Challenges and opportunities of English as the medium of instruction in diploma midwifery programs in Bangladesh: a mixed-methods study.

BACKGROUND: English is generally recognized as the international language of science and most research on evidence-based medicine is produced in English. While Bangla is the dominant language in Bangladesh, public midwifery degree programs use English as the medium of instruction (EMI). This enables faculty and student access to the latest evidence-based midwifery content, which is essential for provision of quality care later. Yet, it also poses a barrier, as limited English mastery among students and faculty limits both teaching and learning. METHODS: This mixed-methods study investigates the challenges and opportunities associated with the implementation of EMI in the context of diploma midwifery education in Bangladesh. Surveys were sent to principals at 38 public midwifery education institutions, and 14 English instructors at those schools. Additionally, ten key informant interviews were held with select knowledgeable stakeholders with key themes identified. RESULTS: Surveys found that English instructors are primarily guest lecturers, trained in general or business English, without a standardized curriculum or functional English language laboratories. Three themes were identified in the key informant interviews. First, in addition to students' challenges with English, faculty mastery of English presented challenges as well. Second, language labs were poorly maintained, often non-functional, and lacked faculty. Third, an alternative education model, such as the English for Specific Purposes (ESP) curriculum,  has potential to strengthen English competencies within midwifery schools. CONCLUSIONS: ESP, which teaches English for application in a specific discipline, is one option available in Bangladesh for midwifery education. Native language instruction and the middle ground of multilingualism are also useful options. Although a major undertaking, investing in an ESP model and translation of technical midwifery content into relevant mother tongues may provide faster and more complete learning. In addition, a tiered system of requirements for English competencies tied to higher levels of midwifery education could build bridges to students to help them access global evidence-based care resources. Higher levels might emphasize English more heavily, while the diploma level would follow a multilingualism approach, teach using an ESP curriculum, and have complementary emphasis on the mother tongue.

The Impact of the Theory of Nursing for the Whole Person on the Professional Practice of Nursing School Graduates.

The Theory of Nursing for the Whole Person (TNWP) is a wholistic theory that focuses on the integration of body, mind, spirit, individual, family, and community. A qualitative descriptive research study explored Oral Roberts University graduates' perceptions of their use of the TNWP in practice. Analysis revealed six major themes. Respondents felt that the TNWP was a necessary tool to truly care for patients.

[Status and development of the role as Parkinson Nurse in Germany - an online survey]. / Stand und Entwicklung der Rolle als Parkinson Nurse in Deutschland ­ Eine Online-Befragung.

Status and development of the role as Parkinson Nurse in Germany - an online survey Abstract. BACKGROUND: In Germany there is a course for Parkinson Nurses (PN) since 2006. Content, structure and organization of their tasks have not yet been systematically described for Germany. AIM: How is the typical working day of PN organised in Germany? Which tasks do they have? Which conditions are promoting or inhibiting for their work? METHODS: Among the graduates of the course, an online survey was conducted from September to November 2016. 39 questionnaires were analysed descriptively (response rate 34 %). RESULTS: 52 % of PN work in specialist hospitals and 26 % work in hospitals of maximum medical care. Only 29 % work according to a concept and only 23 % have a job description. 21 % of respondents no longer work as PN. Counselling and education, information on medication management, educational advertising on Parkinson' disease as well as training of other professionals are at the centre of their work. The activities usually focus the work in the institution; a trans-sectoral support for people with Parkinson's disease is rare. CONCLUSIONS: In the future, concepts and job descriptions should be stored in the institutions, which are oriented towards a cross-institutional orientation framework. On the basis of a common understanding of roles it is possible to facilitate networking of the PN as well as the co-operation with other specialists. The curriculum at an academic level leads to the necessary competencies.

[Palliative care in nursing homes : Results of a survey about knowledge and self-efficacy of nursing staff]. / Palliativversorgung in Pflegeheimen : Ergebnisse einer Befragung zu Wissen und Selbstwirksamkeitserwartung von Pflegepersonal.

BACKGROUND: Nursing homes are confronted more and more with palliative care patients, which present a challenge for nursing and medical personnel. Deficits in the palliative care of geriatric patients have been repeatedly demonstrated and many nursing home residents, especially those suffering from dementia, are undersupplied regarding pain management. OBJECTIVES: The present study was carried out to measure the knowledge and self-efficacy of nursing staff in the province of Carinthia (Austria) regarding palliative care of nursing home residents. MATERIAL AND METHODS: A total of 330 nursing personnel were surveyed using the Bonn test for knowledge in palliative care (BPW), which measures knowledge and self-efficacy in nursing home personnel. In addition to descriptive analyses, the effects of the professional group (registered nurses vs. nursing assistants) and working experience were tested. RESULTS: On average a little more than half of the knowledge items were answered correctly. Nurses' self-efficacy was high. Registered nurses exhibited more knowledge and higher self-efficacy compared to nursing assistants. Effects of working experience could only be demonstrated regarding self-efficacy. CONCLUSION: The results are to a large extent in line with results from Germany and indicate the necessity of interventions for improving nurses' knowledge as a major basis for adequate palliative care in nursing home residents.

S.O.S. (STUDENTS' OPTIMAL SUCCESS): A MODEL FOR INSTITUTIONAL ACTION TO SUPPORT MINORITY NURSING STUDENTS.

BACKGROUND: Success of minority students in higher education is an issue of great relevance today, as the changing United States demographic necessitates that programs in higher education afford success across cultural groups. PURPOSE: The purpose of this study was to examine thematic concepts of academic success as perceived by current nursing students in 2 entry-level nursing programs, and to propose a theoretical model to maximize the success of minority students. METHOD: Data were collected from 31 students enrolled in two registered nursing (RN) programs (baccalaureate and associate) at separate urban academic institutions in the Midwestern region of the United States. Two opened-ended questions were asked from the students. Question 1 asked, "What has helped you be most successful in pursuing your nursing degree at your school?" Question 2 asked, "What could be done to help make your college education more meaningful and/or less stressful?" RESULTS: Key factors of institutional commitment, communication of expectations, academic, social and financial support,feedback and involvement were identified as factors to students' optimal success. CONCLUSION: This data resulted in development of a theoretical model that can serve a framework for the success of minority nursing students.

Transformation of the education of health professionals in China: progress and challenges.

In this Review we examine the progress and challenges of China's ambitious 1998 reform of the world's largest health professional educational system. The reforms merged training institutions into universities and greatly expanded enrolment of health professionals. Positive achievements include an increase in the number of graduates to address human resources shortages, acceleration of production of diploma nurses to correct skill-mix imbalance, and priority for general practitioner training, especially of rural primary care workers. These developments have been accompanied by concerns: rapid expansion of the number of students without commensurate faculty strengthening, worries about dilution effect on quality, outdated curricular content, and ethical professionalism challenged by narrow technical training and growing admissions of students who did not express medicine as their first career choice. In this Review we underscore the importance of rebalance of the roles of health sciences institutions and government in educational policies and implementation. The imperative for reform is shown by a looming crisis of violence against health workers hypothesised as a result of many factors including deficient educational preparation and harmful profit-driven clinical practices.

Systematic Review: Bridging the Gap in RPN-to-RN Transitions.

PURPOSE: To review the evidence examining the influences of successful education and professional role transition for registered practical nurses (RPNs) pursuing a baccalaureate degree in nursing (BScN) and registered nurse (RN) licensure through RPN-to-RN bridging programs. DESIGN: Systematic review of papers published between 1995 and 2014 that evaluated students' education and professional role transitions from RPN to RN. METHODS: Thirty-nine papers were selected that observed or studied the change or transition in designation from RPN to RN, or its equivalent, through bridging programs and analyzed thematically according to Meleis, Sawyer, Im, Hilfinger Messias, and Schumacher's transition model. FINDINGS: Personal, community, and social conditions related to preparation for entry, program enrolment, and postgraduate clinical integration influence successful education and professional role transitions for RPN-to-RN bridging students. CONCLUSIONS: Providing key transition supports may enhance the potential for successful student transition into and throughout a bridging program, but further research is necessary to enhance this understanding and to recommend best practices for optimizing students' success. CLINICAL RELEVANCE: The evidence from this review identifies facilitators and barriers to successful education and professional role transition for RPN-to-RN bridging students, and identifies important considerations for future research.

A comparison of professional value development among pre-licensure nursing students in associate degree, diploma, and bachelor of science in nursing programs.

AIM: The aim of the study was to compare the development of professionalism in pre-licensure nursing students in associate degree, diploma, and baccalaureate programs. BACKGROUND: Concerns have been raised about whether professional values to guide nursing practice are consistently instilled within nursing education programs. METHOD: Degrees of professionalism were operationally measured by the 26-item Nurses Professional Values Scale-Revised (NPVS-R) (Weis & Schank, 2009) in a convenience sample. RESULTS: ANOVA analysis (p = 0.0003) and then pairwise t-test analysis (p = 0.0004) revealed statistical significance when comparing NPVS-R scores and educational preparation. Differences between professional values scores and levels within each program revealed significance for the diploma students (p < 0.0001). Secondary subanalysis of the NPVS-R factors among levels and between educational preparation again revealed significance. CONCLUSION: Curricula revisions, faculty reflection and enrichment, as well as active student engagement are warranted to more vigilantly enhance the role formation process.

Factors influencing nursing career choices and choice of study program.

In advance of a recruitment campaign, Israeli first-year nursing students of all ethnicities were surveyed to elucidate what factors had influenced them to make nursing their career and what sort of training track they preferred. The responses made it clear that different factors influence different groups differently. There were noticeable differences by gender, age, and ethnicity. Overall, training institutions were chosen for their closeness to the student's home but other factors also operated among particular groups, such as institutional prestige and flexible entry criteria. There was a blatant preference for academic, particularly university-sited, programs over diploma programs.

Teaching the quality improvement process to nursing students.

During the past decade, there has been increasing emphasis on nurses leading and participating in quality improvement (QI) activities, creating a need for nursing students to learn QI skills. There is minimal information that explains how to teach QI skills or provide nursing students with the opportunity to participate in actual QI projects. Faculty in a prelicensure diploma RN program developed a project that provides an opportunity for senior students to participate in an interdisciplinary team related to the development, planning, and implementation of QI projects in a geriatric setting.

A national survey of oncology content in prelicensure registered nurse programs.

The current and projected increase in newly diagnosed cancer patients and survivors supports the nation's need to prepare a nursing workforce that is skilled to meet the health care needs of these individuals. It is likely that cancer patients, especially survivors, will receive care from nurses without specialized oncology education who work in various nononcology clinical settings. Because of the lacking practice standards and educational guidelines for nurses who care for cancer survivors in nononcology settings, this article describes findings of a national survey that identified the importance and depth of cancer-care content included in accredited prelicensure registered nurse programs (diploma, associate and baccalaureate degrees). Findings revealed that a gap exists between respondents' reported importance and depth of cancer-care content currently taught and that importance rated consistently higher than depth taught. Lack of time was the most frequently cited barrier. Results will be used to design generalist oncology resources for nurse educators.

Exploring the issue of failure to fail in a nursing program.

A study using a qualitative descriptive design was undertaken to explore the issue of "failure to fail" in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.

Stress, depression, and anxiety among undergraduate nursing students.

Admission to a professional program marks the beginning of fulfilling a career goal. However, the rigors of professional education can be demanding. Stress, depression, and anxiety (SDA) can interfere with learning, affect academic performance, and impair clinical practice performance. Studies report a general increase in the severity of and extent of mental health problems among college/university students. The literature regarding nursing students' mental health distress identifies academic and personal sources of stress and coping efforts, with emphasis on the stress and anxiety associated with clinical practice. This cross-sectional descriptive exploratory study investigated levels of SDA among nursing students in 3 years of a university-based program. The association between quality of life indicators including known stressors, such as financial concerns and balance between school and personal life, and SDA was also investigated. Through an online survey, 437 participants from one mid-western Canadian undergraduate nursing program completed the Depression Anxiety Stress Scales and provided data on quality of life indicators and demographic information. Participants also were invited to provide narrative data about their experiences with SDA. This article will present significant findings including: levels of SDA; comparisons between our sample and a normative sample on the dimensions of SDA; and the results of multiple regression analysis identifying significant predictors of each dimension. Themes from the qualitative comments from 251 of the participants were identified and added depth and clarity to the quantitative findings. The predominant themes represented were: perceptions of clinical practice, coping, personal issues, and balancing school, work, and personal life. Implications and recommendations for curriculum design, ensuring students understand program expectations prior to admission, and enhancing accessibility to mental health/support services need to be considered.

"Nurses' training may be shifted": the story of Bellevue and Hunter College, 1942-1969.

During the mid-20th century, nursing leaders advocated moving nursing education out of hospital-based programs and into colleges and universities for the purpose of preparing nurses to meet the demands of increasingly complex health care situations. Nursing leaders in New York City's municipal hospitals recognized the value of this change and sought to increase the number of baccalaureate-prepared nurses to fill the many vacancies within city hospitals. This article examines the political support New York gave to the expansion of Hunter College's baccalaureate program in nursing (a college within the City University of New York system) while closing the almost 100-year-old Bellevue and Mills Schools of Nursing diploma program. The efforts to change nursing at Bellevue started in the 1940s, but the transfer to Hunter College was not realized until 1967. Although the decision to close the diploma school met resistance among various stakeholders, the expansion ultimately succeeded. It was supported by the New York City Department of Hospitals and received approval from the Board of Estimates and Board of Higher Education. Both Bellevue and Hunter's leadership was ready to make this change and participated in this transformation.

[The nurse training reference framework in Ile-de-France]. / Le référentiel de formation en soins infirmiers en Ile-de-France.

In 2009, the changes introduced by the nurse training reference framework revolutionised the nursing curriculum. Partnerships were set up from the beginning of its implementation. The first three-year cycle has ended and the experience acquired opens up a new phase of further reflection and evolution.

[Reform of nursing studies, impact on the nurse training institutes]. / Réforme des etudes infirmières, impact dans les Ifsi.

The reengineering of nursing training led to the creation of a training reference framework in September 2009, which has considerably modified the reference pedagogical model, pedagogical practices and the monitoring of students. The notion of a partnership with the university has been created; pedagogical and technological innovations have been encouraged.

[Different perspectives on the reform of nursing studies]. / Regards croisés sur la réforme des etudes en soins infirmiers.

Two students and two recently qualified nurses describe their training within the new reference framework, and their reception by their course tutors and by their colleagues in their first jobs.

[National survey on the application of the reform of the state-registered nurse diploma]. / Enquête nationale sur l'application de la réforme du diplôme d'Etat d'infirmier.

Following its first national enquiry, the French Directorate General for Health (DGOS) presents here its findings on the reform of the nurse training which focuses on four main areas: partnership with universities, pedagogical content and methods, work placement resources, attribution of European credits.