Master's Entry Research Articles

Evaluation of a simulation clinic for improving occupational therapy students’ perceptions of interaction with parents and infants

Introduction Occupational therapy education programmes need to graduate students who can confidently and safely deliver child and youth services. This study explores whether a simulation clinic could increase student perceived knowledge and confidence and decrease student anxiety to better prepare them for professional child and youth practice. Method This study used a pre–post quasi-experimental design. Second-year undergraduate and first-year graduate entry master's level occupational therapy students participated in the simulation clinic as a component of an occupational therapy child and youth course. Students completed pre- and post-simulation questionnaires to measure perceived knowledge, confidence, and anxiety related to infant and parent interactions. Findings A sample of 100 students reported significant improvements for perceived knowledge (all p < 0.001) and confidence (all p < 0.001) across all four skills targeted for development in this simulation: Communication, Information Gathering, Information Sharing, and Clinical Intervention Skills. Students reported a significant decrease in anxiety for parental ( p < 0.001) and infant ( p < 0.001) interaction, and felt the experience to have been highly valuable and realistic. Conclusion Findings indicate that simulation is a valuable tool for preparing occupational therapy students to work with infant and parent interaction. Further research investigating the effect of simulation on student competence is recommended.

Should DNP Students Be Permitted to “STEP-OUT” With a Master’s Degree?

Should DNP Students Be Permitted to “STEP-OUT” With a Master’s Degree?

Telesupervision Benefits for Placements: Allied Health Students’ and Supervisors’ Perceptions

Telesupervision (TS) uses Information and Communication Technology (ICT) for communication between university-based staff, clinical supervisors and students undertaking placements in the presence or absence of a clinical supervisor onsite. Despite examples of successful implementation (Carlin 2012, Chipchase et al. 2014, Dudding and Justice 2004, Hall 2013) there has been minimal uptake of TS in allied health. This study investigated students’ and clinical educators’ perceptions of the potential benefits and barriers of TS using readily accessible ICT during placements. During 2014-2015, telesupervision/telesupport was provided to a total of 54 Undergraduate and Graduate Entry Masters students from Speech Language Pathology (SLP), Occupational therapy (OT) and Physical therapy (PT) programs at one Australian and two Canadian universities and Exercise Physiology (EP) students at the Australian university. After receipt of TS, 39 students completed an online survey. Nine participating university-based clinical education coordinators (CECs) were interviewed about their experiences. Survey data were analysed using descriptive statistics and interview data were analysed using thematic analysis. Students valued regular TS contact/communication with their CEC to discuss challenges that arose during their placements. CECs believed students benefitted from the opportunities to discuss their placement experiences through TS sessions used for direct supervision and/or for complementing onsite supervision. Students used TS sessions to debrief and reflect on their placement experiences. CECs gained a better understanding of the students’ placement experiences. TS has the potential to develop greater connection between students and CECs and enhance student and supervisor experience of clinical education.

Nursing students’ reflections on an interprofessional placement in ambulatory care

Reflection has been identified as key to interprofessional education as it facilitates a focus on interprofessional communication, collaborative practice and professional roles, while contributing to debunking ingrained understandings of roles and behaviours. The aim of this study is to explore the written reflections of nursing students following an interprofessional placement in ambulatory care. A deductive analysis of nursing student reflective journal entries mapped against the university interprofessional framework was conducted. A purposeful sample of 19 graduate entry Master of Nursing Science students participating in a two-week interprofessional educational placement completed a reflective journal relating to an interprofessional placement in ambulatory care. The analysis of the journals found that all students were able to reflect on their interprofessional clinical experience, but the ability to reflect varied between students. Despite the challenges that some nursing students experienced in achieving deep levels of reflection, the study demonstrated the usefulness of incorporating reflective journals into nursing curriculums and as part of interprofessional practicums.

Enhancing Entry-Level Physiotherapy Student Learning in Interpreting Radiology – An Action Research Project

Purpose: In Australia, the ability to interpret orthopaedic x-rays is an entry-level skill for physiotherapists. Yet there is a paucity of evidence in the literature which details effective learning and teaching methods to optimise confidence and competence in x-ray interpretation. The aims of this study were to describe the content contained in an orthopaedic radiology module within an Australian 2-year graduate entry Master of Physiotherapy degree; approaches to learning and teaching used in this module; student satisfaction associated with this module over a 2-year period. Method: The University’s framework for quality assurance, which is based on the Plan-Implement-Review-Improve underpinned this action research project. The content of the radiology module was reviewed and feedback was gained from a student focus group and standard university course data. Data were analysed using descriptive content analysis and descriptive statistics to identify areas for improvement. Changes to the module were then developed and implemented, and the effect of these changes were evaluated using a custom-designed survey. Results: It was found that didactic methods of teaching were used in this module that encouraged surface level learning. Students reported feeling stressed during the radiology examination due to the learning tasks and assessment being disconnected, and often reported difficulty transferring knowledge into the clinical placement setting. Constructive alignment was undertaken of learning activities and assessment tasks. An additional non-compulsory tutorial was added to the radiology module, where scaffolding and cooperative learning techniques were used to teach students x-ray interpretation. Students reported that the revised curriculum increased their confidence in interpreting x-rays. Students’ competence in x-ray interpretation also increased based on a significant increase in score on their radiology examination. Conclusion: Based on the findings of this study the addition of a tutorial that focused on interpretation of x-ray films to supplement radiology teaching improved entry-level physiotherapy students’ confidence and competence in interpreting x-rays and their perceived preparedness for clinical placement in a small entry-level physiotherapy cohort at a single Australian University.

Is graduate entry education a solution to increasing numbers of men in nursing?

Males have traditionally constituted a very small proportion of the nursing workforce in many countries, including Australia. Together with a need to address the gender imbalance, nursing workforce shortages require strategies for recruiting new nurses, including males. This study examined characteristics of males entering one accelerated graduate entry masters pre-registration nursing program in Victoria, Australia. A quantitative survey gathered a variety of demographic data and factors relating to participants' decisions to undertake nursing. Data were analysed using descriptive statistics including frequencies and distributions. Forty-three male nursing students from four cohorts of the Master of Nursing Practice (MNP) course from 2009 to 2011 completed the survey. The proportion of males (30%) was considerably greater than traditional nursing courses and the profession generally. Participants demonstrated wide distributions in age ranges, professional backgrounds and previous years in the workforce. Graduate entry appears attractive to males of varying ages, personal and professional backgrounds. More research is needed to examine this phenomenon on a larger scale.

Enacting a Vision for a Master's Entry Clinical Nurse Leader Program: Rethinking Nursing Education

The need to educate nurses at the graduate level and provide them with a different skill set that broadens their view of health and nursing is clearly articulated by the American Association of Colleges of Nursing. Consequently, the role of the clinical nurse leader (CNL) was born. Responding to the need for providing a highly educated and credentialed professional at the bedside, Rush University College of Nursing made the bold move to phase out baccalaureate education and enact a prelicensure, master's entry CNL program. Although there is a clear need for this type of graduate, there is little in the literature to provide guidance to institutions that wish to develop this type of program. This paper describes the factors that came into play in making that decision, the process of curriculum development and implementation, the challenges encountered in implementing this type of program, and the outcomes that the program has evidenced since its inception.

Improving secondary prevention screening in clinical encounters using mhealth among prelicensure master's entry clinical nursing students.

To determine the feasibility and acceptability of a mHealth application among nursing students for health promotion and secondary prevention health recommendations for hospitalized adult patients. A pretest-posttest design with a convenience sample of 169 prelicensure master's entry clinical nursing students in a large urban public university. Survey questions assessed intention to use, perceived usefulness, perceived ease of use, subjective norm, voluntariness, clinical area relevance, output quality, and result demonstrability of the United States Preventive Services Task Force (USPSTF) evidence-based practice guidelines via the mHealth application. Descriptive statistics and frequencies were used to explore sociodemographics; paired t-tests were used to evaluate pre- and posttest differences. Pre- and posttest significant differences (p < .01) were found between intention to use, perceived usefulness, subjective norm, voluntariness, image, clinical relevance, result demonstrability, and output quality (p < .02). Ease use of a mHealth application was not significantly different. These findings highlight the need to integrate evidence-based practice tools using mHealth technology among prelicensure master's entry clinical nursing students in order to engage and foster translational learning and improve dissemination of secondary prevention screening guidelines among hospitalized patients.

Artwork and music: Innovative approaches to physical assessment

Background: Observation and auditory skills are essential competencies for nursing practice. Research studies reveal that observational abilities are improved with visual training in an art museum and that the standing competence of auscultative skills is inadequate. This study details an innovative strategy to improve nursing students' observational and auscultative abilities. Methods: A pretest–posttest experimental design was used in which 77 students in an accelerated master's entry nursing program were randomized to either receive music auditory training and observation training in a museum and music hall or view a DVD of the music intervention and observation training in a classroom using handheld images and artwork display. Results: Students correctly identified approximately 68% of bowel sounds, 38% of lung sounds and 26% of heart sounds after this 2-h intervention, and significantly improved their observational abilities over time (p < 0.0001) on all measures with few exceptions. In addition, there were no differences between the groups over time for most measures, suggesting that the classroom experience is an effective pedagogy for improving observational skills. Conclusion: The activities of viewing works of art and aural training using music sharpen observational and reasoning skills of nursing students and auscultative interpretive abilities, and hold promise for medical education.

The relevance of globalization to nursing: a concept analysis

This paper emerged alongside the development of learning materials for a new unit of study on global health and nursing. The proposed unit was for inclusion in a graduate entry master of nursing course leading to registration. It became evident that there has been growing attention within the nursing literature to the demands of an increasingly globalized world and the subsequent challenges confronting nursing as a profession. At the same time, the literature is inconsistent and contains mixed messages with regard to how nurses and nursing might respond to these challenges. This paper aims to (i) present the findings of a narrative analysis of the current nursing discourse on globalization, and (ii) to identify directional cohesiveness for the nursing profession in the seemingly disparate literature. Concept analysis following extensive literature review. Several nursing authors argue that nurses globally are increasingly sharing concerns expressed by nurses at a local level. Concerns such as the future sustainability of the profession and more specifically practice concerns such as the continuing failure of nurses to adequately deal with social justice issues requires careful consideration by every nurse. While strategies recommended for dealing with these concerns lack a cohesive thread, some interesting themes and innovative recommendations have emerged. For example, the need for nurses to consider replacing environmental considerations with ecological considerations and that nurses consider preventative nursing practice beyond the immediate needs of clients and from a more global perspective.

LOOKING Is Not SEEING and LISTENING Is Not HEARING:Effect of an Intervention to Enhance Auditory Skills of Graduate-Entry Nursing Students

Inspection/observation and listening/auscultation are essential skills for health care providers. Given that observational and auditory skills take time to perfect, there is concern about accelerated students' ability to attain proficiency in a timely manner. This article describes the impact of music auditory training (MAT) for nursing students in an accelerated master's entry program on their competence in detecting heart, lung, and bowel sounds. During the first semester, a two-hour MAT session with focused attention on pitch, timbre, rhythm, and masking was held for the intervention group; a control group received traditional instruction only. Students in the music intervention group demonstrated significant improvement in hearing bowel, heart, and lung sounds (p < .0001). The ability to label normal and abnormal heart sounds doubled; interpretation of normal and abnormal lung sounds improved by 50 percent; and bowel sounds interpretation improved threefold, demonstrating the effect of an adult-oriented, creative, yet practical method for teaching auscultation.

The Nursing Educational Highway in Action:Results of a Needs Assessment and the Formation of a Collaborative Workgroup

DESPITE WIDESPREAD INTEREST IN IMPROVING THE EDUCATION OF NURSES, THE MAJORITY OF CLINICIANS CONTINUE TO BE PREPARED AT THE ASSOCIATE DEGREE (AD) LEVEL. In 2004, 1.2 million nurses with ADs accounted for 42 percent of all registered nurses in the United States, with only 21 percent returning to pursue a baccalaureate or higher degree (National League for Nursing [NLN], 2006; Health Resources and Services Administration [HRSA], 2005). Among nurses with a BSN as their initial nursing degree, only about 22 percent obtain a higher degree in nursing (HRSA). As nurse educators at a public university in the San Francisco Bay Area, we conducted a needs assessment of nurses' educational needs in partnership with administrators and practitioners at a local public hospital. The purpose was to determine barriers faced by nurses who wish to continue their formal education and to identify supports necessary to facilitate their return to school and academic success. This project led to the formation of a much larger consortium of academic and health service organizations. Assessment of Need Although applications to the university school of nursing were increasing, applications to a baccalaureate completion program were dwindling. By 2005, there were only four applicants to the RN-to-BSN program in contrast to 1200 applicants to the traditional BSN program and 400 to the master's entry program. At that time, the program received grant funding for a needs assessment from the Partnerships for Innovation in Nursing Education (PINE) program, which supports research and collaborative relationships between academic institutions and health care service providers. STAKEHOLDERS The university was able to forge a partnership with a local public hospital, one of the largest employers of nurses in the area and a provider of clinical placements for nursing students. The hospital was developing a new preceptor-training program and invited a nurse to sit on the advisory board. Hospital administrators viewed partnership as an opportunity to identify and reduce barriers to continuing formal education in their institution. The hospital nurse educator was integral to the development of the assessment tool, facilitated data collection, and assisted with data analysis. The union that represented the staff nurses at the hospital was another interested party in the partnership; union leaders viewed the issue of continuing education as a core advocacy issue. DEVELOPMENT OF NEEDS ASSESSMENT TOOL The two-part assessment tool was developed based on a review of the literature. Part 1 consisted of four yes/no knowledge questions asking participants: 1) if they were interested in continuing their education; 2) if they knew about educational programs offered at area institutions; 3) if they had knowledge of prerequisites for educational programs; and 4) if they were aware of institutional resources available to them if they decided to continue their education. Part 2 included two multiple-choice questions about personal and work barriers and supports. Four nurse union representatives reviewed the assessment tool, and minor changes were made based on their feedback. DATA COLLECTION The public hospital employed about 700 RNs (30 percent ADNs) and 250 licensed vocational nurses (LVNs) and psychiatric technicians. Nurses working in the hospital's clinics were not included in this assessment; there was no mechanism to distribute and collect information from them. A total of 630 nurses (RNs and LVNs) were eligible for participation. The union representatives on each unit gave a brief oral and written description of the needs assessment, including ethical and confidentiality issues related to participation; participation was voluntary and anonymous. Forms were distributed to nurses who heard an oral presentation, and copies of the study description and blank assessment forms were made available in the staff room. Completed assessments were deposited into secure collection boxes. …

Project‐based fieldwork: Perspectives of graduate entry students and project sponsors

This article builds on an earlier viewpoint regarding the need for project-focussed fieldwork. It presents the findings of an evaluative study into the value of project placements undertaken by final year graduate entry master's students as part of a capstone subject. The authors argue that provision of project placements enable impending graduates to develop and implement macro level strategies to develop prevention, resource and service development skills often required of contemporary occupational therapy practitioners. A qualitative approach is adopted. Student cohorts from 2005 and 2006 completed open-ended, written questionnaires, and agency project sponsors were interviewed to obtain their perspectives of the project placement experience. Despite some concern that project placements might be undertaken at the expense of 'clinical' placements these findings reveal that projects managed by students were perceived by services to add great value enabling them to advance important priorities. Students and sponsors highlighted a range of positive learning outcomes, including the ability to work collaboratively with supervisors and develop advanced communication skills and political acumen. The success of such placements depends on supportive supervision from academic staff. CONCLUSIONS AND SIGNIFICANCE OF THE STUDY: The findings promote project placements as a highly authentic aspect of work integrated learning enabling learners to draw together a range of attributes that support the ability to manage complex issues that have occupational relevance at a macro level. In addition, such experiences help learners to develop agency and political acumen both increasingly important capabilities for the contemporary workplace.

Using Portfolios to Introduce the Clinical Nurse Leader to the Job Market

Development of a portfolio is an effective strategy used by clinical nurse leaders (CNLs) to inform prospective employers of their specialized skills in quality improvement, patient safety, error prevention, and teamwork. The portfolio provides evidence of competence relative to the role of clinician, outcomes manager, client advocate, educator, information manager, systems analyst/risk anticipator, team manager, healthcare professional, and lifelong learner. This article describes the CNL portfolio developed by experts from the University of Tennessee Health Science Center and Methodist LeBonheur Healthcare. Examples of portfolio documents generated throughout the master's entry CNL curriculum are provided, along with student experiences using the portfolio in the employment interview process.

Occupational therapy students’ perceptions of occupational therapy

An understanding of students' perceptions of occupational therapy on entry is required to recognise how professional socialisation occurs through curriculum. Findings pertain to a qualitative study investigating students' perceptions of occupational therapy upon entry to two occupational therapy programmes in Australia. Students commencing Bachelor of Occupational Therapy and Masters of Occupational Therapy Studies programmes participated in the study (n = 462). A purpose-designed questionnaire was distributed to students in the first lecture of each programme. Preliminary analysis comprised identification of keywords/phrases and coding categories were generated from patterns of keywords. Frequency counts and percentages of keywords/phrases within categories were completed. Students' responses were categorised as 'what' occupational therapists do; 'how' they do it; 'why' they do it; and 'who' they work with. In 'what' occupational therapists do students frequently described 'helping' people. Both undergraduate and graduate entry masters students used the term 'rehabilitation' to describe how occupational therapy is done, with graduate entry students occasionally responding with 'through occupation' and 'modifying the environment'. Students perceived the 'why' of occupational therapy as getting back to 'everyday activities', with some students emphasising returning to 'normal' activities or life. Regarding the 'who' category, students also thought occupational therapists worked with people with an 'injury' or 'disability'. Students entered their occupational therapy programmes with perceptions consistent with the general public's views of occupational therapy. However, graduate entry students exposed to a pre-reading package prior to entry had more advanced occupational therapy concepts than undergraduate students.

Predictors of NCLEX-RN Success Across 3 Prelicensure Program Types

Nursing faculty are concerned about the ability of recent graduates to successfully pass NCLEX-RN on their first-attempt. To facilitate student first-time success on the examination, nurse educators need to understand what student characteristics are predictive of success. The purpose of this study was to explore student characteristics across 3 different programs types (university-based BSN, master's entry, and satellite BSN) and in each of the 3 program types to identify predicators of first-time NCLEX-RN success.

A tailored program of support for culturally and linguistically diverse (CALD) nursing students in a graduate entry Masters of Nursing course: A qualitative evaluation of outcomes

This paper aims to firstly explain why a support program is necessary and describe briefly the support program for culturally and linguistically diverse (CALD) nursing students enrolled in a two year accelerated Master of Nursing program at the Faculty of Nursing and Midwifery, the University of Sydney. Secondly, it aims to address the underpinning pedagogical approach to delivery of the program and finally this paper reports the findings of a qualitative evaluation of the program. The program was introduced in semester 1, 2008 and aimed to facilitate improved student satisfaction by addressing the academic, communication and relational challenges identified as having a significant impact on both CALD students’ academic achievement and their performance on clinical placement. Teaching and support strategies included interactive delivery, activities in small groups and the use of video clips, reflective feedback sessions, and open discussions. An evaluation, based on 13 semi-structured interviews explored the consequences of the program on student satisfaction and to determine whether the student learning experience had been enhanced.

Clinical Simulation as an Instructional Strategy for Animating the Clinical Nurse Framework

The Clincal Nurse Leader (CNL) roles include both the management of clinical outcomes and management of the clinical environment. In a program in which students learn the CNL roles as a Master's Entry Option program, both the bedside and the systems roles must be mastered. This article describes how simulation can animate the curriculum by challenging students at both the bedside and microsystem level in a pediatric setting. Fourteen MEO/CNL students were exposed to two clinical days of simulated experience in both well assessment and emergency-response case-based scenarios. Results of a post-experience survey revealed high rates of agreement on the constructs measured. Another cohort of eight MEO/CNL students were assigned to observe and report on the systems-level issues of two cohorts of junior-level baccalaureate students who were engaged in pediatric simulations. Simulation can be used to animate both the bedside and system level roles expected of the Clincal Nurse Leader.

The Evolving Postbaccalaureate Entry: Analysis of Occupational Therapy Entry-Level Master's Degree in the United States

At the American Occupational Therapy Association's Annual Conference in 1999, the Representative Assembly passed Resolution J, which became Resolution 670-99 and mandated that entry to the professional level of practice in occupational therapy be at the post-baccalaureate degree level. The Accreditation Council for Occupational Therapy Education (ACOTE) set the effective date as 2007. As a result, more than 50 of the existing 157 occupational therapy educational programs faced the challenge of developing postbaccalaureate entry degree programs. These programs had previously offered only baccalaureate entry degrees. This article compiles the expectations that were articulated as outcomes of transitioning to postbaccalaureate entry, describes findings from an analysis of the current structure of the evolving master's entry level occupational therapy education and identifies concerns for consideration by educational programs and practitioners.

The Evolving Postbaccalaureate Entry: Analysis of Occupational Therapy Entry-Level Master's Degree in the United States

At the American Occupational Therapy Association's Annual Conference in 1999, the Representative Assembly passed Resolution J, which became Resolution 670–99 and mandated that entry to the professional level of practice in occupational therapy be at the post-baccalaureate degree level. The Accreditation Council for Occupational Therapy Education (ACOTE) set the effective date as 2007. As a result, more than 50 of the existing 157 occupational therapy educational programs faced the challenge of developing postbaccalaureate entry degree programs. These programs had previously offered only baccalaureate entry degrees. This article compiles the expectations that were articulated as outcomes of transitioning to postbaccalaureate entry, describes findings from an analysis of the current structure of the evolving master's entry level occupational therapy education and identifies concerns for consideration by educational programs and practitioners.