Narrative Pedagogy: Transforming Nursing Education Through 15 Years of Research in Nursing Education.

AIM: This article provides a review of current disciplinary understanding of Narrative Pedagogy and describes the implications for ongoing transformation in nursing education. BACKGROUND: Narrative Pedagogy has been enacted and investigated by teachers around the world for more than 15 years. Few nursing educational innovations or pedagogies in nursing have been adopted in such an array of settings/levels. METHOD: A review of the nursing literature was conducted to locate reports of research on and teaching innovations derived from Narrative Pedagogy. RESULTS: Narrative Pedagogy has an extensive and longitudinal body of research describing how the approach contributes to the educational transformation the discipline seeks. CONCLUSION: Narrative Pedagogy and the growing literature describing how it is enacted provides a way for teachers and students to persist in questioning their current understanding of nursing, the ways they think about the situations they encounter, and how their practice can best be learned.

Enabling narrative pedagogy: inviting, waiting, and letting be.

AIM: This article describes how teachers enable Narrative Pedagogy in their courses by explicating the Concernful Practice Inviting: Waiting and Letting Be. BACKGROUND: Narrative Pedagogy, a research-based, phenomenological approach to teaching and learning, extends conventional pedagogies and offers nursing faculty an alternative way of transforming their schools and courses. METHOD: Using hermeneutic phenomenology, interview data collected over a 10-year period were analyzed by coding practical examples of teachers' efforts to enact Narrative Pedagogy. RESULTS: When Narrative Pedagogy is enacted, teachers and students focus on thinking and learning together about nursing phenomena and seek new understandings about how they may provide care in the myriad situations they encounter. CONCLUSION: Although the Concernful Practices co-occur, explicating inviting experiences can assist new teachers, and those seeking to extend their pedagogical literacy, by providing new understandings of how Narrative Pedagogy can be enacted.

Clinical education in nursing: rethinking learning in practice settings.

Clinical education is a time- and resource-intensive aspect of contemporary nursing programs. Despite widespread agreement in the discipline about the centrality of clinical experiences to learning nursing, little is known about if and how current clinical experiences contribute to students' learning and readiness for practice. Before large-scale studies testing specific educational interventionals can be conducted, it is important to understand what currently occurs during clinical experiences. This study, funded by the National Council of State Boards of Nursing, examined the nature of contemporary clinical education by describing students' and faculty's experiences at three geographically diverse universities in the United States. Findings suggest that teachers' and students' focus on task completion persists and often overshadows the more complex aspects of learning nursing practice.

Research in nursing education: state of the science.

The purpose of this pilot study was to assess the educational research currently conducted in U.S. schools of nursing. In this article, we describe the results from a small sample of schools of nursing (N = 21) and report the prevalence, type and level of funding for educational research, perceived barriers to developing and conducting rigorous programs of educational research in nursing, and support required. The respondents reported conducting primarily descriptive studies, most of which were underfunded, as well as a variety of barriers to conducting programs of educational research. The findings from this study provide some initial insights into the state of nursing education science in the United States. Despite the small sample, the findings affirm the paucity of research in nursing education and that the discipline must attend to the developmental needs of nurse researchers who study phenomena related to nursing education.

Fostering geriatrics in associate degree nursing education: an assessment of current curricula and clinical experiences.

The proportion of older adults in the population is rapidly increasing, and this trend is expected to continue. Because more than half of all new graduates eligible to enter the nursing workforce are prepared in associate degree (AD) programs, it is critical these new nurses are well prepared to care for older adults. This study examined how the care of older adults is currently taught in AD programs. Representatives from 531 AD programs responded to a survey providing information about the structure and content of AD curricula, the clinical sites and instructional resources used, and faculty expertise. Findings highlight opportunities for enhancing geriatric content and experiences in AD curricula through the creation of standards for geriatrics in AD nursing programs, the use of diverse clinical settings, and the creation of strategies that strengthen the focus on the care of older adults in acute care across the curriculum.

Fostering patient safety competencies using multiple-patient simulation experiences.

This multisite study examined the impact of multiple-patient simulation experiences on the development of nursing students' patient safety competencies in the final semester of their baccalaureate or associate degree nursing program. It extends the Jeffries Simulation Model by investigating how the student factors of tolerance for ambiguity and self-reported grade point average (GPA), in addition to age, relate to the outcomes of simulation. The study showed that students' safety competencies improved significantly from the first to the second simulation. Student age, GPA, and tolerance of ambiguity were not significantly correlated to the students' demonstration of patient safety competencies. The findings of this study contribute to the science of nursing education by providing evidence for nursing educators related to the impact of multiple-patient simulations on improving and documenting students' patient safety competencies before their entry into the workforce.

Doing Heideggerian hermeneutic research: a discussion paper.

BACKGROUND: Much has been published related to the epistemology of Heideggerian hermeneutic research. We seek to reveal insights from our experience of enacting such research. OBJECTIVE: To articulate the lived experience of 'doing' Heideggerian hermeneutic research. DESIGN: The authors of this paper shared their experiences with the primary author towards articulating the process of 'doing' such research. PARTICIPANTS: The authors all have long experience with Heideggerian hermeneutic research and meet regularly at the Institute for Interpretive Phenomenology. They supervise student's research and are mindful of the process of coming to understand how to work in a phenomenological/hermeneutic manner. METHODS: First the section on philosophical underpinnings was written by the primary author and then shared with all authors. There was published data related to the experience of three of the participants already available. This provided a spring board to further conversations when the primary author visited America, able to engage in daily conversations with three of the co-authors. In the spirit of phenomenology this paper represents a process of reading, talking, writing, talking, reading, re-writing, re-talking and so forth. RESULTS: The process of doing hermeneutic phenomenology is represented as a journey of 'thinking' in which researchers are caught up in a cycle of reading-writing-dialogue- which spirals onwards. Through such disciplined and committed engagement insights 'come'. The researcher is always open to questions, and to following a felt-sense of what needs to happen next. However, it is not a process of 'do whatever you like' but rather a very attentive attunement to 'thinking' and listening to how the texts speak. CONCLUSION: This paper argues that alongside a disciplined understanding of the methodology, both researcher and reader need to share a commitment to 'thinking' which is willing to question, and open to trusting the resonance of understanding that 'comes' without expecting answers that are declared 'truth' for all time.

Safeguarding patients through continuing competency.

To ensure patient safety, it is crucial that nursing change the paradigm from demonstrating competency to continuing competency.

Burnout and Its Contributing Factors Among Midlevel Academic Nurse Leaders.

BACKGROUND: Amid concerns regarding administrator shortages, a survey conducted by the American Association of Colleges of Nursing indicates that 10% of all vacant faculty positions are those that include administrative responsibilities. This study was designed to determine the frequency, predictors, and potential retention consequences of burnout among midlevel academic nurse leaders, such as assistant deans, associate deans, and others. METHOD: The sample consisted of 146 midlevel academic nurse leaders from 29 schools of nursing. Burnout was measured by the emotional exhaustion subscale of the Maslach Burnout Inventory. Logistic regression models were estimated to determine effects of study variables on burnout and intent to leave. RESULTS: Dissatisfaction with workload, dissatisfaction with work-life balance, and hours typically worked per week increased odds of burnout. Burnout was associated with intent to leave. CONCLUSION: High workloads and long work weeks are increasing the odds of burnout among midlevel academic nurse leaders. [J Nurs Educ. 2018;57(1):28-34.].

Advancing the science of nursing education: rethinking the meaning and significance of impact factors.

It is not the case that impact factors are unhelpful and that their use should be abolished. Indeed, ISI is continuing to refine existing and develop new databases to provide important information to researchers, administrators, librarians, and editors. Impact factor data do provide useful information for the review process if used judiciously and with an awareness of what these data do and do not indicate. Perhaps it is timely for members of the nursing discipline to think more broadly about the nature of impact and to talk more about the ways in which review processes can account for the many ways the impact of research can be demonstrated. For example, as part of the review process, reviewers might ask each researcher to provide exemplars from teaching or clinical practice settings in which their research is actually being used. Researchers might also be asked to describe the impact that has occurred in ways other than through publication (e.g., presentations, consulting) and how this impact was determined. Creating review processes that allow researchers to describe their decision making related to disseminating their research and how this reflects their ability to influence the discipline may provide a more realistic picture of impact than calculated figures alone.

Rethinking the meaning and significance of journal impact factors.

It is not the case that impact factors are unhelpful and that their use should be abolished. Indeed, ISI is continuing to refine existing and develop new databases to provide important information to researchers, administrators, librarians, and editors. Impact factor data do provide useful information for the review process if used judiciously and with an awareness of what these data do and do not indicate. Perhaps it is timely for members of the nursing discipline to think more broadly about the nature of impact and to talk more about the ways in which review processes can account for the many ways the impact of research can be demonstrated. For example, as part of the review process, reviewers might ask each researcher to provide exemplars from teaching or clinical practice settings in which their research is actually being used. Researchers might also be asked to describe the impact that has occurred in ways other than through publication (e.g., presentations, consulting) and how this impact was determined. Creating review processes that allow researchers to describe their decision making related to disseminating their research and how this reflects their ability to influence the discipline may provide a more realistic picture of impact than calculated figures alone.

Advancing the science of nursing education: rethinking the meaning and significance of impact factors.

It is not the case that impact factors are unhelpful and that their use should be abolished. Indeed, ISI is continuing to refine existing and develop new databases to provide important information to researchers, administrators, librarians, and editors. Impact factor data do provide useful information for the review process if used judiciously and with an awareness of what these data do and do not indicate. Perhaps it is timely for members of the nursing discipline to think more broadly about the nature of impact and to talk more about the ways in which review processes can account for the many ways the impact of research can be demonstrated. For example, as part of the review process, reviewers might ask each researcher to provide exemplars from teaching or clinical practice settings in which their research is actually being used. Researchers might also be asked to describe the impact that has occurred in ways other than through publication (e.g., presentations, consulting) and how this impact was determined. Creating review processes that allow researchers to describe their decision making related to disseminating their research and how this reflects their ability to influence the discipline may provide a more realistic picture of impact than calculated figures alone.

Comparison of Nurses' Self-Reported and Objectively Measured Evidence-Based Practice Knowledge.

BACKGROUND: This study provides a first-time, objective assessment of the evidence-based practice (EBP) knowledge of RNs working in Magnet®-designated hospitals. METHOD: This multisite, cross-sectional, descriptive, correlational study uses the Evidence-Based Practice Knowledge Assessment in Nursing (EKAN) and Evidence-Based Practice Questionnaire (EBPQ). RESULTS: EBPQ subscale scores revealed overall positive self-ratings of EBP knowledge/skills, attitudes, and practice/use. EKAN sum scores were not correlated with EBPQ scores (r = .017 to .123, p = not significant). Higher levels of nursing education were associated with higher scores on EKAN and were the only statistically significant predictor of EKAN scores. CONCLUSION: Nurses' self-reported EBP knowledge/skills, attitudes, and practice/use were not statistically significantly correlated with objectively measured EBP knowledge. Direct, objective measurement is recommended as the standard when testing interventions aimed at advancing EBP knowledge, skills, and ability. J Contin Educ Nurs. 2017;48(2):65-70.

Implementation of a State Legislative Fellowship for Doctor of Nursing Practice Students.

Doctor of Nursing Practice (DNP) students need to be effective health policy leaders and contribute their expertise to legislative discussions. Nursing faculty have unique opportunities to prepare future DNP health policy leaders through legislative experiential learning opportunities. Yet, the creation of legislative fellowships can seem challenging. This article describes a state legislative fellowship based on Kolb's experiential learning theory and explores ways faculty can support DNP student preparation.

Working together, creating excellence: the experiences of nursing teachers, students, and clinicians.

This study, conducted to inform the development and implementation of the National League for Nursing Centers of Excellence in Nursing Education Program, provides a hermeneutical analysis of the common experiences and shared meanings of excellence as described by nursing students, teachers, and clinicians. Findings highlight how excellence resides in students and teachers working and learning together through enacting new pedagogies. Two themes are reported: "Working Together: Creating New Partnerships Between and Among Teachers and Students" and "Learning Together: Creating Excellence and Shaping the Future of Nursing Education Through Enacting New Pedagogies".

Teaching thinking and reaching the limits of memorization: enacting new pedagogies.

Contemporary practice environments are complex and require students and new graduates to possess high-level thinking capabilities to ensure patient safety and quality of care. To achieve this goal, many nurse educators are exploring new pedagogies (critical, feminist, phenomenological, and postmodern) to teach students the practices of thinking that contemporary clinical situations demand. These new pedagogies offer alternatives to the predominant use of conventional pedagogies, which emphasize students' memorization of content and its subsequent application in practice situations. This study, using Heideggerian hermeneutics, documents how teachers are using new pedagogies in ways that shift their attention to teaching thinking and away from devising strategies to help students memorize and apply more content. One of the themes that emerged from this study, Teaching Thinking and Reaching the Limits of Memorization, and two subthemes, Thinking AS Memorization and Recall, and Beyond Memorization: Thinking in Context are presented.