Community Health Course Research Articles

Empowering Nursing Students to Adopt and Embody Strengths-Based Nursing and Healthcare.

This paper presents an international academic partnership in teaching and research with two case studies. The cases explore the integration of Strengths-Based Nursing and Healthcare (SBNH) and SBNH-Leadership (SBNH-L) in nursing science programs. SBNH values and foundations were integrated within an undergraduate-level community health course in Canada and SBNH-L was introduced into a graduate-level program in Brazil. Both cases comprise active learning activities promoting the uptake of the values and foundations of SBNH and the capacity to identify strengths and innate capacities. This paper synthesizes the issues and provides recommendations to enhance teaching-learning strategies to support SBNH adoption by students to support the humanization of healthcare. International partnerships in education and research and facilitating factors are discussed.

Examining the Perceptions Among Undergraduate Nursing Students Using Virtual Reality in a Community Course: A Mixed-Methods Explanatory Study

ABSTRACT Purpose This study investigated undergraduate nursing students’ perceptions of integrating virtual reality (VR) technology into a community nursing course, specifically home and environmental patient safety assessments. Design This study used a mixed-methods approach with an explanatory design. Methods Participants were recruited from a community health course. The students engaged in a VR simulation involving home visits using the vizHome platform. Quantitative and qualitative data were gathered using the Technology Acceptance Model (TAM) and the System Usability Scale (SUS). Semi-structured interviews were conducted. Quantitative data were collected through Qualtrics and secure Zoom connections for the interviews. The data were analyzed with SPSS and MAXQDA. Findings The results indicated that participants perceived VR as valuable and easy to use for learning home assessment skills. The System Usability Scale (SUS) score revealed room for improvement. Technical limitations were identified as challenges that must be addressed to enhance the user experience. Conclusion Participants acknowledged VR’s potential to supplement traditional learning methods, providing safe and realistic exposure to diverse home environments. While VR was seen as beneficial, it was not considered a replacement for actual home visits in community nursing education. Clinical evidence This study provided clinical teaching evidence on the usability and student perceptions of VR in community courses.

Virtual Poverty Simulation: Effect on Attitudes Toward Poverty in Nursing Students

Background: Simulation has been shown to be an effective teaching strategy for increasing nursing students' knowledge and empathy toward individuals with low income. Virtual simulation is effective in teaching critical thinking, situational awareness, and empathy. Method: This mixed-method study examined three virtual poverty simulation programs. The study sample included senior baccalaureate nursing students ( n = 99) in a Community Health course. Results: Fifteen of the 21 items on the Attitudes Toward Poverty–Short Form (ATP–SF) scale showed a statistically significant increase in knowledge and understanding of people living in poverty. Qualitative data analysis revealed four themes: (1) empathy; (2) sacrifice; (3) stress; and (4) moral struggle. Conclusion: Virtual poverty simulation is a teaching strategy for increasing nursing students' empathy, knowledge, and understanding of those living in poverty to provide compassionate, culturally competent care for individuals with low income. The simulation can be implemented in a variety of settings. [ J Nurs Educ . 2023;62(11):642–646.]

Going Virtual: Transitioning an Older Adult Community Health Clinical Course to Online During COVID-19.

Nursing students in a community health course implemented a quality improvement project with active older adults (AOA). This article describes a process for transitioning an in-person community health quality improvement (QI) project to online. To communicate with AOA, students created a blog, "Healthy Living From Home," that enabled communication among the AOA, partner organizations staff, and students. A quick response code was created that linked to the 6-week program. At the end of the 6 weeks, participants were asked to complete a survey. Data collected from the QI project website tracked more than 1,000 visits to the blog. Participants rated project enjoyment, helpfulness, and educational content as 4.5 on a 5-point Likert scale. Using a multifocal online format to engage with AOA was successful and can continue to be used in the future. [J Nurs Educ. 2024;63(5):332-334.].

Training Medical Students to Recognize, Understand, and Mitigate the Impact of Racism in a Service-Learning Course.

The Morehouse School of Medicine's Community Health Course (CHC) trains first-year medical students to work with people of racial and ethnic minorities and economically and medically disadvantaged communities. This service-learning course includes the diagnosis/assessment of the health of a community and the development, implementation, and evaluation of a plan to improve some aspect of the community's health. The CHC teaches about the impact of racism on the health of communities through lectures, educational games, and videos focused on social determinants of health, cultural competence, and effective community engagement. Students complete small group assessments, interventions, and service activities at assigned sites. This pedagogical approach integrates the Association of Medical Colleges' Diversity, Equity, and Inclusion competencies and engages many community partners. The course's strengths include a multidisciplinary faculty, a culturally and educationally diverse student body, and community partners with varied backgrounds and resources. Opportunities exist for collaborations with other degree programs to sustain and increase the impact of community interventions and link this community-based educational activity to clinical training years. Course evaluations, exams, and short essays assess students' awareness of racism and the extent to which unconscious bias affects students' completion and interpretation of community assessment data and their engagement with community partners.

“It's normal to admit you're not okay”: New York City college students shaping mental health through journaling

Emerging data make clear that, while there are common pandemic experiences related to mental health across different populations, access to those shared experiences is often disproportionate. In the context of exploring expansive definitions of health as part of their Introduction to Urban Community Health course, students at a large, public university in New York City were given the opportunity to engage with the Pandemic Journaling Project (PJP) beginning in June 2020. This paper explores the impact of both creating their own journals, and reading and reflecting on the public entries of others, on student mental health, and on students' abilities to discuss and process their health status, holistically defined. It raises questions of how definitions of “normal” in relation to feelings of diminished mental health are shared and reified in the context of the pandemic, asking if the process of journaling might be a way not just to capture mental health histories of the pandemic, but also to create an inclusive, therapeutic space for a conversation around mental health.

Transitioning Community Health Clinical Experiences to an Online Format During COVID-19

This article describes how nursing students in a community health course transitioned to an online clinical experience when coronavirus disease 2019 limited in-person gatherings. A weekly video series was created to provide content to help educate 18 at-risk women using the Plan-Do-Study-Act cycle. Objectives for the nursing students were met. Successful implementation occurred, and objectives for the community health class were met; however, engagement was more difficult to achieve. Transitioning to online video conferencing allowed the nursing students to still engage with the study participants. Using the PDSA cycle allowed for structured changes to be made. [J Nurs Educ. 2022;61(3):159-161.].

Development and evaluation of an interprofessional community health course in Zambia

ABSTRACT Persistent global health inequities and workforce shortage require innovative strategies to prepare professionals for teamwork in a global context. Over two years, students (n = 33) from education, nursing, occupational therapy, public health, and physical therapy participated in a course in Zambia that emphasized interprofessional collaborative practice (IPP), cultural fluency, and understanding ecological approaches to health. Faculty measured the learning outcomes of the course using the Interprofessional Education Collaborative (IPEC) Competency Self-Assessment Tool (pre and posttest), and a focus group to gain a deeper understanding of the student experience and course effectiveness. The Beliefs, Events and Values Inventory (BEVI) was used post trip to determine feasibility of distribution and response of the tool via e-mail. These preliminary results suggested that students developed skills and knowledge related to IPP, cultural fluency, and ecological approaches to health. Specifically, students acknowledged growth in their ability to communicate more effectively with other health professions, and ability to evaluate personal assumptions and biases toward health, healthcare, and cultural practices. The method of developing this course could be a model for other institutions wanting to grow IPP experiences for their students.

Centering Ethnic Studies in Health Education: Lessons From Teaching an Asian American Community Health Course.

Anti-Asian racism and violence dramatically increased during the COVID-19 pandemic. As a result, recent studies and reports are showing that the health and well-being of Asian Americans are negatively affected. To address this urgent problem, the field of health education and public health must be equipped with the critical frameworks and concepts to analyze racism and White supremacy and how it affects the health and well-being of Asian Americans. We argue that using an ethnic studies lens in health education can help educators, researchers, and practitioners teach and train health educators to address racism experienced by Asian Americans during COVID-19 in relation to their health. We will discuss the elements of ethnic studies and demonstrate how to use it as a lens in understanding health disparities in the Asian American population influenced and exacerbated by the COVID-19 pandemic.

Community Health course load before clerkship in Brazilian medical schools

Abstract: Introduction: The limits of the Community Health (CH) course load (CL) before medical clerkship (MC) in undergraduate medical courses are not defined neither in the National Curriculum Guidelines nor in other documents, and have not been investigated in a comprehensive way in national studies. Objective: To analyze the community health course load before clerkship in Brazilian medical schools. Method: Cross-sectional study of schools acknowledged by the Ministry of Education, which started activities until December 31, 2017. The sites of the 323 existing schools were accessed and the schools that had their curricula available in the internet with details of the CH CL before MC were included. The variables were school geographic region and administration type, medical course CL and CH CL before MC, also including epidemiology, biostatistics and occupational health course loads. Data were analyzed using descriptive statistics, Pearson chi-square (Ӽ2) for categorical variables and Mann-Whitney-U (U) and Kruskal Wallis Ӽ2 tests for continuous variables. Results: Out of 323 existing medical schools, 222 were included (68.7%). Among the included schools, 83 were tuition-free (37.4%) and 139 were not (62.6%). The median of the CH CL before MC was 440.0 hours (P25-75 = 300.0 - 640.0), equivalent to 5.4% (P25-75 = 3.5 - 7.8) of the medical course CL. The median of the CH CL before MC in hours in private and municipal schools was, respectively, 480.0 (P25-75 = 330.7 - 679.2) and 576.0 (P25-75 = 360.0 - 766.0), and of state and federal schools, respectively, 337.0 (P25-75 = 281.2 - 524.2) and 370.0 (P25-75 = 300.0 - 480.0), Ӽ2(3) = 11.48, p = .009. The median of the total CH CL in non-tuition-free schools was 500.0 hours (P25-75 = 336.0 - 690.0) and in the tuition-free schools, it was 364.0 hours (P25-75 = 285.0 - 504.0), U = 4.259.0, z = -3.26, p = .001. The median of epidemiology and biostatistics CL in hours before MC in the 124 schools was 88.0 (P25-75 = 60.0 - 120.0), whereas the occupational health CL in 63 schools was 40.0 (P25-75 = 33.0 - 60.0). Conclusions: The CH CL before clerkship varies widely, being higher in non-tuition-free medical schools.

Community Health course load before clerkship in Brazilian medical schools

Abstract: Introduction: The limits of the Community Health (CH) course load (CL) before medical clerkship (MC) in undergraduate medical courses are not defined neither in the National Curriculum Guidelines nor in other documents, and have not been investigated in a comprehensive way in national studies. Objective: To analyze the community health course load before clerkship in Brazilian medical schools. Method: Cross-sectional study of schools acknowledged by the Ministry of Education, which started activities until December 31, 2017. The sites of the 323 existing schools were accessed and the schools that had their curricula available in the internet with details of the CH CL before MC were included. The variables were school geographic region and administration type, medical course CL and CH CL before MC, also including epidemiology, biostatistics and occupational health course loads. Data were analyzed using descriptive statistics, Pearson chi-square (Ӽ2) for categorical variables and Mann-Whitney-U (U) and Kruskal Wallis Ӽ2 tests for continuous variables. Results: Out of 323 existing medical schools, 222 were included (68.7%). Among the included schools, 83 were tuition-free (37.4%) and 139 were not (62.6%). The median of the CH CL before MC was 440.0 hours (P25-75 = 300.0 - 640.0), equivalent to 5.4% (P25-75 = 3.5 - 7.8) of the medical course CL. The median of the CH CL before MC in hours in private and municipal schools was, respectively, 480.0 (P25-75 = 330.7 - 679.2) and 576.0 (P25-75 = 360.0 - 766.0), and of state and federal schools, respectively, 337.0 (P25-75 = 281.2 - 524.2) and 370.0 (P25-75 = 300.0 - 480.0), Ӽ2(3) = 11.48, p = .009. The median of the total CH CL in non-tuition-free schools was 500.0 hours (P25-75 = 336.0 - 690.0) and in the tuition-free schools, it was 364.0 hours (P25-75 = 285.0 - 504.0), U = 4.259.0, z = -3.26, p = .001. The median of epidemiology and biostatistics CL in hours before MC in the 124 schools was 88.0 (P25-75 = 60.0 - 120.0), whereas the occupational health CL in 63 schools was 40.0 (P25-75 = 33.0 - 60.0). Conclusions: The CH CL before clerkship varies widely, being higher in non-tuition-free medical schools.

Community based medical education – specific needs of elderly population

Abstract Background Many countries in the world are facing problem of population ageing. As a part of medical education regarding that matter, The Community Health Course, based on line that main fields of work for physicians are communities, not physician's consulting rooms, has been conducted at School of Medicine University of Zagreb. Objectives Students of last (sixth) year of study attend The Course through one week in rural and semi-urban areas of Croatia. They have insight in living conditions and needs of elderly population trough participation in work with community nurses, family doctors/general practitioners and gerontology house helpers. Students evaluate activities by anonymous questionnaire, giving a grade (from one-very bad to five-outstanding) and writing a short description of experience. For the purpose of this paper we analysed student's evaluation from academic year 2018./19. Results Very good and outstanding found 94% of students (N = 299) work with community nurse, 92% with gerontology helpers and 87% with physicians. The value of activities they described as: “ we got an insight into functioning and organization of healthcare outside clinical hospital centres and Zagreb, we entered homes of people and saw how and in what conditions they live”, “being able to participate in work with gerontology helpers and community nurses, first-hand learning, we learned a lot about community”, “extremely valuable insight into lives of people in very difficult life situations and evidenced value of gerontology home helpers”, “I saw differences of living conditions and health care between countryside and city”. Conclusions The results of evaluation showed students recognition of importance community oriented medical education, emphasising awareness about specific needs of elderly population. Key messages Community oriented medical education could motivate students to choose work in countryside areas in future carriers. Students recognized importance of community oriented medical education, emphasising awareness about specific needs of elderly population.

Screening, Brief Intervention, and Referral to Treatment: Implementation Into an RN-BSN Curriculum.

Background: The incidence of alcohol and substance misuse continues to be a problem in the workplace. Methods: A partnership between two universities and a federal agency implemented SBIRT (Screening, Brief Intervention, and Referral to Treatment) into a three-credit, 7-week online Community and Environmental Health Course for licensed nurses earning their Bachelor of Science in Nursing degree. SBIRT is an early intervention, targeting nondependent substance users before needing specialized treatment. Findings: Over seven semesters, 119 students completed the SBIRT curriculum. We observed a significant increase in knowledge about standard drink sizes and recognizing the most reliable alcohol use questionnaire (Alcohol Use Disorders Identification Test [AUDIT]). Students perceived themselves as competent in assessing patient readiness to change, making the best treatment decisions, and referring patients for appropriate care. Most students found significant value of SBIRT in their current practice setting. Conclusion/Application to Practice: The SBIRT curriculum was found to be a valuable tool for nurses in screening and referring patients to care who are at risk of alcohol and drug misuse. It is important for occupational health nurses to learn the necessary skills for assessing workers for alcohol and drug misuse. The occupational health nurse is encouraged to practice their skills at every patient encounter for purposes of refining their skills. Employers are concerned about drug and alcohol misuse in the workplace and occupational health nurses are the optimal group to intervene with workers who need assistance.

Current State of International Clinical Experiences in US Prelicensure Nursing Programs.

The study purpose was to describe current international clinical experience (ICE) practices in RN prelicensure programs in the United States. There is interest in ICE to fulfill the goal of preparing global citizens; however, lack of evidence on developing, implementing, and evaluating best practices for ICE limits the enactment of this approach. An electronic survey was completed by 900 deans and/or directors of diploma, associate, bachelor's, accelerated bachelor's, and master's-entry RN prelicensure programs. Respondents (n = 241, 27 percent) indicated their programs included ICE. Across programs, ICE occurred most often in community health courses. The predominant reason for offering ICE was alignment with the institutional mission and vision. Wide variability exists in methods used to implement ICE for credit toward the nursing major. There is a need to continue to assess and disseminate best practices in implementing ICE to accomplish the goal of global health engagement.

Global Perspective: "Be the Bridge" Collaboration: Our journey

Students in the McMaster School of Nursing, likein other Health Sciences programs, learn aboutevidence-based practice in a variety of hospitalsettings. However, best practice must also beprovided at a systems level in the community,guided by the principles of primary healthcare. During a third-year community healthcourse, we were placed in the South Shermanneighbourhood, a low-income, high-priorityarea in Hamilton. Within this community, welearned that improving health requires lookingbeyond the healthcare system. Therefore, wedeveloped an intervention to address the gapbetween services and residents in the area.After a successful pilot project, our initiative isnow becoming a full-scale partnership betweenMcMaster students and the Hamilton communitymembers who act as our hosts and teachers.

Student Perceptions of Nursing Research Following an Experiential Learning Activity

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Abstract Many undergraduate nursing students fail to appreciate the importance of research and its role in guiding practice. Education promoting nursing research is critical to guide nursing practice and to ensure patient quality and safety. Experiential learning activities may provide opportunities to move undergraduate nursing research beyond the traditional classroom setting to a more engaged learning experience. This study evaluated the student’s perceptions on nursing research following an experiential learning opportunity during their senior year in a community health course. Data were collected in May 2017 from 19 nursing students via a paper-pencil survey including open ended questions. Two independent members of the research team completed content analysis. The results suggest three major themes: 1) nursing research is valuable to guide practice; 2) research requires planning and organization; and 3) patients benefit by research participation. Results of the study indicated experiential learning activities may foster student appreciation of nursing research and its role in improving patient care. Keywords: experiential learning, nursing education, qualitative study, undergraduate research DOI : 10.7176/JEP/10-18-02 Publication date :June 30 th 2019

Transforming Nursing Students' Attitudes Toward End-of-Life Care.

End-of-life care is an important nursing competency and must be incorporated into the baccalaureate nursing curriculum. The purpose of this research was to examine the outcomes of an actual hospice compared with a simulated hospice clinical experience. This pretest and posttest nonequivalent 2-group design consisted of a sample of 65 undergraduate nursing students enrolled in a community health course. All students enrolled in the community health course have 1 day for hospice experience and a 2-hour orientation from the nurse educator at a local hospice agency. Students enrolled in the first 7 weeks were paired with a hospice nurse and conducted home visits. Students enrolled in the second 7-week session participated in 2 simulated hospice clinical experiences on campus. Thirty-two students were in the simulated hospice group and 33 were in the home hospice group. Attitudes toward end-of-life care were measured before and after the intervention with the Frommelt Attitudes Toward Care of the Dying. The findings indicated positive attitude changes toward end-of-life care. After the hospice clinical experience, both groups seemed to show increases in their mean Frommelt Attitudes Toward Care of the Dying scores, possibly indicating a greater comfort with caring for dying patients.

Abstract NS3: Engaging Nursing Students in Stroke Research & Practice

Problem & Background: Residents of an urban, ethnically & racial diverse & resource-limited community where the college of nursing is located are at high risk for stroke. Recognizing this as a major population health issue for our community & nursing’s essential role improving health outcomes, faculty engaged with stroke center leadership to determine concerns. In addition, a curricular audit revealed stroke care competencies (knowledge, skills & attitudes-KSAs) were not well reflected in the curriculum & thus, the need for enriched graduate and undergraduate stroke curriculum. Also, we needed to build our research & EBP capacity with relevant & meaningful activities. Purpose: To increase student KSA’s in stroke care & stroke related nursing research/EBP. Methods: Faculty leading the stroke initiative worked with the stroke center nursing & physician leaders to identify teaching content & clinical practice opportunities for undergraduate & graduate students to integrate into existing courses. Stroke was an exemplar for population health teaching & learning in several courses. Faculty also identified stroke related research & EBP topics for students in a graduate research course. Results: Faculty & students are involved in several inter-professional projects & are applying for grants to support their work. Other learning opportunities include: stroke nursing unit as a designated education unit; student-led stroke support groups; & reducing missed appointments & readmissions. Community health course undergrads are conducting a study to describe the organization & delivery of community stroke services. Graduate students developed 4 stroke EBP project proposals presented at graduate & nursing research days on campus. Faculty & students presented their research & EBP proposals at outside conferences & have been recognized as STTI Rising Stars. Conclusions: All involved have expressed excitement & satisfaction with the stroke initiative. Students have demonstrated significant learning about stroke, their role in care across the continuum & stroke related research & EBP. Thus, this effort contributes to nursing engagement in stroke research & practice that promises to improve stroke related outcomes in our at risk community.

Opening the door to your nursing potential.

It was only when I started teaching an undergraduate community health course that I became aware of the general lack in knowledge about nursing career options.

Visualising the health of communities: Using Photovoice as a pedagogical tool in the college classroom

Objective: To describe the use of Photovoice as a pedagogical tool to promote experiential learning and critical dialogue among participants on an undergraduate community health course. Design: A descriptive study of the use of the pedagogical tool Photovoice, based on three foundational education theories. Results: Based on teachers’ reflective evaluation of student responses, Photovoice emerged as a useful tool for encouraging dialogic engagement in the classroom, for experiential learning through interaction with the physical environment and for increasing student agency by reducing the teacher as authority model. Conclusion: Photovoice may be useful in a variety of college courses as a way to foster critical thinking, to promote agency among students, to enhance understanding of complex social phenomena and to expand the ways in which both students and teachers think about their physical and social worlds.