and feasible. Use of the tool as a quality assurance measure is likely to improve education and practice in clinical environments. Further international evaluation of the instrument is required to fully determine its psychometric properties.
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The purpose of this review was to identify the role and contribution of community-based nurse-led wound care as a service delivery model. Centres increasingly respond proactively to assess and manage wounds at all stages - not only chronic wound care. We conducted an integrative review of literature, searching five databases, 2007-2018. Based on inclusion and exclusion criteria, we systematically approached article selection and all three authors collaborated to chart the study variables, evaluate data, and synthesise results. Eighteen studies were included, representing a range of care models internationally. The findings showed a need for nurse-led clinics to provide evidence-based care using best practice guidelines for all wound types. Wound care practices should be standardised across the particular service and be integrated with higher levels of resources such as investigative services and surgical units. A multi-disciplinary approach was likely to achieve better patient outcomes, while patient-centred care with strong patient engagement was likely to assist patients' compliance with treatment. High-quality community-based wound services should include nursing leadership based on a hub-and-spoke model. This is ideally patient-centred, evidence-based, and underpinned by a commitment to developing innovations in terms of treatment modalities, accessibility, and patient engagement.
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Serviços de Saúde Comunitária , Padrões de Prática em Enfermagem , Indicadores de Qualidade em Assistência à Saúde , Úlcera Cutânea/terapia , Pele/lesões , Ferimentos e Lesões/terapia , HumanosRESUMO
AIMS AND OBJECTIVES: To extract, examine and report the highest available levels of evidence from healthcare disciplines in the use of simulation-based education as substitution for clinical placement in prelicensure programmes. BACKGROUND: Simulation is widely employed across prelicensure health professional education to create safe, realistic clinical learning experiences for students. Whether simulation can be employed to substitute for actual clinical placement, and if so, in what proportion, replacement ratio and duration, is unclear. METHODS: A systematic review and quality appraisal of primary studies related to prelicensure students in all health disciplines, guided by the PRISMA checklist. RESULTS: Ten primary studies were included, representing 2,370 students from three health disciplines in four countries. Nine studies were experimental and quasi-experimental and methodological quality was assessed as moderate to high with good to very good inter-rater agreement. Direct substitution of simulation for clinical practice ranged from 5% to 50%. With one exception, replacement ratios were 1:1 and duration of replacement ranged from 21 hr-2 years. Levels of evaluation included measures of reaction, knowledge and behaviour transfer; no negative outcomes were reported. We appraised practicalities for design of substitution, design limitations and knowledge transfer to accreditation standards for prelicensure programmes. CONCLUSIONS: This review synthesised highest levels and quality of available evidence for substitution of simulation for clinical placement in health professional education. Included studies were heterogenous in simulation interventions (proportion, ratio and duration) and in the evaluation of outcomes. Future studies should incorporate standardised simulation curricula, widen the health professions represented and strengthen experimental designs. RELEVANCE TO CLINICAL PRACTICE: Current evidence for clinical educational preparation does not appear to be translated into programme accreditation standards governing clinical practice experience for prelicensure programmes in relevant jurisdictions. Overall, a stronger evidence base is necessary to inform future curricula and policy development, to strengthen clinical practice in health.
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Educação Profissionalizante/normas , Ocupações em Saúde/educação , Treinamento por Simulação/organização & administração , Currículo/normas , Humanos , Licenciamento/normasRESUMO
AIM: To explore Registered Nurses' attitudes and behaviour towards patients' use of complementary therapies. BACKGROUND: Despite high rates of use of complementary therapies by the general population, little is known of how nurses respond to patients' use of these therapies. DESIGN: A two-phase sequential exploratory mixed methods design. METHODS: Nineteen Registered Nurses working in Australia participated in a semi-structured interview in 2015-2016 and emerging themes informed the development of a quantitative survey instrument administered online nationwide in 2016. FINDINGS: Emerging key themes "Promoting safe care"; "Seeking complementary therapies knowledge";" Supporting holistic health care"; and "Integrating complementary therapies in practice" were reflected in survey results. Survey responses (N = 614) revealed >90% agreement that complementary therapies align with a holistic view of health and that patients have the right to use them. Most nurses (77.5%) discussed complementary therapies with patients and 91.8% believed nurses should have some understanding of the area. One-third did not recommend complementary therapies and there was a lack of overall consensus as to whether these therapies should be integrated into nursing practice. Nurses with training in complementary therapies held more positive views than those without. CONCLUSION: Nurses were generally supportive of patients' interest in complementary therapies, although their primary concern was safety of the patient. Despite broad acceptance that nurses should have a basic understanding of complementary therapies, there was a lack of consensus about recommendation, integration into nursing practice and referral. Further research should explore how nurses can maintain safe, patient-centred care in the evolving pluralistic healthcare system.
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Atitude do Pessoal de Saúde , Terapias Complementares , Relações Enfermeiro-Paciente , Enfermeiras e Enfermeiros/psicologia , Adulto , Idoso , Austrália , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Saúde Holística , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Inquéritos e QuestionáriosRESUMO
AIMS AND OBJECTIVES: To explore service provision for Victorian regional refugee families from the perspective of maternal and child health nurses. BACKGROUND: Increasingly, more families from a refugee background are resettling in regional Victoria. The refugee journey has significant effect on families. Refugee families with infants and young children can be provided with support by maternal and child health services; however, many families experience barriers to ongoing engagement with this service. DESIGN: This descriptive study used focus group and questionnaire. A purposive sample of 26 maternal and child health nurses was drawn from six municipalities throughout regional Victoria, where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio-recorded narratives were transcribed, prior to inductive thematic analysis. METHODS: This descriptive study used focus group and questionnaire. A purposive sample of 26 Maternal and Child Health nurses was drawn from six municipalities throughout regional Victoria where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio-recorded narratives were transcribed verbatim, prior to inductive thematic analysis. RESULTS: Participating nurses were experienced nurses, averaging 12 years in the service. Four major themes emerged from thematic analysis: "How to identify women from a refugee background"; "The Maternal and Child Health nurse role when working with families from a refugee background"; "Interpreting issues"; and "Access to other referral agencies." Nurses worked to develop a relationship with families, attending to a complex mix of issues which were complicated by language barriers. Nurses found their role in supporting refugee families required additional time and more home visits. CONCLUSIONS: To provide best practice, maternal and child health nurses need (i) ongoing professional development; (ii) time, flexibility and creativity to build relationships with refugee families and (iii) better access to services that enhance communication, such as interpreting services and translated resources. RELEVANCE TO CLINICAL PRACTICE: Nurses require ongoing professional development to help them address the multifaceted needs of families of refugee background. With limited resources available in regional areas, accessing further education can be challenging. Distance education models and organisational support could provide nurses with educational opportunities aimed at improving service provision and clinical practice.
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Competência Cultural , Acessibilidade aos Serviços de Saúde/normas , Enfermagem Materno-Infantil/normas , Padrões de Prática em Enfermagem/normas , Refugiados/psicologia , Adulto , Criança , Família/psicologia , Feminino , Grupos Focais , Humanos , Lactente , Serviços de Saúde Materno-Infantil/organização & administração , Pessoa de Meia-Idade , Inquéritos e Questionários , Vitória , Adulto JovemRESUMO
BACKGROUND: There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. METHODS/DESIGN: In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST(2)ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST(2)ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. DISCUSSION: In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016).
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Instrução por Computador , Internet/estatística & dados numéricos , Segurança do Paciente , Simulação de Paciente , Qualidade da Assistência à Saúde , Treinamento por Simulação , Instrução por Computador/normas , Comportamento Cooperativo , Hospitais Rurais , Humanos , Enfermeiras e Enfermeiros , Estudos Retrospectivos , Índice de Gravidade de Doença , Treinamento por Simulação/normasRESUMO
Clinical placement shortages and rising costs have created demand to provide low-resource, high value student learning opportunities. Malnutrition screening provides a vehicle for achieving this. A mixed methods explanatory sequential intervention study investigated time costs, and students' perceptions of preparedness after performing routine patient screening tasks, as well as students' overall views on their feelings of confidence and preparedness when commencing their first clinical placements. Pre-clinical student dietitians commencing initial placements participated (n=58), with 16 of these forming a subgroup who performed malnutrition screening tasks while the others attended usual placement orientation. The time saved when students undertook screening tasks usually assigned to nurses was substantial. Questionnaires revealed that student perceived confidence increased in the screening group when compared with controls. Focus group themes included "anxiety and confidence," "learning in the clinical learning environment," "communication skill development," and "the pre-placement screening experience." Students performing routine patient-screening tasks prior to initial clinical placement has potential cost savings for healthcare organizations and was perceived to be valuable for learning.
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Percepção , Medição de Risco/métodos , Estudantes de Enfermagem , Austrália , Estudos de Casos e Controles , Competência Clínica/normas , Bacharelado em Enfermagem/métodos , Feminino , Grupos Focais , Humanos , Masculino , Projetos Piloto , Pesquisa QualitativaRESUMO
This study explores preregistration nursing students' views of a Web-based simulation program: FIRST ACTWeb (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends-Web). The multimedia program incorporating three videoed scenarios portrayed by a standardized patient (human actor) aims to improve students' recognition and management of hospital patient deterioration. Participants were 367 final-year nursing students from three universities who completed an online evaluation survey and 19 students from two universities who attended one of five focus groups. Two researchers conducted a thematic analysis of the transcribed narratives. Three core themes identified were as follows: "ease of program use," "experience of e-Simulation," and "satisfaction with the learning experience." The Web-based clinical learning environment was endorsed as functional, feasible, and easy to use and was reported to have high fidelity and realism. Feedback in both focus groups and surveys showed high satisfaction with the learning experience. Overall, evaluation suggested that the Web-based simulation program successfully integrated elements essential for blended learning. Although Web-based educational applications are resource intensive to develop, positive appraisal of program quality, plus program accessibility and repeatability, appears to provide important educational benefits. Further research is needed to determine the transferability of these learning experiences into real-world practice.
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Instrução por Computador , Educação a Distância , Educação em Enfermagem/métodos , Avaliação em Enfermagem , Treinamento por Simulação , Feminino , Grupos Focais , Humanos , Internet , Masculino , Multimídia , Avaliação de Programas e Projetos de Saúde , Estudantes de Enfermagem , Adulto JovemRESUMO
International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.
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Competência Clínica , Instrução por Computador , Progressão da Doença , Educação em Enfermagem/métodos , Treinamento por Simulação/métodos , Adolescente , Adulto , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Multimídia , Informática em Enfermagem , Estudantes de Enfermagem , Adulto JovemRESUMO
BACKGROUND: Professional nursing practice is informed by biological, social and behavioural sciences. In undergraduate pre-registration nursing programs, biological sciences typically include anatomy, physiology, microbiology, chemistry, physics and pharmacology. The current gap in the literature results in a lack of information about the content and depth of biological sciences being taught in nursing curricula. The aim of this study was to establish what priority is given to the teaching of science topics in these programs in order to inform an understanding of the relative importance placed on this subject area in contemporary nursing education. METHOD: This study employed a cross-sectional survey method. This paper reports on the first phase of a larger project examining science content in nursing programs. An existing questionnaire was modified and delivered online for completion by academics who teach science to nurses in these programs. This paper reports on the relative priority given by respondents to the teaching of 177 topics contained in the questionnaire. RESULTS: Of the relatively small population of academics who teach science to nursing students, thirty (n = 30) completed the survey. Findings indicate strong support for the teaching of science in these programs, with particular priority given to the basic concepts of bioscience and gross system anatomy. Of concern, most science subject areas outside of these domains were ranked as being of moderate or low priority. CONCLUSION: While the small sample size limited the conclusions able to be drawn from this study, the findings supported previous studies that indicated inadequacies in the teaching of science content in nursing curricula. Nevertheless, these findings have raised questions about the current philosophy that underpins nursing education in Australia and whether existing practices are clearly focused on preparing students for the demands of contemporary nursing practice. Academics responsible for the design and implementation of nursing curricula are encouraged to review the content of current programs in light of the findings of this research.
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AIM: This study aims to describe how senior nursing students viewed the clinical learning environment and matured their professional identity through interprofessional learning in a student-led hospital 'ward'. BACKGROUND: Undergraduate nursing and medical student teams participated in a trial of ward-based interprofessional clinical learning, managing patients over 2 weeks in a rehabilitation ward. METHODS: Qualitative and quantitative program evaluation was conducted using exit student focus groups and a satisfaction survey. RESULTS: Twenty-three nursing and medical students in three placement rounds provided positive feedback. Five main themes emerged describing their engagement in 'trying on' a professional role: 'experiencing independence and autonomy'; 'seeing clearly what nursing's all about'; 'altered images of other professions'; 'ways of communicating and collaborating' and 'becoming a functioning team'. CONCLUSIONS: Ward-based interprofessional clinical placements offer senior students authentic ideal clinical experiences. We consider this essential learning for future interprofessional collaboration which should be included in senior nursing students' education.
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Bacharelado em Enfermagem , Relações Interprofissionais , Papel do Profissional de Enfermagem , Equipe de Assistência ao Paciente , Centros de Reabilitação , Grupos Focais , Humanos , Percepção Social , Inquéritos e QuestionáriosRESUMO
Urinary incontinence is a common and distressing condition. Using focus groups, we explored the views of ten ethnic language groups in Melbourne about knowledge and awareness of incontinence. The 218 participants (with or without incontinence) spoke with trained interpreters. Twenty focus group discussions of single and mixed sex groups were audio-recorded and transcribed into English. Narratives were analyzed using thematic analysis with open coding and also incorporated themes from literature. Participants' knowledge of incontinence was low and incontinence was thought to be an inevitable consequence of ageing. There was little understanding of treatments or assistance available under government-funded programmes. No group was aware of the national continence programme or phone helpline. Sensitivities of the topic plus language barriers in immigrant culturally and linguistically diverse communities may impose barriers to accessing help. Several groups thought they would cope with incontinence by themselves, while all groups suggested they would be able to discuss the condition with a doctor. Various preferences voiced about social limitations and permissible communications with others are described. Nurses should be aware of the needs and communication preferences of ethnic language groups regarding continence information and continence service delivery.
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Educação em Saúde , Relações Enfermeiro-Paciente , Incontinência Urinária , Coleta de Dados , Grupos Focais , Humanos , Qualidade de VidaRESUMO
This paper focuses on changes in the educational preparation of undergraduate nurses in line with contemporary primary and preventative healthcare models. We evaluated a new Australian nursing and community care degree programme using focus groups with 38 students in their first years of study, and quantitative performance data (regarding entry, performance and course attrition). Four main themes were identified related to students' course experience: 'I think community health should be an elective'; 'Focus on relevance to practice'; 'Teaching by non-nursing academics' and 'Access to support during transition to university.' Overall pass rates were 94% (first year) and 97% (second year) with a low 11% attrition rate. We conclude that based on prior experiences and stereotypical views, students may be ambivalent about the inclusion of primary and preventative care models which nevertheless are essential to enhance practice and to prepare the future nursing workforce.
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Enfermagem em Saúde Comunitária/educação , Bacharelado em Enfermagem/organização & administração , Estudantes de Enfermagem , Austrália , Currículo , Grupos FocaisRESUMO
Health assessment is a fundamental aspect of the professional nursing role. The teaching of skills in physical assessment is therefore a large component of pre-registration nursing programmes. As the nursing curriculum becomes more crowded with what is deemed to be essential content, there is a need to rationalise what is taught in preparatory nursing programmes to ensure readiness for practice. The study outlined in this paper, as part of a larger project, explored the teaching of physical assessment skills in pre-registration nursing programmes across Australia. Fifty-three academics completed the 121 item online survey, indicating whether each skill was taught with practice, taught with no practice or not taught at all. The results suggest that only half the skills were being taught by more than 80% of the academics and 23 skills (19%) were taught by more than 90%. Of the 121 skills commonly taught--69 skills (57%) were taught with student practice and 29 (24%) were taught with no student practice. The results of this study raise questions about the teaching of physical assessment in pre-registration nursing programmes. The suggestion is not that skills that are used regularly or infrequently should be removed from the curriculum, rather, the authors propose that consideration be given to whether the teaching of skills that are never likely to be used is occurring at the expense of comprehensive mastery of core skills.
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Educação em Enfermagem/organização & administração , Avaliação em Enfermagem , Exame Físico , AustráliaRESUMO
AIMS: To review the contemporary international literature on nurse preceptor competencies and map the components and their descriptors. REVIEW METHODS: A mapping review. DATA SOURCES: Articles reporting evidence-based and validated Registered Nurse (RN) preceptor competencies published between 2013 and 2022 were identified. Open access databases such as PubMed and Google Scholar and the library healthcare databases Scopus and CINAHL were searched. The authors collaborated at each review stage that included screening, article selection, tabulation, mapping and preparation of findings. RESULTS: Seven quantitative studies were included. Three were based on existing nurse preceptor competency data sets and four were purposely developed using collaborative research methods. Each study validated findings through a survey of nurse stakeholders. Three key competencies shared across all studies were 'facilitating teaching', 'being a role model' and 'evaluating student's performance'. The number of competency categories ranged from three to 10 and the accompanying item descriptors from 9 to 83. Although terminology describing data sets was inconsistent, similarity was seen across competency domains. CONCLUSION: The contemporary nursing preceptor role is considered an emerging specialist education role. The results offer a set of validated preceptor competency descriptors, applicable to practice, that provide insight into ways employers may recruit, support and retain nurse preceptors. IMPLICATIONS FOR THE PROFESSION: The mapped results provide a concise summary of nurse preceptor competency research internationally that can inform further development of RN preceptors. IMPACT: This review addresses the lack of consensus around nursing preceptor competencies for clinical supervision of undergraduate nursing students. Seven competency domains were identified describing key preceptor role capabilities. The domains Facilitator', 'Role model' and 'Evaluator' featured across the included studies: 'More than 300 competency descriptors were reported'. Our review results could better prepare RN preceptors for their important role. Employers of RN preceptors could use the results to design performance competencies that may enhance nursing preceptorship. REPORTING METHOD: This review adheres to the PRISMA-ScR EQUATOR guidelines as the recommended reporting method for mapping reviews.
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Bacharelado em Enfermagem , Enfermeiras e Enfermeiros , Estudantes de Enfermagem , Humanos , Papel do Profissional de Enfermagem , Preceptoria/métodosRESUMO
AIM: To evaluate the quality of student nurses' experiences and overall satisfaction with professional experience placements at a regional Australian University. BACKGROUND: Professional experience placements are a crucial component of pre-registration nursing programs. However, the absence of standardised approaches to assess placement quality has created uncertainty on what constitutes a high-quality placement from a student's perspective. DESIGN: Cross-sectional survey. METHODS: A descriptive cross-sectional survey was administered online to 800â¯second and third year undergraduate nursing students at an Australian university. The survey contains demographic questions (e.g., year of study, placement specialty, duration, setting and geographic location), a validated Placement Evaluation Tool and free-text comments. The Placement Evaluation Tool is a 20-item questionnaire that measures two key factors: clinical environment (factor 1), learning support (factor 2) and overall satisfaction of students' learning experiences during a professional experience placement. A descriptive analysis was conducted to evaluate the student's overall experience and satisfaction. Multivariate linear regression was used to assess the relationship between the quality of the student experience and demographics and presented as beta coefficient (ß) and confidence interval (CI). Free-text comments were thematically analysed. RESULTS: A total of 1104 survey responses were received (as students may rate more than one placement), with an estimated 71% response rate. Most responses (60.3%) were third-year students. Most students experienced high-quality placements, reflected in the overall positive placement experience (PET item 1-19 score: mean 85.9 out of 95) and high student satisfaction (PET item 20: mean 8.53 out of 10). Multiple linear regression analyses revealed that the third year of study and public facilities were independent predictors of positive student experiences (ß: 2.61, 95% CI: 0.75, 4.47 and ß: 3.72, CI: 0.90, 6.55, respectively). Further analysis of PET items related to factor 1 and factor 2 revealed that high positive experiences in public facilities may be due to the higher learning support (ß: 2.54, CI: 0.80, 4.27). Three main themes were perceived to be important to students' professional experience: (i) staff and facilitator attitudes, (ii) learning opportunities and (iii) a team-based learning environment. CONCLUSIONS: Most students reported high-quality placement experience and high satisfaction; however, a lack of learning support may contribute to less positive student experiences. This finding emphasises the importance of collaboration between clinical facilities and educational institutions to enhance the student's placement experience.