Exploring factors affecting the facilitation of nursing students to learn paediatric pain management in Rwanda: A descriptive qualitative study.

Nurse educators and nurse preceptors play a fundamental role in facilitating nursing students' acquisition and utilization of professional competencies. Previous studies about key elements for teaching and learning about pain in nursing education programs include students' personal characteristics and previous experiences; educators' knowledge, skills, and beliefs; learners' exposure to leaders in pain education; and curricular pain content and delivery approaches. These studies were mainly carried out in developed countries, with a context of educational and health care systems different from those of developing countries. The current study explores academics', clinical nurse preceptors', and nursing students' perceptions about factors influencing the facilitation of nursing students' competency for paediatric pain management in Rwanda. A qualitative descriptive exploratory design was used in this study that utilized in-depth interviews with six nurse educators and eight nurse preceptors, and focus group discussions with nineteen senior year nursing students. The study setting included five sites: two academic institutions and three clinical settings. Narratives from participants were transcribed verbatim and analysed using thematic analysis. The analysis yielded six themes describing factors that affected the facilitation of students' learning about paediatric pain management. The themes included student motivation, facilitators' attributes, collaboration between academics and clinicians, nurses' limited autonomy for decision-making regarding PPM practices, shortage of human and material resources, and educational qualification. Knowing these factors is essential as it provides an opportunity to design targeted interventions aimed to enhance the capacity of nurse educators and clinical nurse preceptors involved in teaching nursing students about paediatric pain management.

Simulated Wound Care as a Competence Assessment Method for Student and Registered Nurses.

OBJECTIVE: To describe the development and use of a wound care simulation assessing RNs' and graduating student nurses' practical wound care competence and to describe observations of participants' wound care competence. METHODS: A descriptive, qualitative design was used. Data were collected in 2019 from 50 healthcare professionals and students using a simulated wound care situation and an imaginary patient case. The simulation was based on a previously developed and tested wound care competence assessment instrument, which included a 14-item checklist that assesses practical wound care competence of chronic wounds. The data were analyzed and described based on the 14 competence areas or as other competencies. RESULTS: Participants showed competence in identification of wound infection, debridement, dressing selection, tissue type identification, and consultation. Participants' shortcomings were related to pain assessment and management, asepsis, offloading, and documentation. Simulation was shown to be a promising tool to assess healthcare professionals' and students' practical wound care competence in a safe and standardized situation. CONCLUSIONS: This study provided new information about simulation as a method to assess student nurses' and RNs' wound care competence. The results could be used in wound care education planning and development in both undergraduate nursing education and continuing education for nursing professionals.

Student Nurse Knowledge of and Attitudes Toward Pressure Injury Prevention: How Sufficient Is Undergraduate Education?

OBJECTIVES: To assess the knowledge and attitudes of student nurses regarding evidence-based guidelines for preventing pressure injuries. METHODS: This study used a descriptive research design. The participants included second-, third-, and fourth-year nursing students completing their bachelor's degrees at a faculty of nursing in Turkey. Data collection forms consisted of a student nurse information form, the Pressure Ulcer Prevention Knowledge Assessment Instrument, and the Attitude Towards Pressure Ulcer Prevention Instrument. RESULTS: The overall mean score for knowledge was 49.9% (11.7/26). The highest scores for the instrument's subthemes were for nutrition (72%), and the lowest were for etiology and development (40.1%). The overall mean attitude score was 42.20 ± 2.40, although a statistically significant difference among grades was found (P < .001). The highest mean scores showed agreement among students that pressure injury prevention should be a priority (10.50 ± 1.43). A significant difference was found in the competence subscale according to the number of dressing changes observed and sense of competence in pressure injury care (P = .003). A weak but statistically significant positive relationship was found between knowledge and attitude scores (r = 0.158; 95% confidence interval, .040-.269; P < .001). CONCLUSIONS: This study revealed that certain revisions are needed in the nursing curriculum to improve the knowledge and attitudes of nursing students toward the prevention and care of pressure injuries. More details should be covered in the classroom and laboratories through simulation or clinical practice for improved management of pressure injuries.

Feedback in clinical settings: Nursing students' perceptions at the district hospital in the southern part of Namibia.

BACKGROUND: Feedback was the backbone of educational interventions in clinical settings. However, it was generally misunderstood and demanding to convey out effectively. Nursing students were not confident and did not feel free to practise clinical skills during practical placements because of the nature of the feedback they received whilst in these placements. Moreover, they experienced feedback as a barrier to completing practical workbooks. OBJECTIVE: The purpose of this article was to report on a qualitative study, which explored nursing students' perceptions of the feedback they received in clinical settings, at a district hospital. METHOD: This study was conducted at a district hospital located in southern Namibia. An explorative qualitative design with an interpretivist perspective was followed. A total of 11 nursing students from two training institutions were recruited by purposive sampling and were interviewed individually. All interviews were audio recorded with a digital voice recorder followed by verbatim transcriptions, with the participants' permission. Thereafter, data were analysed manually by qualitative content analysis. RESULTS: Themes that emerged as findings of this study are feedback is perceived as a teaching and learning process in clinical settings; participants perceived the different nature of feedback in clinical settings; participants perceived personal and interpersonal implications of feedback and there were strategies to improve feedback in clinical settings. CONCLUSION: Nursing students appreciated the feedback they received in clinical settings, despite the challenges related to group feedback and the emotional reactions it provoked. Nursing students should be prepared to be more receptive to the feedback conveyed in clinical settings.

Assessing Undergraduate Student Nurses' Performance in Various Public Health Roles Using Simulation.

Purpose: To expose students to various public health roles and complement clinical experience using simulated encounters.Design: This exploratory study assessed students' performance of basic nursing tasks for three public health nurse roles.Methods: 15-guided questions were used to evaluate a convenience sample of 137 students' expected performance compared to their actual performance of basic nursing skills.Findings: Students' performed well in all nurse roles with some significant differences in completing a few critical tasks in the case manager and school nurse roles.Conclusion: Simulation can address gaps in nursing programs and expose student nurses to various public health roles using real-life scenarios.Clinical Evidence: Lack of clinical sites in public health limits students' experience to a myriad of nurse functions within communities.

"He just teaches whatever he thinks is important": Analysis of comments in student evaluations of teaching.

Student evaluations of teaching are ubiquitous in higher education; however, most prior research has focused on the numeric ratings, with little systematic attention given to the qualitative comments. In this study, written comments were collected as part of the regular evaluation of a community health nursing course over four semesters. Taken as a whole, student comments were strikingly consistent and mostly negative. Students emphasized the authority of the textbook and framed the course as preparation for the National Council Licensure Examination (NCLEX). Instructor efforts to focus on critical analysis of social issues were met with confusion, suspicion, and resistance. Student comments were further analyzed in relation to 3 levels of discourse: the student/teacher level, the nursing-education level, and the social-historical level. For each level, the comments reveal problems, but not the ones suggested by a conventional reading of student evaluations. If students and teachers have conflicting expectations about goals and methods for learning, formal student evaluations may be less useful as a measure of teaching effectiveness. This study also raises troubling concerns about current practices in nursing pedagogy, particularly the emphasis on standardized testing and highly structured didactics, and the overlap between student evaluation systems and the technologies of neoliberalism.

Experiences of undergraduate nursing students during clinical practice at health facilities in Western Cape, South Africa.

BACKGROUND: This study explored the experiences of undergraduate nursing students during clinical practice at healthcare facilities in the Boland Overberg area in Western Cape, South Africa. Few studies have been done on experiences of nursing students during clinical practice. However, there are still inadequacies, which lead to the deterioration of clinical practice quality. OBJECTIVES: To explore and describe the experiences of undergraduate student nurses during clinical practice in healthcare facilities in Boland Overberg, in Western Cape, South Africa. METHOD: A qualitative, exploratory descriptive design was applied. Data collection was done using focus-group interviews to ascertain the undergraduate student nurses' experiences during clinical practice in healthcare facilities in the Boland Overberg area in Western Cape Region. Thirty-eight undergraduate nursing students from Boland Campus were selected, using purposive sampling. The sample size was based on data saturation. Colaizzi's method of coding and thematic content analysis was used to interpret the data. Ethical principles were adhered to. RESULTS: After data analysis, the following themes emerged: clinical learning environment, challenges and inability to reach objectives. CONCLUSION: During clinical practice in healthcare facilities, students were confronted with dilemmas which must be addressed with proper planning to decrease the challenges in clinical education of future nurses. The findings can be used in planning of nursing education, could provide help to develop effective clinical teaching strategies in nursing education and to support these undergraduate nursing students.

Can nursing educators learn to trust the world's most trusted profession?

Nursing and nursing education face a paradox whereby the world's most trusted profession seems not to trust its own students and practitioners. Much of nursing education has adopted what has been memorably described as the 'cop shit' approach. This is the panoply of surveillance, anti-plagiarism and proctoring technologies that appear to be used more for policing and punishment of an inherently dishonest student body than to develop ethical and scholarly writing among future peers and colleagues. Nurses in practice may experience similar levels of distrust as they face growing micromanagement and control of both their appearance and nursing practice. We propose that these practices of distrust emerge, not from malice, but rather from the omnipresent neoliberalism and managerialism that engulf almost every aspect of health and university life. Neoliberalism's success has been to reformat academia and practice to the point where such ingrained mistrust has become merely a neutral recognition of 'the real world'. Dismantling nursing and education's 'cop shit' culture and replacing it with the trust and respect that the world's most trusted profession is accorded by wider society will not be easy, but it is vital for the future of nursing.

A preceptorship model to facilitate clinical nursing education in health training institutions in Botswana.

BACKGROUND: Despite the wide use of preceptorship, there is evidence that preceptorship and the role of preceptor in clinical nursing education are not clearly understood or supported. OBJECTIVES: To develop a preceptorship model to facilitate clinical nursing education in Botswana. METHOD: The model development in this study followed the steps of theory generation as described by Chinn and Kramer. These four steps are concept analysis, relationship statements, description and critical reflection of the model. RESULTS: Four main themes emerged from the empirical study that formed the basis for key concepts and model development. The model has six components, namely, agent, recipient, context, procedure, dynamics and terminus. The description of the model is based on Chinn and Kramer. CONCLUSION: The need for a preceptorship model to facilitate preceptorship cannot be overemphasised in this regard. This model will guide the planning and implementation of preceptorship procedures by different stakeholders to improve its effectiveness in clinical nursing education.

The Glasgow Coma Scale: A European and Global Perspective on Enhancing Practice.

Although the Glasgow Coma Scale has made a positive contribution to the care of people with neurologic orders, variance exists in its understanding and application secondary to inconsistency in guidelines, their interpretation, and the educational approach to the use of the tool. This fragmentation has been evidenced to result in variances in practice, some potentially harmful. Also, recent evidence demonstrates human factors, such as distress, have not been addressed within such education and guidelines for use. An opportunity now exists to take a new, unified approach to education and standards for use of the tool, framed within a person-centered context.

Exploratory Factor Analysis of the Indonesian Version of the Clinical Learning Environment, Supervision, and Nurse Teacher Scale (CLES + T).

BACKGROUND AND PURPOSE: The purpose of this article is to describe an evaluation of psychometric properties of the Indonesian version of the Clinical Learning Environment, Supervision, and Nurse Teacher (CLES + T) scale, a scale that measures nursing students' perceptions of their clinical learning environment. METHODS: The CLES + T was completed by 292 nursing students. Inter-item correlations, exploratory factor analysis, Cronbach's alpha, and evidence of validity were used to examine reliability and validity. RESULTS: Four factors were extracted that explained 58% of the variance. Cronbach alphas ranged from .86-.95. Wording to describe different titles of supervisors was unclear to some of the participants. CONCLUSION: The Indonesian version of the CLES + T is a reliable version. More research is needed to clarify some of the wording.

Findings from a context specific accreditation assessment at 38 public midwifery education institutions in Bangladesh.

BACKGROUND: In order to promote sustainable midwifery education, it is important to understand what the structural shortcomings are. In this study of 38 public nursing institutions in Bangladesh, we aim to identify a number of structural shortcomings and to discuss strategies for limiting them. METHODS: An evaluated context-specific accreditation assessment tool consisting of 37 multi-choice closed-response questions encompassing 14 educational standards aligned with international standards for midwifery education programs and competences for midwifery educators was used to assess all public nursing institutions in Bangladesh (n=38), the results of which are presented in simple descriptive statistics; number (n), percentage (%), mean, SD and minimum-maximum value. RESULTS: Provision around clinical practice sites is the key structural shortcoming within the Bangladeshi midwifery educational system. Twenty-five percent of the institutions provided no opportunity for midwifery students to practice comprehensive sexual and reproductive health care. Twenty-nine per cent of the clinical sites were not aware of the content of midwifery courses and syllabi. Finally, one third of students achieving a midwifery qualification did not meet the learning outcomes to support women in birth. CONCLUSIONS: To measure progress towards national and global milestones to ensure students are equipped with required competencies before graduating as registered midwives will be difficult to meet unless shortcomings within the educational system are addressed. We recommend (i) the inclusion of clinical placement sites in future assessments, (ii) the introduction of an integrated feedback-appeal-response system, and (iii) the development of a system for improved communication links between educational institutions and clinical placement sites.

Effectiveness of simulation-based cardiopulmonary resuscitation training programs on fourth-year nursing students.

BACKGROUND: Cardiopulmonary resuscitation (CPR) training for nursing students is important. The aim of study is to examine the effectiveness of a simulation-based CPR training program on the knowledge, practices, satisfaction, and self-confidence of nursing students. METHODS: The study was conducted with a mixed-method design. The quantitative data were obtained by using the "CPR Knowledge Questionnaire," the "Students' Satisfaction and Self-Confidence Scale," and the "CPR Skills Observation Checklist", and the qualitative data were collected by using the "Semistructured Interview Form" in four focus group sessions, each consisting of six participants. RESULTS: The mean pretest CPR knowledge score of the students before the simulation-based CPR training was 5.66 ± 1.97 out of 10.0. The mean posttest CPR knowledge score (8.38 ± 1.30) increased significantly after the simulation (p < 0.001). In addition, the mean posttest CPR skills score was significantly higher than the mean pretest CPR skills score (p < 0.001). Themes from the qualitative data revealed that the students considered the simulation to be an interesting and useful teaching method. These themes were "worries before simulation" and "satisfaction following simulation". CONCLUSION: Simulation-based CPR training improved the levels of knowledge and skills of nursing students. In addition, after the simulation training, satisfaction and self-confidence scores were found to be high.

A Nationwide Italian Cross-sectional Study on Nursing Students' Perceived Workplace Safety During Clinical Practice.

BACKGROUND: Nursing students' perception of a safe clinical working environment may impact the development of professional skills and progression in the profession. PURPOSE: The aims of this study were to describe to what extent nursing students perceive the working environments as safe during their most recent clinical rotation and to explore factors associated with their perception of a safe workplace environment. METHODS: A nationwide Italian cross-sectional study involving 9607 students in 27 universities across 95 three-year nursing programs was performed in 2015-2016, and secondary analyses were run in 2019. RESULTS: The workplace environment was perceived by students as only a little (n = 2598 [27.0%]), to some extent (n = 4048 [42.1%]), and always (n = 2555 [26.0%]) safe; 406 (4.2%) students reported to have never felt that the workplace as safe. At the multivariate level, factors promoting students' perception of a safe clinical environment were a setting offering higher (a) learning opportunities, (b) safety and nursing care quality, (c) quality of tutorial strategies, and (d) self-directed learning opportunities. CONCLUSIONS: Nursing faculty should assess the quality of clinical settings before deciding on environments for students' learning experience.

Nursing students' perspectives on observed weight bias in healthcare settings: A qualitative study.

BACKGROUND: Weight bias continues to be problematic within the healthcare setting among practicing healthcare providers (HCPs). These HCPs serve as influential role models for nursing students when immersed in the clinical environment. However, if HCPs are demonstrating bias toward patients with obesity, this may influence nursing students' beliefs and practices. AIMS: This study aimed to explore nursing students' reflections of observed weight bias within the healthcare setting. MATERIALS & METHODS: A descriptive qualitative study design was used involving reflective journaling and qualitative content analysis. Two cohorts of third-year baccalaureate nursing students (n = 197) participated in weight sensitivity training and submitted reflective journals over one academic semester. RESULTS: Reports of weight bias were categorized into three themes-(1) Direct Impact: Observed Implicit and Explicit Provider Weight Bias; (2) Indirect Impact: Weight Bias Due to Skills, Equipment, or Staffing/Environmental Deficits; and (3) Reactions toward HCP Weight Bias: Conflict Between Weight Bias Training and Real-World Healthcare Experiences. DISCUSSION: Weight bias was observed in some HCPs within the healthcare setting. Student reflections explored weight bias and the opposing messages between weight sensitivity training and real-world practices. CONCLUSION: Preventing bias through continuing education for HCPs is crucial to provide compassionate care and instill ethical values in the next generation nurses.

Houser Gear Conceptual Model for New Nurse Educators.

This article presents a conceptual model explaining classroom dynamics, to guide novice nurse educators who are transitioning from clinical practice to academia. A critical review using Fawcett's framework for analysis and evaluation of nursing models was used to develop the Houser gear conceptual model, a visual representation of a gear system depicting the fundamental relationship among nursing leadership, active teaching strategies, and student learning outcomes.

Improving Portfolio Assessment: Addressing Challenges in Transition to Eportfolio.

BACKGROUND: As health care education programs adopt electronic portfolios (eportfolios), a midwestern university baccalaureate nursing program faces challenges in transitioning from a 25-year-old paper-based system to eportfolio. METHOD: Process improvements and faculty development were implemented through collaboration with the information technology (IT) department and the involvement of students as ambassadors. Pre- and posttransition surveys and portfolio benchmarks were used to evaluate the efficacy of the new eportfolio system. RESULTS: Results of faculty and student surveys revealed improved positive experiences regarding the value, clarity, and ease of use of the eportfolio system. Benchmark deficits decreased from six of eight portfolio criteria in Fall 2017 to none in Fall 2019. CONCLUSION: Buy-in through faculty and student involvement, along with a user-centered design, are essential for a successful eportfolio transition. Student and faculty engagement would be secured when they are well-informed in the transition process. [J Nurs Educ. 2020;59(12):705-708.].

Nursing Education in Catalonia: Novice Professionals' Appraisal of Its Quality and Usefulness. Does Mobility Play a Role?

The present study aimed to examine the relationship between the quality of undergraduate education perceived by novice nurses and their retrospective satisfaction with their education. It also studied the relationships between the perceived usefulness of their education for their current jobs and the quality of the jobs held by novice nursing professionals. The moderator role of mobility in this relationship was also analyzed, as it reflects a boundary condition in which additional preparation or job opportunities may occur. The study used data from the graduates' survey carried out by the Agència per a la Qualitat del Sistema Universitari de Catalunya (AQU) in 2017. The analysis of data from 644 graduates of Catalan Universities in 2014 highlights different functions of two types of knowledge and skills; those directly related to science and the practice of nursing are stronger predictors of retrospective satisfaction with nursing education. In turn, the perception of the usefulness of horizontal skills, such as transversal and communication skills, plays a stronger role in predicting job quality. The results about the role of mobility were not conclusive, and more research is needed to clarify its influence on nursing education and subsequent professional practice.

Intended and Actual Outcomes of Study Abroad Programs: Nursing Students' Experiences.

BACKGROUND: Many nursing students participate in study abroad opportunities; yet, few studies explore their experiences. Given the increasing emphasis on evaluating the quality of higher education internationalization, this study explored the motivations for, and outcomes of, Maltese nursing students' Erasmus+ exchanges against the program's intended outcomes. METHOD: Sixty-five Erasmus+ mobility participants completed an online questionnaire (response rate = 44.8%), and 16 participated in a 2-hour focus group. RESULTS: Participants overwhelmingly agreed that intended outcomes of the Erasmus+ program were achieved. Thematic analysis revealed five themes: Enhanced Employability as a Nurse; Exposure to Nursing Beyond the National Shores; Personal Growth; Context-Sensitivity of Nursing Care Delivery; Language and Citizenship. CONCLUSION: These positive experiences confirm that nurse educators should continue encouraging and facilitating study abroad experiences, and that such opportunities should be offered to even more students. However, more research is required to explore any negative outcomes of student mobility and whether the participants' perceptions change over time. [J Nurs Educ. 2020;59(9):501-505.].

Striving for Gerotranscendence: Preparing Nursing Students to Care for the Aging Population.

BACKGROUND: The population of older adults in America is increasing rapidly, but many prelicensure nursing students do not understand the unique needs of these patients. Educational methods are needed that foster a mindset of research and inquiry to help older adults thrive. METHOD: A three-pronged educational hybrid was designed to help students create meaningful links between geriatric nursing theory in the classroom and application in the clinical setting. RESULTS: Test scores increased for 45% of students after the intervention, and 89% reported a greater understanding of evidence-based geriatric care. Students demonstrated increased confidence in discussing geriatric care and sharing theoretical knowledge with peers. CONCLUSION: With guided application of nursing theory in the clinical setting, students can use evidence-based care and develop nursing practice that helps older adults thrive. This prepares students to meet the demands of today's health care environment and develop practice standards that will follow them throughout their careers. [J Nurs Educ. 2020;59(9):536-538.].