Mentors' cultural competence at mentoring culturally and linguistically diverse nursing students in clinical practice: An international cross-sectional study.

AIMS: This study aimed to identify mentors' cultural competence profiles at mentoring culturally and linguistically diverse nursing students in clinical practice and explore associating factors. BACKGROUND: Globalization has had a significant impact on healthcare, increasing the diversity of healthcare workforces and the number of culturally and linguistically diverse nursing students in clinical practice. The cultural competence of mentors is important to secure students' safe and successful learning. The mentor role in clinical practice contributes toward enabling and ensuring students' high-quality and goal-oriented development of competence. DESIGN: This study implemented a cross-sectional design with a final sample of 270 clinical practice mentors from Finland, Lithuania, Spain and Slovenia. METHODS: The data were collected using an online survey including the Mentors' Cultural Competence Instrument, Mentors' Competence Instrument and background questions during 2020-2021. The data were analyzed using a K-mean cluster algorithm to identify mentors' competency profiles. RESULTS: Three significantly differing mentor competency profiles (Profile A 42%, Profile B 41%, Profile C 17%) were identified in this study. The cultural competence of the mentors in clinical practice varied between intermediate and high levels. Mentors rated their cultural competence as best in the area of cultural sensitivity and awareness, whereas the lowest scored area was cultural interaction and safety. CONCLUSIONS: This study showed that the cultural competence of mentors in clinical practice varied and was influenced by mentors' work experience, age, job title and frequency of mentoring. This study provides new knowledge that could help to develop cultural competence operating models and education to enhance the cultural competence of healthcare professionals.

Educational Needs of European Intensive Care Nurses with Respect to Multicultural Care: A Mix-Method Study.

The aim of the study is the analysis of educational needs of European intensive care nurses (ICNs) with regard to multicultural care. A mixed-method multinational study was performed among 591 ICNs coming from 15 European countries. An online survey was utilised with three research tools: participants' sociodemographic details, Healthcare Provider Cultural Competence Instrument, and a tool to assess the educational needs of ICU nurses with respect to multicultural care. The highest mean values in self-assessment of preparation of ICU nurses to provide multicultural nursing care and their educational needs in this regard were detected in the case of nurses coming from Southern Europe (M = 4.09; SD = 0.43). With higher age, nurses recorded higher educational needs in the scope of multicultural care (r = 0.138; p = 0.001). In addition, speaking other languages significantly correlated with higher educational needs related to care of patients coming from different cultures (Z = -4.346; p < 0.001) as well as previous education on multicultural nursing care (Z = -2.530; p = 0.011). Experiences of difficult situations when caring for culturally diverse patients in ICU were classified into categories: 'treatment procedures and general nursing care', 'family visiting', 'gender issues', 'communication challenges', and 'consequences of difficult experiences'. The educational needs of intensive care nurses in caring for culturally diverse patients are closely related to experiencing difficult situations when working with such patients and their families.

Mentoring of nursing students-A comparative study of Japan and five European countries.

AIMS: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan. METHODS: The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis. RESULTS: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring. CONCLUSION: Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses.

European intensive care nurses' cultural competency: An international cross-sectional survey.

OBJECTIVES: To determine the level of cultural competence of European critical care nurses. DESIGN: A multi-country survey performed in 2017 as a part of the European project Multicultural Care in European Intensive Care Units. METHOD: Online survey of critical care nurses in 15 European countries (n = 591) using the Healthcare Provider Cultural Competence Instrument consisting of 49 items divided into five subscales: awareness and sensitivity, behaviour, patient-centred orientation, practice orientation and self-assessment. Descriptive and correlational analyses were performed. RESULTS: Critical care nurses scored highest for 'awareness and sensitivity' (M = 5.09, SD = 0.76), and lowest for 'patient-centred communication' (M = 3.26, SD = 0.94). Nurses from northern and southern Europe scored higher across all subsets of the cultural competence instrument (all subsets, p < 0.001) than nurses from central Europe. Speaking other languages significantly correlated with higher scores in all subscales (all > 0.05) except 'practice orientation'. Previous education on multicultural nursing significantly correlated with higher scores in all subscales (all > 0.01) except patient-centred communication; and visits to other countries was negatively correlated with all subscales (all, p > 0.001) except patient-centred communication. CONCLUSION: Being exposed to cultural diversity in different ways, like living in a multicultural country, speaking a second language and visiting other countries may influence development of cultural competence. Therefore, programmes which facilitate multicultural clinical practice are strongly recommended in nursing education.

Development and testing of an evidence-based model of mentoring nursing students in clinical practice.

BACKGROUND: Mentoring in clinical settings is an important factor in the development of nursing students' professional knowledge and competences, but more knowledge of mentors' current and required competences is needed to improve nursing students' clinical learning. OBJECTIVES: This study aimed to develop and test an evidence-based model of mentoring nursing students in clinical practice. DESIGN: An international cross-sectional survey coordinated in five European countries: Finland, Italy, Lithuania, Slovenia and Spain. METHODS: Mentors, 4980 registered nurses working in both primary and specialist healthcare organizations, were invited to participate in the study during 2016-2019. The final sample consisted of 1360 mentors (mean age 41.9 ± 11). Data were collected with background questions and the Mentor Competence Instrument. The instrument was psychometrically validated then the data were used to construct a Structural Equation Model (SEM) with Full Imputation Maximum Likelihood (FIML) estimation. RESULTS: All of six hypotheses were verified. In summary: mentors' characteristics related to their motivation and reflection are positively related to mentoring practices in the workplace, which (together with constructive feedback) are positively related to and foster goal-orientation in students' clinical learning and student-centered evaluation. All parameters in the SEM model were significant and the model's fit indexes were verified (RMSEA = 0.055; SRMR = 0.083; CFI = 0.914, TLI = 0.909). CONCLUSION: Our evidence-based modeling confirms the research hypotheses about mentorship, and identifies focal competences for designing mentors' education to improve students' clinical learning and establish a common European mentoring model. Mentorship is important for both healthcare organizations and educational systems to enhance students' clinical competences, professional growth and commitment to the nursing profession and organizational environments.

Mentors' self-assessed competence in mentoring nursing students in clinical practice: A systematic review of quantitative studies.

AIMS AND OBJECTIVES: To examine registered nurses' self-evaluation of their competence in mentoring nursing students in clinical practice. BACKGROUND: Clinical mentors have significant roles and responsibility for nursing students' clinical learning. Moreover, the mentors' role is becoming increasingly important internationally, as the role of nurse teachers in mentoring students in clinical practice has declined. However, in most EU countries there are no specific educational requirements for clinical mentors, although they need targeted education to increase their competence in mentoring nursing students. DESIGN: The systematic review of quantitative studies was designed according to guidelines of the Centre for Reviews and Dissemination and PRISMA protocol. METHODS: Studies published during 2000-2019 that met inclusion criteria formulated in PiCOS format were systematically reviewed by three independent reviewers. CINAHL (Ebsco), PubMed (MEDLINE), Scopus, ERIC and Medic databases were used to retrieve the studies. Three independent reviewers conducted the systematic review process. The studies were tabulated, thematically compared and narratively reported. RESULTS: In total, 16 peer-reviewed studies met the inclusion criteria. The studies identified various dimensions of mentors´ competence and associated environmental factors. Generally, participating mentors rated competences related to the clinical environment, mentoring, supporting students' learning processes and relevant personal characteristics fairly high. They also rated organisational practices in their workplaces, resources in the clinical environment and their mentor-student and mentor-stakeholder pedagogical practices, as respectable or satisfactory. CONCLUSION: The results indicate considerable scope for improving mentors' competence, particularly through enhancing organisational mentoring practices and relevant resources in clinical environments. RELEVANCE FOR CLINICAL PRACTICE: Pedagogical practices of mentors in relations with both students and stakeholders should be enhanced to improve future nurses' learning. This systematic review addresses a gap in knowledge of mentors' self-evaluated competence that could assist the formulation of effective educational programmes for mentors internationally and improving clinical environments.

Assessment of nursing students' competence in clinical practice: A systematic review of reviews.

BACKGROUND: The assessment of nursing students' nursing competence is a matter of concern worldwide and the complexity of assessing students' clinical competence has challenged educators for decades. It has been recognized that there is inconsistency among assessment methods and tools between countries and institutions. OBJECTIVE: To identify the current best evidence on the assessment of nursing students' competence in clinical practice. DESIGN: Systematic review of reviews. DATA SOURCES: The electronic databases CINAHL, PubMed, Eric, Medic and the JBI Database of Systematic Reviews and Implementation Reports were searched in autumn 2018. REVIEW METHODS: Two researchers independently assessed the eligibility of the studies by title, abstract and full-text, and then assessed the methodological quality of the included studies. Analysis of study findings was conducted using the thematic synthesis approach. RESULTS: Six reviews were included following critical appraisal. Assessment tools used to assess students' nursing competence commonly focus on the domains of professional attributes, ethical practices, communication and interpersonal relationships, nursing processes, critical thinking and reason. Clinical learning environments and mentoring provide important support structures and guide the learning of students. The availability of assessment tools and criteria along with providing individualized feedback and time for reflection strengthen the objectivity and reliability of assessment. CONCLUSIONS: There continues to be a need to develop consistent and systematic approaches in assessment, and to use reliable and valid instruments in assessment. Mentors find assessment of students' competence to be particularly challenging and emphasize the importance of clear assessment criteria, support from nurse educators and further education on assessment. Further development in feedback practices and providing students with opportunities for reflection are important in supporting the continuous learning process of students.

Is the holistic physical factor linked to life satisfaction in older age?

BACKGROUND: The physical factor (health literacy, health status, functional ability to perform daily basic and instrumental activities and risk factors) is linked to life satisfaction in older age. The aim of this study is to establish the correlation between the physical holistic factor and life satisfaction in older age. MATERIAL AND METHODS: The quantitative research method was used. In order to sample the data, the authors chose a simple random sample. The designed questionnaire was filled in by 1064 older persons aged ≥ 65 years, living in social care institutions/nursing homes for older persons or in the home environment. The number of correctly completed survey questionnaires was 656. In order to measure life satisfaction, the Satisfaction with Life Scale was used. Within the physical factor, 4 indexes were formed. In order to be able to show the desired influences or links between the physical factor and life satisfaction, the authors used propensity score methods. RESULTS: The individual indexes within the physical factor are linked to life satisfaction to a varying degree: health literacy (R2 = 0.137), health status (R2 = 0.047), the functional ability to perform daily basic and instrumental activities (R2 = 0.015), and risk factors (R2 = 0.001). The physical holistic factor is linked to life satisfaction in older age (R2 = 0.05). CONCLUSIONS: With this research, the authors have proven that the older persons with high levels of health literacy, a good health status without chronic diseases, who are independent in performing daily basic and instrumental activities, and do not have any risk factors present, are more satisfied with their lives. Med Pr. 2019;70(5):535-43.