Clinical Faculty Orientation Practices in the United States: A Descriptive Study.

BACKGROUND: Due to the nursing faculty shortage, expert clinical nurses are working as novice clinical instructors (CIs). Orientation is needed to prepare these nurses to teach; however, lack of evidence-based guidelines for orientation programs can lead to variability among institutions. PURPOSE: The purpose of this study was to describe clinical nursing faculty orientation practices in the United States. METHODS: A descriptive convergent mixed methods design was used. RESULTS: One hundred thirteen CIs participated. Of these, 70.8% were not provided with a formal orientation to their role. Duration, modality, and content varied widely among orientations. Four themes were derived from the qualitative data: Administrative Requirements, Transition to Clinical Educator, Mentorship, and Resilience. CONCLUSIONS: Clinical faculty orientation practices vary widely in the United States. Evidence-based guidelines are needed to streamline orientations to provide CIs with the requisite knowledge and skills to support clinical students.

Pilot Testing of Evidence-Based Symptom Management Telehealth Simulation-Based Experiences in an Oncology Nursing Seminar.

ABSTRACT: Telehealth simulation-based experiences (T-SBEs) offer one approach to prepare nursing students with the requisite skills to deliver oncology evidence-based symptom management (EBSM) using telecommunication technology. Fourteen baccalaureate nursing students participated in this one-group, pretest/posttest, convergent mixed-methods pilot study with questionnaire variant. Data were collected before and/or after two oncology EBSM T-SBEs using standardized participants. The T-SBEs resulted in significant increases in self-perceived competence, confidence, and self-confidence in clinical decision-making related to oncology EBSM. Qualitative themes included value, application, and preference for in-person SBEs. Future research is warranted to definitively determine the effect of oncology EBSM T-SBEs on student learning.

Pilot Testing of Virtual Simulation-Based Experiences in an Oncology Nursing Seminar.

BACKGROUND: The coronavirus disease 19 (COVID-19) pandemic challenged nurse educators to develop teaching strategies to engage students in a virtual classroom. This pilot study examined the effect of virtually delivered video-recorded (VDVR) simulation-based experiences (SBEs) with standardized participants on the management of clinical emergencies in patients and families affected by cancer on nursing student learning outcomes. METHOD: A pre- and posttest, one-group, convergent mixed-methods design with questionnaire variant was used. Data were collected before and after SBEs. RESULTS: Nineteen senior baccalaureate nursing students participated in this pilot study. The VDVR SBEs resulted in a significant increase in self-perceived competence. Participants had positive perceptions about the use of VDVR SBEs as a teaching strategy. Qualitative themes included realism, critical analysis, and preference for hands-on learning. CONCLUSION: The VDVR SBEs were well-received by prelicensure nursing students as a supplemental teaching strategy to enhance self-perceived competence. Additional research is needed about the effects of VDVR SBEs on learning outcomes. [J Nurs Educ. 2023;62(3):167-170.].

Effect of Multiple-Patient Simulation on Baccalaureate Nursing Students' Anxiety and Self-confidence: A Pilot Study.

BACKGROUND: Multiple-patient simulation (MPS) allows nursing students to develop leadership skills. Limited research examining student outcomes following MPS exists. PURPOSE: This pilot study investigated the impact of MPS on (1) anxiety with transition to practice, (2) anxiety with clinical decision-making, (3) self-confidence with clinical decision-making, and (4) perceptions about MPS as a learning strategy. METHODS: Twenty-two senior baccalaureate nursing students participated in this 2-group mixed-methods study. Data were collected before and after a leadership course using the State-Trait Anxiety Inventory, Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale, and a researcher-developed perceptions survey. RESULTS: Self-confidence with clinical decision-making significantly increased for all participants regardless of group assignment. Anxiety and anxiety with clinical decision-making decreased without significant changes. No significant differences were found between groups. Qualitative findings yielded 3 themes: preparation for clinical practice, overcoming anxiety, and confidence. CONCLUSION: Research investigating additional student outcomes after MPS with larger, more diverse samples is needed.

Male nursing students' experiences during prelicensure education: An integrative review.

BACKGROUND: Males represent less than 10 % of the global nursing workforce. To increase the recruitment and representation of male nurses, their experiences in prelicensure nursing education must be understood. OBJECTIVES: The purpose of this integrative review was to explore literature related to male nursing students' experiences during prelicensure education. DESIGN: An integrative review of the literature was conducted using Whittemore and Knafl's methodology. DATA SOURCES: Database searches of CINAHL, PubMed, ERIC, Emcare, and Scopus were conducted. REVIEW METHODS: Database searches identified 237 articles for initial review. Titles, abstracts, and full-text articles were screened for relevance. Quality appraisal was evaluated using the Mixed Methods Appraisal Tool Version 2018. Data analysis was conducted using Conventional Content Analysis. RESULTS: Twenty-two articles (19 qualitative, two quantitative, and one mixed-methods) were included in this review. The existing literature suggests that male nursing students have generally negative experiences during their prelicensure education due to external reactions from family, friends, peers, and healthcare providers to their choice of nursing as a profession; lack of male role models; extensive assistance with physical tasks in the clinical setting; exclusion in obstetrics clinical experiences; and female-gendered descriptions of nurses within the educational environment. Fostering new relationships was identified as a positive experience during prelicensure education. CONCLUSIONS: Generally, male nursing students have negative experiences during their prelicensure education, with limited positive experiences. As such, nurse educators should implement strategies, such as avoiding gendered references when referring to the nurse, offering male mentorship when possible, and providing comparable clinical assignments to students regardless of gender, to improve male nursing students' experiences in prelicensure education and, consequently, increase the recruitment and retention of men into the nursing profession. Future research is needed to more comprehensively understand male nursing students' experiences during prelicensure education and the impact of teaching strategies on their experiences.

The Effects of a Simulation-Based Experience with Standardized Participants on Learning and Clinical Decision-Making Related to Nursing Management of Oncologic Emergencies.

Upon entry-to-practice, graduate nurses must be able to effectively manage oncologic emergencies to ensure best patient and family outcomes. Thus, nurse educators must develop active teaching strategies to prepare prelicensure nursing students with appropriate nursing oncology knowledge and skills. The purposes of this study were to determine the effect of simulation-based experiences (SBEs) with standardized participants (SPs) involving a patient and family member on baccalaureate nursing students' confidence and competence, anxiety and self-confidence with clinical decision-making, and satisfaction and self-confidence in learning using SBEs related to management of oncologic emergencies within a seminar-style course. A longitudinal, one-group, convergent mixed-methods design was used. Baccalaureate nursing students enrolled in a senior seminar participated in two SBEs. Study data were collected pre-seminar, pre-SBE, and post-SBE. Twenty-five senior nursing students participated in this study. There was a significant increase in students' confidence and self-perceived competence, and a significant decrease in anxiety and increase in self-confidence with clinical decision-making related to the nursing management of oncologic emergencies over time. All seven student groups in the hypercalcemia SBE, and five student groups in the hypersensitivity reaction SBE demonstrated objective competence. Qualitative themes identified included: realism, critical thinking, and benefits for professional practice. Study findings support the use of SBEs with SPs to enhance nursing students' confidence and competence, and to increase self-confidence and reduce anxiety with clinical decision-making related to the management of oncologic emergencies in a seminar-style course. The inclusion of a family member enhanced the realism of complex SBEs.

Standardized Patient Simulation in an Oncology Symptom Management Seminar-Style Course: Prelicensure Nursing Student Outcomes.

A critical role of the professional nurse is to manage symptoms associated with cancer and its treatments. Currently, prelicensure nursing curricula lack adequate oncology content and associated opportunities for clinical application. Thus, many graduate nurses do not possess the requisite knowledge and skills required to effectively manage cancer-related symptoms upon entry to practice. The purposes of this study were to evaluate the effect of standardized patient simulation on nursing students' knowledge, confidence, and competence (objective and self-perceived) related to oncology evidence-based symptom management principles, and to determine nursing students' perceptions, satisfaction, and self-confidence with learning using standardized patient simulation in a seminar-style course. A longitudinal, one-group, convergent mixed-methods design with questionnaire variant was used. Data were collected at three time points: (T1) pre-seminar, (T2) pre-simulation, and (T3) post-simulation. A convenience sample of sixty-three senior baccalaureate nursing students in an oncology symptom management seminar participated in two standardized patient simulation scenarios. There was a significant increase in students' knowledge, confidence, and self-perceived competence over time with a large effect size. All student groups (n = 14) demonstrated objective competence in the colorectal cancer scenario and all participants, with the exception of one student group, demonstrated objective competence in the breast cancer scenario. Participants also reported positive perceptions of, a high level of satisfaction with, and self-confidence in learning with the standardized patient simulations. Qualitative themes identified included unique focus, realism, and application of knowledge. Standardized patient simulation holds promise to enhance nursing students' knowledge, confidence, and competence related to oncology evidence-based symptom management principles.

Medication administration errors made among undergraduate nursing students: A need for change in teaching methods.

BACKGROUND: Systems factors, such as interruptions, contribute to nursing errors. Gaining an understanding of what contributes to nursing student errors can inform educational strategies aimed to improve patient safety. PURPOSE: The aims of this study were to investigate: (a) within-subjects differences in error rates among nursing students during interrupted compared to uninterrupted simulated medication administration, (b) types of medication administration errors made by nursing students, and (c) nursing students' perceptions of their ability to independently administer medication. METHODS: A descriptive comparative within-subjects design was utilized in this two-site study. Data on errors were collected via direct observation. Senior baccalaureate nursing student participants discussed their experience of interrupted and uninterrupted simulated medication administration during individual debriefing sessions. RESULTS: Nearly one-third of participants made errors. Error rates were similar in interrupted (19.4%) and uninterrupted (16.7%) conditions. Near-misses, which were not included in the error rates, were reported by 8% of participants. The most common error types were documentation and dose errors. Students attributed the interruption and lack of independent medication administration practice as causes for errors. CONCLUSION: Educational programs must adequately prepare nursing students for independent safe medication administration in complex work environments. The inclusion of systems factors in educational modalities is critical.

The experience of baccalaureate clinical nursing faculty transitioning to emergency remote clinical teaching during the COVID-19 pandemic: Lessons for the future.

BACKGROUND: Experiential clinical learning in undergraduate nursing education allows for fusion of nursing knowledge with practice to ensure the development of competent graduate nurses. The global COVID-19 pandemic necessitated an abrupt transition from in-person clinical educational experiences to emergency remote clinical teaching. OBJECTIVES: The purpose of this study was to describe the experiences of baccalaureate nursing clinical faculty who transitioned from in-person clinical to emergency remote clinical teaching during the COVID-19 pandemic in spring 2020. DESIGN: A qualitative descriptive design was used. SETTING: The study took place in the United States. PARTICIPANTS: Nineteen baccalaureate nursing clinical faculty participated in the study. METHODS: Participants engaged in semi-structured, in-depth, online interviews. RESULTS: Five themes emerged from the data: transition, collaboration and support, the joy of teaching, authentic professional experience, and the overarching primary theme, stress of the moment. CONCLUSIONS: The transition to emergency remote clinical teaching during the COVID-19 pandemic caused stress and anxiety. However, there were important lessons learned about how to best support students and faculty while providing a robust online learning experience. Understanding the experiences of clinical nursing faculty during this abrupt transition can support recommendations for best practices in the future.

Undergraduate Nursing Students and Management of Interruptions: Preparation of Students for Future Workplace Realities.

AIM: The aim of this study was to investigate interruption management strategies and associative cues used by nursing students when interrupted during simulated medication administration. BACKGROUND: Interruptions occur with high frequency in health care settings and are associated with increased medication errors and decreased task efficiency. The Altmann and Trafton memory for goals model, a cognitive-science model, proposes use of associative cues during an interruption to mitigate these negative effects. METHOD: A mixed-methods, two-site study explored associative cues and other management strategies that nursing students used when interrupted during simulated medication administration. Data were collected via direct observation and semistructured interviews. RESULTS: Students primarily multitasked (66.7 percent) during the interruption. Few students (5.5 percent) used associative cues. Students voiced the need for education and practice on how to manage interruptions. CONCLUSION: Evidence-based strategies are required to prepare nursing students for workplace interruptions. Use of associative cues during interruptions warrants further investigation.

TeamSTEPPS Curricular-Wide Integration: Baccalaureate Nursing Students' Knowledge, Attitudes, and Perceptions.

BACKGROUND: To promote safe patient care, nurses must work collaboratively with members of the interprofessional health care team. PURPOSE: The purposes of this study were to explore the effect of a curricular-wide integration of TeamSTEPPS training on baccalaureate nursing students' teamwork knowledge and attitudes and to describe students' perceptions of TeamSTEPPS curricular-wide integration. METHODS: In this quasi-experimental, mixed-methods study, the experimental group engaged in a curricular-wide integration of TeamSTEPPS throughout the baccalaureate nursing program, whereas the control group received no TeamSTEPPS training. RESULTS: The experimental group had significantly higher teamwork knowledge than the control group after training. The curricular-wide integration of TeamSTEPPS was positively received by students. CONCLUSIONS: This study demonstrated the feasibility and benefits of integrating TeamSTEPPS teamwork training throughout a baccalaureate nursing curriculum, as well as the knowledge gained by students because of this curricular-wide integration. With further research, TeamSTEPPS could offer an evidence-based approach to promote the interprofessional teamwork knowledge and skills nursing students need for safe patient care.

The transition from nursing student to practicing nurse: An integrative review of transition to practice programs.

The transition from student to novice is a difficult time. Although the novice nurse is excited to start working, the nurse struggles with acclimating to a new role with new responsibilities and the need to reconcile disparities between what was taught in school and what is practiced in the real world. To lessen the impact of the transition experience, health care organizations have implemented transition-to-practice programs including orientations, preceptorships, and residencies. Despite these efforts, if the novice nurse does not find these programs helpful, there is still a risk that the transition experience will not conclude with successful results. This integrative review examined qualitative studies that explored the transition-to-practice experience of novice nurses who participated in a transition-to-practice program provided by their place of employment. Thirteen articles met the criteria for this integrative review; seven themes emerged from the commonalities in the studies: socialization, professional growth, feeling supported, transition challenges, reflections, transition shock, and feelings. Though the transition period includes unique experiences for each novice nurse, the common feelings and needs identified in these studies require nurse educators and the healthcare organizations to ensure that novice nurses are prepared and given the tools to successfully transition to professional nursing practice.

Simulated Participants as Health Care Providers: An Innovative Approach to Interprofessional Simulation.

ABSTRACT: With the increased attention to patient safety and quality care in health care, it is imperative that prelicensure health care provider students are taught to collaborate effectively to decrease medical errors. For this project, simulated participants were utilized as health care providers for a simulation in a stand-alone nursing school without affiliation to a medical or allied health school. Both simulated participants and students reacted positively to the experience. This project demonstrated that utilizing simulated participants to portray health care providers in simulation scenarios is a feasible and well-received method of providing learning experiences that emphasize the importance of collaboration.

Simulation Strategies Used in the Transition From Expert Clinician to Novice Educator.

ABSTRACT: As the demand for nurses increases across the United States, nursing programs are challenged to increase enrollment. Thus, expert clinicians without teaching experience are often hired as clinical faculty. Using simulation to train novice clinical faculty is one method to bolster the clinical faculty workforce. For this project, six Quality and Safety Education for Nurses (QSEN)-focused simulation-based learning experiences (SBLEs) were developed to train novice clinical faculty. Master's-level nurse educator students participated in the SBLEs. The SBLEs were found to be valuable for learning the clinical faculty role and debriefing increased understanding of the QSEN competencies.

Nonclinical Transition-to-Practice Courses: A Review of Course Content.

BACKGROUND: Both clinical and nonclinical transition-to-practice courses have been offered to facilitate the transition from student to novice nurse. PROBLEM: Nonclinical transition-to-practice courses are less widely discussed in the literature; thus, their content and effectiveness have not been examined. APPROACH: Academic institutions with baccalaureate nursing programs were surveyed to determine if they offered a nonclinical transition-to-practice course and to identify the associated content. OUTCOME: Of 19 responding institutions, 15 reported having a nonclinical transition-to-practice course. Eighty-seven percent of the courses address ethical dilemmas, and 80% include delegation, interview preparation, stress management, and work/life balance. CONCLUSION: Although schools of nursing are urged to address students' transition to practice, there is considerable variation in the nonclinical topics addressed. Research is needed to provide guidance to maximize the impact of these nonclinical transition-to-practice courses on new nurses' transition experience.

Evaluating the transition from nursing student to practicing nurse: An integrative review.

The transition period from student nurse to novice nurse is a stressful time. Patient outcomes, healthcare organizations, the new nurse, and the nursing profession can be negatively affected if the transition from nursing student to novice nurse is not a positive and successful experience. Currently, there are numerous interventions aimed at easing the transition for the new nurse with just as many instruments used to evaluate the success of the interventions in doing so. This integrative review examined quantitative studies that evaluated the outcomes of interventions implemented to ease the transition from student to professional nurse. The seven articles that met the criteria for this review discussed four types of programs and one curriculum revision and collectively used 14 instruments to measure a total of 18 concepts related to new nurse transition. Despite the significance of the studies' results that indicate interventions to ease the transition-to-practice experience are beneficial and can have a positive impact on areas such as job satisfaction and retention, overall findings from this integrative review suggest the need for greater standardization of concepts that should be evaluated and the instruments used to determine if new nurses are successfully transitioning into professional nursing.

Nurses' Perceived Causes of Medication Administration Errors: A Qualitative Systematic Review.

BACKGROUND: Medication administration errors (MAEs) are a critical patient safety issue. Nurses are often responsible for administering medication to patients, thus their perceptions of causes of errors can provide valuable guidance for the development of interventions aimed to mitigate errors. Quantitative research can overlook less overt causes; therefore, a qualitative systematic review was conducted to present a synthesis of qualitative evidence of nurses' perceived causes of MAEs. METHODS: Publications from 2000 to February 2019 were searched using four electronic databases. Inclusion criteria were articles that (1) presented results from studies that used a qualitative or mixed methods design, (2) reported qualitative data on nurses' perceived causes of MAEs in health care settings, and (3) were published in the English language. Sixteen individual articles satisfied the inclusion criteria. Methodological quality of each article was assessed using the Critical Appraisal Skills Programme (CASP) tool. Thematic analysis of the data was performed. Perceived causes of errors were labeled as knowledge-based, personal, and contextual factors. RESULTS: The primary knowledge-based factor was lack of medication knowledge. Personal factors included fatigue and complacency. Contextual factors included heavy workloads and interruptions. Contextual factors were reported in all the studies reviewed and were often interconnected with personal and knowledge-based factors. CONCLUSION: Causes of MAEs are perceived by nurses to be multifactorial and interconnected and often stem from systems issues. Multifactorial interventions aimed at mitigating medication errors are required with an emphasis on systems changes. Findings in this review can be used to guide efforts aimed at identifying and modifying factors contributing to MAEs.

Outcomes of TeamSTEPPS Training in Prelicensure Health Care Practitioner Programs: An Integrative Review.

BACKGROUND: Patient safety, morbidity, and mortality are directly correlated with interprofessional collaboration among health care practitioners. TeamSTEPPS offers a standardized curriculum for interprofessional teamwork training that can be incorporated into prelicensure education. This article describes the current state of the science related to the quantitative literature exploring the outcomes of TeamSTEPPS training in prelicensure health care practitioner students' education. METHOD: The Whittemore's and Knafl's method guided this integrative review. The CINAHL and PubMed databases were queried and ancestral searches of the reference lists of all retrieved articles were conducted. RESULTS: Nine quantitative research studies were identified for inclusion in this integrative review. CONCLUSION: The available literature suggests that using TeamSTEPPS within prelicensure education supports the development of teamwork knowledge and attitudes in interdisciplinary health care practitioner students. Most of the reviewed studies focused on nursing and medical students; thus, further research is needed on allied health care practitioner students. [J Nurs Educ. 2020;59(11):610-616.].

Pre-licensure nursing students' attitudes toward clinical research, education research, and pedagogical research participation in the United States.

BACKGROUND: Researchers worldwide have found that nursing students tend to have favorable attitudes toward clinical research. However, little is known about their attitudes toward education research and pedagogical research participation. OBJECTIVES: The purposes of this study were to: describe nursing students' attitudes toward clinical research, education research, and pedagogical research participation; explore the association of select demographic and academic factors with students' attitudes; and identify facilitators and barriers of pedagogical research participation. DESIGN: A convergent mixed-methods design with questionnaire variant was used. SETTINGS: Pre-licensure students from nursing programs throughout the United States. PARTICIPANTS: Four hundred and thirty-six pre-licensure students, aged 18 or older, who were active members of the National Student Nurses' Association (NSNA). METHODS: Research participants were recruited using the NSNA e-mail distribution list. Nursing students completed a demographic survey and three instruments that measured attitudes toward clinical research, education research, and pedagogical research participation. RESULTS: Quantitative findings indicated that nursing students had generally positive attitudes toward clinical research, education research, and pedagogical research participation. Prior experience as a research assistant or a research participant was significantly associated with students' attitudes on all three measures. Factors identified by students to enhance pedagogical research participation were the potential to improve practice, research topic interest, and opportunities for personal and professional development; while time-related concerns were identified as barriers to research participation. Qualitative data supported these findings, and also revealed some negative attitudes toward pedagogical research participation, concerns about current educational practices, and confusion about the definition of education research. CONCLUSIONS: Findings from this study provide nurse educators with students' perspectives of education research, which may be used to develop a student-driven framework to enhance the implementation of pedagogical research. Further research is warranted to more fully understand these phenomena with explicit attention to international students' perspectives.

Psychometric Evaluation of the Nursing Students' Attitudes Toward Nursing Education Research Questionnaire.

BACKGROUND AND PURPOSE: While nursing students' attitudes about research are generally positive, little is known about their attitudes toward education research. The purpose of this study was to test the psychometric properties of the newly developed Nursing Students' Attitudes toward Nursing Education Research Questionnaire (NSANERQ). METHODS: The 25-item NSANERQ was adapted from an existing tool measuring nursing students' attitudes toward nursing research. Content and construct validity, and internal consistency and test-retest reliability were evaluated. Content validity was assessed using a panel of five experts. Internal consistency reliability and construct validity were assessed in a sample of 156 senior, junior, and sophomore baccalaureate nursing students with a mean age of 20.55 years. A separate sample of 49 freshmen baccalaureate nursing students with a mean age of 18.35 years was used to assess test-retest reliability. Both samples were predominantly female, White, and non-Hispanic/non-Latino. RESULTS: The NSANERQ demonstrated excellent content validity (S-CVI = 0.92), good internal consistency reliability (α = .88), and acceptable test-retest reliability (r = 0.71) over 2 weeks. Exploratory factor analysis resulted in a six-factor solution, which was confirmed through confirmatory factor analysis. CONCLUSIONS: The NSANERQ is a valid and reliable instrument that can be used to measure students' attitudes toward nursing education research.