Nursing Education Research Articles

Development and Usability Assessment of Virtual Reality- and Haptic Technology-Based Educational Content for Perioperative Nursing Education

Background/Objectives: In perioperative nursing practice, nursing students can engage in direct, in-person clinical experiences in perioperative environments; however, they face limitations due to infection and contamination risks. This study aimed to develop and evaluate educational content for perioperative clinical practice for nursing students using virtual reality (VR) and haptic technology. Methods: The program, based on the Unity Engine, was created through programming and followed the system development lifecycle (SDLC) phases of analysis, design, implementation, and evaluation. This program allows nursing students to engage in perioperative practice using VR and haptic technology, overcoming previous environmental limitations and enhancing practical and immersive experiences through multi-sensory stimuli. Results: Expert evaluations indicated that the developed content was deemed suitable for educational use. Additionally, a usability assessment with 29 nursing students revealed high levels of presence, usability, and satisfaction among the participants. Conclusions: This program can serve as a foundation for future research on VR-based perioperative nursing education.

Investigating Students' Clinical Experiences of Learning the Nursing Process Using an Integrated Teaching-Learning Method at Shahid Qazi Tabatabaei Hospital: A Qualitative Content Analysis

Introduction: Integrated teaching-learning methods have demonstrated potential in enhancing students' cognitive skills and, subsequently, the quality of patient care. This qualitative study aimed to explore the learning experiences of nursing students engaged in an integrated teaching-learning method during their clinical education in oncology nursing. Method: : Semi-structured interviews were conducted with 19 nursing students who had completed a clinical training program in oncology nursing using an integrated teaching-learning method. Conventional qualitative content analysis was employed to analyze the data, identifying sub-categories and categories related to students' experiences. Results: The analysis revealed four main categories: (1) sustained cognitive learning, (2) non-cognitive learning, (3) application of learned concepts in real-world situations, and (4) students' suggestions for improving the learning of the nursing process. Conclusion: The findings suggest that an integrated teaching-learning method, implemented as a creative and student-centered approach at the bedside, effectively enhances both cognitive and non-cognitive skills, facilitating the practical application of learned concepts. To fully leverage the benefits of this method, its implementation should be expanded across clinical education units, starting in lower semesters. Simultaneously, optimizing real-world clinical education environments will further accelerate positive educational outcomes, enhancing students' cognitive and non-cognitive skills and creating a foundation for applying learned concepts in clinical practice.

Embracing Our Differences: Advancing Diversity, Equity, and Inclusion Through Perioperative Nursing Education.

A focus on diversity, equity, and inclusion (DEI) in a health care system is critical to ensure patient safety and improve the health outcomes of all surgical patients and communities. Some patient populations continue to experience disparities that negatively affect their burden of illness, ability to access quality care, and health-related outcomes. Unconscious (or implicit) bias among clinicians can lead to unintentional discrimination against marginalized groups. Organization and perioperative leaders should recognize the importance of developing a workplace culture committed to DEI and implement strategies to educate and empower clinicians to embrace these initiatives. When developing educational offerings on DEI for personnel, educators should use a framework and a variety of educational strategies, such as listening tours, computer-based learning, simulations, and journal and book clubs, to engage teams focused on optimizing the health and well-being of the diverse surgical populations in their communities.

A cooperative learning intervention for improving a simulation-based paediatric nursing course: A quasi-experimental study

AimThis study aimed to examine if a cooperative intervention improved outcomes for a simulation-based paediatric nursing course. BackgroundFostering cooperative learning can enhance student engagement and improve learning. Simulation-based courses provide nursing students an opportunity to practice and hone nursing skills when hands-on experiences are limited. Providing instruction in cooperative learning could improve course outcomes. DesignA quasi-experimental study with pre-test/post-test assessments. MethodsThird-year nursing students enrolled in an 18-week paediatric simulation-based nursing course were purposively recruited (N = 110). One class (n = 55) received a researcher-developed cooperative learning program, which encouraged student support during class activities and simulations. The second class (control) received usual class instruction and simulations. The efficacy of the intervention was assessed by comparing mean scores at class enrolment (pre-test) and completion (post-test) for self-perceived problem-solving attitude, cooperative learning experience and knowledge of paediatric nursing. Paired t-tests compared pre-test with post-test scores for the two groups. ANCOVA examined differences in mean scores between groups. Correlations between differences in mean pre-test and post-test subscale scores for problem-solving attitude and cooperative learning experience were also examined. ResultsThere was no significant difference in age or gender between groups. Mean post-test scores on the final exam were significantly higher for students who received the intervention (85.26, 95 % CI 84.19, 86.33) compared with controls (83.61, 95 % CI 82.52, 84.69; F = 4.63, p = 0.034). There were no significant differences in total scores for problem-solving attitude or cooperative learning experience or between groups. For the intervention group, two problem solving subscales were correlated with two cooperative learning subscales: problem solving confidence with learning motivation, respectively (r = 0.302, p = 0.025) and personal control with classroom learning, respectively (r = 0.389, p = 0.003). For the control group, approach-avoidance problem solving was negatively correlated with cooperative learning efficacy (r = −0.343, p = 0.01). ConclusionsCompared with the control group, nursing students who received the cooperative learning intervention had higher scores for knowledge of paediatric nursing, as well as learning motivation and attitude and problem-solving confidence, suggesting that the researcher-designed intervention facilitated simulation-based learning as well as confidence in problem-solving. Nurse educators could easily integrate the intervention into simulation-based paediatric nursing courses to enhance students' problem-solving abilities.

Introducing a Resource to Support Neonatal Nurse Engagement in Clinical Research©.

This paper introduces the Resource to Support Neonatal Nurse Engagement in Clinical Research© to educate and support engagement of nurses in study design and protocol review. The resource serves to promote collaboration between nurses and pharmaceutical researchers to advance the development of neonatal therapies. Neonates remain therapeutic orphans, underserved by the drug development community. Off-label use of drugs in neonates negatively impacts the evaluation of their safety and efficacy. Although NICU nurses' competencies are examples of expertise needed for well-designed clinical trials, nurses may have limited experience in providing insights. Resource development included a literature review and usability testing by multiple stakeholders. Usability testing indicated the resource was comprehensive and relevant to pharmaceutical and nonpharmaceutical studies. Reviewers commented resource prompts are beneficial in assessing study feasibility. Sponsors of research need nurse engagement to improve feasibility and flexibility and prevent protocol deviations in clinical trials. Leveraging the "Resource to Support Neonatal Nurse Engagement in Clinical Research©" can enhance research education and foster engagement of nurses in neonatal research. The resource has implications for the nursing profession, the pharmaceutical industry, and the advancement of new therapies. Individual nurses benefit from education and a framework for research engagement. The profession benefits from enhanced visibility through research collaboration. The pharmaceutical industry gains valuable insights on neonatal care, family dynamics, and NICU standard of care. A resource to foster collaboration in the study development process is an important step for advancing new therapies for neonates.

Upholding ethical pillars in nursing academia.

This manuscript explores the philosophical implications of ethical principles such as honesty, integrity, fairness, reliability, and objectivity and their impact on professional nursing. By examining these values within Western society, the discussion highlights the importance of integrating these virtues into contemporary nursing education. Through a detailed analysis of each precept, the document underscores their potential to enhance the quality of education, improve interactions among faculty and staff, and achieve positive student outcomes. Ultimately, this treatise advocates for a balanced pedagogical approach in nursing that leverages these elements to foster a more compassionate world, where ethical connections in academia underpin our collective existence.

Clinical learning of nursing students during the COVID-19 pandemic in Limpopo province, South Africa.

The Nursing Education Programme was affected during the coronavirus disease 2019 (COVID-19) pandemic, resulting in nursing students being unable to participate in the clinical experiential learning required by the South African Nursing Council. The study seeks to explore and describe nursing students' experiences of clinical experiential learning during the COVID-19 pandemic. A qualitative, explorative and descriptive, research design was used in the study. A non-probability purposive sampling method was used, and 55 nursing students participated in the study. Data were collected through six focus group discussions, consisting of 8-12 nursing students in each group. Data were analysed following Tesch's open coding method. Three themes emerged from the study's findings: The impact of COVID-19 on the clinical experiential learning of nursing students, the effects of COVID-19 on the mental well-being of nursing students, and nursing students' experiences of support during the COVID-19 pandemic. Notably, 11 sub-themes emerged. The findings of this study reveal that the COVID-19 pandemic severely disrupted the Nursing Education Programme, highlighting the challenges of inadequate clinical hours, restricted clinical access and the significant psychological impact on students.Contribution:This study adds to the literature on students' experiences during clinical experiential learning in South Africa during the COVID-19 pandemic.

Unveiling the SChematic Organization of Pharmacological Information for Nurses: A New Approach to Pharmacology Education for Nurses.

Unveiling the SChematic Organization of Pharmacological Information for Nurses: A New Approach to Pharmacology Education for Nurses.

Management of Bladder and Bowel Dysfunction in Patients with Multiple Sclerosis

Bladder and bowel dysfunctions are common in patients with multiple sclerosis (MS) and negatively affect their quality of life. Bladder dysfunction, which is prevalent in people with MS (PwMS), can impact almost all patients within 10 years after diagnosis. Conservative, medical, and electrical stimulation approaches are used in the treatment of these problems. Bladder dysfunction in patients with multiple sclerosis can lead to issues such as fluid intake restriction, withdrawal from work life, inability to socialize, and the need for constant use of pads, resulting in a depressive lifestyle. Bowel dysfunction in patients with multiple sclerosis can manifest as fecal incontinence and/or constipation, which can also negatively affect patients' quality of life. Various approaches are utilized in the management of bladder and bowel dysfunction. Multiple sclerosis nurses play a key role in the multidisciplinary team for the diagnosis, treatment, and follow-up of patients' bladder and bowel symptoms. Effective nursing care, education, and counseling in the management of these symptoms enhance the comfort of patients with multiple sclerosis. In this review, the bladder and bowel dysfunctions experienced by patients with multiple sclerosis and the management of these problems are discussed in line with current knowledge.

Norwegian nursing students' experience of international clinical placement abroad: A qualitative study

BackgroundFor several years, the Norwegian government's goal has been that half of those who complete a degree in Norwegian higher education, should have had a study period abroad. This also applies to undergraduate nursing students. Nurse education programs in Norway often offer clinical practice abroad in order for their students to gain experience from another country's health care system. There is a knowledge gap in the literature on how Norwegian nursing students' experience their study period and internships abroad. ObjectiveThe aim of the study was to explore Norwegian undergraduate nursing students' experiences of their clinical practice abroad. DesignA descriptive and exploratory qualitative study. Setting and participantsNursing students were recruited from one specialized university in Norway.Nine students were interviewed. MethodThree focus groups were conducted via the online platform Zoom with nursing students who had their clinical practice abroad during their bachelor's degree. The interviews were conducted in June 2020. The collected data were analyzed using thematic reflective analysis inspired by Braun and Clarke. ResultsFour themes were developed from the analysis: 1) Motivation for studying abroad, 2) Professional and personal development, 3) Different nursing role and 4) Different supervisor role. ConclusionStudents provided valuable insight from their experiences of studying abroad. The study highlights that there were other learning opportunities abroad than in Norway, but that the learning approach was somehow different and that it made the students take more initiative thus becoming more independent. The nursing role was different from what they were used to in Norway. In general, the Norwegian students experienced the nurse role abroad as more medical oriented. In addition, in countries like India, Spain and Cuba the family was taking a greater part of the care of people's basic needs.

International nursing students and clinical learning environments: A convergent mixed-methods study

AimTo acquire a comprehensive understanding of the international nursing students' clinical learning environments, comparing and contrasting qualitative and quantitative insights. BackgroundThe influx of international nursing students has increased in Italy and across Europe. These students, diverse in culture and language, encounter significant challenges to their education in clinical learning environments. Designconvergent mixed-methods research. MethodsQualitative and quantitative data were collected concurrently and independently, with equal emphasis, following a QUAL-QUANT structure. Qualitative analysis used descriptive content analysis, while quantitative data were based on descriptive and correlation analyses on surveys using the CALD scale. ResultsOverall 96 international nursing students participated in 24 focus groups. The CALD scale mean scores ranged from 2.7 to 4.5. The qualitative analysis presented two overarching themes: factors that promote a successful clinical learning environment and factors that inhibit a successful clinical learning environment in international students. The integration of qualitative and quantitative data generated four concordant and one discordant meta-inferences about the learning environment. ConclusionsCulturally sensitive clinical learning environments are imperative for the holistic development of international nursing students. Nurse educators must cultivate transcultural competencies and pedagogical skills to enhance the competencies and skills of this student population effectively.

Virtual Reality Technology in Nursing Education: A Qualitative Study

ABSTRACTVirtual reality (VR) technology plays a significant role in nursing education by enhancing the quality of training by applying knowledge, decision‐making, intervention completion and feedback. This study aims to examine nursing students' experiences and perceptions regarding the ventrogluteal injection training provided through VR technology. Conducted between May and June 2022, this qualitative descriptive phenomenology study took place at a state university in Turkey, involving 70 students who participated in Ventrogluteal Drug Administration training using VR glasses. The sample included 12 students selected via the Criterion Sampling Method. Data collection tools comprised the ‘Descriptive Information Form’ and a ‘Semi‐Structured Questionnaire’. Qualitative data were analysed using the Content Analysis Method, while quantitative data were assessed through descriptive statistical methods (frequency, percentage, mean). The study identified 13 codes, four sub‐themes and two main themes from the students' evaluations. The first main theme, ‘Weaknesses of Virtual Simulation’, included two sub‐themes: ‘Due to its Nature’ and ‘Due to its Technique’, resulting in five codes. The second main theme, ‘Strengths of Virtual Simulation’, was divided into two sub‐themes: ‘Permanence, Integrity, and Applicability’ and ‘Emotions towards Virtual Simulation’, with eight codes identified. The findings indicate that students view VR technology positively in their education. However, they also highlighted specific issues related to the simulation's technique and inherent nature.

The implementation and evaluation of a mock trial using a flipped classroom pedagogy in practical nursing education.

Background: This quality improvement study explores the implementation and evaluation of a mock trial within a flipped classroom pedagogy to help first-year practical nursing learners meet the class objectives. Methods: Sixty-two (N=62) practical nursing learners participated in a mock trial as part of their first year Nursing Arts course at Bow Valley College in July 2022. The mock trial was evaluated using qualitative and quantitative data collection. Results: The thematic analysis suggested that a mock trial using a flipped classroom pedagogy may be an effective way of teaching course objectives. The learners reported a moderate to high level of confidence in managing challenging situations after participating in the mock trial. Conclusions: The study highlights the potential benefits of incorporating a mock trial using a flipped classroom pedagogy in practical nursing education.

Nursing Education in the Era of ChatGPT: Implications and Opportunities

ChatGPT is a generative pre-trained transformer language model developed by OpenAI. ChatGPT is designed to generate conversational, human-like text responses and has been trained with diverse textual data to provide coherent and contextually relevant answers to user queries. This article highlights the advantages of using ChatGPT in nursing education, emphasizing the benefit of enhancing teaching and learning experiences, supporting critical thinking, and providing personalized learning opportunities. The article also discusses barriers to use of ChatGPT, such as limited access to technology and concerns about information accuracy. Discussion of ethical concerns related to AI, including biases, data privacy, transparency, and other psychosocial concerns is also included, along with an overview of efforts to address these potential dilemmas. The article concludes by providing recommendations for best practices to responsibly integrate artificial intelligence products into nursing education, emphasizing the need for educators to become informed about AI technologies and guide cautious and ethical use of AI within nursing education. The work herein underscores the importance of transforming nursing curricula to equip future nurses with digital and data literacy skills necessary for working in today’s increasingly AI-driven environments.

Profile of Primary Care Managers in A Municipality in Northern Brazil and their Leadership Styles

Objective: Know the profile and leadership style of managers of Basic Health Units (BHU). Theoretical Framework: The 2017 National Primary Care Policy (NPCP) suggested the inclusion of managers in BHU to perform technical-managerial functions, based on the manager's assessment and according to the needs of the territory and coverage of Basic Care (BC). Method: Descriptive, cross-sectional and quantitative research, carried out in the municipality of Barcarena, in the state of Pará. The sample was 22 AB managers, carried out from October 2022 to May 2023. The data obtained from a questionnaire with sociodemographic and of experiences in Primary Health Care (PHC) and another on leadership style, the Multifactorial Leadership Questionnaire (MLQ). Results and Discussion: Most BC managers are female (86.4%), aged 20 to 39 (54.5%), married (59.1%), with higher education (90.9%) in Nursing (59 .1%) and 50.0% have a postgraduate degree at Lato sensu level and have a temporary employment relationship (59.1%). They had previous experience in management (59.1%) and had experience in PHC (72.7%). Regarding leadership styles, transformational leadership was more self-perceived (m=3.33) and was statistically significant (p=0.020), as an attribute, motivational inspiration (m=3.67). Research Implications: This study is one of the few works involving research focused on the leadership profile of BC managers. Originality/Value: This study contributes to the literature by understanding the aspects associated with the leadership style of BC managers, and the relationship between leadership and the guidance suggested by the 2017 NPCP.

Improving the quality of clinical training in maternal and neonatal health in undergraduate nursing students: a participatory action research

BackgroundImproving the quality of clinical training is synonymous with accomplishing nursing education goals and improving the quality of nursing care. This study aimed to improve the quality of clinical training in Maternal and Neonatal Health (MNH) in nursing students.MethodsThis action research was conducted in two cycles from June 2017 to June 2018. The study setting was the School of Nursing and Midwifery of Lorestan University of Medical Sciences in southwest Iran. The participants were nursing students, faculty members, clinical trainers, educational managers, and teaching personnel. In the first cycle, semi-structured interviews were held with stakeholders to identify clinical problems and improvement strategies. Based on the results of these sessions, the changes needed to improve the quality of clinical training were planned and implemented. The weaknesses and strengths of the implemented changes were then identified through group discussions with the stakeholders. In the second cycle, a second plan was carried out to correct the weaknesses of the changes planned in the first cycle, and the modifications were implemented and evaluated.ResultsThe main three categories extracted included an unsystematic curriculum and inadequate monitoring, inadequate resources and facilities, and the student’s lack of motivation. The measures taken for improvement included holding communication workshops, developing and internalizing logbooks, reducing the number of students in clinical training groups, using modern clinical training methods, and changing clinical evaluation methods.ConclusionImproving communication skills among the students, trainers, and hospital personnel and using modern clinical training methods, such as conceptual maps, triple jumps, and clinical skill centers, are the best strategies for improving clinical training in MNH nursing students.

Digital learning in nursing education: lessons from the COVID-19 lockdown

BackgroundThe COVID-19 pandemic necessitated a swift transition to e-learning, significantly impacting nursing education due to its reliance on practical, hands-on experiences and the critical role nurses play in healthcare. Nursing students need to achieve high levels of clinical competence through experiences traditionally obtained in clinical settings, which e-learning had to replicate or supplement. Understanding the unique challenges faced by nursing students in e-learning environments is crucial for developing educational strategies that enhance learning outcomes and contribute to improved patient care. This study aimed to explore the experiences of nursing students and newly qualified nurses (as students) with e-learning during the COVID-19 lockdown, focusing on how it influenced their learning and professional development.MethodThis exploratory and descriptive study employed qualitative interviews with 31 participants, including full-time nursing students, part-time nursing students, and newly qualified nurses (as nursing students). Conducted online via Zoom during February and March 2022.ResultsThe findings suggest that integrating small group interactions and employing strategic pedagogical support can enhance e-learning effectiveness. However, barriers such as technological difficulties, psychological challenges, and social isolation were also identified. Understanding these unique opportunities and challenges can help educational institutions optimize e-learning strategies, ensuring nursing students are well-prepared for their crucial roles in healthcare.ConclusionThe rapid shift to e-learning due to the COVID-19 pandemic presented challenges such as technological, psychological and social aspects, but also opportunities to rethink and enhance nursing education delivery. Implementing appropriate pedagogical e-learning strategies, such as scaffolding and small group learning, can better prepare nursing students for their essential roles in healthcare. This study contributes to the body of knowledge on digital education and provides a foundation for future research aimed at optimizing e-learning in nursing education.

Hope, passion and perseverance: experiences of internationally educated nurses pursuing nursing authorisation in Norway–a qualitative study

BackgroundThe global nursing shortage is driving nursing professionals to migrate from their home countries to other regions of the world, leading to increased diversity in healthcare settings and nursing education across Europe. Although research on the experiences of internationally educated nurses has gained more attention in Norway, a substantial gap remains in understanding the challenges these nurses face when participating in bridging programs and seeking authorisation as registered nurses in the host country.MethodsThe aim of the present study is to gain knowledge about the experiences of students in a digitised bridging program for nurses, related to being a nurse educated outside the European Union and a student with a Norwegian as a second language and migrant/refugee background. Oslo Metropolitan University initiated a decentralised education programme in 2021, offering a bridging programme for individuals with a nursing education from countries outside the European Union. This programme was conducted in a decentralised, gathering-based, and predominantly digitised format. The study has a qualitative descriptive design and includes a purposive sample of eight former nursing students enrolled in the programme. Data were collected through individual semistructured interviews conducted between November and December 2023. The data were analysed by employing thematic analysis. The study is reported in accordance with the COnsolidated criteria for REporting Qualitative research (COREQ).ResultsAnalyses revealed a main theme—the participants’ ability to persist in their goal over the long term, maintaining their interest, overcoming challenges, working hard and finishing tasks rather than giving up. This theme is supported by three themes: (i) ‘Navigating bureaucratic challenges – The struggle with authorisation and overwhelming requirements, (ii) ‘An emotional journey – The ups and downs of participating in the program’, and (iii) ‘Achieving recognition – The journey to authorisation and professional confidence’.ConclusionsThe study underscores the numerous challenges encountered by internationally educated nurses seeking registered nurse’ recognition in Norway. Despite these challenges, the participants displayed remarkable hope, passion and perseverance, remaining committed to their goal of becoming registered nurses in Norway.

Debriefing to nurture clinical reasoning in nursing students: A design-based research study

BackgroundStudents' clinical reasoning can be stimulated by guiding them to use their experiences with patients to develop own illness scripts. Debriefing during hospital shifts invites students to put patient experiences into words, link them to previously acquired knowledge and make connections. ObjectivesTo develop, implement and evaluate a debriefing procedure for nursing internships based on illness script theory and generate corresponding design principles. DesignQualitative design-based research. SettingClinical education in dedicated educational hospital units. ParticipantsNurse educators, nursing students. MethodsFrom a collaboration between nurse educators and a researcher, a short, peer-debriefing procedure was designed, tested and enacted through four cycles of planning, action, evaluation and reflection. Students drew mind maps about patients. Nurse educators and students joined focus group discussions to evaluate outcomes and processes. Mind map and iterative thematic analysis were applied to these data. ResultsAn adjusted design and more extensive design principles resulted. Differences in mind maps were evident over time. Three themes in the process evaluation were established: trigger to reason; energy giving and taking; and form follows function. ConclusionsThis design-based investigation displays how nurse educators could design and implement a debriefing procedure to facilitate students' clinical reasoning skills and how students could learn from this. This method integrates research, innovation and collaboration. The design and enactment under real-life hospital conditions generated design principles for educators and researchers which may be useful for those seeking to improve teaching and learning clinical reasoning in practice. More clarification is needed about the path from design through enactment to real change in practice.

The Impact of Upgrading Basic Nursing Certificate to Baccalaureate Level in Ghana

Objective: This paper aims to analyze the impact of upgrading basic nursing certificate to baccalaureate level education in Ghana, focusing on competency, patient outcomes, and professional development. Method: A comprehensive literature review and thematic analysis of relevant studies were conducted to examine the potential effects of this educational upgrade. Findings: The analysis reveals significant benefits of BSN education, including enhanced clinical competency, improved patient safety and care quality, expanded career opportunities, and better adaptation to evolving healthcare needs. Conclusion: Upgrading to BSN-level nursing education in Ghana has the potential to significantly improve nursing practice, patient outcomes, and professional development. Recommendations: The findings support the consideration of mandatory BSN education for nurses in Ghana, similar to the Nigerian model. Significance: This paper contributes valuable insights to the discourse on nursing education reform in Ghana, providing evidence-based arguments for policymakers and stakeholders to consider in decision-making processes regarding the future of nursing education.