Registered nurses' attitudes towards e-learning and technology in healthcare: A cross-sectional survey.

BACKGROUND: Online learning, also known as e-learning, has increased considerably during the COVID-19 pandemic and is now an important feature of nursing education globally. An understanding of registered nurses' online self-regulated learning, attitudes to e-learning and the relationship of these to attitudes to Information and Communication Technology (ICT) in healthcare facilitates successful educational outcomes. OBJECTIVE: To explore the association between registered nurses' attitudes to e-learning and self-regulated online learning skills on their attitudes towards the use of ICT in healthcare. DESIGN: A quantitative study employing a cross-sectional survey. SETTINGS AND PARTICIPANTS: A convenience sample of registered nurses (n = 120) enrolled in a nursing degree conversion program delivered in Singapore. METHODS: Participants (n = 120) completed an online anonymous survey consisting of three validated instruments (Information Technology Attitude Scale for Health (ITASH), Attitudes towards e-learning and, Online Self-regulated Learning Questionnaire. Descriptive and inferential statistics analyses were conducted. RESULTS: Participant's levels of online self-regulated learning were positively correlated with attitudes to e-learning (r = 0.663, p < 0.001). Attitudes to e-learning (70.4, SD 11.5) were also positively predictive of ITASH (R2 = 0.306, p < 0.001), but online self-regulated learning was not contributory to the prediction of attitudes to ICT in healthcare. CONCLUSIONS: It is recommended that educators involved in online learning focus on strategies aimed at promoting positive attitudes to e-learning and ICT prior to employing those aimed at developing online self-regulation skills. Further research exploring online learning and ICT needs in the workplace are required.

Registered nurses understanding of academic honesty and the perceived relationship to professional conduct: Findings from a cross-sectional survey conducted in Southeast Asia.

BACKGROUND: Academic dishonesty is increasing in prevalence in universities globally. Concerns exist that engagement in academic dishonesty by nursing students may transfer to professional misconduct in the clinical setting, thereby jeopardising the quality of patient care. OBJECTIVES: To determine the type and prevalence of academic dishonesty engaged in by post-registration nursing students and their understanding of the relationship between academic honesty and professional conduct. DESIGN: An exploratory quantitative study employing a cross sectional survey. SETTINGS AND PARTICIPANTS: A convenience sample of undergraduate students enrolled in an Australian post-registration nursing degree program delivered in a Southeast Asian country. METHODS: An online anonymous survey comprising 38 Likert-style items was completed by 179 voluntary participants. Descriptive statistics were used to analyse data pertaining to the frequency and type of academic dishonesty. Chi-square tests were used to identify associations between issues such as frequency of engagement to academically dishonest activities and perceptions of professional misconduct. Responses to open-ended questions was undertaken using descriptive summative content analysis. RESULTS: Almost 96% (n = 153) of participants agreed that academic dishonesty constitutes a breach of professional codes of conduct with 97.5% (n = 156) stating it should be viewed as professional misconduct. Findings revealed 44.1% (n = 79) of participants reported engagement with at least one type of academic dishonesty. Of these, 55 (69%) reported involvement in two or more types. CONCLUSIONS: Academic dishonesty continues to be an issue in nursing education with serious ramifications for professional conduct and patient outcomes. Educators must take a targeted approach to educating students about the importance of academic integrity and its relationship to professional conduct. This includes supporting students to develop academic skills such as referencing. Appropriate penalties and reporting of students who engage in academic dishonest behaviour to academic and professional regulatory authorities are also essential actions required to prevent academic dishonesty.

Evaluating a large-scale introductory interprofessional education workshop for developing interprofessional socialisation in medical, nursing and pharmacy students: A quasi-experimental pre-test post-test study.

BACKGROUND: Traditionally, healthcare students have been educated in discipline-specific silos with minimal interprofessional socialisation. Interprofessional education is fundamental for interprofessional socialisation and is an essential component of healthcare education. OBJECTIVES: To evaluate the effect of a large-scale interprofessional workshop implemented for first year medical, nursing and pharmacy students on changes in attitudes towards interprofessional socialisation and its perceived value. DESIGN: A quasi-experimental study design using pre and post questionnaires. SETTING: A Faculty of Medicine and Health at a large university in Australia. PARTICIPANTS: 1008 students from the 2018 and 2019 cohorts of pre-qualification first year medical students (n = 444), nursing (n = 461) and pharmacy (n = 103) enrolled in a graduate entry degree program participated in the workshop. Complete data sets were collected from 37.1% (n = 374) of the participants. METHODS: The short-form Interprofessional Socialisation and Valuing Scale (ISVS-9) was administered before and after the IPE workshop. Linear mixed models were used to compare both the within group and between group pre- and post- questionnaire data. Percentages and frequencies were used to analyse data pertaining to participants' perceptions and experience of the workshop. Descriptive qualitative analysis of free-text responses was undertaken. RESULTS: Findings indicated that 80.8% (n = 440) of participants rated their workshop experience as good/very good. 64.6% (n = 352) of participants reported that it had changed how they considered other health professionals. Significant higher (p < 0.001) post questionnaire mean scores were demonstrated for nursing (5.63, SE0.05) and pharmacy students (5.82, SE 0.11). CONCLUSION: Findings provide support for the implementation of IPE for nursing, and pharmacy students. It is recommended that these initiatives are introduced at an early stage in their education to promote interprofessional socialisation and are repeated throughout the curricula.

Factors associated with final year nursing students' desire to work in the primary health care setting: Findings from a national cross-sectional survey.

BACKGROUND: Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs. Similar programs in primary health care settings may be a valuable strategy for developing the primary health care nursing workforce, yet little is known about nursing students desire to work in this setting, factors that influence this, or their expectations of primary health care-focused transition to professional practice programs. OBJECTIVES: This study sought to identify factors associated with final year nursing students' desire to work in primary health care setting including demographic factors, expectations of future employment conditions, and job content. It also explored expectations of graduate transition programs based in primary health care. DESIGN: A cross-sectional survey design comprising a quantitative online survey. SETTING: 14 Australian universities from all states/territories, both rural and urban. PARTICIPANTS: 530 final-year nursing students. METHODS: Binary logistic regression identifying factors contributing to desire to work in primary health care. RESULTS: The desire of nursing students to work in primary health care is associated with older age, greater perceived value of employment conditions including flexibility, and less perceived importance of workplace support. CONCLUSIONS: Collaborative efforts from primary health care nurses, health professionals, academics and policy makers are needed to attract new graduate nurses to primary health care.

Practice manager expectations of new graduate registered nurses in Australian general practice: a national survey.

Practice managers are often involved in the employment of practice nurses and are likely to have a significant role in future transition programs in general practice. Therefore, the aim of the study was to explore practice managers' expectations of new graduate registered nurses working in general practice. A nation-wide web-based electronic survey distributed by the Australian Association of Practice Management was used to collect demographic data and practice managers' expectations of new graduate nurses directly transitioning into general practice in their first year of practice. The sample was broadly representative of the Australian state and territory population numbers. Respondents were predominantly female with postgraduate qualifications. The findings of this study highlight that practice managers who currently work with practice nurses would be supportive of graduate registered nurses in general practice in their first year with preceptor support. The results of this study have important implications for nursing workforce development and it is recommended that such initiatives are widely introduced with appropriate financial support.

Factors influencing the development of end-of-life communication skills: A focus group study of nursing and medical students.

BACKGROUND: Poor communication between health care professionals and dying patients and their families results in complaints about end-of-life care. End-of-life communication skills should be a core part of nursing and medical education but research suggests that qualified doctors and nurses find this a challenging area of practice. AIMS: The aim of this study was to explore factors influencing the development of end-of-life communication skills by nursing and medical students. DESIGN: A qualitative study comprising five focus groups. PARTICIPANTS: Second year undergraduate nursing (n=9 across 2 focus groups) and fourth year undergraduate medical students (n=10 across 3 focus groups) from a London University. FINDINGS: Barriers and facilitators influenced nursing and medical students' experience of communication with dying patients and their families in clinical practice. Extrinsic barriers included gatekeeping by qualified staff and lack of opportunity to make sense of experiences through discussion. Intrinsic barriers included not knowing what to say, dealing with emotional responses, wasting patients' time, and concerns about their own ability to cope with distressing experiences. Facilitating factors included good role models, previous experience, and classroom input. CONCLUSION: In addition to clinical placements, formal opportunities for reflective discussion are necessary to facilitate the development of students' confidence and skills in end-of-life communication. For students and mentors to view end-of-life communication as a legitimate part of their learning it needs to be specified written practice-learning outcome. Mentors and supervisors may require training to enable them to facilitate students to develop end-of-life communication skills.

Nursing students' intentions to enter primary health care as a career option: Findings from a national survey.

This paper reports findings from the first phase of a national study conducted to identify the intention of nursing students' to work in a Primary Health Care setting following registration. An online survey of final year nursing students enrolled at Australian universities offering education leading to eligibility for registration as a nurse with the Australian Health Practitioner Regulation Agency was undertaken during July-August 2014. Data were collected about students' intention to enter Primary Health Care as a career option, as well as their exposure to primary health care during their nursing education and whether they had undertaken practice placements in a primary health care setting. Analysis was conducted on 456 completed surveys. The findings demonstrated that, despite the majority (98.2%; n = 447) of students being exposed to Primary Health Care during their studies, less than a quarter (22.8%; n = 104) of the students who responded identified this as an area in which they intended to work following registration. No association was found between students' clinical experiences and their identification of primary health care as a career preference. Given the ageing population in Australia, the increased prevalence of chronic health issues and the predicted ongoing primary health care workforce shortages, educational and workplace strategies aimed at attracting new graduate nurse into Primary Health Care settings are imperative.

Enhancing student communication during end-of-life care: A pilot study.

BACKGROUND: Quality end-of-life care requires effective communication skills, yet medical and nursing students report limited opportunities to develop these skills, and that they lack confidence and the related competence. OBJECTIVES: Our purpose was to design, implement, and evaluate an educational intervention employing simulated patient actors to enhance students' abilities to communicate with dying patients and their families. METHODS: A study employing a mixed-methods design was conducted with prequalification nursing and medical students recruited from a London university. The first phase involved focus groups with students, which informed the development of an educational intervention involving simulated patient actors. Questionnaires measuring students' perceptions of confidence and competence levels when communicating with dying patients and their families were administered before and after the intervention. RESULTS: The themes from focus groups related to responding to grief and anger, difficulties dealing with emotions, knowing the "right thing" to say, and a lack of experience. A significant increase (p < 0.5) in competence and confidence from baseline levels followed participation in the simulated scenarios. SIGNIFICANCE OF RESULTS: Simulation was found to be an effective means of preparing students to communicate with dying patients and their families. The opportunity to develop communication skills was valued. Integration of educational interventions employing simulated patient actors into nursing and medical curricula may assist in improving the care provided to patients at the end of life.

Using e-learning to support clinical skills acquisition: exploring the experiences and perceptions of graduate first-year pre-registration nursing students - a mixed method study.

BACKGROUND: Clinical skills education must accommodate the different needs of nursing students, particularly in view of increasing numbers of graduate entrants. E-learning has been promoted for its ability to engage learners and customise the learning process and evidence supports its use for clinical skill acquisition. However, graduate nursing students have unique needs, and their perceptions and experiences of e-learning require exploration. AIM: The aim of the study was to explore graduate first year nursing students' perceptions and experiences of e-learning when used to supplement traditional methods to learn clinical skills. DESIGN/METHOD: Mixed methods, employing qualitative and quantitative approaches, were used. Eighty-three (46%) participants were recruited from a cohort of graduate students (n=180) enrolled in an accelerated pre-registration nursing programme. Participants completed e-learning educational materials prior to attendance at clinical skills sessions. Focus groups (n=2) explored participants' (n=15) experiences and perceptions of e-learning and identified common issues. Discussions were transcribed verbatim and analysed using a thematic approach. Findings informed the development of a questionnaire which sought to confirm perceptions of e-learning and the perceived value for clinical skills acquisition in the larger student group. Data from questionnaires (n=83) were analysed using descriptive statistics. RESULTS/DISCUSSION: Students found e-learning valuable for developing clinical skills and, although they viewed it positively, they did not want to relinquish conventional teaching methods, preferring both in combination. Video clips were perceived as the most useful feature while online readings were viewed as the least useful. An underestimate of time requirements, navigational issues and technical difficulties were reported frustrations. CONCLUSION: Although limited by potential volunteer bias, findings contribute to the ongoing discourse on how e-learning can support clinical skills education and provides insights from the perspective of graduate nursing students. E-learning does not suit the needs of all learners. This must be recognised to enhance the learning experience.

Clinical skills education for graduate-entry nursing students: enhancing learning using a multimodal approach.

This paper discusses the development of a new clinical skills course at a school of nursing and midwifery in London. The course, part of a two year pre-registration programme for graduates in other disciplines, adopted an innovative multimodal approach. This comprised a range of teaching, learning and assessment strategies designed to maximise comprehensiveness, complementarity and flexibility. The background to the development is discussed and each component is described in detail. A brief summary of relevant feedback generated from anonymous student evaluations is included. This provides important insights into the perceived strengths and weakness of the module from a learner perspective. The paper concludes by identifying proposed future developments and recommending wider applications of the multimodal approach within nursing and healthcare education on an international level.

Chemotherapy in the community: the importance of patient assessment.

The use of chemotherapy has expanded considerably in the UK in recent years, with an increase of around 60% in the amount of chemotherapy delivered over a four-year period (National Chemotherapy Advisory Group (NCAG), 2009). This has led to an increased demand for the delivery of chemotherapy, putting pressure on existing cancer services. Combined with the current political agenda which aims to improve the convenience and experience of health for patients' this has prompted the reorganisation of chemotherapy services, with a movement away from the delivery of chemotherapy in dedicated cancer centres to community-based models of care. This article discusses the implications of these changes for community nurses with regard to their role in the assessment of patients receiving chemotherapy.

Using computer assisted learning for clinical skills education in nursing: integrative review.

AIM: This paper is a report of an integrative review of research investigating computer assisted learning for clinical skills education in nursing, the ways in which it has been studied and the general findings. BACKGROUND: Clinical skills are an essential aspect of nursing practice and there is international debate about the most effective ways in which these can be taught. Computer assisted learning has been used as an alternative to conventional teaching methods, and robust research to evaluate its effectiveness is essential. DATA SOURCES: The CINAHL, Medline, BNI, PsycInfo and ERIC electronic databases were searched for the period 1997-2006 for research-based papers published in English. Electronic citation tracking and hand searching of reference lists and relevant journals was also undertaken. FINDINGS: Twelve studies met the inclusion criteria. An integrative review was conducted and each paper was explored in relation to: design, aims, sample, outcome measures and findings. Many of the study samples were small and there were weaknesses in designs. There is limited empirical evidence addressing the use of computer assisted learning for clinical skills education in nursing. Computer assisted learning has been used to teach a limited range of clinical skills in a variety of settings. CONCLUSION: The paucity of evaluative studies indicates the need for more rigorous research to investigate the effect of computer assisted learning for this purpose. Areas that need to be addressed in future studies include: sample size, range of skills, longitudinal follow-up and control of confounding variables.