Experiences of Nurses Speaking Up in Healthcare Settings: A Qualitative Metasynthesis.

AIM: To systematically review and synthesise qualitative research on nurses' experiences of speaking up in various contexts and to identify factors facilitating or impeding such a behaviour. DESIGN: This review was conducted as a qualitative metasynthesis, utilising the qualitative meta-ethnography approach. METHODS: A total of 6250 articles were screened. Two reviewers screened titles, abstracts and full texts. A total of 15 studies were included in this review. Researchers conducted a quality appraisal using the JBI critical appraisal checklist for qualitative research. An a priori protocol was created and registered on the Open Science Framework. DATA SOURCES: Literature searches were conducted in five international bibliographic databases (MEDLINE, Embase, PsycINFO, CINAHL and ProQuest Dissertations and Theses Global) and five Korean databases (RISS, KISS, DBpia, KCI and NDSL). RESULTS: Three main themes were identified from the 15 studies used in the metasynthesis: (1) decisional complexity of speaking up, (2) motivators for speaking up and (3) barriers to speaking up. Nurses experienced challenges in speaking up. They were, and continue to be, concerned about negative responses. Hierarchy structure and poor work environment were identified as barriers to speaking up; professional responsibility and a supportive atmosphere were identified as facilitators for speaking up. CONCLUSIONS: This review synthesised nurses' experiences of speaking up and influencing factors. Speaking up is crucial for nurses to improve patient safety, as frontline nurses are ideally positioned to observe early indicators of unsafe conditions in healthcare delivery. IMPACT: Identified motivators and barriers of nurses' speaking-up behaviour offer considerations and opportunities for healthcare leaders and managers. This could lead to improvement in patient safety through the establishment of a safety culture that facilitates nurses' speaking-up behaviour. REPORTING METHOD: The review adhered to the ENTREQ guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution has been made in this review.

The use of photovoice in nursing education: A scoping review.

Given the variety of uses of photovoice in nursing education, the importance of clarifying and describing this method is apparent. This scoping review aimed to explore the evidence on the use of photovoice in nursing education, describe the state of knowledge in this area, and identify knowledge gaps within the existing literature. A comprehensive search was performed in seven databases including MEDLINE, CINAHL, Embase, and Education Full Text. Three gray literature databases (ProQuest Dissertations and Theses Global database, EThOS, and PapersFirst) were also searched. This scoping review was conducted with reference to the JBI scoping review guidelines and reported using the PRISMA-ScR statement. A total of 22 studies published between 2001 and 2022 were included in this scoping review. The findings indicate that photovoice is used globally in nursing education to teach in various courses and content areas within online, hybrid, and in-person environments. Despite the heterogeneity within the definition of photovoice and associated pedagogical strategies, the results of this scoping review suggest that photovoice can serve as an educational tool for nursing students.

Supporting self-determination among internationally educated nurses: a discussion.

Background: The COVID-19 pandemic has exacerbated the global nursing shortage. As the shortage worsens, reliance on internationally educated nurses is expected to increase, presenting challenges and opportunities for health care systems and nurse leaders worldwide. While internationally educated nurses bring cultural and ethnic diversity to domestic workforces, they face significant hurdles in successfully integrating due to racism, discrimination, and isolation, which can have a negative impact on their self-determination. The challenges encountered by internationally educated nurses can not only affect their self-determination, but they can also pose risks to patient safety.Objectives: This purpose of this paper was to examine the extant literature to describe the experiences of internationally educated nurses through the lens of Ryan and Deci's Self-Determination Theory. Another aim was to offer nurse managers and administrators strategies for supporting internationally educated nurses within their health care facilities.Design: Discussion Paper.Conclusions: Health care organizations should allocate time and resources to facilitate the professional transition of internationally educated nurses, promoting their psychological well-being and self-determination by fostering autonomy, competence, and relatedness.

The experience of resilience in newly graduated nurses: A qualitative metasynthesis.

AIM: The aim of the present study was to understand the experiences and perceptions of newly graduated nurses in relation to resilience by providing an interpretive synthesis of the existing qualitative literature on this topic. BACKGROUND: Resilience in newly graduated nurses has been associated with increased satisfaction and decreased turnover. As the experience of resilience is unique to each individual, qualitative studies are well suited to explore this concept, yet the existing data is heterogenous. DESIGN: A qualitative metasynthesis was conducted using a meta-ethnographic approach. METHODS: The search was performed using PubMed, CINAHL, Embase, PsycINFO, ProQuest Dissertations and Theses Global for the English literature and NDSL, KCI, RISS, KISS and DBpia for the Korean literature. The JBI Critical Appraisal Checklist for Qualitative Research was used to assess the quality of studies. An a priori protocol was created and registered on the Open Science Framework (Randall & De Gagne, 2022). RESULTS: The final review included seven articles published between 2008 and 2021. Three main themes were identified: (1) internal experience of resilience; (2) external sources of resilience; and (3) building resilience over time. Subthemes were also identified. CONCLUSIONS: This study indicates that resilience can be developed over time during the period of transition from student nurse to professional nurse and is impacted by personal and organizational influences. The promotion of resilience presents considerations and opportunities for health care leaders and administrators.

The Use of Metaverse in Nursing Education: An Umbrella Review.

BACKGROUND: Given the wide range of metaverse technologies, there is a need to synthesize evidence of metaverse pedagogy used effectively for nursing education. PURPOSE: This umbrella review synthesized systematic reviews on the use of metaverse in nursing education. METHODS: A search was performed in MEDLINE, EMBASE, CINAHL, Web of Science, and Education Full Text. This umbrella review was conducted with reference to the Joanna Briggs Institute (JBI) Reviewer's Manual and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The JBI Critical Appraisal Checklist for Systematic Review was used to assess the quality of studies. RESULTS: The final review comprised 15 articles published between 2013 and 2021, most of which indicate that metaverse interventions support increased knowledge, self-confidence, engagement, satisfaction, and performance in nursing students. Several articles in this review presented mixed findings related to certain learning outcomes. CONCLUSION: This umbrella review supports the viability and effectiveness of metaverse in nursing education.

Exploration of Cyberethics in Health Professions Education: A Scoping Review.

As digital technologies rapidly integrate into Health Professions Education (HPE), understanding cyberethics is increasingly crucial. This scoping review explores the pedagogy of cyberethics in HPE, highlighting a significant gap in explicit definitions and conceptualizations. Additionally, the absence of specific theoretical frameworks in most documents raises concerns about research progression. Only four articles introduce educational interventions in cyberethics, indicating a promising avenue for future research. While comprehensive search methods are employed, limitations, including language biases, exist. Future investigations should broaden the discourse to encompass ethical implications of emerging technologies within HPE. Cultivating comprehensive, culturally sensitive, and inclusive guidelines is vital for ethical digital practices in the health care community.

Effectiveness of speak-up training programs for clinical nurses: A scoping review.

BACKGROUND: Speaking up about patient safety concerns is critical when bedside nurses encounter unsafe situations. Training programs that encourage nurses' speaking up behavior have been introduced, but there is limited evidence regarding whether such training leads to behavior change or improves patient safety. OBJECTIVE: The aim of this review was to identify the effectiveness of speak-up training programs for clinical nurses, focusing on program content and outcomes. DESIGN: A scoping review was conducted using the Joanna Briggs Institute methodology and reported according to the Cochrane and Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews guidelines. METHODS: This study used bibliographic databases of PubMed, Embase, PsycINFO, Scopus, ProQuest Dissertations and Theses Global for the English language, and NDSL, KCI, RISS, KISS, and DBpia for the Korean language. The literature search used a combination of keywords and subject headings related to speak-up training programs for nurses or any type of nurse training program with an assertiveness component. Training outcomes were evaluated according to the 4-level Kirkpatrick model. RESULTS: A total of 4808 references were retrieved, of which 21 articles were selected. These 21 studies were conducted in different parts of the world and published from 1981 to 2020. Speak-up training primarily increased some degree of nurses' levels of assertiveness and speak-up behavior, and also led to secondary outcomes such as job stress, work motivation, and communication conflicts. Most studies (n = 19) applied traditional training formats which consisted of multi-session lectures and practice, whereas three studies applied new methodologies such as high-fidelity simulations and online learning. According to the Kirkpatrick model, five studies assessed reactions to speak-up training (level 1), all studies evaluated learning as a result of training (level 2), two studies measured the effect of speak-up training on nurses' behavior (level 3), and one study evaluated nurses' results (level 4) while no studies evaluated patient-level outcomes. CONCLUSIONS: Speak-up training for nurses can improve their levels of assertiveness or speak-up behaviors. Despite inconsistent or mixed findings, speak-up training has the potential to improve nurses' psychological well-being, leading to positive organizational performance. New training methods are directed at specialized education for clinical situations. Future speak-up training should consist of training programs based on real clinical situations in which team members participate together to comprehensively evaluate the effect of training on behavioral changes of health professionals as well as patient safety.

The Psychological Impact of the COVID-19 Pandemic on Postsecondary Students: An Analysis of Self-Determination.

The COVID-19 pandemic has put postsecondary students across the world at risk of psychological distress, negatively impacting their basic psychological well-being, including self-determination. Although the concept of self-determination has been widely discussed in literature, it is poorly understood within the context of postsecondary students during the COVID-19 pandemic. This study aimed to examine the concept of self-determination (SD) as it relates to postsecondary students amid the COVID-19 pandemic. The Rodgers' evolutionary method of concept analysis was used. PubMed, CINAHL, PsycINFO, and ERIC were electronically searched using the keywords "postsecondary students" "coronavirus pandemic" and "self-determination." The historical, legal, educational, and health science literature were investigated to generate a holistic definition of SD in the past. This analysis has identified the antecedents, attributes, and consequences of self-determination in postsecondary students during this global health crisis. This analysis adds to the knowledge base regarding the evolution, significance, and application of the concept of SD in the context of postsecondary students amidst the COVID-19 pandemic. Implications for future research were also explored, such as using strategies to promote SD in postsecondary students to develop resilience during the pandemic.