Does reading ability predict student success? A scoping review.

OBJECTIVES: Nursing students do not only have to understand the content they read, but they must also analyze, synthesize, and think critically as these skills are required for success in clinical practice. This review investigates if testing reading in students can predict outcomes of student success in nursing programs. DESIGN: A scoping review of the literature on reading assessments in nursing education. DATA SOURCES: Databases explored included CINAHL, ERIC, and MEDLINE and included English language papers published from January 2001 to November 2022. REVIEW METHODS: Joanna Briggs Institute scoping review methods informed this review. RESULTS: Data were extracted from 34 full text papers and dissertations. All papers examined reading as an independent predictor of outcomes such as NCLEX-RN success, program completion, or early program success. Various reading tests delivered at admission were more likely to predict proximal outcomes such as early program success rather than more distal outcomes such as NCLEX-RN failure or program completion. CONCLUSION: Reading assessments are effective predictors of a student's potential for academic success in nursing programs which has many implications for admission and progression policies. Many areas for future research are proposed including examining the developmental nature of reading improvement across nursing programs, development of reading interventions, and building faculty capacity for reading support. This body of literature said very little about the impact of race and racism on reading as they relate to academic outcomes which also must receive attention in future research.

Language as a proxy for race: Language and literacy and the nursing profession.

Defining a nurse as literate is disciplinary and contextual, linked to professional identity formation, and an issue impacting patient safety. Literacy and language proficiency are concepts assessed through examining skills in four pillars: reading, writing, speaking, and listening. This article explores how literacy is not only a practice issue but inextricably intertwined with issues of race, equity, diversity, and inclusiveness in our profession-both in regulatory policy and classroom pedagogy. In making the argument that language is a proxy for race, three cases of language and literacy will be presented. First, the deficit discourse of multilingual student struggle is stereotyped to the presence or absence of an accent, with multilingual student needs often treated homogeneously in disregard of population heterogenous abilities. Second, regulatory policies for language testing internationally educated nurses are discriminatory with testing context bearing little relationship to the language needs of nursing practice. Third, that the myth of "one standard English" results in racist evaluation practices of student academic performance. Recommendations are made for reframing how language and literacy are viewed in nursing education and regulation of practice with a focus on acknowledgment of one's personal relationship to racial issues and emphasizing the need for a change in mindset toward racialized multilingual students and writers.

Should the concepts chosen to guide concept-based curricula be threshold concepts?

In this paper we propose that the concepts guiding concept-based curricula should be threshold knowledge concepts. We briefly discuss some of the hurdles of current concept-based curricular designs and describe how the concepts themselves, paradoxically, might perpetuate the continued emphasis on content in nursing courses. Until now, threshold concept theory has not been part of the mainstream conversation about concept-based curricula. Threshold concepts act as portals to professional identity development and are recognized by their troublesome and transformative potential to enhance knowledge acquisition and change worldviews. This feature differentiates them from the core concepts often described within concept-based curriculum literature. The identification of threshold concepts in existing nursing courses might help structure curricular revision with the goal of enhancing transfer of learning and decreasing faculty resistance to the concept-based curricular approach.

Exploring integrated threshold concept knowledge as a route to understanding the epistemic nature of the evidence-based practice mindset.

BACKGROUND: An evidence-based practice (EBP) mindset is the embodiment of the belief that a professional nursing identity requires consideration of research evidence in all practice encounters. Historical tensions between research and practice have contributed to practitioner and student resistance to research knowledge. Examining the troublesome nature of learning research may facilitate the development of teaching strategies to enhance the uptake of research in practice. AIM: To use Timmermans and Meyer's Integrated Threshold Concept Knowledge Framework to explore the troublesome nature of learning research and evidence-based practice and identify how threshold concepts of EBP can be leveraged to understand the epistemic nature of the evidence-based practice mindset. METHODS: A multimethod case analysis using a triangulated approach was applied to 169 written artifacts from 61 nursing students. Written artifacts included course assignments and a learning survey that were examined to identify troublesome EBP concepts. RESULTS: Threshold concepts of EBP are leveled as foundational, application, or epistemic, with some concepts acting as prerequisites to others. Epistemic threshold concepts include awakening to the importance of research to nursing practice and discursive ability with research and EBP concepts. CONCLUSION: Understanding the epistemic nature of EBP knowledge may be a route to identifying the most effective pedagogies to simulate transformative and irreversible EBP threshold concept knowledge. EBP concepts require mindful threading in nursing curriculums to startle students into epiphanies about the importance of research to practice.

Reflective writing pedagogies in action: a qualitative systematic review.

OBJECTIVES: Reflective practice is a core value of nursing education and emphasizes the self as a source of learning. Writing and reflection are often viewed as inseparable. The goal of this qualitative meta-study is to explore the mechanisms writing stimulates to promote learning transformation for nursing students in both clinical and classroom contexts. METHODS: A literature search using the CINHAL, Medline, ERIC, and Academic Search Complete databases, using systematic methods, identified 26 papers and dissertations which gathered narrative data from nursing students in pre- and post-registration undergraduate courses. RESULTS: Three themes were found describing: 1) Evolving through time and space to reflect; 2) Surfacing and absorbing; and 3) Trust, judgement, and social desirability in the feedback process. CONCLUSIONS: Transformative learning is promoted through forming a bond with faculty during the writing process to normalize emotions, create critical self-awareness, and providing a safe, non-judgemental space to reflect on their practice and their learning.

Evaluating the impact of an arts-based multimedia knowledge translation assignment on undergraduate nursing students.

BACKGROUND: Despite the expectation that nurses utilize research to provide excellent patient care, students often fail to recognize the value of learning about evidence-informed practice. Experiential, creative pedagogical approaches are needed to engage undergraduate nursing students in evidence-informed practice. In two undergraduate courses, we implemented an innovative assignment in which students created an arts-based multimedia knowledge translation presentation to communicate systematic review findings to patients. OBJECTIVE: To evaluate how the assignment affected nursing students' satisfaction, learning, and anticipated behaviour changes regarding evidence-informed practice and to assess what factors influenced their evaluation of the assignment. DESIGN AND METHODS: Kirkpatrick's Evaluation Model and Groff's Theory of Whole-Mindedness informed our study, incorporating an observational cross-sectional survey design. We recruited a convenience sample of nursing students (N = 242) from two baccalaureate programs. We collected data with an online survey comprised of closed- and open-ended questions. Quantitative data were analyzed with descriptive statistics, univariate analysis, and general linear models, and qualitative data with content analysis. RESULTS: Most students were satisfied (68%) and reported learning (77%) and benefits for their future practice (75%). Age, enjoyment of and experience with the arts, type of motivation, and valuing evidence-informed practice were significant predictors (p < 0.01) and the model predicted 59% of the variance in positive student perceptions of the assignment. Students reported experiencing relational and engaged learning, translating research findings creatively and clearly, understanding complex research concepts through experiential learning, and having frustrations and pragmatic concerns. CONCLUSION: Creative approaches that contextualize research findings hold potential to deepen students' understanding of evidence-informed practice. This study identified key factors that influenced students' evaluation and experience of the assignment. These results provide valuable insights to inform effective implementation of arts-based assignments in nursing education.

The development of academic identity in graduate nursing students: An interpretive descriptive study.

BACKGROUND: Mentorship is an important element in the development of academic identity among graduate students in nursing. Although most often occurring within the context of faculty advisor-student relationships, mentorship should extend beyond formal advisor-advisee relationships. Peer mentorship is known to be beneficial for graduate students, yet little is known about how peer mentorship specifically impacts the development of academic identity. OBJECTIVE: The purpose of this study was to explore how peer mentorship, within the context of an international research conference, impacts the development of academic identity. DESIGN: Qualitative descriptive study. Graduate nursing students from a research-intensive university in Canada were invited to participate in a peer mentorship initiative. Data were collected through reflective journals. Data analysis was conducted iteratively and collaboratively using an interpretive descriptive approach. PARTICIPANTS: Eight mentees, two peer mentors and five faculty mentors participated in the initiative. With the exception of one faculty mentor, all participants provided reflective journals on their experiences, in response to journal prompts. RESULTS: Findings centered on five themes: walking through quicksand, navigating a complex academic world, developing academic identity through relationships, intentional cultivation of community, and finding solid ground. Our findings highlight the relational nature of academic identity development, and the significant benefit of providing mentorship to graduate nursing students outside of formal learning spaces. CONCLUSIONS: Given the urgent need to increase the numbers of nurses with advanced research training, it is important that effective strategies like this innovative mentorship initiative, that enhance professional identity development, are integrated into graduate education programs.

Writing activities and the hidden curriculum in nursing education.

Nursing programs are complex systems that articulate values of relationality and holism, while developing curriculums that privilege metric-driven competency-based pedagogies. This study used an interpretive approach to analyze interviews from 20 nursing students at two Canadian Baccalaureate programs to understand how nursing's educational context, including its hidden curriculums, impacted student writing activities. We viewed this qualitative data through the lens of activity theory. Students spoke about navigating a rigid writing context. This resulted in a hyper-focus on "figuring out" the teacher with minimal focus on the act of writing. Students used a form of behavioral "code-switching" to maximize their grade while considering how their "valuing" of the assignment fit within their writing motives. Hidden curriculum messages taught students that academic success was assured whether their writing mirrored instructor preferences. Instructional practices of rigidity reinforced unequal social conditions for some minority students. Faculty can counteract the impact of the hidden curriculum through encouragement of choice and independent thinking about writing activities. Acknowledging power relationships and their influence on how students navigate writing assignments and nursing discourse may relieve pressures on students who fear penalties for countering norms and result in a more flexible learning environment.

Strategies for retention of nursing students: A scoping review.

Retention of students in nursing programs is a costly concern that affects the supply and demand of nurses to the healthcare system. Successful retention strategies require consideration of social and academic institutional systems with attention to student integration in a program. This systematic review explores implemented retention strategies in nursing programs worldwide and provides guidance for nursing programs and researchers considering the retention question. Joanna Briggs Institute scoping review methods informed this review. CINAHL, ERIC, PsychINFO, and MEDLINE, databases were searched from January 1998 to December 2019. Data was extracted from 112 full text papers and dissertations. Papers were of varying quality and inconsistently evaluated, usually lacking theoretical grounding. Student participants in strategies were preselected by racial minority status or through various markers of academic performance. Retention strategies described in the literature are single program and multifactorial, with mentorship, study skills, literacy and language approaches, and tutoring the most common components. Reports of graduation rates or attrition rates through comparison with a pre-strategy time period or a comparison group were the most informative evaluations. Whole-program strategies that provided pathway options to students based on reading assessments or other academic criteria were the most comprehensive and effective strategies presented in the literature.

Seeking transformation: how students in nursing view their academic writing context - a qualitative systematic review.

Writing practices in nursing education programs are situated in a tension-filled context resulting from competing medical-technical and relational nursing discourses. The goal of this qualitative meta-study is to understand, from the student perspective, how the context for writing in nursing is constructed and the benefits of writing to nursing knowledge development. A literature search using the CINHAL, Medline, ERIC, and Academic Search complete databases, using systematic methods identified 21 papers and dissertations which gathered qualitative interview or survey data from students in nursing at the pre-registration, continuing education, and graduate levels. The studies provided evidence that writing assignments promote professional identity development but overemphasis on writing mechanics when grading have a deleterious effect on learning and student engagement with writing. Relationship building with faculty should extend beyond what is needed to maximize grades. Suggestions for writing pedagogical reform are identified to facilitate a change in focus from mechanical-technical to transformative writing.

Social and academic integration strategies for retention of nursing students: a scoping review protocol.

REVIEW QUESTION: The review question is: what are the types of formal and informal social and academic integration strategies that have been explored to influence nursing student persistence and increase retention in nursing programs? A secondary review objective is to address how the described strategies have specifically been implemented with minority nursing students.

A curriculum-wide assessment of writing self-efficacy in a baccalaureate nursing program.

OBJECTIVES: This study explores patterns of writing self-efficacy fluctuation across three academic years in a baccalaureate nursing program. The goal was to assess if writing self-efficacy predicted program grades. DESIGN: Longitudinal exploratory design. SETTING: Three-year accelerated nursing program in a college setting in Canada. PARTICIPANTS: Follow-up cohort included 49 students; 32 (65.3%) synchronous in program progression and 17 (34.7%) had become asynchronous between first and third year. METHODS: Data was collected five times between August 2013 and May 2016 at program admission, the start of their discipline-specific first-year writing course, the end of the writing course, start of third-year, and the end of third-year. Variables assessed included writing self-efficacy (two measures), writing anxiety, entrance degrees of reading power (DRP) scores, final college cumulative grade point average (GPA), and grades earned on first, second, and third-year papers. RESULTS: Writing self-efficacy statistically significantly improved from the start of the nursing program to the finish (p < .001). Writing self-efficacy fluctuated decreasing from post first-year writing course to the start of the third-year, returning to or exceeding end of writing course levels by the end of the third year. Students who progressed normally through the program (synchronous) were academically stronger (paper grades, DRP, GPA scores) and had higher writing self-efficacy scores than asynchronous students. Using hierarchical regression, DRP scores and synchronous/asynchronous status in the program made a larger contribution to the prediction of final program GPA and paper grades, while the inclusion of writing self-efficacy in the models made a minor contribution to overall variance. CONCLUSIONS: Writing self-efficacy will fluctuate based on context and complexity of writing demanded in academic programs. Second and third-year students require continued support with writing beyond an introductory course. Programs should attend to developing reading comprehension in students as part of their across-the-curriculum writing plans.

Constructing Writing Practices in Nursing.

BACKGROUND: Although the quality of student writing is often lamented by faculty, writing instruction is an area of nursing education that has received little attention. Nursing programs rarely teach writing from a disciplinary perspective, and promoting the drilling of basic skills, such as grammar, has failed to engage student writers. METHOD: A critical examination of the history of writing research, the nursing academic context, and the epistemology of writing as meaning making will provide the rationale behind a need for a new perspective on nurses' writing. RESULTS: A model to support socially constructed writing is proposed, which explores the writer's identity, relational aspects of writing, creative and emotional knowing, and the writing context. CONCLUSION: This article continues the conversation about re-visioning and enhancing the value of writing within the nursing profession. The knowledge created while writing can contribute to stimulating thinking, decision making in practice, and identity formation of nurses. [J Nurs Educ. 2018;57(7):399-407.].

Digital storytelling as a method in health research: a systematic review protocol.

BACKGROUND: Digital storytelling is an arts-based research method with potential to elucidate complex narratives in a compelling manner, increase participant engagement, and enhance the meaning of research findings. This method involves the creation of a 3- to 5-min video that integrates multimedia materials including photos, participant voices, drawings, and music. Given the significant potential of digital storytelling to meaningfully capture and share participants' lived experiences, a systematic review of its use in healthcare research is crucial to develop an in-depth understanding of how researchers have used this method, with an aim to refine and further inform future iterations of its use. METHODS: We aim to identify and synthesize evidence on the use, impact, and ethical considerations of using digital storytelling in health research. The review questions are as follows: (1) What is known about the purpose, definition, use (processes), and contexts of digital storytelling as part of the research process in health research? (2) What impact does digital storytelling have upon the research process, knowledge development, and healthcare practice? (3) What are the key ethical considerations when using digital storytelling within qualitative, quantitative, and mixed method research studies? Key databases and the grey literature will be searched from 1990 to the present for qualitative, quantitative, and mixed methods studies that utilized digital storytelling as part of the research process. Two independent reviewers will screen and critically appraise relevant articles with established quality appraisal tools. We will extract narrative data from all studies with a standardized data extraction form and conduct a thematic analysis of the data. To facilitate innovative dissemination through social media, we will develop a visual infographic and three digital stories to illustrate the review findings, as well as methodological and ethical implications. DISCUSSION: In collaboration with national and international experts in digital storytelling, we will synthesize key evidence about digital storytelling that is critical to the development of methodological and ethical expertise about arts-based research methods. We will also develop recommendations for incorporating digital storytelling in a meaningful and ethical manner into the research process. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registry number CRD42017068002 .

Writing self-efficacy in nursing students: The influence of a discipline-specific writing environment.

AIM: To explore if writing self-efficacy improved among first-year nursing students in the context of discipline-specific writing. The relationship between writing self-efficacy, anxiety and student grades are also explored with respect to various learner characteristics such as postsecondary experience, writing history, English as a second language status and online versus classroom instruction. DESIGN: A one group quasi-experimental study with a time control period. METHOD: Data was collected over the 2013-2014 academic year at orientation, start of writing course and end of writing course. RESULTS: Writing self-efficacy improved from pre- to post writing course but remained stable during the time control period. Anxiety was negatively related to writing self-efficacy but remained stable across the study period. Inexperienced students and students with less writing experience, appeared to over-inflate their self-assessed writing self-efficacy early in the programme. This study gives promising evidence that online and classroom delivery of instruction are both feasible for introducing discipline specific writing.

A Template Analysis of Writing Self-Efficacy Measures.

BACKGROUND AND PURPOSE: This investigation reviews the item content of writing selfefficacy (WSE) measures developed for undergraduate students. Bandura's self-efficacy theory and a writing theory by Flower and Hayes informed the a priori themes used to develop a template of WSE categories critical to the concept. METHOD: Articles describing WSE measures were identified through Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Education Resources Information Center (ERIC), PubMed, Scopus, and Google Scholar (1984-2015). A template analysis method was used to analyze 182 individual items present on 11 WSE instruments. A nursing perspective was applied. RESULTS: The analysis identified 16 categories influencing WSE as well as gaps in current measurement items. CONCLUSION: The theoretical examination of WSE is the first step toward the development of a WSE measure specific to the nursing context and contributes to nursing education by advancing the measurement of WSE.

Academic voice: On feminism, presence, and objectivity in writing.

Academic voice is an oft-discussed, yet variably defined concept, and confusion exists over its meaning, evaluation, and interpretation. This paper will explore perspectives on academic voice and counterarguments to the positivist origins of objectivity in academic writing. While many epistemological and methodological perspectives exist, the feminist literature on voice is explored here as the contrary position. From the feminist perspective, voice is a socially constructed concept that cannot be separated from the experiences, emotions, and identity of the writer and, thus, constitutes a reflection of an author's way of knowing. A case study of how author presence can enhance meaning in text is included. Subjective experience is imperative to a practice involving human interaction. Nursing practice, our intimate involvement in patient's lives, and the nature of our research are not value free. A view is presented that a visible presence of an author in academic writing is relevant to the nursing discipline. The continued valuing of an objective, colorless academic voice has consequences for student writers and the faculty who teach them. Thus, a strategically used multivoiced writing style is warranted.

Acetylcholine and choline amperometric enzyme sensors characterized in vitro and in vivo.

Acetylcholine (ACh) and choline (Ch) are important neuroactive molecules, yet detection of these substances in vivo presents significant analytical challenges. New multienzyme amperometric biosensors are presented here with measurement of physiologically relevant levels of ACh and Ch in vivo. Poly(m-(1,3)-phenylenediamine) (pmPD) electropolymerized on a platinum iridium wire (Pt) served as a template for immobilization of enzymes. A multienzyme layer containing choline oxidase (ChOx) and ascorbic acid oxidase (AAO) for a Ch sensor or ChOx, acetylcholinesterase (AChE), and AAO for a ACh/Ch sensor was immobilized with bovine serum albumin by cross-linking with glutaraldeyhyde. The pmPD enzyme sensors displayed enhanced sensitivity, stability, and selectivity compared to the same multienzyme systems immobilized to solvent cast Nafion and cellulose acetate-modified Pt. Sensor response was linear up to 100 microM ACh or Ch. Detection limits were 0.66 +/- 0.46 microM ACh and 0.33 +/- 0.09 microM Ch, and response times were <1 s. Selectivity for Ch and ACh relative to potential interferences and pharmacological agents commonly used to examine cholinergic physiology was demonstrated. Temperature and pH dependence and the effect of storage conditions on sensor sensitivity and selectivity were determined. Exogenous and endogenous Ch and ACh were measured in the rat brain in vivo.