Situation awareness in undergraduate nursing students managing simulated patient deterioration

Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice.

Work readiness of nursing graduates: current perspectives of graduate nurse program coordinators

BACKGROUND: The transition from nursing student to graduate remains problematic internationally with issues arising concerning graduates' work readiness upon commencing employment. AIM: This exploratory study specifically investigated perceptions of graduate nurse program coordinators on the work readiness of nursing graduates, with the aims of identifying strengths, weaknesses and challenges that exist. DESIGN: Qualitative descriptive design. METHODS: Sixteen graduate nurse program coordinators were interviewed from various health-care services in the state of Victoria, Australia. Interviews were audio-recorded and transcribed verbatim and thematic analysis was used to disclose reoccurring themes and sub-themes. FINDINGS: This paper reports on one theme, preparation readiness, and three sub-themes associated with this theme; clinical skills deficits, communication issues and transitioning as an enrolled nurse to a registered nurse. CONCLUSIONS: There are several areas of weaknesses and challenges for nursing graduates in their preparation for practice. As a poorly understood area, evidence from this study will inform curriculum development and transition programs, not only in Australia, but also internationally.

The Personal Background and Preparation Survey Early Identifies Nursing Students at Risk for Attrition

Introduction Nursing student attrition continues to negatively impact the supply of nurses and nursing workforce diversity. Little research has addressed student attributes affecting nursing student attrition today. Research with college undergraduates has indicated that noncognitive attributes influence academic achievement and retention as much as academic attributes. Early identification of such attributes can help students to timely access appropriate services, providing improved opportunities for success. However, convenient, valid, quantitative, reliable assessment instruments appropriate for nursing students have been lacking. The Personal Background and Preparation Survey (PBPS) addresses the need for such a tool. [See PDF for complete abstract]

Irish and Jordanian general student nurses’ attitudes towards people with mental illness (PWMI) and their relationship to cultural and religious beliefs

Background Attitudes held and cultural and religious beliefs of general nursing students towards individuals with mental health problems are key factors that contribute to the quality of care provided. Negative attitudes towards mental illness and to individuals with mental health problems are held by the general public as well as health professionals. Negative attitudes towards people with mental illness have been reported to be associated with low quality of care, poor access to health care services and feelings of exclusion. Furthermore, culture has been reported to play a significant role in shaping people’s attitudes, values, beliefs, and behaviours, but has been poorly investigated. Research has also found that religious beliefs and practices are associated with better recovery for individuals with mental illness and enhanced coping strategies and provide more meaning and purpose to thinking and actions. The literature indicated that both Ireland and Jordan lack baseline data of general nurses’ and general nursing students’ attitudes towards mental illness and associated cultural and religious beliefs. Aims: To measure general nursing students’ attitudes towards individuals with mental illness and their relationships to socio-demographic variables and cultural and religious beliefs. Method: A quantitative descriptive study was conducted (n=470). 185 students in Jordan and 285 students in Ireland participated, with a response rate of 86% and 73%, respectively. Data were collected using the Community Attitudes towards the Mentally Ill instrument and a Cultural and Religious Beliefs Scale to People with Mental Illness constructed by the author. Results: Irish students reported more positive attitudes yet did not have strong cultural and religious beliefs compared to students from Jordan. Country of origin, considering a career in mental health nursing, knowing somebody with mental illness and cultural and religious beliefs were the most significant variables associated with students’ attitudes towards people with mental illness. In addition, students living in urban areas reported more positive attitudes to people with mental illness compared to those living in rural areas.

Testing the psychometric properties of two self-report clinical competence scales for nursing students.

Background: It is important to assess the clinical competence of nursing students to gauge their educational needs. Competence can be measured by self-assessment tools; however, Anema and McCoy (2010) contend that currently available measures should be further psychometrically tested.
Aim: To test the psychometric properties of Nursing Competencies Questionnaire (NCQ) and Self-Efficacy in Clinical Performance (SECP) clinical competence scales.
Method: A non-randomly selected sample of n=248 2nd year nursing students completed NCQ, SECP and demographic questionnaires (June and September 2013). Mokken Scaling Analysis (MSA) was used to investigate structural validity and scale properties; convergent and discriminant validity and reliability were also tested for each scale.
Results: MSA analysis identified that the NCQ is a unidimensional scale with strong scale scalability coefficients Hs =0.581; but limited item rankability HT =0.367. The SECP scale MSA suggested that the scale could be potentially split into two unidimensional scales (SECP28 and SECP7), each with good/reasonable scalablity psychometric properties as summed scales but negligible/very limited scale rankability (SECP28: Hs = 0.55, HT=0.211; SECP7: Hs = 0.61, HT=0.049). Analysis of between cohort differences and NCQ/SECP scores produced evidence of discriminant and convergent validity; good internal reliability was also found: NCQ α = 0.93, SECP28 α = 0.96 and SECP7 α=0.89.

Discussion: In line with previous research further evidence of the NCQ’s reliability and validity was demonstrated. However, as the SECP findings are new and the sample small with reference to Straat and colleagues (2014), the SECP results should be interpreted with caution and verified on a second sample.
Conclusions: Measurement of perceived self-competence could start early in a nursing programme to support students’ development of clinical competence. Further testing of the SECP scale with larger nursing student samples from different programme years is indicated.

References:
Anema, M., G and McCoy, JK. (2010) Competency-Based Nursing Education: Guide to Achieving Outstanding Learner Outcomes. New York: Springer.
Straat, JH., van der Ark, LA and Sijtsma, K. (2014) Minimum Sample Size Requirements for Mokken Scale Analysis Educational and Psychological Measurement 74 (5), 809-822.

Effects of two teaching strategies on the relationship between nursing students’ self-efficacy and performance in BLS/AED

Purpose: Nurses and nursing students are often first responders to in-hospital cardiac arrest events; thus they are expected to perform Basic Life Support (BLS) and use an automated external defibrillator (AED) without delay. The aim of this study was to explore the relationship between nursing students’ self-efficacy and performance before and after receiving a particular training intervention in BLS/AED. Materials and methods: Explanatory correlational study. 177 nursing students received a 4-h training session in BLS/AED after being randomized to either a self-directed (SDG) or an instructor-directed teaching group (IDG).1 A validated self-efficacy scale, the Cardiff Test and Laerdal SkillReporter® software were used to assess students’ self-efficacy and performance in BLS/AED at pre-test, post-test and 3-month retention-test. Independent t-test analysis was performed to compare the differences between groups at pre-test. Pearson coefficient (r) was used to calculate the strength of the relationship between self-efficacy and performance in both groups at pre-test, post-test and retention-test. Results: Independent t-tests analysis showed that there were non-significant differences (p-values > 0.05) between groups for any of the variables measured. At pre-test, results showed that correlation between self-efficacy and performance was moderate for the IDG (r = 0.53; p < 0.05) and the SDG (r = 0.49; p < 0.05). At post-test, correlation between self-efficacy and performance was much higher for the SDG (r = 0.81; p < 0.05) than for the IDG (r = 0.32; p < 0.05), which in fact was weaker than at pre-test. Finally, it was found that whereas the correlation between self-efficacy and performance increased from the post-test to the retention-test to almost reach baseline levels for the ILG (r = 0.52; p < 0.05), it slightly decreased in this phase for the SDG (r = 0.77; p < 0.05). Conclusion: Student-directed strategies may be more effective than instructor-directed strategies at promoting self-assessment and, therefore, may help to improve and maintain the relationship between nursing student self-efficacy and actual ability to perform BLS/AED.

Clinical skills and communication in nursing students

Abstract Background: Communication is a basic tool in nursing, a crucial element of care. The quality of the interactions that take place between the nurse and the user/family influence their satisfaction and security felt with the care received. Objectives: To identify the communication skills and interpersonal relationship of nursing students in health care; identify the sociodemographic and academic variables influencing communication skills and interpersonal relationship of nursing students in health care. Methodology: Quantitative study, cross-sectional, descriptive and correlational. The data collection instrument was a questionnaire with questions concerning the socio-demographic and academic characterization; basic skills of interview and clinical communication in health care; learning of clinical communication skills and range of communication skills and interpersonal relationship. The sample consisted of 374 nursing students from two Portuguese schools. Results: The majority were female (80.5%), in the age group of 18-21 years. The students recognize the importance of clinical communication skills and interpersonal relations in nursing practice (82.4%); agreed on the teaching methods of communicational skills (54.3%). Evaluated their training in the area as good (71.7%). Age, semester and school influenced communication skills and interpersonal relationship of students (p <0.5) Conclusion: The results obtained allow us to state that the education / training of nursing student in the relational context is of fundamental importance in building capacity for competent professional practice.

the health and well-being of nursing students in clinical practice . what prevents it? what promotes it?

Introduction: The training of nursing students in the context of clinical practice, is characterized by educational experiences, subject to various emotional stress (stress, ambivalence, frustration, conflict), sometimes making it very vulnerable student.However not all students use the same strategies minimizing their meanings and negative effects on the level of your health and well-being Objetiv:To analyze the perception that nursing students have about the determinants of their health status and well-being in clinical practice Methods: Exploratory research Results:The results reveal the complexity of the teaching / learning process in clinical practice, identified determinants that limit and / or promote health and well-being of students, or not contributing to their motivation, self-confidence and learning. All students value the presence of the following dimensions: affective-emotional (humanization in learning experiences); relational dynamics (interactions developed with all stakeholders); methods used (professional competence of the clinical supervisor and teacher); school curriculum (adaptation of learning in theory); socialization to the profession (become nurse).Conclusions: The results indicate, that although all students evidencing the dimensions described as fundamental to learning in clinical practice, the study results are dichotomous and ambivalent. Students 2nd and 3ºanos refer a low perception in clinical practice, the indicated dimensions, and for these source of concern and uncertainty in learning, such as limiting their health condition and well-being. For students of the 4th year, these dimensions are percecionadas as gifts, and sources of motivation, learning and catalysts such as promoting their health and well-being.

The development of a clinical learning environment scale

Within nursing, there is a strong demand for high-quality, cost-effective clinical education experiences that facilitate student learning in the clinical setting The clinical learning environment (CLE) is the interactive network of forces within the clinical setting that influence the students'clinical learning outcomes The identification of factors that characterize CLE could lead to strategies that foster the factors most predictive of desirable student learning outcomes and ameliorate those which may have a negative impact on student outcomes The CLE scale is a 23-item instrument with five subscales staff–student relationships, nurse manager commitment, patient relationships, interpersonal relationships, and student satisfaction These factors have strong substantive face validity and construct validity, as determined by confirmatory factor analysis Reliability coefficients range from high (0 85) to marginal (0 63) The CLE scale provides the educator with a valid and reliable instrument to evaluate affectively relevant factors in the CLE, direct resources to areas where improvement may be required, and nurture those areas functioning well It will assist in the application of resources in a cost-effective, efficient, productive manner, and will ensure that the clinical learning experience offers the nursing student the best possible learning outcomes

The performance and politics of practice for New Graduate Nurses

The change from nursing student to Registered Nurse (RNs) is both a desirable and anticipated event for New Graduate Nurses (NGNs). Having completed their formal education, most NGNs approach the threshold of their professional career with mixed emotions. While excited about the future and eagerly awaiting the commencement of employment, many are aware that this change also signifies a time of personal upheaval, professional insecurity and further personal learning. In the nursing professions’ enthusiasm to facilitate a smooth passage for NGNs a vast literature now addresses preparation-for-practice degrees, as well as the perceived workplace deficits and support needs of NGNs. However, the importance this change from working as a student to working as a NGN is not well conceptualised, theorised or understood as this largely instrumental literature essentially reduces the problematisation of the NGN transition experience to the problematisation of the individual by identifying NGNs as ‘the’ problem. Subsequently it fails to expose or challenge the normative assumptions underpinning processes that have formerly been considered solutions, or, the impact of such processes in a workplace that frames itself as “supportive”. Conspicuously absent is an exploration of how the NGN role is performed by former students, now beginning RNs undergoing the very personal transition of “becoming registered nurses”. Using Goffman’s (1956) theorisation of performance in everyday life exploring how process and meaning in mundane interactions present themselves in the “regular” lives of people at large, and Margaret Archer’s (2000) work emphasising the significance of the inner dialogue for managing the emotions that emerge out of situations that confront us, this paper draws upon data collected during a study of NGNs’ experience of transition to practice (Malouf 2010). It focuses on an emergent understanding of the need to differentiate the performance of ‘student’ from that of ‘NGN’ role. Further, it explores how these roles have become conflated into a conceptual continuum and viewed as a slide from student to NGN performance, rather than a significant moment of change involving roles that need to be distinctly defined as a necessary precursor to enhancing and supporting the professional and personal development of beginning practitioners.

本科实习男护生压力源、应对方式与心理健康关系的研究

Objectives:To investigate stressor and stress level,coping styles and mental health of male nursing undergraduates in clinical practice;To find out the factors that influence mental health of male nursing undergraduates in clinical practice and to put forward some suggestions to improve the mental health status of male nursing undergraduates. Methods: After doing many literaturere search both at home and abroad,I gather further consulting many nursing undergraduates in clinical practice,Finally I formulate the “Nursing Student's Clinical Stressor Scale”.80 male nursing ungraduates from Bengbu Medical Colledge were recruited. While 140 female nursing ungraduates who were in clinical practice in the same period of time were taken as a comparative group.The following questionnaire package including a background questionnair,Nursing Student's Clinical Stressor Scale NSCSS,Simplified Coping Style Questionnaire SCSQ,The Symptom Checklist 90 SCL-90 were distributed and collected together in the 14th week during the clinical practice.Of the 220 questionnaires were distributed and 198 were found to valid,the valid callback rate was 92%.The endudeed 77 were male and 121 were female .Statistices analysis was performed by SPSS13.0 and AMOS5.0 software. Results： 1.25% of male nursing undergraduates had a higher level of stress, mainly from employment,major,working nature,working contents and so on.Compared with female nursing undergraduates,male nursing undergraduates underwent a higher pressure in the employment and the profession aspect,but lower in their insufficient knowledge and ability.There was a significant negative correlation between the male undergraduates’ stress level and their satisfaction degree to clinical nursing teaching and the professional title of the clinical teachers,but it was positively correlated with their family monthly income. Stress level of female nursing undergraduates positively related with the number of children in their families,but negatively correlated with their family monthly income; 2.Male nursing undergraduates' coping style both positive and negative coping styles were adopted by male nursing undergraduates but mean at while positive coping styles.The positive coping styles adopted by male nursing undergraduates were significantly lower than that adopted by female nursing undergraduates; 3.The scores of depression,interpersonal sensitivity and anxiety in male nursing undergraduates were significantly higher than those of the nationwide youths norm.Alist all subscales scores of male nursing group were more than those of female nursing undergraduates except for fear subscale. Mental health of male nursing undergraduates was inversly correlated with the professional title of the clinical teachers and satisfaction of their majors; 4.Among male nursing undergraduates,the total score of stress and most subscale(except working nature and working contents,employment)scores of stress were positively correlated with the negative coping styles.The scores of stress level was positively correlated with the scores of SCL-90,Negative coping styles was positively correlated with the scores of SCL-90 among male nursing undergraduates,while positive coping styles were inversly correlated with most subscales(except phobic,paranoia,psychoticism)scores of SCL-90. Conclusions： 1.25% male nursing undergraduates have a higher level of stress,which is from employment, profession,working nature and working contents,financial difficulties and so on.The coping styles adopted by male nursing undergraduates were mainly positive coping styles.The mental health of male nursing undergraduates were lower; 2.Different genders have significant differences between stressors, coping style and mental health; 3.Stress,coping style,satisfaction degree to clinical nursing teaching and the professional title of the clinical teachers are predietors of mental health among male nursing undergraduates.

An Innovative teaching tool for students is it Appropriate?

Background: Clinical supervision takes place once the newly qualified nurse is employed in clinical practice. However, often the variety and diversity of nursing jobs can result in a hit and miss delivery of supervision training. By introducing training uniformly at undergraduate stage a more seamless transition may occur (McColgan K, Rice C. 2012).

There is an increased interest in higher education in the use of online learning resources for students. As part completion of a DNP an App. for training students in clinical supervision was developed.

Aim: The creation of a clinical supervision training App. for use in undergraduate nursing.

Objectives:
•To develop a teaching tool that is up to date, current and easily accessible to students.
•To introduce supervision training for undergraduate nursing students
•To motivate the undergraduate nursing student to identify examples from their clinical experience to encourage change and promote professional development.

Approach:
Stage 1
In 2010/11 informal inquiries with senior nurses regarding the introduction of supervision training in undergraduate nursing
Stage 2
A review of UK supervision training.
Stage 3
Template production of teaching tool.
Stage 4
Collaboration with a computer technician to transfer multimedia outputs onto an App.
Stage 5
App. piloted with lecturers (n=4) and post registration students (n=20).
Stage 6
Minor alterations made to App. design template
Stage 7
App. included in an experimental study looking at online learning versus blended learning June 2013 (n=61, n=63)

Conclusion: A collaborative approach to the development of any educational programme is essential to ensure the success of the final teaching product (McCutcheon 2013). The end result is that this App. could be:
•Made available to nurses in the UK.
•Adapted to suit other healthcare professionals and students.
•Used as a prototype for other healthcare related subjects.

McColgan K., Rice C. (2012) An online training resource for clinical supervision. Nursing Standard, 26(24) 35-39.
McCutcheon K. (2013) Development of a multi-media book for clinical supervision training in an undergraduate nursing programme. Journal of Nursing Education and Practice, 3(5) 31-38.

Vision and deaf awareness training is it app.ropriate?

Title
Visual and deaf awareness training is it app.ropriate
Purpose
Some of our most vulnerable patients have a sensory deficit. An app which focused on patients with a vision and/or hearing loss was developed for healthcare students. The intent was to embed the core values necessary for students to provide appropriate care for patients with a sensory deficit.
Setting
Queen’s University Belfast, School of Nursing and Midwifery.
Methods
Stage 1
A review of current sensory awareness training in the United Kingdom
Stage 2
Application for funding
Stage 3
Development of a teaching tool template with the essential aspects required for sensory awareness training
Stage 4
Collaboration with others: Royal National Institute for the Blind, Action on Hearing Loss, Computer technician.
Stage 5
Production and transfer of multimedia outputs onto a software application system.
Stage 6
App Piloted with a sample of lecturers (n=5), undergraduate nursing students (n=20), service users (n=5)
Stage 7
Editing
Stage 8
App made available to all undergraduate nursing students
Stage 9
App evaluation (n=300)



Results
Overall nursing students positively evaluated the app, 100% of students rated the app between good and excellent. Qualitative evidence from service users and practice partnerships was extremely positive:
"At last I feel listened too in respect to my hearing loss and empowered. I don't feel like I am complaining I am actually helping to create something which should benefit staff and all of us with a hearing or vision loss". Patient
“Very insightful into the lives of those with a disability will be so useful in practice as an aid to jog my memory". 1st year nursing student
Conclusion
It is hoped that further evaluation and implementation of the app will show an improved quality to the care delivered to those with a sensory deficit. We believe that by working in partnership with service users we have helped to create an innovative tool that benefits both staff and patients.
Financial disclosure Yes
Funding of £2700 was awarded in 2014 through the Martha McMenamin Memorial Northern Ireland Scholarship.