[Implementation of reference frameworks at nursing schools - A qualitative study on beneficial and hindering factors]. / Implementierung der Rahmenpläne für die Pflegeausbildung ­ eine qualitative Studie zu förderlichen und hinderlichen Faktoren.

BACKGROUND: The reference frameworks that have been developed for the first time by the Specialist Committee in accordance with Sect. 53 of the German Nursing Professions Act follow a new didactic-curricular structure and are intended to support the nursing schools in creating their own curricular documents. RESEARCH QUESTION/OBJECTIVE: The commissioned study investigated hindering and promoting factors in the implementation of reference frameworks at nursing schools. METHODS: Expert interviews (n = 16 pair interviews) were conducted with teachers responsible for curriculum development (n = 32) at nursing schools and analysed deductively using qualitative content analysis. Internal school curricula (n = 15) were subjected to a criteria-based document analysis. The results were used to establish implementation types based on the degree of completion of the curricula and the implementation of the new didactic-curricular structure. RESULTS: Four implementation types were identified: reform-oriented implementation, partially reform-oriented implementation, traditional implementation and lack of implementation. The key factors for a reform-oriented, successful implementation include the supportive behaviour of the school administration & management, the acceptance of the novel vocational education & training in nursing and the opportunity to take part in further trainings. DISCUSSION: The implementation types identified are largely characterized by the supportive behaviour of the school administration & management as well as the acceptance and knowledge of the teaching staff. The opportunity to take part in further training courses in order to deal with the reformed vocational education and didactic-curricular recommendations is a central implementation factor. CONCLUSION: All federal German states should set up funding programs for the didactic and curricular requirements for the new vocational education & training in nursing in order to specifically promote the implementation of the reference frameworks.

The growth and development of a novel distance accelerated bachelor of science in nursing program.

Severe nursing shortages threaten the sustainability of US health systems. Rural and underserved communities are disproportionately affected by staffing crises and associated facility closures, as well as health disparities. A major factor contributing to geographic gaps in care is the absence of nursing schools, nursing faculty, and locations for clinical rotations in many rural and underserved areas. Emory School of Nursing is helping to solve for these issues through the Distance Accelerated Bachelor of Science in Nursing (DABSN) program. The DABSN is establishing accelerated pipelines of nursing students into practice in locations where nursing education has historically been difficult or impossible to access. This innovative nursing education model allows students to enroll in a top-ranked nursing school while remaining in their home communities. Students complete synchronous didactic coursework with peers in every US time zone while performing clinical rotations in local healthcare facilities. This paper details the growth and development of the DABSN. It describes the challenges and opportunities we have navigated in implementing the program, along with information about its pedagogy, clinical placement practices, and student/faculty characteristics. We share program outcomes and conclude with recommendations for the future.

Unifying a school of nursing: Developing a framework to guide nursing education.

For one School of Nursing in a mid-sized, urban, private, liberal arts university in the upper Midwest, internal and external factors coalesced, requiring the reassessment/alignment of the baccalaureate, masters, and doctoral programs with professional standards/competencies and institutional mission/values. The development process of a new curricular framework to conceptually support the curriculum within the School of Nursing was reflective of participatory inquiry. The process closely followed the principles of the nursing complexity leadership model, complexity science, and improvement science. The new curricular framework grounds the School of Nursing's programming in a shared mental model through three functional definitions and six guiding constructs. The curricular framework development from this collaborative effort provides consistency for future curricular development and design across and within each program in the School of Nursing, shaping who we are, who we are educating, and the vision we see for our future.

Social entrepreneurship and public health nursing knowledge: Opportunities for innovating nursing education in population health.

Public health nursing (PHN) competencies are fundamental for addressing population health inequities. Few pathways exist for employing these competencies in the United States (US). Social entrepreneurship in nursing education might provide opportunities for innovating engagement in population health. Partnerships between business and nursing schools have the potential to fulfill this opportunity. PURPOSE: Explore opportunities for re-invigorating public health nursing through social entrepreneurship education in nursing-business partnerships in U.S. universities. METHODS: Reviewed programs in nursing/business school partnerships from Carnegie-classified R1 Universities. Identified appropriate coursework. RESULTS: Of 96 identified nursing schools, eight had business school partnerships, providing 12 programs. Most programs (n = 11) targeted graduate students and addressed core competencies for entrepreneurship. Five business schools had entrepreneurship expertise. Five nursing schools had PHN expertise. Three programs included population health competencies. DISCUSSION: Despite missed opportunities for advancing social entrepreneurship education among undergraduate and graduate nursing students, existing curricular offerings in the partnerships provide promise. Business/nursing partnerships and PHN knowledge can stimulate the preparation and agency of nurses in addressing population health inequities.

Embarking on a cultural transformation within a school of nursing.

Schools of Nursing across the country are encountering fiscal, programmatic and leadership challenges exacerbated by chaos and fragmentation in health care systems. This article focuses on the transformation journey of the School of Nursing at the University of Minnesota highlighting the complex context of higher education, challenges faced, and strategies executed that focused on significant and sustained culture change. Recommendations are offered to enable all schools to embark on their own transformative journeys.

Commission on collegiate nursing education standards inspire a new model of shared governance.

PURPOSE: A school of nursing re-envisioned its faculty organization structure and created a Shared Governance model based on the Commission on Collegiate Nursing Education Standards (CCNE). The model promotes shared decision-making and encourages nursing faculty and staff to exercise greater control over their professional endeavors. PRINCIPAL RESULTS: The Shared Governance model launched as a one semester pilot before it was formally adopted by faculty. Faculty and staff are organized into four councils, each one representing the CCNE standards: Governance, Institutional Resources, Curriculum, and Quality. The Academic Leadership Team meets regularly with Shared Governance Council Chairs to foster communication and ensure a cohesive, proactive approach to conducting school of nursing business. MAJOR CONCLUSIONS: The Shared Governance model has provided an excellent mechanism for new school of nursing faculty and staff to become oriented to their roles and the culture of academia. It has broken down silos and increased connections across programs and campuses. Ongoing conversations about the priority work of the school of nursing and each council's coordinated effort to document fulfillment of the Standards gave structure to preparation for our accreditation visit. The accreditation process is no longer seen as the sole responsibility of the Dean and Associate Deans.

Leadership qualities faculty desire in academic leaders: An international Delphi study.

BACKGROUND: The global nursing workforce is confounded by shortages of nurses, faculty, and academic nursing leaders. Nursing academic leaders influence faculty recruitment and retention influencing the enrollment pipeline to fill nurse workforce capacity. OBJECTIVE: To identify leadership qualities nursing faculty prefer in nursing academic leaders globally. DESIGN: A multi-country exploratory design employed a three-round Delphi process including Demographic Data and open-ended questions. SETTING: An online Qualtrics survey was emailed to schools of nursing selected from seven global regions: United States (North America), Mexico (Latin America/ Caribbean), South Africa (Africa), Saudi Arabia (Middle East), Korea (Asia), Sweden (Europe), and Australia (Oceania). PARTICIPANTS: A convenience sample of faculty members employed in schools of nursing in the seven countries. METHOD: A 43-item Qualtrics survey developed from literature review of leadership qualities of nursing academic leaders was distributed to nursing faculty who participated in three Delphi rounds using descriptive statistics to analyze each round. Open-ended questions were analyzed using qualitative descriptive analysis. RESULTS: In Round 1, 54 faculty rated the 43 leadership qualities using a Likert Scale, identified the top 10, and added additional qualities not in the list. In Round 2, 26 of the original participants rated the resulting 29 leadership qualities. In Round 3, 16 of the original participants ranked their top 8 leadership qualities: mutual trust and respect; clear communication; creating a cohesive culture; assuring diversity, equity, and inclusivity; integrity; developing effective team structure; effective decision-making; and leading by example. In Round 3 participants rated nurses' preparedness for academic leadership. Open-ended questions identified 1) Strategies to prepare nurses for academic leadership roles and 2) Essential characteristics for effective academic leaders. CONCLUSION: Developing key leadership skills can increase the leadership capacity of nursing academic leaders, enhancing work environments, faculty recruitment and retention, helping mitigate a global challenge.

History of Midwifery at Tuskegee: Vanguards of Midwifery Education.

Tuskegee, in Macon County, Alabama, has played an important role in Alabama's midwifery legacy and was home to 2 different midwifery education programs from the 1920s through the 1940s. In response to a 1918 state law requiring midwives to pass an examination to receive a practice permit in their county, stakeholders developed a four-week course for Black Alabamian midwives on the grounds of Tuskegee Institute at the John A. Andrew Memorial Hospital. In the 1940s, in the same location on the grounds of Tuskegee Institute, the Tuskegee School of Nurse-Midwifery educated Black nurse-midwives to improve Black maternal and neonatal outcomes in the South.

Leadership styles and personal values of professors at a school of nursing.

OBJECTIVES: to identify professors' leadership styles and personal values. METHODS: a quantitative, descriptive-exploratory study. Population was made up of professors in doctoral category 1 at a public university in the state of São Paulo. Data collection took place from June to August 2021. Sociodemographic characterization was extracted, and the Leadership Team Values Assessment was applied. Data were analyzed using measures of central tendency. RESULTS: population included 13 professors. The level that represents authentic leadership was the most prevalent. The commitment, positive attitude and trust values stood out. The level portrayed by visionary leadership was the least identified. CONCLUSIONS: professors' personal values provide a theoretical basis for guiding and analyzing professors' leadership styles. Leadership in the educational context must be recognized and studied to promote a more comprehensive and effective approach to developing and improving educational leaders.

Sustainable Academic-Clinical Alliance: A Model to Improve Academic-Practice Partnerships.

Background: National nurse shortages, ongoing nurse faculty retirements, and a dearth of clinical sites make it challenging to prepare advanced practice registered nurses (APRNs) who are ready to transition into independent provider roles, especially in acute care settings. One of the most effective ways to address these experiential learning challenges is for academic institutions and healthcare systems to form collaborative academic-practice partnerships. However, many partnerships between schools of nursing and healthcare institutions have found numerous challenges, including time to devote to the partnership, funding of ideas, competing initiatives and needs, and sustainability. Objective: The University of Maryland School of Nursing (UMSON) set out to expand the traditional academic-clinical partnership approach with a new collaborative model. Methods: Rather than both parties coming to the table with their own goals, the partnership focused on intentional relationship building, transparency, measurable outcomes, and sustainability. This model, further called the Sustainable Academic-Clinical Alliance (SACA), assures that both sides of the partnership benefit. The SACA model was used to create an academic-practice partnership with the University of Maryland Upper Chesapeake Health System in order to increase APRN clinical practice sites and readiness of APRN students to provide care across the continuum in the state of Maryland. Results: Since July 2016, the SACA model has enabled over 40 clinical providers in over 20 different clinical areas to offer 329 different clinical and nonclinical experiences to APRN students from UMSON. At the end of the 5-year alliance, 150 unique UMSON APRN students completed 257 different clinical rotations. Conclusion: The SACA model effectively promotes the development and achievement of sustainable academic-practice partnerships by focusing on (a) intentional relationship building, (b) transparency in goal setting and alliance maintenance, (c) development of outcome measures, and (d) sustainability. Implications for Nursing: The components of the SACA model made sustainability more achievable, which has eluded previous academic-clinical partnerships. This model can serve as a blueprint for other academic and healthcare institutions to establish sustainable academic-practice partnerships.

Nursing students' approaches to learning in selected Malawian nursing schools: a cross-sectional study.

BACKGROUND: Students' approaches to learning are of essence in nursing education. This is because nursing is a profession where classroom learning leads to clinical performance. Although the literature recognizes student's approaches to learning as a significant aspect affecting the quality of students' learning, studies suggest that quality of learning has not been highly achieved in Malawian nursing colleges. Currently, there is a scarcity of empirical data on the learning approaches that Malawian nursing and midwifery students in nursing colleges employ. This study assessed the different approaches to learning among nursing and midwifery students in selected Malawian nursing colleges. METHODS: This was a cross- sectional study that employed quantitative methods. The target population was nursing and midwifery students pursuing nursing diplomas from Nkhoma College of Nursing, Ekwendeni College of Health Sciences and Malawi College of Health Sciences. A total of 251 students were sampled randomly from the three nursing colleges. Data was collected through a self-administered questionnaire (R-SPQ-2 F) by Biggs. The data was analyzed using chi-square and binary logistic regression. In this study Cronbach's alpha was 0.6. RESULTS: Most students had used a deep approach to learning (M = 3.201, SD = 0.623) than the surface approach (M = 2.757, SD = 0.732). Being in the age category of 16-20 had more likelihood of adopting a surface approach to learning compared to other age categories (X2 = 7.669, DF 2, P = .02). Students from Malawi College of Health Sciences were more likely to adopt a surface approach to learning compared to students from Nkhoma Nursing College and Ekwendeni College of Health Sciences (X2 = 12.388, df = 2, P = .002). CONCLUSION: A deep approach to learning emerged as the most preferred approach to learning which indirectly implies that most students attain meaningful learning. Age and environment are some of the key determinants associated with different learning approaches. More attention should be given to younger students during teaching and learning to promote deep learning.

Implementation of the São Paulo Nursing Courses Consortium for the Progress Test: experience report.

OBJECTIVE: To report the experience of implementing the São Paulo Nursing Courses Consortium for the Progress Test. METHOD: This is an experience report of the consortium's work in Progress Test preparation and application for Public Schools of Nursing in São Paulo in 2019, 2021 and 2022, with a descriptive analysis of the work process and the results obtained. RESULTS: The consortium's activities are structured into the following stages: planning; theme review; distributing and requesting questions; professor training; question elaboration; question reception; question selection; question validation; student registration; test application; analysis and dissemination of results. A total of 57.3% of enrolled students participated. There was a predominance of questions of medium difficulty and a gradual progression in the level of discrimination of the questions, with, in 2022, 82.5% being considered adequate. FINAL CONSIDERATIONS: The consortium has allowed the test to be applied interinstitutionally, with greater scope, accuracy, and quality of questions. Through this experience, it is expected to encourage progress testing in undergraduate nursing courses in other contexts.

How is feedback perceived by Brazilian students and faculty from a nursing school?

AIM: This study aims to explore the perceptions of feedback among undergraduate students and faculty members at a Brazilian private nursing school. BACKGROUND: Feedback plays a crucial role in the socioemotional development of learners, with its interpretation varying across different sociocultural contexts. Student evaluations frequently express dissatisfaction regarding both the quality and quantity of feedback received. Conversely, delivering feedback poses a challenge for faculty, requiring the establishment of an empathetic connection that fosters trust and credibility. Brazil, being a developing country characterized by social disparities and economic challenges, presents a unique backdrop for examining feedback dynamics. DESIGN: Qualitative research, employing Inductive Content Analysis, was used to understand feedback perceptions in Brazilian nursing education. Symbolic interactionism was adopted as methodological framework and guided data interpretation. METHODS: We carried out five virtual focus groups composed of a group of teachers (n=5) and four of students (n=34). Semi-structured interviews guided data collection. The recorded sessions were subsequently analyzed to identify key themes and codes. Symbolic interactionism was employed as a framework to derive meaning from qualitative data. RESULTS: Content analysis generated two categories that reveal the perception of teachers and students in the feedback process. The first, called "Feedback in Education: Sociocultural Influences for Students and Teachers", expresses the beliefs and interpretations of students and teachers within the shared feedback environment. The second called "Challenging resonance, transformative construction: Navigating the dualities of feedback for teachers and students", which elucidated how relational dynamics shape behaviors and attitudes, promoting the development of social skills and learning. Faculty's previous feedback experiences significantly influence their self-perception and behavior with students. As a result of the resonance of these past interactions, we recognize that the teaching self also plays a crucial role in the quality and perception of feedback. Furthermore, students construct social reality with similar beliefs and values, they believe in the learning potential generated by feedback. Our findings also corroborate that perceptions of feedback are deeply influenced by the sociocultural context and the narratives corroborate previous findings indicating that, in Brazil, honest feedback can be implicitly perceived as criticism rather than an opportunity for growth. CONCLUSIONS: Faculty members often draw on their past experiences when providing feedback, highlighting the adaptive nature of feedback interactions. Additionally, the feedback process is consistently influenced by the commitment to maintaining positive relationships with students. Students recognize the constructive dimension of feedback as a valuable tool for learning and personal growth.

Reimagining the Future of Clinical Nursing Education: A Cohort Partnership Model.

BACKGROUND: As the demand for registered nurses increases, innovative methods for stabilizing, improving, and ensuring the longevity of quality clinical nursing education should be considered. Traditionally, full-time nursing faculty teach nursing students in clinical settings. PROBLEM: Considering the impending nurse educator crisis, characterized by increasing demands on a dwindling nursing faculty, traditional approaches to clinical nursing education are no longer feasible. APPROACH: A new clinical cohort model (CCM), developed from an academic/health system partnership, is proposed as an innovative approach to future clinical nursing education. OUTCOMES: CCM implementation resulted in a significant reduction in the cost of educating nursing students. The health care system noted a 100% postgraduation 2-year retention rate among cohort students. Nursing students overwhelmingly expressed satisfaction, comfort, and new opportunities through participation in the CCM. CONCLUSIONS: This new CCM has significant benefits for schools of nursing, health care systems, and nursing students.

Ensuring robust OSCE assessments: A reflective account from a Scottish school of nursing.

AIM: This paper reflects on the experience of one Scottish University in conducting a face-to-face Objective Structured Examination (OSCE) for large cohorts of student nurses. It outlines the challenges experienced and learning gained. Borton's model of reflection frames this work due to its simplicity, ease of application and cyclical nature. BACKGROUND: The theoretical framework for the OSCE is critical thinking, enabling students to apply those skills authentically. OSCE's are designed to transfer classroom knowledge to clinical practice and offer an authentic work-based assessment. DESIGN: Validity and robustness are key considerations in any assessment and in OSCE, the number of stations that students encounter is important and debated. We used a case-study based OSCE approach initially over four stations and following reflection, changed to one long station with four phases. RESULTS: In OSCE examinations, interrater reliability is a necessity, and students expect equity of approach. We identified that despite clear marking criteria, marks were polarised, with students achieving high or low marks with little middle ground. Review of examination papers highlighted that although students' overall performance was good, some had failed in at least one station, suggesting a four-station approach may skew results. On reflection we hypothesised that using a one station case study-based, phased approach enabled the examiner to build up a more holistic picture of student knowledge and skills. It also provided the student opportunity to develop a rapport with the examiner and standardised patient, thereby putting them more at ease. We argue that this approach is holistic, authentic and student centred. CONCLUSIONS: Our experience highlights that a single station, four phase OSCE is preferrable, enabling students to integrate all aspects of the assessment and provides a holistic view of clinical skills and knowledge.

Shared Governance Through Bylaws: Transformation Within a College of Nursing.

BACKGROUND: Enhancing faculty voice and promoting shared governance within academia has long been called for but has not been well-reported. A college of nursing in the midwestern United States identified shortcomings in its organizational structure including lack of faculty voice, communication barriers, lack of faculty participation in decision making, and academic programs operating independently. METHOD: A workgroup was formed to transform the bylaws to promote shared governance, including faculty voice, equality, and engagement. RESULTS: The bylaws were revised and presented to faculty for discussion, further revisions, and vote. The revised bylaws were approved and implemented in August 2021. CONCLUSION: Through transformation of the bylaws, the college's 12-committee structure was reconceptualized to five standing committees and 13 subcommittees. Clear communication lines and cross-committee collaboration was established to break down the former academic program silos. Faculty with primary teaching assignments are equally represented throughout the structure with voice, vote, and responsibility. [J Nurs Educ. 2024;63(5):277-281.].

School of Nursing Climate Commitment: Nursing Faculty Bring Climate to the Classroom.

In 2021, the American Association of Colleges of Nursing (AACN) added "the impact of climate change on environmental and population health" into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year prior, the Nurses Climate Challenge (NCC)-a campaign to educate 50,000 health professionals about health impacts of climate change-launched the School of Nursing Commitment through a series of focus groups and collaborative content development. With an aim of increasing access to knowledge and tools to support education about the health impacts of climate change, the NCC Commitment partners with nursing schools and provides a community of practice. Partner schools use NCC resources in courses and report the number of students educated. Within three years, 61 nursing schools in 30 states joined the Commitment. Participants included academic health centers, research institutions, multi-state schools, and small private colleges, and programs ranged from AD to PhD. Faculty (1) integrated resources into didactic and clinical settings, such as population or organ-system content, leadership, and policy; and (2) used resources to support assignments. In four years, faculty reported educating over 37,700 students, using NCC resources in 439 educational sessions. The Commitment may be valuable for faculty fulfilling AACN Essentials by bringing climate change to the classroom, community, and bedside. Furthermore, the Commitment may be a replicable model for health professional education and inspiring action on climate change.

Equity and inclusivity in the faculty ranks: Our experience with a clinical track.

BACKGROUND: The evolution of nursing education requires a combination of strong academic faculty and expert clinicians. Different professional growth and development pathways are necessary to build a robust faculty with clinical and research expertise. Some schools have implemented a formal clinical track (CT) to complement the traditional tenure track for the professional advancement of CT. METHODS: The article presents a case example of how one institution maintains and advances a strong CT using the Kotter Change Model and discusses future directions. RESULTS: The school's infrastructure for promotion, which follows a similar structure and guidelines as Tenure Track (TT) Promotion and Tenure Guidelines, has led to an increase in the school's scholarly productivity among CT faculty across ranks. Increasing poster and podium presentations as well as publications to a national and international audience results in greater reach and improved reputation for the school, both nationally and internationally. CONCLUSIONS: While there is still work to be done to advance equity and inclusion for nursing CTs, developing and maintaining a CT with system-level structures holds significant value and provides a clear path to promotion, invests in clinical scholarship, and includes clinical faculty as full citizens in academia.