Nursing students' experiences of a post-licensure practical nurse bridging program: a qualitative systematic review.

OBJECTIVE: The objective of this systematic review was to synthesize qualitative evidence on students' experiences of a post-licensure practical nurse to registered nurse bridging program. INTRODUCTION: A worldwide shortage of registered nurses has prompted governments and educational institutions to develop alternate pathways to nursing licensure. One strategy used to increase the supply of registered nurses is bridging programs. Such programs grant practical nurses academic credit for previous educational and practical experience, which allows them to complete a bachelor of nursing degree in a shorter length of time. Understanding the experience of students enrolled in bridging programs will help identify their specific needs and the educational support needed for them to successfully transition into the registered nurse role. INCLUSION CRITERIA: This review considered qualitative studies that examined the experiences of practical nurses enrolled in bridging programs. METHODS: The literature search was conducted in CINAHL, MEDLINE, Embase, and ERIC. The search for unpublished articles included ProQuest Dissertations & Theses and GreyNet International. Studies published in English were included with no date limits applied to the searches. Papers were screened independently by 2 reviewers against the inclusion criteria. Papers that met the criteria were appraised using the JBI critical appraisal checklist for qualitative research. Key findings were extracted from the included studies using a standardized tool and assigned a level of credibility. The review followed principles of meta-aggregation in line with the JBI approach. The final synthesized findings were graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis. RESULTS: Twenty-four studies, published between 1989 and 2020, were included in the review. A total of 83 findings were extracted and aggregated into 11 categories. From the 11 categories, 4 synthesized findings were developed and are summarized as: i) growth through professional advancement reflects that bridging students report personal growth and professional transformation when they return to school and study to become a registered nurse; ii) need for support indicates that bridging students recognize and appreciate a need to have positive support networks in their lives, mainly with their family, coworkers, and classmates; iii) expecting more reflects that, as adult learners with prior nursing experience, bridging students anticipate receiving more support from the educational institutions and higher levels of clinical expertise and competence amongst faculty than what is provided; and iv) finding balance indicates that bridging students struggle to balance and manage multiple roles and responsibilities in their lives as they return to school to study to become a registered nurse. CONCLUSION: The findings of this review highlight that, as adult learners with prior nursing experience, when post-licensure practical nurses return to study there is often a need to balance multiple roles and responsibilities. It is with the support of family, coworkers, classmates, and faculty that bridging students are able to manage competing personal and academic demands. While many bridging students express disappointment with some of the learning opportunities and/or faculty expertise associated with the nursing program, they ultimately achieve growth through both personal and professional advancement upon completing the program and becoming a registered nurse. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021278408. SUPPLEMENTAL DIGITAL CONTENT: A French-language version of the abstract of this review is available as Supplemental Digital Content [ http://links.lww.com/SRX/A10 ].

Nursing Home Residents' Use of Radiography in New Brunswick: A Case for Mobile Radiography?

Introduction: Identifying ways to eliminate unnecessary transfer of nursing home (NH) residents to hospitals provides an opportunity to improve outcomes and use scarce healthcare resources more efficiently. This study's goal was to better understand where NH residents access X-ray (XR) and computed tomography (CT) scans and to determine if there was a case for mobile radiography policies in New Brunswick. Methods: A retrospective analysis of all the visits to the emergency department (ED) and outpatient imaging departments in two hospitals in Saint John, New Brunswick, in 2020, that involved XR or CT investigations was conducted. Results: There were 521 visits by 311 unique NH residents and 920 investigations (688 XR and 232 CT scans). Most investigations were ordered in the ED (696 of 920; 75.6%; confidence interval: 72.8-78.3%). Of the NH residents who visited the ED and received either an XR or a CT scan, 33.2% received only XR imaging and were discharged back to the NH after a mean ED stay of 5.15 hours. Discussion: The pattern of NH residents' use of the ED for their imaging needs supports the creation of mobile XR policies to deliver more safe and efficient care in a Canadian medium population urban centre.

Strategies Used in Canadian Nursing Programs to Prepare Students for NCLEX-RN® Licensure Exam.

Nursing educators need strategies for preparing students to be successful in the National Council Licensure Examination (NCLEX-RN®). Understanding the educational practices used is an important step in informing curricular decisions and helping regulatory agencies evaluate nursing programs' efforts to prepare students for practice. This study described strategies used in Canadian nursing programs to prepare students for the NCLEX-RN®. A cross-sectional descriptive national survey was completed by the program's director, chair, dean, or another faculty member involved in the program's NCLEX-RN® preparatory strategies using the LimeSurvey platform. Most participating programs (n = 24; 85.7%) use one to three strategies to prepare students for the NCLEX-RN®. Strategies include the requirement to purchase a commercial product, the administration of computer-based exams, NCLEX-RN® preparation courses or workshops, and time dedicated to NCLEX-RN® preparation in one or more courses. There is variation among Canadian nursing programs in how students are prepared for the NCLEX-RN®. Some programs invest considerable effort in preparation activities, while others have limited ones.

Education and training for infection prevention and control provided by long-term care homes to family caregivers: a scoping review protocol.

OBJECTIVE: The objective of this review is to map the infection prevention and control education and training that long-term care homes use with families during a pandemic or infectious outbreak. INTRODUCTION: During the COVID-19 pandemic, restrictions were imposed on visits to long-term care homes to decrease the risk of virus transmission. These restrictions had negative consequences for both residents and families. A scoping review of infection prevention and control education and training used with families will inform family visitation practices and policies during future infectious outbreaks. INCLUSION CRITERIA: This review will examine literature describing infection prevention and control education and training provided to families in long-term care homes. Research and narrative papers, including experimental; quasi-experimental; descriptive observational quantitative and qualitative studies; and reviews, text, policy, and opinion papers, will be considered for inclusion. METHODS: A 3-step approach will be followed, in line with the JBI methodology for scoping reviews. Published literature will be searched for in databases, including CINAHL, Embase, ERIC, MEDLINE, and AgeLine. Published and unpublished papers will be considered from 1990 to the present, in English or French. The World Health Organization, Centers for Disease Control, and the Public Health Agency of Canada websites will be searched for unpublished and gray literature. Two authors will independently review and assess studies for inclusion and extract the data. The findings will be charted in a narrative summary and tables.

Iatrogenesis in the Context of Residential Dementia Care: A Concept Analysis.

Background and Objectives: This concept analysis aims to explore iatrogenesis within the context of residential dementia care and to distinguish this phenomenon from similar phenomena, such as abuse and inadvertent harm. Research Design and Methods: Walker and Avant's method for concept analysis was used to define critical attributes of iatrogenesis within residential dementia care, and to explore antecedents and consequences of its occurrence. A review of the literature about iatrogenesis in the context of residential dementia was conducted across 4 electronic databases. Texts about iatrogenesis in surgery, medicine, social work, psychology, and other relevant disciplines were also reviewed to provide additional context for the concept. Results: Iatrogenesis takes a unique form in residential dementia care. The final definition of the concept proposed in this article is habituated, forceful, hands-on care provided to residents who exhibit responsive behaviors that result in emotional, physical, spiritual, social harm, and/or gradual functional decline, that is provided with the intention of supporting the resident's safety and dignity. Discussion and Implications: The definition of iatrogenesis proposed in this article is an initial step toward developing evidence-based practice for the provision of nonconsensual assistance in residential dementia care. A theoretical definition like the one proposed in this article may serve as a starting point for the operationalization of the concept, which would promote future empirical research into staff and residents' experiences of health care-inflicted harms in this context. Theoretically, it contributes to critical conversations about the narratives, myths, and misperceptions that facilitate the provision of nonconsensual care.

Nursing students' experiences of a post-licensure practical nurse bridging program: a qualitative systematic review protocol.

OBJECTIVE: This systematic review will synthesize the qualitative literature on students' experiences of a post-licensure practical nurse to registered nurse bridging program. INTRODUCTION: The worldwide shortage of registered nurses has prompted governments and educational institutions to develop alternative pathways to nursing licensure. One strategy used to increase the supply of registered nurses is bridging programs. These grant practical nurses academic credit for previous educational and practical experience, which allows them to complete a Bachelor of Nursing degree in a shorter period of time. However, attrition in bridging programs is a concern. Understanding the experiences of students enrolled in bridging programs will help identify their specific needs and the educational support needed for them to successfully transition into the registered nursing role. INCLUSION CRITERIA: This review will include published and unpublished studies that examine the experiences of practical nurses enrolled in bridging programs. Studies published in English will be considered, with no date limitations. METHODS: Databases to be searched include CINAHL, MEDLINE, Embase, and ERIC. Gray literature will be searched for in ProQuest Dissertations and Theses and GreyNet International. Reference lists of included studies will also be reviewed to identify additional studies. The critical appraisal of selected studies and the extraction of data will be independently undertaken by two reviewers using JBI methodology. The findings will be pooled using meta-aggregation to produce comprehensive synthesized findings. A ConQual Summary of Findings will also be presented. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021278408.

Use of an Ambient Activity Technology for Long-Term Care Residents With Dementia.

The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY®, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviors, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome. [Journal of Gerontological Nursing, 48(1), 35-41.].

The Functional Resonance Analysis Method as a health care research methodology: a scoping review.

OBJECTIVE: The objective of this review was to examine and map the literature on the use of the Functional Resonance Analysis Method (FRAM) in health care research. INTRODUCTION: The FRAM is a resilient health care tool tat offers an approach to deconstruct complex systems by mapping health care processes to identify essential activities, how they are interrelated, and the variability that emerges, which can strengthen or compromise outcomes. Insight into how the FRAM has been operationalized in health care can help researchers and policy-makers understand how this method can be used to strengthen health care systems. INCLUSION CRITERIA: This scoping review included research and narrative reports on the application of the FRAM in any health care setting. The focus was to identify the key concepts and definitions used to describe the FRAM; the research questions, aims, and objectives used to study the FRAM; the methods used to operationalize the FRAM; the health care processes examined; and the key findings. METHODS: A three-step search strategy was used to find published and unpublished research and narrative reports conducted in any country. Only papers published in English were considered. No limits were placed on the year of publication. CINAHL, MEDLINE, Embase, PsycINFO, Inspec Engineering Village, ProQuest Nursing & Allied Health were searched originally in June 2020 and again in March 2021. A search of the gray literature was also completed in March 2021. Data were extracted from papers by two independent reviewers using a data extraction tool developed by the reviewers. Search results are summarized in a flow diagram, and the extracted data are presented in tabular format. RESULTS: Thirty-one papers were included in the final review, and most (n = 25; 80.6%) provided a description or definition of the FRAM. Only two (n = 2; 6.5%) identified a specific research question. The remaining papers each identified an overall aim or objective in applying the FRAM, the most common being to understand a health care process (n = 20; 64.5%). Eleven different methods of data collection were identified, with interviews being the most common (n = 21; 67.7%). Ten different health care processes were explored, with safety and risk identification (n = 8; 25.8%) being the most examined process. Key findings identified the FRAM as a mapping tool that can identify essential activities or functions of a process (n = 20; 64.5%), how functions are interdependent or coupled (n = 18; 58.1%), the variability that can emerge within a process (n = 20; 64.5%), discrepancies between work as done and work as imagined (n = 20; 64.5%), the resiliency that exists within a process (n = 12; 38.7%), and the points of risk within a process (n = 10, 32.3%). Most papers (n = 27; 87.1%) developed models representing the complexity of a process. CONCLUSIONS: The FRAM aims to use a systems approach to examine complex processes and, as evidenced by this review, is suited for use within the health care domain. Interest in the FRAM is growing, with most of the included literature being published since 2017 (n = 24; 77.4%). The FRAM has the potential to provide comprehensive insight into how health care work is done and how that work can become more efficient, safer, and better supported.

Experiences of faculty and staff nurses working with nursing students during clinical placement in residential aged care facilities: a systematic review of qualitative evidence.

OBJECTIVE: The objective of this review was to synthesize evidence on the experiences of faculty and staff nurses working with nursing students in clinical placement in residential aged care facilities. INTRODUCTION: Nursing education helps prepare students to provide quality care to older adults. Nursing programs across the globe are championing the integration of content on the care of older adults into their curricula as well as recognizing the value of clinical placements that focus exclusively on this population. Staff nurses who work in residential aged care facilities often work alongside students. In this role, they can support faculty and mentor students. This review explored faculty and staff experiences of nursing student placements in such facilities. INCLUSION CRITERIA: This review considered qualitative studies that address the experiences of faculty and staff nurses working with nursing students in residential aged care facilities. Studies published in English from 1995 onward were included. METHODS: The literature search was conducted in CINAHL, MEDLINE, Embase, and ERIC. The search for unpublished articles included Proquest Dissertations and Theses and Google searches of the Canadian Nurses Association and American Nurses Association websites. Papers were screened by two reviewers independently against the inclusion criteria. Those meeting the criteria were appraised using the JBI critical appraisal checklist for qualitative research. Key findings from included studies were extracted using a standardized tool and classified as unequivocal, credible, or not supported. This review followed the principles of meta-aggregration in line with the JBI approach. RESULTS: Six studies, published between 2001 and 2017, were included in the review. A total of 32 findings were extracted and aggregated into nine categories. From the nine categories, four synthesized findings were developed: i) students enhance the environment, whereby faculty and staff perceive that student presence enhances the residential aged care work and living environment, ii) effort is required by faculty and staff to make the experience work, reflecting a need for faculty and staff to accept and work with negativities, iii) residential aged care facilities provide rich learning experiences, indicating an appreciation for available learning opportunities, and iv) importance of a residential aged care-academic partnership for a collaborative approach in creating positive experiences for faculty and staff working with students in this setting. CONCLUSION: Faculty and staff experiences highlight that residential aged care has the potential to provide students with valuable learning experiences, including how to provide comprehensive and quality nursing care to older adults. A lack of resources in residential aged care inspires faculty and staff to be creative in how they work with students. However, working with students can be challenging for faculty who lack interest and expertise in caring for older adults in this setting. Additionally, staff can become frustrated when they perceive that students do not value the learning opportunities that are available or do not appreciate the expertise required to work with older adults. Partnerships between residential aged care facilities and academic programs can ensure that faculty and staff have the support and resources required to optimize the clinical placements for students. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020168698.

Improving Primary Health Care for Residents Living in Assisted Living: Evidence for Practice and Policy.

The fact that there is a large and growing number of older Canadians has generated a sense of urgency in improving seniors' access to health and long-term care services. Many provincial health care systems have engaged in a range of reforms to help older adults remain healthy and independent. Although many transformational changes have taken place across Canada to improve primary care, variations exist across provinces and territories in terms of older adults' access to primary health care. Opportunities exist for provinces to learn from successful reforms implemented in other Canadian jurisdictions. Residents of assisted living (AL) facilities are an ideal group to whom to target primary health care reforms, given the important role these facilities play in the care continuum and the complex needs of their residents. Allowing practitioners to practice to their full scope and assume greater responsibility within the health care system is a strategy adopted in some jurisdictions with success. This article reports on reforms that have been made to expand the scopes of practice of nurse practitioners and paramedics in some provinces, but also have the potential to improve access to primary health care for those living in AL across the entire country, including those living in smaller provinces such as New Brunswick.

Approaches for defining and assessing nursing informatics competencies: a scoping review.

OBJECTIVE: The objective of this scoping review was to examine and map the literature on defining and assessing nursing informatics competencies for nurses and nursing students. INTRODUCTION: Over the past three decades, nursing informatics competency research has evolved markedly within countries and nursing roles. It is important to examine the available literature on defining and assessing nursing informatics competencies to inform education, clinical practice, policy, and future research. INCLUSION CRITERIA: We considered literature that defined or assessed the concept of nursing informatics competency as a combination of knowledge, skills, and attitudes. This included nursing informatics competencies of nurses and nursing students in a variety of health care or academic settings. METHODS: An extensive search was conducted in Ovid MEDLINE, CINAHL Plus with Full Text via EBSCO, Ovid Embase, Ovid PsycINFO, ProQuest ERIC, Health and Psychosocial Instruments, ProQuest Australian Education Index, ProQuest Education Databases, ProQuest Dissertations and Theses Global, OCLC PapersFirst, Scopus, Web of Science Core Collection, Wiley Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and the JBI Database of Systematic Reviews and Implementation Reports. The initial search was conducted in May 2017 and updated several times. Nursing informatics websites were searched for gray literature, including unpublished research and organizational documents. Additional papers were identified based on a search of reference lists of all the included papers. Neither language nor date restrictions were applied. Two reviewers assessed each of the included papers independently. Data extraction was undertaken using an extraction tool developed specifically for the scoping review objectives. RESULTS: Fifty-two papers were included. Thirty-four papers identified nursing informatics competencies, grouped into four categories: i) nursing informatics competencies for students, entry-level nurses, or generalist nurses; ii) nursing informatics competencies for a specific nursing role; iii) recommendations for consensus on defining core nursing informatics competencies at the international level; and iv) forecasting future nursing informatics competencies as per evolving nursing roles. Eighteen papers reported on nursing informatics competency assessment tools. Results were discussed in a narrative format supported by tables. CONCLUSIONS: This review provided insights to the state of the science on defining and assessing nursing informatics competencies for nurses and nursing students. Several nursing informatics competency lists are available, and despite some variations in domains of nursing informatics competency and indicator statements, they mostly share common themes. This literature demonstrates a heightened awareness of the importance of nursing informatics competency; however, the availability of many lists may be challenging for frontline nursing staff, nursing educators, administrators, researchers, and students to assimilate. Further research is needed to reach a consensus on core domains of nursing informatics competency and associated indicators, preferably per nursing roles, with international involvement and consensus. Additionally, while many nursing informatics competency assessment tools exist, further research is needed to examine psychometric properties of some of these tools.

Modeling and analyzing hospital to home transition processes of frail older adults using the functional resonance analysis method (FRAM).

The main purpose of this study was to model and analyze hospital to home transition processes of frail older adults in order to identify the challenges within this process. A multi-phase, multi-sited and mixed methods design was utilized, in which, Phase 1 included collecting semi-structured interviews and focus group data, and Phase 2 consisted of six patient/caregiver dyad prospective case studies. This study was conducted in three hospitals in three cities in a single province in Canada. The Functional Resonance Analysis Method (FRAM) was employed to model daily operations of the transition process. The perspectives of both healthcare providers and patients/caregivers were used to build the FRAM model. The transition model was then tested using a customized version of the FRAM. The six patient/caregiver cases were used in the process of testing the FRAM model. The results of building the FRAM model showed that five categories of functions contributed to the transition model, including admission, assessment, synthesis, decision-making, and readmission. The outcomes of using the customized version of the FRAM revealed challenges affecting the transition process including waitlists for geriatric units, team-based care, lack of a discharge planner, financial concerns, and follow-up plans. The findings of this study could assist managers and other decision makers to improve the transition processes of frail older adults by addressing these challenges. The FRAM method employed in this study can be applied widely to identify work practices that are more or less successful, so that procedures and practices can be adapted to nudge healthcare processes towards paths that will yield better outcomes.

Nurses' provisions for self-determination in residents with cognitive impairment who live in a residential aged care facility: a scoping review.

OBJECTIVE: This scoping review aimed to map the existing literature about nursing provisions for self-determination in residents with cognitive impairments living in residential aged care facilities. INTRODUCTION: Freedom to decide for oneself and express preferences about daily care is important for all older adults. When older adults transition to residential aged care facilities, they may experience barriers to self-determination due to routine care practices and staff attitudes about autonomy. This is particularly true for residents living with cognitive impairments. Residents with cognitive impairments are often prevented from making choices that nursing staff perceive to be unwise or harmful, as nurses uphold their professional duties to protect and care. This can result in the denial of preferences and the right to self-determination. Mapping the ways nurses balance their duty to protect with residents' rights to self-determine provides insight into nurses' roles and residents' experiences of care. INCLUSION CRITERIA: Research and narrative articles about nursing provisions for self-determination in residents with cognitive impairments living in residential aged care facilities were included in this review. The main concepts explored were nurses' provisions and residents' self-determination. Self-determination included residents' preferences and expressions of choice, while nurses' intentional reactions to residents' preferences were considered nurses' provisions. METHODS: The review included qualitative and quantitative studies as well as text and opinion papers. Only studies and papers published in English from 1992 onwards were included. The databases searched were CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), and ERIC (EBSCO). The search for unpublished papers included ProQuest Nursing and Allied Health Database, ProQuest Dissertations and Theses, and Google (with advanced search strategies). The reference lists of included articles were searched for additional studies not captured by the search strategy. Data were extracted using a standardized tool created by the authors and included details on study design, strategies to promote, and conditions that deny residents' self-determination. Charting tables were developed to record and analyze data related to the review questions. RESULTS: The final set of 17 articles were published from 1995 to 2018. The literature was analyzed in relation to the review's four questions to map the boundaries of the nurse's role in providing for residents' self-determination. Nurses' roles as investigators, advocates, protectors, and assessors emerged as critical to providing for self-determination. CONCLUSIONS: Literature about this topic has tended to describe nursing provisions for self-determination in people with cognitive impairments in terms of an ethical dilemma between the resident's right to act autonomously and their right to protection as a vulnerable population. In mapping the literature, this scoping review demonstrates a more complex process at work in providing for self-determination in the context of cognitive impairment and highlights a need for deeper reflexivity around nurses' understandings of personhood and autonomy. Further research should focus on determining if nurses' perceptions of residents' experience with self-determination are accurate. The complexity of self-determination in the context of cognitive impairment and nurses' advocacy role highlights the need for ongoing support and education for staff working in residential aged care facilities.

Nurses' provisions for self-determination when caring for clients with cognitive impairment who live in a residential aged care facility: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to examine and map knowledge of nursing provisions for self-determination while providing care to clients with cognitive impairment in residential aged care facilities. INTRODUCTION: Maintaining the ability to have choices and to make decisions about daily activities is important for older adults. In residential aged care facilities, nurses' can be challenged to preserve clients' self-determination in favor of ritualistic care routines and a perceived duty to care. Moreover, nurses may perceive that their professional responsibilities to protect clients requires them to guard against decisions that are considered unwise or pose a risk to clients' health or safety. Insight into how nurses negotiate choice with clients with cognitive impairment who are living in a residential care facility will provide an in-depth understanding of the role self-determination plays in clients' lives. INCLUSION CRITERIA: The scoping review will consider research and narrative reports on nursing provisions for self-determination in clients with cognitive impairment who are living in a residential aged care facility. The concepts of interest are self-determination and nursing provisions. Self-determination is defined as client choice and nursing provisions are the intentional reactions to clients' expressed choices. METHODS: This scoping review will aim to locate published and unpublished literature employing a three-step search strategy. Only papers published in English from 1995 onward will be included. Data extracted from included papers will outline details on the participants, context, strategy, activity, and outcomes. Extracted data will be reported in a tabular form and presented narratively to address the review objective.

The functional resonance analysis method as a health care research methodology: a scoping review protocol.

OBJECTIVE: The objective of this review is to examine and map the literature on the use of the functional resonance analysis method in health care research. INTRODUCTION: Health care systems are highly complex and involve interrelated functions, organizations, individuals, and technologies. Understanding how these elements interact and impact health care processes is difficult because of inherent contextual and human variables. The functional resonance analysis method offers an approach to deconstruct complex systems and examine relationships between individual processes and elements. By using the functional resonance analysis method, researchers can map health care processes and uncover performance variables that can emerge and strengthen, or compromise, intended outcomes. Insight into how the functional resonance analysis method has been operationalized in health care research will help researchers and policy makers understand how the method can be used to strengthen health care systems. INCLUSION CRITERIA: The scoping review will consider research and narrative reports on the application of the functional resonance analysis method in health care research. The concepts of interest are the research questions/aims/objectives, methods used to operationalize the functional resonance analysis method, key concepts and definitions of the functional resonance analysis method, and key findings. Studies that used the functional resonance analysis method in any health care setting will be considered. METHODS: The scoping review will aim to locate published and unpublished literature by employing a three-step search strategy. Only papers published in English will be considered and no limits will be placed on the year of publication. Data extracted will include key concepts and definitions of the functional resonance analysis method, research questions/aims/objectives, methods used to operationalize the functional resonance analysis method, and key findings. Extracted data will be reported in tabular form and presented narratively to express the review question.

Nursing students' experiences with clinical placement in residential aged care facilities: a systematic review of qualitative evidence.

OBJECTIVE: The objective of this systematic review was to synthesize the best available evidence on nursing students' experiences with clinical placement in residential aged care facilities. INTRODUCTION: Nursing education programs play a key role in preparing future nurses to care for the growing number of older adults who will require health care. A key component of this preparation involves ensuring that curricula optimize student learning through carefully designed clinical learning practice experiences. Residential aged care facilities provide students with opportunities to work exclusively with older adults. Studies that address clinical placements in residential aged care facilities highlight both the benefits and concerns of student learning and professional development. Insight into student experiences of clinical placements in residential aged care facilities can help inform nursing curricula and contribute to a better understanding of how best to prepare students to care for an aging population. INCLUSION CRITERIA: This review considered all qualitative studies that included undergraduate and diploma nursing students. Nursing students included individuals or groups identified as nursing students independent of the type of program, level of learning, or time spent in the setting. METHODS: A three-step search strategy was used to identify English language qualitative primary research studies. Two reviewers independently appraised the included studies using the JBI Critical Appraisal Checklist for Qualitative Research. Key findings were extracted and classified as unequivocal or credible. RESULTS: Fourteen qualitative studies were included, published between 2003 and 2018. A total of 53 findings were extracted and aggregated into seven categories. From the seven categories, two synthesized findings were developed: the evolution of learning and embracing opportunity. CONCLUSION: This review captured student experiences of clinical placement in residential aged care facilities. The findings highlight the importance of students entering the setting with knowledge of how to care for older adults and being able to respond to challenging resident behavior. Equally important is the need for students to understand the roles and contributions of all care staff in the setting, including nurses and unregulated care providers. Although the residential aged care setting can be a challenging learning environment for students, it also offers opportunities for student growth and professional development, especially when there are clearly articulated learning outcomes and appropriate role models available.

Teaching strategies and activities used for students' clinical placement in residential aged care facilities: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to examine and map current knowledge of teaching strategies and activities used with nursing students during clinical placements in residential aged care facilities. INTRODUCTION: Residential aged care facilities provide opportunities for nursing students to develop skills and interest in caring for older adults. Studies that address students' clinical placements in these settings highlight the benefits of and concerns with their experiences. Insight into the state of knowledge regarding teaching strategies used in residential aged care facilities could benefit nursing education programs and help to ensure student learning is maximized. INCLUSION CRITERIA: This scoping review will consider research and narrative reports on teaching activities and strategies used by nursing faculty and residential aged care facility staff in teaching nursing students. The concepts of interest include planned and intentional activities and strategies used to facilitate student learning and student clinical experiences. A clinical experience is defined as when a student enters a residential aged care facility and is assigned an individual or individuals to care for. METHODS: This scoping review will aim to locate published and unpublished literature employing a three-step search strategy. Only papers published in English from 1992 onward will be included. Data extracted from eligible papers will include details on the participants, context, strategy, activity and outcomes. Extracted data will be reported in a tabular form and presented narratively to address the review objective.

Teaching strategies and activities to enhance students' clinical placement in residential aged care facilities: a scoping review.

OBJECTIVE: The purpose of this scoping review was to examine teaching strategies and activities used in nursing students' clinical placement in residential aged care facilities. INTRODUCTION: Population aging necessitates that nursing curricula ensure student interest and commitment to working with older adults. While searching for suitable clinical placements that provide students with opportunities to care for older adults, nursing programs have turned to residential aged care facilities. Studies show that carefully planned placement in these environments supports students' needs and offers rich learning possibilities. INCLUSION CRITERIA: This review examined intentional teaching strategies and activities used during student placement in residential aged care facilities, and considered research and textual papers on the subject. The strategies and activities included those that took place prior to, during, or after the experience. METHODS: The review included qualitative and quantitative research reports as well as text and opinion papers. Only research reports and papers published in English from 1992 to August 2019 were included. The databases searched were: CINAHL (EBSCO), MEDLINE (Ovid), Academic Search Premier (EBSCO), Embase (Elsevier), ERIC (EBSCO), ProQuest Dissertations and Theses, and Google (with advanced search strategies). Two independent reviewers screened citations for inclusion while a third reviewer resolved discrepancies. A table was developed for data extraction to record data relating to the review objective. Specific data extracted included the details on research design, geographical location, year of publication, description of the teaching strategy or activity. RESULTS: Of the 84 research reports and papers that were eligible for full-text review, only 25 (30%) were included in the final set. Sixteen papers were research reports including a variety of qualitative, quantitative, and mixed method designs. The remaining nine were textual papers and included frameworks, descriptions, and evaluations of a teaching strategy or activity. Most research reports and papers identified more than one strategy and/or activity used concurrently. The use of care staff as student mentors and facility orientation for students were the two most common strategies and activities reported. CONCLUSION: A range of teaching approaches during clinical placements in residential aged care facilities was revealed. These approaches targeted students, staff of aged care facilities, and nursing faculty. Collaborative efforts between aged care facilities and educational institutions allowed for the pooling of resources and the delivery of teaching approaches to students and the engagement of care staff. Many of the approaches were co-designed by educational programs and residential aged care facilities. The number of approaches that used more than one teaching strategy and/or activity reflects an appreciation for the importance of student placements and the complexities of aged care facilities. A lack of longitudinal or evaluative research highlights a gap in the literature. There is a need for further work to understand and evaluate the long-term effects and benefits of teaching strategies and activities used to enhance students' clinical placements in resident aged care facilities.