Infusing Systems and Quality Improvement Throughout an Undergraduate Nursing Curriculum.

BACKGROUND: Nurse educators are constantly revising curricula to ensure that graduating nurses have the requisite skills for today's fast-paced, rapidly changing, nonlinear complex care environment. Key nursing education and practice organizations identify systems thinking and quality improvement as essential skills for nurses at the point of care. METHOD: Systems thinking and quality improvement were embedded across a Bachelor of Nursing (BSN) curriculum in a manner that does not dislocate other, more traditional content. RESULTS: To date, approximately 500 students have been exposed to the new BSN curriculum. Sustainable approaches, preliminary results, lessons learned, and recommendations for sustainability and replication are discussed. CONCLUSION: Integrating systems thinking and quality improvement with traditional content across the entire undergraduate curriculum exposes students to increasingly sophisticated real-world experiences that highlight the relevance and significance of these skills in the health care context. Feedback from practice partners suggests this approach helps bridge the education and practice gap. [J Nurs Educ. 2017;56(12):752-757.].

Enhancing Critical Thinking Via a Clinical Scholar Approach.

BACKGROUND: Safety, quality improvement, and a systems perspective are vital for nurses to provide quality evidence-based care. Responding to the call to prepare nurses with these perspectives, one school of nursing used a clinical scholar approach, enhanced by systems engineering to more intentionally develop the ability to clinically reason and apply evidence-based practice. METHOD: A two-group, repeated-measures control trial was used to determine the effects of systems engineering content and support on nursing students' clinical judgment and critical thinking skills. RESULTS: Findings indicated this approach had a positive effects on student's clinical judgment and clinical reasoning skills. This approach helped students view health care issues from a broader perspective and use evidence to guide solution development, enhancing the focus on evidence-based practice, and quality improvement. CONCLUSION: Intentional integration of an evidence-based, systems perspective by nursing faculty supports development of nurses who can function safely and effectively in the current health care system. [J Nurs Educ. 2017;56(11):679-682.].

Impact of pedagogical approaches on cognitive complexity and motivation to learn: Comparing nursing and engineering undergraduate students.

BACKGROUND: The changing higher education landscape is prompting nurses to rethink educational strategies. Looking beyond traditional professional boundaries may be beneficial. We compare nursing to engineering because engineering has similar accreditation outcome goals and different pedagogical approaches. PURPOSE: We compare students' cognitive complexity and motivation to learn to identify opportunities to share pedagogical approaches between nursing and engineering. METHOD: Cross-sectional data were collected from 1,167 freshmen through super senior students. Comparisons were made across years and between majors. FINDINGS: Overall nursing and engineering students advance in cognitive complexity while maintaining motivation for learning. Sophomores reported the lowest scores on many dimensions indicating that their experiences need review. The strong influence of the National Council Licensure Examination on nursing students may drive their classroom preferences. Increased intrinsic motivation, coupled with decreased extrinsic motivation, suggests that we are graduating burgeoning life-long learners equipped to maintain currency. DISCUSSION: The disciplines' strategies for incorporating real-world learning opportunities differ, yet the students similarly advance in cognitive complexity and maintain motivation to learn. Lessons can be exchanged across professional boundaries.

Toward creating an optimal acute care clinical learning environment: insights from staff, faculty, and students.

Understanding how a clinical site impacts student learning was the focus for a participatory action research study in which three separate focus groups for students, faculty, and staff were convened. Participants were asked to identify what they enjoyed or liked about the clinical setting, what they disliked about the clinical setting, and what they would change about the clinical setting. Themes identified by a constant comparative method included experiences provided, attitudes, and expectations. Although the researchers anticipated that each group would have a unique and different perspective on the clinical experience, respondents were consistent in their beliefs both within and among groups. Of interest, each participant group attributed an ineffective clinical learning environment to external causes.

Developing a sense of community among nursing students.

For beginning students, becoming a member of the nursing profession starts with experiences in nursing school. Better understanding of the experiences that contribute to sense of community for students can guide faculty efforts and curricular decisions. Using the sense of community model as a framework, the authors assessed the influence of a freshman-level class and other leadership and student organization experiences on the students' perceptions of the school of nursing as community. The authors discuss the study and its outcomes.

The Doctor of Nursing Practice capstone project: consensus or confusion?

Considerable diversity exists among Doctor of Nursing Practice (DNP) programs regarding capstone projects, which reflect the knowledge gained and the competency achieved during the immersion experience. This article describes a conversation of the DNP capstone project among participants of the Committee on Institutional Collaboration DNP Invitational Conference. The focus of the dialogue was to discuss the intent and breadth of the DNP capstone project and how it demonstrates competencies, to consider in what way it differs from the PhD dissertation, and to identify the similarities and differences among multiple forms of the project in terms of scope and expected deliverables, as well as to examine other related issues. The participants addressed eight salient questions in an effort to clarify the value, form, and key elements of the final project. Responses to these questions are presented, and the agenda for a national dialogue regarding the capstone project is considered.