Enhancing nursing education for Indigenous students: Indigenous nursing students' insights and strategies.

BACKGROUND: Indigenous nursing students contended with far-reaching challenges during the pandemic that significantly altered their experiences of nursing education. These experiences are poorly understood by nursing educators and strategies for Indigenous nursing student success rarely involve the insights of current Indigenous nursing students. AIM: The aim of this article is to offer Indigenous-student derived recommendations regarding strategies for improving their experiences and success within nursing education during the pandemic and beyond. DESIGN AND METHODS: This qualitative study employed an Indigenous methodology including land-based learning, ceremony, and sharing circles. PARTICIPANTS AND SETTING: Indigenous nursing students (n = 17) from a Western Canadian school of nursing participated in one of three sharing circles. RESULTS: Indigenous nursing students recommended institutional and program adaptations along with increases to cultural safety for enhancing their experience in nursing education. Institutional and program strategies included: decreasing course loads and class sizes; an Indigenous-specific cohort; a transition program after course failure; increasing academic supports such as additional clinical skills and academic writing practice. Recommendations for increasing cultural safety included: mandatory and recurrent cultural safety training for faculty, staff and students; differential learning and evaluation strategies; and increased inclusion of Indigenous ceremonies and practices. CONCLUSION: The findings of this study provide insights that can help guide curriculum development, pedagogical approaches, and policy development to improve nursing education for Indigenous students.

"Safety Means Everything": An ethnographic methodology to explore the formation of professional identity in nursing students.

AIM: The aim of this qualitative study is to explore how various conditions within educational contexts impact nursing students' experiences of becoming professional nurses and how these conditions affect their agency and the formation of their professional identities. BACKGROUND: Nursing education is essential to becoming professional and competent in caring for patients. A strong professional identity in nursing contributes to better patient outcomes and improves the well-being, retention, and recruitment of practitioners in the health care system. At the same time, research indicates that development of a professional identity during education is challenging and needs further investigation. DESIGN: The qualitative research design draws on the theoretical and methodological framework of critical psychology practice research. The practice research design and close collaboration with users ensure the continuous development and implementation of theory and practice. METHODS: The data used in this study originated from ethnographic fieldwork, which involved following two nursing students through their final clinical placement training at the Geriatric Department of a university hospital in Denmark. Additionally, nursing students in two classes were observed as part of their nursing education practice at a university college from April to July 2022. The participant observational design, combined with in-situ interviewing, facilitated a comprehensive understanding of the students' engagement in social practices and interactions within the context of nursing education. RESULTS: Our results show how the conditions of nursing students' everyday lives have a critical impact on their self-understanding and journey to becoming competent and professional nurses. Three main themes emerged from the analysis: (1) Perception of safety, (2) Motivation for learning in different communities of practice, and (3) The meaning of learning culture and role models. CONCLUSION: The development of nursing students into professionals is profoundly influenced by factors affecting their ontological safety that are deeply embedded in socio-cultural and educational contexts. The results underscore the need to foster ontological safety in nursing education. Creating safe, participatory, and supportive learning environments is essential to the holistic development of students into caring, competent nurses. Educators and stakeholders must remember their crucial role in this context and focus on establishing these environments to facilitate students' sense of belonging in the nursing profession. TWEETABLE ABSTRACT: The development of professional identity in nursing starts with safety. Ontological Safety in learning environments ensures competent and professional nurses. #NursingEducation#Safety#ProfessionalIdentity.

Nursing Students' Experience of a Poverty Simulation and Its Impact on Empathy and Social Justice Awareness: A Descriptive Qualitative Study.

Holistic nursing practice requires an understanding of the constraints of poverty as one of the social determinants of health. Future nurses need to be change agents for social justice. A descriptive, qualitative study was conducted to explore students' experience of the Missouri Association for Community Action Poverty Simulation© (CAPS) and its impact on empathy and social justice awareness among a purposive sample of 56 sophomore baccalaureate nursing students at a public university in the Northeastern United States. Inductive thematic analysis was applied to data collected from a postparticipation reflection paper. Five themes emerged: (a) emotions, (b) personal history of poverty, (c) empathy, (d) rising advocacy, and (e) lessons learned. The results support that the CAPS simulation provides an experiential opportunity which impacts empathy and foundational attitudes to be a change agent for social justice. Recommendations include structured education about social determinants of health prior to the CAPS simulation, continued education throughout nursing curricula, and experiential opportunities to apply social justice skills before graduation.

Understanding the processes, practices and influences of calibration on feedback literacy in higher education marking: A qualitative study.

BACKGROUND: In the University setting, striving for consistency and reliability of assessment evaluation is essential to reducing the impact of marking variations. Marking processes such as consensus calibration have the potential to reduce issues which arise from the influence of markers professional knowledge and experience, as well as fixed and acquired marking habits. Furthermore, the influence of marker feedback which supports learning development is associated with the feedback literacy of both the teacher and the student. A gap is currently present in the literature as these practices are not discussed together. OBJECTIVES: To explore how nursing academics perceive and understand calibration practices and associated feedback literacy. DESIGN: Theoretical underpinnings in participatory and person-centred research methodology supported the critical ontological perspective of this study where the intent of the research was to explore the reality that exists within the context where the research was conducted. SETTING: A single School of Nursing in an Australian University with six campuses spanning metropolitan, regional and rural sites. PARTICIPANTS: Nursing academics and casual tutors with various levels of experience in assessment marking and feedback. METHODS: Semi-structured group interviews that were analysed using reflexive thematic analysis. RESULTS: Four overarching themes were identified; rubrics, calibration, feedback and justice. CONCLUSION: Calibration improves staff cohesion, fosters better practices and consistency, and permits nuanced interpretation of assessments while maintaining uniformity. Enhanced feedback literacy that integrates principles of equity, justice, and learner-centeredness is required. Fundamentally calibration guides educators toward holistic approaches that foster consistency, equity, and thorough feedback practices.

Block learning: Evaluation of a new teaching approach for nursing and midwifery education.

AIM: The aim is to present outcome and engagement data from the initial years of the implementation of a new teaching approach in entry to practice nursing and midwifery education. BACKGROUND: The Block Model (TBM) is a teaching approach that involves studying one unit of study at a time over a four-week period, as opposed to the traditional semester model. This paper presents data revealing the impact of TBM on student engagement and overall experience in entry to practice Bachelor of Nursing and Midwifery programs. DESIGN: The evaluation retrospectively compared key indicators pre- Block Model implementation with outcomes for nursing and midwifery students using TBM approach using standard data sets and external comparators such as the Student Experience Survey and National Employability Survey. METHODS: The study presents a comparative analysis of key indicators and graduate outcomes for students. We use reportable data and two external comparators, the Student Experience Survey and the National Employability Survey, to gauge student learning and graduate employability. The evaluation was conducted in a tertiary institution in Australia with for nursing and midwifery students who completed their studies using TBM approach at the university. RESULTS: The implementation of TBM in nursing and midwifery programs resulted in improvements in learner engagement, retention rates and pass rates. Improvements were also noted graduate outcomes, with an increase in full-time graduate employment. CONCLUSIONS: The results suggest the Block Model is a promising new teaching approach in nursing and midwifery education, with potential benefits for learner engagement, retention and pass rates.

Preparing for practice, the effects of repeated immersive simulation on the knowledge and self-efficacy of undergraduate nursing students: A mixed methods study.

AIM: The aim of this study was to compare the effects of two immersive simulation-based education instructional designs, immersive simulation with team deliberate practice and immersive repeated standard simulation, when delivered over the same time on the knowledge and self-efficacy of nursing students. BACKGROUND: Implementing immersive simulation-based education is not without its resource challenges, making it prohibitive for simulation educators to include it in their curricula. Subsequently, there is a need to identify instructional designs that meet these challenges. DESIGN: A two-stage mixed methods approach was used to compare the two instructional designs. METHODS: In stage one, data were collected using questionnaires and differences estimated using analysis of covariance. In stage two, data were collected from two focus groups and analysed using a qualitative content analysis approach. Data were collected as part of a doctoral study completed in 2019 and was analysed for this study between 2022 and 2023. The justification for this study was that the identification of effective designs for immersive simulation remains a key research priority following the increase in allowable simulation hours by the Nursing and Midwifery Council. RESULTS: In stage one, there was no statistical significance in the participant's knowledge or self-efficacy between the models. In stage two, four themes were identified: vulnerability, development of knowledge, development of self-efficacy and preparation for placement. In contrast to stage one, participants reported that the repeated nature of both designs reinforced their knowledge base increased their self-efficacy, reduced their anxiety levels, and helped them to prepare for placement. CONCLUSION: The results inferred that both designs had a positive impact on the participants. Overall, participants reported that it helped them prepare for placements. Based on the findings, wherever possible, repeated immersive simulation-based education designs should be used and not a standalone immersive simulation-based education scenarios. If resources allow, this could be either a repeated scenario, or if there are resource constraints to use, over the same time, immersive simulation with team deliberate practice, or a similar model. Thus, giving a potential return on investment, one that supports simulation educators making those sensitive decisions regarding the inclusion of immersive simulation with team deliberate practice in their curriculum. Further research is needed into this area to ascertain the design features that maximise this impact and support a move away from standalone scenarios to an approach that uses repetitive immersive simulation.

Analysis of the Current Situation and Factors Influencing the Clinical Thinking Ability of Nursing Undergraduates.

Context: Clinical thinking encompasses the critical analysis, judgment, and decision-making pertaining to the existing or potential nursing problems of patients. It plays a pivotal role in effectively executing clinical nursing work in alignment with the prescribed nursing procedures. Proficient clinical thinking empowers nurses with the capability to identify, analyze, and resolve problems. Objective: The study intended to investigate the current situation of clinical thinking ability of nursing students and its influencing factors, so as to improve their clinical thinking ability. Methods: This was a cross-sectional study and the research took place at Taizhou University in Taizhou, Zhejiang province, China in the Faculty of Nursing. 143 full-time undergraduate nursing students at the University were selected for the cross-sectional survey, including a general questionnaire and a clinical thinking ability questionnaire for undergraduate nursing students. The respondents included nursing students in their sophomore, junior and senior years. Results: The survey results obtained between the first and the third year of study were included. Age of the participants ranged from 18 to 24 years, with an average age of 21.58 ± 2.45 years. The professional knowledge score of undergraduate nursing students in this survey was found to be 52.59 ± 13.93; ​the score of professional emotion was 14.21 ± 2.40; ​the score of professional will was 19.51 ± 2.15; ​the score of professional values was 14.40 ± 2.31; ​the professional skill score was 18.52 ± 2.06; the professional expectation was found to be 12.73 ± 1.30; and ​the total score was (99.26 ± 7.96). All dimensions and total scores of clinical ability of thinking among undergraduate nursing students in this survey were found to be average. Conclusions: Clinical thinking of undergraduate nursing students is found to be of a medium level, and the main influencing factors are grade and the satisfaction of teachers. Nursing colleges and practice hospitals should unite to adopt various ways to help nursing undergraduates cultivate and improve their clinical thinking ability.

Facilitating a Virtual International Experience for Undergraduate Students: Creating Global Awareness and Connection.

BACKGROUND: Preparing nursing students for practice is supported by developing a global perspective of health care delivery models. However, many schools of nursing and students lack the resources for study abroad. METHOD: Using a virtual stay-in place model, 42 international students applied an evidenced-based approach to study statistics, research, transitions in care, and elder care models that supported collaboration among peers from Austria, Switzerland, Chile, the United Kingdom, and the United States. Students explored social, economic, and reimbursement factors not encountered in the typical classroom. RESULTS: Student beliefs and perspectives changed after completing a program with global peers. Survey results and themes in reflection papers indicated increased ability to conceptualize content in new ways, including holistic elder care, cultural practices and reimbursement options, and effects on future practice. CONCLUSION: Virtual international learning experiences are an effective education innovation that allows student to connect and learn from one another using a stay-in place model. [J Nurs Educ. 2023;62(11):647-649.].

Sounds good to me: A qualitative study to explore the use of audio to potentiate the student feedback experience.

BACKGROUND: The provision and uptake of feedback on academic performance is widely debated throughout higher education. Whilst many educators strive to provide students with suitable feedback on their academic work, it is often reported that the feedback is frequently not delivered in a prompt or detailed manner or is not acted upon by students. Traditionally feedback has been delivered in writing, and this study investigates the potential value of an alternative method by providing formative feedback using short audio clips. AIM: The aim of the study was to determine baccalaureate student nurses' perceptions of the influence of audio feedback on the quality of their academic work. METHOD: This is a qualitative descriptive study conducted online to determine the perceived usefulness of formative feedback. A cohort of baccalaureate nursing students (n = 199) in one Higher Education Institution in the Republic of Ireland were offered audio and written feedback on an academic assignment. Following receipt of the feedback participants completed an anonymous online questionnaire exploring their perceptions of the usefulness of audio and written feedback. The questionnaire was analysed using a thematic analysis framework. RESULTS: Thematic data analysis identified four themes: connectivity, engagement, enhanced understanding, and validation. Findings indicate that both audio and written feedback on academic work were perceived to be beneficial, however almost all of the students indicated an overwhelming preference for audio feedback. A sense of connectivity between the lecturer and the student, created through the provision of audio feedback, was the prevailing theme throughout the data. Written feedback conveyed the relevant information, but the audio feedback was more holistic and multi-dimensional and included an emotional and personal quality to which the students responded positively. CONCLUSIONS: What has not been explicitly highlighted in earlier studies but is apparent in this study, is the centrality of this sense of connectivity as a motivator to student engagement with the feedback received. Students perceive that the engagement with the feedback enhances their understanding of how they might improve their academic writing. An enhanced link between the student and the academic institution during clinical placements, achieved by the audio feedback, was a welcome and unexpected finding beyond the aim of this study.

The effect of laughter yoga applied before simulation training on state anxiety, perceived stress levels, self-confidence and satisfaction in undergraduate nursing students: A pragmatic randomized controlled trial.

AIM: This study aimed to examine the effect of laughter yoga applied before simulation training on state anxiety, perceived stress levels, self-confidence and satisfaction in undergraduate nursing students. BACKGROUND: Clinical simulation-based teaching implied a revolution in nursing education. Along with the many opportunities that simulation offers, some disadvantages, such as anxiety and stress experienced during simulation scenarios, could affect students' satisfaction and self-confidence in learning. Therefore, laughter yoga could be an alternative method that reduces students' anxiety and stress levels and increases their self-confidence and satisfaction with simulation training. DESIGN: The study was designed as a pragmatic randomized controlled trial. SETTING: This study was conducted at a university in Turkey. PARTICIPANTS: A total of 88 undergraduate nursing students were randomized to the intervention group (n = 44) or control group (n = 44). METHODS: The intervention group participated in the laughter yoga sessions just before the clinical simulation scenario, while the control group only performed the simulation training. The researchers examined the effect of laughter yoga on state anxiety, perceived stress levels, self-confidence and satisfaction in learning before and after the intervention. Data were collected between January - February 2022. RESULTS: This study showed that the mean scores of state anxiety, perceived stress, mean pulse rate and arterial pressure of the intervention group were significantly lower than those of the control group (p < 0.05). In addition, there was also a significant group*time interaction between the groups on state anxiety, perceived stress, pulse, respiratory and mean arterial pressure scores (p < 0.05). Moreover, the mean scores of student satisfaction and self-confidence in the learning of the intervention group were significantly higher than those of the control group (p < 0.05). CONCLUSION: The findings showed that laughter yoga helped nursing students reduce their state anxiety and perceived stress levels related to simulation training and improved their self-confidence and satisfaction with learning. Additionally, it enhanced the students' vital signs (including mean pulse rate and mean arterial pressure). These positive results are promising for using LY as an easy, safe and effective method to reduce undergraduate nursing students' stress and anxiety levels and to improve their learning satisfaction and self-confidence levels in clinical skills training such as simulation training.

The use of educational technology in teaching and assessing clinical psychomotor skills in nursing and midwifery education: A state-of-the-art literature review.

BACKGROUND: An integral part of both undergraduate and postgraduate nursing and midwifery programmes, is the teaching and assessment of clinical psychomotor skills. In order to provide safe care, there is an expectation that technical nursing procedures are performed competently and effectively. Due to limited opportunities to practice clinical skills there is a challenge to advance and implement innovative teaching approaches. Technological advances provide us with alternative options, outside of the traditional teaching approaches, to teach these skills. OBJECTIVE: The aim of this state-of-the-art review was to examine and provide an overview of the current use of educational technologies in nursing and midwifery education in teaching clinical psychomotor skills. METHODS: A-state-of -the-art literature review was carried out, as this type of evidence synthesis design reveals the current knowledge on a topic and identifies gaps for future research. We used a focused search strategy with the expertise of a research librarian. Data extraction included research designs and educational theories guiding the included studies along with the type of technologies studied. A descriptive summary of each study's findings in relation to the educational outcomes was performed. FINDINGS: Sixty studies were sourced which met this reviews' eligibility criteria. Technologies in which most research was carried out included; simulation, video and virtual reality. The most common research design noted included randomized or quasi-experimental studies. The vast majority of studies (n = 47) did not elaborate whether educational theories guided them, while of the remaining thirteen studies, eleven theoretical frameworks were reported. CONCLUSION: Technology use in nursing and midwifery educational research surrounding psychomotor skills education is present. The educational outcomes reported by the majority of studies on the use of educational technology in teaching and/or assessing clinical psychomotor skills are encouraging. Additionally, the majority of studies noted that students evaluated the technology positively and were satisfied with its use in their education. Future research may include evaluating the technologies in both undergraduate and postgraduate populations. Finally, opportunities exist to expand the evaluation of student learning or assessment of these skills using technologies from the educational environment to the clinical environment. REGISTRATION: Not registered.

The effect of professional portfolio learning on nursing students' professional self-concepts in geriatric adult internship: a- quasi-experimental study.

BACKGROUND: Professional self-concept is one of the important outcomes of nursing professionalism. There is a lack of adequately planned curriculum may limit nursing students' practical knowledge, skills and professional self-concept in providing comprehensive geriatric-adult care and promoting nursing professionalism. Professional portfolio learning strategy has allowed nursing students to continue professional development and enhance nursing professionalism in professional clinical practice. However, there is little empirical evidence in nursing education to support the use of professional portfolios in blended learning modality among internship nursing students. Therefore, this study aims to examine the effect of the blended professional portfolio learning on professional self-concept among undergraduate nursing students during Geriatric-Adult internship. METHODS: A quasi-experimental study two-group pre-test post-test design. A total of 153 eligible senior undergraduate students completed the study (76 in the intervention group and 77 in the control group). They were recruited from two Bachelor of Sciences in Nursing (BSN) cohorts from nursing schools at Mashhad University of Medical Sciences (MUMS), in Iran, in January 2020. Randomization was undertaken at the level of school via a simple lottery method. The intervention group received the professional portfolio learning program as a holistic blended learning modality, though the control group received conventional learning during professional clinical practice. A demographic questionnaire and the Nurse Professional Self-concept questionnaire were used for data collection. RESULTS: The findings imply the effectiveness of the blended PPL program. Results of Generalized Estimating Equation (GEE) analysis was indicated significantly improved professional self-concept development and its dimensions (self-esteem, caring, staff relation, communication, knowledge, leadership) with high effect size. The results of the between-group comparison for professional self-concept and its dimensions at different time points (pre, post and follow up test) showed a significant difference between groups at post-test and follow up test (p < 0.05),while at pre-test there was no important dissimilarity between two groups (p > 0.05).The results of within-group comparison for both control and intervention showed that there were significant differences in professional self-concept and for all its dimensions across the time from pre-test to post-test and follow-up (p < 0.05), and also from post-test to follow-up it was significant (p < 0.05) for both groups. CONCLUSION: This professional portfolio learning program demonstrates as an innovative and holistic blended teaching-learning approach to improve professional self-concept during professional clinical practice among undergraduate nursing students. It appears that the use of a blended designed of professional portfolio can promote a link between theory and the advancement of geriatric adult nursing internship practice. The data obtained from the present study can be useful for nursing education to evaluate and redesign a curriculum for development of nursing professionalism as a quality improvement process and groundwork to develop new models of teaching-learning and assessment.

Students as researchers: An example of high-level participation of undergraduate midwifery students as co-investigators in research.

BACKGROUND: There is a shift in focus of the curricula of undergraduate midwifery research-education - from research content to the research process, and the student from being an observer to a participant. AIM AND METHODS: To explore an example of how to involve midwifery students as co-investigators in research. This paper discusses the experiences of an educational research project that adopted the highest level of student autonomy in research, involving six Bachelor of Midwifery final-year students participating as co-investigators in qualitative research focusing on women's lived experiences of traumatic childbirth. The experiences are supported by the parameters of research-education and learning, and are discussed in the context of the dimensions of framing undergraduate research: Motivation, Inclusivity, Content, Originality, Setting, Collaboration, Focus and Audience DISCUSSION: Crucial for this educational research project is the recognition of the motivation, interests, (experiential) knowledge and real-world experiences of students. It starts with listening to the questions, thoughts and ideas that students bring, recognising and respecting the content and importance of their work and what is important and meaningful to them, while facilitating a student-led learning process. Collaboration between students and students and supervisors needs to be formally facilitated and supported, as this contributes to qualitative products for curricular and extra-curricular products. An academic infrastructure is necessary to support extra-curricular activities. CONCLUSION: To embed research adequately and effectively in the curriculum, a pedagogical approach, institutional learning and student-centred teaching strategies and practices, including high impact practices to mainstream undergraduate research and enquiry, are crucial.

Self-Care Skills to Prevent Burnout: A Pilot Study Embedding Mindfulness in an Undergraduate Nursing Course.

Background Burnout negatively affects nurses and increases nursing turnover. Many student nurses experience burnout throughout their academic program, negatively affecting student success and patient care. Objectives To explore effects of mindfulness education / self-care skills training in undergraduate nursing students on stress and self-care. Design A four-week pilot with four-week follow-up. Setting In-person mindfulness sessions were offered to first-year nursing students. Participants 67 students enrolled in a nursing skills course. Methods Four in-person mindfulness educational sessions were provided with a 4-week follow-up. Outcomes were stress and self-care, measured by the Perceived Stress Scale and Mindful Self-Care Scale at pre-, post-, and follow-up. Results 58 (86.6%) completed pilot; mean age = 22.8 (5.75), majority females (84%) and Caucasian (79%). Students practicing one or more mindfulness techniques at least 8 times outside class increased self-care 9.5% pre- to post-intervention (p = .01), although not sustained at follow-up. Stress did not change significantly in either direction (p = .94), potentially mediating the stress of starting clinical immediately following the intervention. Conclusions Mindfulness education increased self-care in first-year nursing students who practiced mindfulness outside class. Recommendations include further research and integration of mindfulness into courses to assess benefits and coping skills for future nurses.

Building Spiritual Care Competency in Undergraduate Psychiatric Mental Health Nursing Students: A Quality Improvement Project.

Purpose: The spiritual care of patients is often overlooked in health care as many nurses are unprepared to provide competent, holistic care that addresses patients' spiritual needs. Since undergraduate academic instruction prepares nurses for practice, innovative strategies that train pre-licensure nurses to care for the spiritual needs of patients are essential. Design: A course needs assessment identified spiritual care as the most deficient competency for undergraduate psychiatric students. A three-phase quality improvement project designed to increase student awareness and practice of spiritual care included (a) development of a quality improvement plan, (b) implementation, and (c) outcome evaluation. Methods: Spiritual care was introduced into the Spring 2020 semester through didactic content and experiential practice. Additionally, an evidence-based spiritual assessment tool (i.e., HOPE questions) was integrated into the course to train students for use in clinical and simulation. Surveys were used to compare the 2019 and 2020 cohorts. Findings: Results showed a statistically significant increase in students' perception of spiritual care competency after project completion. Conclusions: Future implications include the use of similar methods to improve spiritual care competency for pre-licensure nursing students. Keywords: Spiritual care, undergraduate nurse, spiritual assessment.

Implementing a Spiritual Care Subject for Holistic Nursing Practice: A Mixed Method Study.

Aim: The aims of this sequential explanatory mixed method study were twofold 1. Firstly, to evaluate the implementation of a spiritual care subject in a nursing program. 2. Secondly, to examine undergraduate nursing students' perceptions of providing spiritual care within their holistic care practice. Background: Studies conducted internationally indicate many nurses feel inadequately prepared to provide holistic care inclusive of spiritual care due to insufficient spiritual care education. Design: Two phase, sequential explanatory mixed method design which comprised of a quantitative study followed by a qualitative study. Methods: The setting was an Australian faith-based university. Participants comprised of undergraduate nursing students who were enrolled in a spiritual care subject. Findings: Two study findings emerged: 1. Participants' knowledge and practice of spiritual care were transformed by the spiritual care subject, and 2. The spiritual care subject broadened perceptions of spiritual care so participants viewed themselves more equipped to provide spiritual care in their holistic care provision. Conclusion: The spiritual care subject had an affirmative influence on participants' perceptions of providing spiritual care within holistic care practice. The findings have implications for nurse educators to consider how spiritual care content can be included within undergraduate nursing curricula.

The Use of Educational Technology in Undergraduate and Postgraduate Nursing and Midwifery Education: A Scoping Review.

Technology has become integral to our personal and professional lives. Its use is increasing in healthcare, both in clinical and educational settings, with healthcare institutions and regulatory bodies recognizing that technology is ever-present. The aim of this scoping review was to examine and quantify the current evidence concerning the use of educational technologies in undergraduate and postgraduate nursing and midwifery education. This review was guided by the JBI methodology for scoping reviews. A tailored search strategy was developed with a research librarian and a number of databases were searched. A total of 19 638 literature sources were screened by three reviewers. Literature published from January 2016 to December 2020 was included and limited to the English language. The reporting of the review process is guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Scoping Reviews checklist. This review provides an overview of the current use of educational technologies within nursing and midwifery education; it provides a list of the technologies used, the research methodologies and designs undertaken, and the educational theories, models or frameworks considered. The review highlights the wide range of technologies in use and the paucity of studies that are guided by an educational theory, model or framework.

Current Situation and Factors Influencing the Disaster Response Capability of Undergraduate Nursing Students.

Context: China is a country in which frequent natural disasters occur, but there is a lack of disaster education in Chinese institutions of higher education. Nursing students should receive disaster and emergency training in addition to their professional medical training. Objective: Our study aimed to investigate the current situation and disaster knowledge and training needs of nursing students and to increase the disaster first aid knowledge of college nursing students. Design: This was a cross-sectional study. Setting: The study took place at Taizhou University in Taizhou, Zhejiang, China. Participants: Participants were 443 full-time undergraduate nursing students at Taizhou University in China. Outcome Measures: This cross-sectional survey included a general questionnaire and an undergraduate nursing student disaster nursing ability questionnaire. Results: The survey results were from the first to the third year of study. Students were age 20 to 23 years, with an average age of 20.57±1.85 years. The largest group (35.44%) was made up of juniors. The scores of 3 dimensions of this survey were: dimension of physical and mental quality dimension (3.76 ± 0.71), theoretical system dimension (3.00 ± 0.57) and practical competencies dimension (2.89 ± 0.68). The ability to adapt to rescue needs at the disaster site and whether or not the student had heard of the term "disaster nursing" is the dominant factor affecting the disaster nursing skills of undergraduate nursing students. Conclusions: The disaster relief of male undergraduate nursing student seniors is more positive and their physical and mental quality is better than female nursing students, but knowledge of disaster prevention and practical capability in disaster relief remain weak and there is a lack of a corresponding theoretical system and competence in practical knowledge and skills. It is recommended that systematic disaster nursing education at universities be improved. Knowledge of disaster rescue should be taught systematically to improve awareness of disaster procedures and response and improve the level of practical skills in disaster rescue. We should learn from the educational approach and models of disaster nursing training in developed countries in order to establish a disaster nursing education model in China.

Critical thinking development in undergraduate midwifery students: an Australian validation study using Rasch analysis.

BACKGROUND: Well-developed critical thinking skills are required to provide midwifery care that is safe, evidence-based, and woman-centred. A valid, reliable tool to measure is required the application of critical thinking in midwifery practice. The Carter Assessment of Critical Thinking in Midwifery (CACTiM) has previously been psychometrically assessed using classical methods at a single site. This study aims to further evaluate the properties of CACTiM tools using Rasch analysis in a diverse group of midwifery students and preceptors.  METHODS: The CACTiM tools were completed by undergraduate midwifery students studying at three Australian universities and their preceptors. Midwifery students' critical thinking was evaluated separately through student self-assessment and preceptor assessment and then matched. Rasch analysis was used to evaluate the validity of the tools.  RESULTS: Rasch analysis confirmed both the preceptor and student CACTiM tools demonstrated good reliability and unidimensionality. The items can differentiate between students' ability to apply critical thinking in midwifery practice. Person reliability and item reliability were above .92 for both scales indicating excellent reliability and internal consistency. Several improvements were identified to the tools, including enhanced wording to some items, and reduction to a 5-point Likert scale. Through analysis of lower-scoring items, midwifery programs can identify curricula enhancements. CONCLUSION: The CACTiM student and preceptor tools are valid and reliable measures of critical thinking in midwifery practice. The tools can assess students' critical thinking abilities and identify areas for development for individuals and across student cohorts through curricula enhancements.

Domains of competence in midwifery students: a basis for developing a competence assessment tool for iranian undergraduate midwifery students.

BACKGROUND: Current study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students. METHODS: Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth. RESULTS: Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20-56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories. CONCLUSION: The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.