Nursing students' reactions to a graphic novel: A multi-national descriptive qualitative study.

BACKGROUND: Undergraduate nursing programme teaching and learning methods and content must evolve to meet the changing evidence base, healthcare context and needs of new generations of nurses. Art-based and narrative methods have been employed to help student nurses explore complex issues, including patient experiences of health and illness, person-centred care and social determinants of health. One creative visual teaching tool is the graphic novel. However, little is known about student perceptions of graphic novels and how they facilitate student nurses' reflection, engagement and learning. Gaining such an understanding may be of especial value for teaching Generation Z students who are used to interacting with complex visual imgery and prefer alternatives to text-heavy documents. OBJECTIVE: The objective was to explore student nurses responses to Vivian, and graphic novels in general, as teaching resources in undergraduate nursing curricula in England, Sweden, and Aotearoa New Zealand. DESIGN: A social constructionist critical framework informing a descriptive qualitative study. SETTING AND PARTICIPANTS: Undergraduate nursing students in Sweden, England, and Aotearoa New Zealand. METHODS: Data were collected using focus groups and semi-structured interviews. Braun & Clark's method for thematic analysis was used to analyse the data. RESULTS: Three themes were developed: 1) reflections on clinical practice, including reflections on palliative care, holistic care for older people and communication between patients and staff; 2) graphic novels' usefulness as a teaching resource, in which students regarded them as an alternative way to learn; and 3) Vivian as a form of the graphic novel. CONCLUSION: The graphic novel Vivian helped nursing students engage in critical reflection and with challenging theoretical concepts. It, and graphic novels in general offer an alternative to print-based texts, which may heighten their appeal to Generation Z learners.

Memento Mori: Can art assist student nurses to explore death and dying? A qualitative study.

OBJECTIVE: To report how an art-based workshop assisted undergraduate nursing students to explore their experiences and beliefs about death and dying. DESIGN: A descriptive qualitative study. PARTICIPANTS: Year three adult nursing students studying on a full-time undergraduate pre-registration programme. METHODS: Long answer questionnaires were completed by 48 undergraduate student nurses, all of whom had participated in the art-based workshop. Qualitative thematic analysis was used to identify, analyse and report themes identified. RESULTS: Four themes were identified: (1) exploring experiences and beliefs, (2) the role of the art in supporting discussions, (3) the gallery environment, and (4) impact on practice. Participants valued the opportunity to 'slow down', fully examine, and be challenged by, the art prompting reflective and critical discussion. The calm and peaceful gallery environment, and the skilled facilitation increased participant confidence to share experiences and beliefs. Reflecting on the workshop participants reported the workshop increased their understanding of the complexities of care and of addressing these on an individual basis. CONCLUSIONS: This shared experience encouraged open and honest discussion and reflection, enhanced critical thinking and the need for compassionate person, and family-centred palliative and end-of-life care. While this study focused on an educational strategy delivered to student nurses, it is an approach that could be used with other health and social care professionals. Close and critical observation of the selected art increased participant understanding and insight of the many experiences and interpretations of death and dying.