Student nurses' experiences with a digital educational resource supporting learning in nursing home placements: A qualitative study.

BACKGROUND: Nursing education should improve clinical placements in nursing homes to foster and enhance student nurses' learning experiences. Initiatives for digital educational resource used to teach and supervise students to complement learning are increasingly being adopted and considered important in nursing education. However, little is known about how digital educational resources can facilitate learning in placements. Research on the value of such resources from student nurses' perspective is required. AIM: To explore first-year student nurses' experiences with a digital educational resource developed to support learning in nursing home placements. DESIGN: This study has a qualitative explorative design and is part of a larger research project in which a digital educational resource named DigiQUALinPRAX was developed. SETTINGS: This study was conducted at three publicly funded nursing homes affiliated with one Norwegian university. PARTICIPANTS: Twenty-three first-year student nurses. METHODS: Data was generated through pre- and post-placement group interviews and analysed using reflexive thematic analysis. Standards for Reporting Qualitative Research were applied in this stud. FINDINGS: One overreaching theme and three subthemes related to student nurses' experiences with a digital educational resource were identified. The digital educational resource gave a feeling of being acknowledged as a learner by (1) providing a structure and preparation that made the placement feel less overwhelming, (2) supporting professional reflection and assessment practices, and (3) facilitating collaboration when all stakeholders used the resource actively. CONCLUSIONS: This study indicates that student nurses' learning process in nursing home placements can be supported through digital educational resources customised for this learning arena. The findings indicate that the digital educational resource facilitated pre-placement preparedness, provided structure and flexibility, and enhanced reflection and assessment practices during clinical placement. However, encouraging tripartite usage is essential to exploit the full potential of digital educational resources.

Comparing didactic approaches for practical skills learning in Scandinavian nursing simulation centres: A qualitative comparative study.

AIM: To explore and compare the didactic approaches to practical skills learning at simulation centres in Scandinavian universities and university colleges. BACKGROUND: Academic simulation centres are an important arena for learning practical nursing skills which are essential to ensure competent performance regarding patient safety and quality of care. Knowledge of didactic approaches to enhance learning is essential in promoting the provision and retention of students' practical nursing skills. However, research on didactical approaches to practical nursing skills learning is lacking. DESIGN: A qualitative comparative design was used. METHODS: During November and December 2019, interviews were conducted with a total of 37 simulation centre directors or assistant directors, each of whom possessed in-depth knowledge of practical skills in teaching and learning. They represented bachelor nursing education in Denmark, Norway and Sweden. A qualitative deductive content analysis was conducted. RESULTS: The results revealed all five predetermined didactical components derived from the didactical relationship model. Twenty-two corresponding categories that described a variation in didactic approaches to practical skills learning in Scandinavian nursing simulation centres were identified. The didactical components of Learning process revealed mostly similarities, Setting mostly differences and Assessment showed only differences in didactic approaches. CONCLUSION: Although various didactic approaches were described across the countries, no common approach was found. Nursing educational institutions are encouraged to cooperate in developing a shared understanding of how didactic approaches can enhance practical skills learning. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: Cross-country comparisons of practical nursing skills learning in Scandinavian countries highlight the importance of educator awareness concerning the impact diverse didactic approaches may have on competent performance in nursing education. Competent performance is pivotal for ensuring patient safety and the provision of high-quality care. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. REPORTING METHOD: This study followed the Consolidated Criteria for Reporting Qualitative Research reporting guidelines.

Usefulness of pedagogical design features of a digital educational resource into nursing home placement: a qualitative study of nurse educators' experiences.

BACKGROUND: The rapid advancement of technology-enhanced learning opportunities has resulted in requests of applying improved pedagogical design features of digital educational resources into nursing education. Digital educational resources refers to technology-mediated learning approaches. Efficient integration of digital educational resources into nursing education, and particularly into clinical placement, creates considerable challenges. The successful use of digital educational resources requires thoughtful integration of technological and pedagogical design features. Thus, we have designed and developed a digital educational resource, digiQUALinPRAX, by emphasizing pedagogical design features. The nurse educators' experiences of the usefulness of this digital educational resource is vital for securing improved quality in placement studies. AIM: To obtain an in-depth understanding of the usefulness of the pedagogical design features of a digital educational resource, digiQUALinPRAX, in supporting nurse educators' educational role in nursing home placements in the first year of nursing education. METHODS: An explorative and descriptive qualitative research design was used. Individual semi-structured interviews were conducted with six nurse educators working in first year of a Bachelor's of Nursing programme after using the digital educational resource, digiQUALinPRAX, during an eight-week clinical placement period in nursing homes in April 2022. RESULTS: Two main categories were identified: (1) supporting supervision and assessment of student nurses and (2) supporting interactions and partnerships between stakeholders. CONCLUSION: The pedagogical design features of the digiQUALinPRAX resource provided nurse educators with valuable pedagogical knowledge in terms of supervision and assessment of student nurses, as well as simplified and supported interaction and partnership between stakeholders.

Exploring stakeholders' experiences in co-creation initiatives for clinical nursing education: a qualitative study.

BACKGROUND: Co-creation is an emerging approach in nursing education, wherein academics engage in multi-stakeholder collaborations to generate knowledge, ideate solutions, promote sustainability, and enhance educational quality. However, knowledge on stakeholders' experiences in participation in co-creation initiatives for nursing education is scarce. This study aimed to explore the experiences of student nurses, nurse educators, and e-learning designers in co-creation initiatives to design and develop a digital educational resource for clinical nursing education. METHODS: The study adopted an exploratory qualitative design. Data were collected via three separate semi-structured focus group interviews with student nurses (n = 7), nurse educators (n = 8), and e-learning designers (n = 3) who participated in co-creation workshops. Collected data were then thematically analyzed. RESULTS: Three themes related to the participants' experiences emerged: (1) The co-creation workshops were enjoyable, useful, and instructive; (2) power imbalances influenced the students' engagement; and (3) contextual factors influenced the participants' overall engagement. CONCLUSIONS: This study shows that co-creation through workshops is a novel, enjoyable, and instructive approach that facilitates knowledge exchange. It also highlights the needs and experiences of stakeholders, especially student nurses. However, the use of co-creation in nursing education presents some challenges. Recognizing and managing power differentials are essential for successful co-creation in clinical nursing education, alongside a mindset of collaboration and mutuality. Future research is required to systematize knowledge about the benefits and impacts of the processes and outcomes of co-creation initiatives, including stakeholders' motivation, barriers, and facilitators to participation in co-creation, to improve the quality of clinical nursing education.

Nurse educators' suggestions for a digital educational resource suitable for undergraduate student nurses' placement studies: Qualitative empirical research.

AIMS: To explore and describe nurse educators' suggestions regarding a digital educational resource addressing quality in placement studies for first-year student nurses in nursing homes. DESIGN: A qualitative, explorative, and descriptive research design. METHODS: Focus group interviews with eight nurse educators and individual interviews with six nurse educators. The interviews were audio-recorded and transcribed verbatim; subsequently, data were analysed in lines with content analysis as described by Graneheim and Lundman. RESULTS: The analysis revealed three main categories: 'Suggestions for a digital educational resource to strengthen and support nurse educators' role in follow-up students', 'Suggestions for a digital educational resource to complement and support interaction between stakeholders in placement', and 'Suggestions for a digital educational resource to facilitate student nurses' learning processes'. The categories were captured by the overarching theme, 'A digital educational resource facilitating interaction between stakeholders and students' learning processes. CONCLUSION: This study revealed nurse educators' suggestions regarding design elements, content, and use of a digital educational resource addressing placement studies for first-year student nurses' in nursing homes. Implications for the profession and/or patient care: Nurse educators should be involved in designing, developing, and implementing digital educational resources aiming to support student learning in nursing education placement studies. IMPACT: This study explored nurse educators' suggestions for a digital educational resource. They suggested a digital educational resource to strengthen and support their role, support interaction between stakeholders, and facilitate student nurses' learning processes. Further, they suggested a digital educational resource to be used as a supplement rather than as a replacement for nurse educators' physical presence in placements. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research reporting guidelines were used. No Patient or Public Contribution.

Nursing students' clinical judgment skills in simulation and clinical placement: a comparison of student self-assessment and evaluator assessment.

BACKGROUND: Clinical judgment is an important and desirable learning outcome in nursing education. Students must be able to self-assess their clinical judgment in both the simulation and clinical settings to identify knowledge gaps and further improve and develop their skills. Further investigation is needed to determine the optimal conditions for and reliability of this self-assessment. AIMS: This study aimed to compare the same group of students' self-assessment of clinical judgment with an evaluator's assessment in both simulation and clinical settings. The study further aimed to investigate whether the Dunning-Kruger effect is present in nursing students' self-assessment of clinical judgment. METHODS: The study applied a quantitative comparative design. It was conducted in two learning settings: an academic simulation-based education course, and a clinical placement course in an acute care hospital. The sample consisted of 23 nursing students. The Lasater Clinical Judgment Rubric was used to collect data. The scores were compared using a t-test, intraclass correlation coefficient, Pearson's correlation coefficient, and Bland-Altman plots. The Dunning-Kruger effect was investigated using linear regression analysis and a scatter plot. RESULTS: The results showed an inconsistency between student self-assessment and evaluator assessment of clinical judgment in both simulation-based education and clinical placement. Students overestimated their clinical judgment when compared to the more experienced evaluator's assessment. Differences between students' scores and the evaluator's scores were larger when the evaluator's scores were low, indicating the presence of the Dunning-Kruger effect. CONCLUSION: It is vital to acknowledge that student self-assessment alone may not be a reliable predictor of a student's clinical judgment. Students who had a lower level of clinical judgment were likely to be less aware that this was the case. For future practice and research, we recommend a combination of student self-assessment and evaluator assessment to provide a more realistic view of students' clinical judgment skills.

Influence of simulation and clinical settings on peripheral vein cannulation skill learning in nursing education: A qualitative study.

Background: Peripheral vein cannulation is a complex yet common practical skill. Learning to insert a peripheral vein cannula is fundamental in nursing education; however, the most beneficial pedagogical approaches are yet to be elucidated. Objective: To explore and impart a deeper understanding of the learning conditions in nursing education for developing competency in peripheral vein cannulation. Design: Qualitative, explorative. and comparative research design. Settings: Two nursing educational settings in southern Norway: an academic setting for simulation-based peripheral vein cannulation skill learning, followed by a hospital setting that provided a 9 week clinical placement period. Participants: Nine student nurses in the second year of a bachelor's programme in nursing. Methods: Focus group interviews, individual interviews, and ad hoc conversations with the student nurses on their experiences during and after the process of developing competency in peripheral vein cannulation. Thematic analysis was used to identify categories and common themes. Results: Eight major themes were identified: 'Anatomical and physiological conditions related to the training modalities', 'Realism in training', 'Sequences in peripheral vein cannulation training', 'Different training modalities affording varied learning opportunities', 'Professional nursing assessments', 'Patients' and peers' emotional reactions', 'Student nurses' own emotional reactions', and 'Significance of the relationship between the student nurse and patient'. Conclusions: Simulation-based peripheral vein cannulation practice was an important starting point for the students' skill learning. However, the students experienced the complexity of the skill only in the clinical setting because it offered several learning opportunities. Nonetheless, our findings indicate a need to further review peripheral vein cannulation skill learning, especially patient contributing factors, to enhance the transfer of learning from the simulation setting to the clinical setting. Tweetable abstract: Clinical setting-based peripheral vein cannulation practice is vital for student nurses' skill learning because of the skill's complexity.

Clinical placement education during the coronavirus disease 2019 pandemic shapes new nurses: A qualitative study.

Background: Many newly qualified nurses experience transition challenges because they feel unprepared for the reality of the nursing profession owing to the theory-practice gap. Transition challenges amongst newly qualified nurses have profound consequences for the nursing profession and patient care. A detailed and nuanced understanding of the complexity in transition-related challenges during extraordinary conditions like the coronavirus disease 2019 pandemic is needed for newly qualified nurses to remain in the nursing profession. Objective: This study explored the experience of newly qualified nurses entering the nursing profession who had their clinical placement education missed, shortened, or substituted since they had to serve as health care assistants during the coronavirus disease 2019 pandemic. Design: An exploratory and descriptive study design was used. Settings: Workplaces for newly qualified nurses. Participants: A purposive sample of 10 newly qualified Norwegian nurses working in various clinical placement nursing settings were included. Methods: Data were collected in April and May 2022 via individual interviews conducted via Zoom. Thematic analysis was applied to identify themes. Triangulation was employed to ensure trustworthiness. Findings: Three major themes emerged: relational aspects of nursing, practical aspects of nursing, and inadequacies in the pedagogical plan of teaching and learning. The themes indicate that the limited or suspended clinical placement education during the pandemic affected the competence of newly qualified nurses. Conclusions: During the coronavirus disease 2019 pandemic, clinical placement education for student nurses was limited or suspended owing to safety concerns. The short clinical placement durations affected the competence of newly qualified nurses, as they lacked exposure to real-world patient care scenarios as in non-pandemic times. Furthermore, our findings indicate that newly qualified nurses' clinical placement experiences provide important knowledge and insight for educators in terms of education and support for future student nurses going into situations with short clinical placement hours. The conclusion highlights the implications of the findings and recommendations and the need for further support and education for newly qualified nurses after the pandemic. Study registration details: The study was approved by the Norwegian Social Data Service (project number 396247). The registration date was 2021-11-04. Tweetable abstract: Transition-related challenges became more prominent during the coronavirus disease 2019 pandemic than during non-pandemic times.

Changes in nursing students' self-reported professional competence in simulation-based education and clinical placement: A longitudinal study.

BACKGROUND: A primary learning outcome for nursing students is to achieve the professional competence necessary to provide safe and high-quality care in complex and specialized health services. Simulation-based education (SBE) and clinical placement are two educational settings in which nursing students' professional competence can be facilitated as a learning outcome. OBJECTIVES: The study objectives were to investigate changes in nursing students' self-reported professional competence in SBE and clinical placement and the transfer of this competence from SBE to clinical placement. We also aimed to investigate which competence areas were highest and lowest rated. DESIGN: A quantitative longitudinal survey design was applied. SETTINGS: The study took place from May 2019 to January 2020 in a simulation center at a Norwegian university and clinical placement in hospital units. PARTICIPANTS: Bachelor nursing students (N = 38) in their second and third year of a four-year part-time Norwegian nursing bachelor's degree program. METHODS: The Nurse Professional Scale Short Form (NPC Scale-SF) consisting of six competence areas was used to measure nursing students' self-reported professional competence across four time points. Paired sample t-test and descriptive statistics were used to analyse data. RESULTS: For changes in the longitudinal perspective, students' self-reported professional competence increased significantly. In the transfer perspective, from SBE to clinical placement, four competence areas declined significantly. Value-based nursing care were scored highest, whilst Development, leadership, and organization of nursing care were scored lowest score at all time-points. CONCLUSIONS: Findings indicate that nursing students' self-reported professional competence increased in the longitudinal perspective. Supporting students in transfer of professional competence should be addressed in SBE and clinical placement, whilst nursing education should be strengthened concerning development, leadership, and organization of nursing care.

Development and Testing of an Instrument for Summative Assessment of Practical Skill Performance: A Generalizability Theory Approach.

BACKGROUND AND PURPOSE: Many newly graduated nurses lack proficiency in practical skill performance. Presently, nursing students' practical skill is assessed by summative instruments with overarching items. The purpose of this study was to develop a more detailed instrument to use in summative assessment of nursing students' practical skill performance and to assess its psychometric properties. METHODS: A 50-item instrument was developed. Video-recorded performances were rated by experienced clinical supervisors. A multifacet measurement design was developed. Relevant parameters were estimated by generalizability analysis. RESULTS: Findings indicated that error of measurement were mainly caused by raters far more than by items. CONCLUSIONS: The present study suggested that summative assessment in realistic settings may not apply one rater only. Two to three/four raters appear necessary to dependably measure most skills.

Using "Knowing That" and "Knowing How" to Inform Learning of Peripheral Vein Cannulation in Nursing Education.

Background Peripheral vein cannulation is one of the most common invasive practical nursing skills performed by registered nurses. However, many registered nurses lack competence in this practical skill. Learning peripheral vein cannulation associated with successful placement and maintenance is not well understood. Framework Ryle's ways of knowing, "knowing that" and "knowing how", can be used during peripheral vein cannulation learning to guide development and competence in this practical skill. Aim The aim of the article was to provide an overview of Ryle's ways of knowing and to make recommendations for best practices for nurse teachers and nurses teaching students peripheral vein cannulation. Conclusion Ryle's ways of knowing can assist nursing students in their learning and development of peripheral vein cannulation.

Conditions Affecting the Performance of Peripheral Vein Cannulation during Hospital Placement: A Case Study.

Learning practical nursing skills is an important part of the baccalaureate in nursing. However, many newly qualified nurses lack practical skill proficiency required to ensure safe patient care. The invasive skill peripheral vein cannulation (PVC) is particularly challenging to learn and perform. This study explored conditions influencing nursing students' learning and performance of the technical implementation of a PVC during their clinical placement period. A qualitative and descriptive case study design with two students in Norway practicing PVC during their clinical placement was conducted. One student who mastered the vein cannulation was compared with one student who did not. Data were collected in late 2012 using multiple data sources: semistructured interviews, ad hoc conversations, and video recordings. Video recordings of the two students' cannula implementations were used to help clarify and validate the descriptions and to identify gaps between what students said and what they did. Thematic analysis of the transcribed text data enabled identifying themes that influenced skill performance. There were two overall themes: individual and contextual conditions influencing the technical implementation of a peripheral vein cannula. These findings were evaluated in terms of Benner's work on scientific and practical knowledge, defined as "knowing that" and "knowing how."

Defining and comparing learning actions in two simulation modalities: students training on a latex arm and each other's arms.

AIMS AND OBJECTIVES: To explore, describe and compare learning actions that nursing students used during peripheral vein cannulation training on a latex arm or each other's arms in a clinical skills centre. BACKGROUND: Simulation-based training is thought to enhance learning and transfer of learning from simulation to the clinical setting and is commonly recommended in nursing education. What students actually are doing during simulation-based training is, however, less explored. The analysis of learning actions used during simulation-based training could contribute to development and improvement of simulation as a learning strategy in nursing education. DESIGN: A qualitative explorative and descriptive research design, involving content analysis of video recordings, was used. METHODS: Video-supported observation of nine nursing students practicing vein cannulation was conducted in a clinical skills centre in late 2012. RESULTS: The students engaged in various learning actions. Students training on a latex arm used a considerably higher number of learning actions relative to those training on each other's arms. In both groups, students' learning actions consisted mainly of seeking and giving support. The teacher provided students training on each other's arms with detailed feedback regarding insertion of the cannula into the vein, while those training on a latex arm received sparse feedback from the teacher and fellow students. CONCLUSION: The teacher played an important role in facilitating nursing students' practical skill learning during simulation. The provision of support from both teachers and students should be emphasised to ensure that nursing students' learning needs are met. RELEVANCE TO CLINICAL PRACTICE: This study suggest that student nurses may be differently and inadequately prepared in peripheral vein cannulation in two simulation modalities used in the academic setting; training on a latex arm and on each other's arms.