Nursing Education Research Articles

Exploring Education Interventions for Stroke Prevention Among Adults and Older Individuals: A Scoping Review.

This investigation aims to conduct a comprehensive review of educational interventions targeting stroke prevention to provide effective preventive measures and optimize resource utilization in adults and the elderly populations. A comprehensive literature search was conducted on PubMed, SCOPUS, and Embase for articles published online or in print until February 22, 2022. Inclusion criteria for studies were limited to the studies that examined stroke education or training interventions aimed at improving knowledge among adults aged 30 years and above, with a particular focus on older adults. A review of 97,848 papers was conducted, resulting in the inclusion of 19 papers. Of these, six were randomized controlled trials (RCTs), six were non-randomized studies, five were campaign studies, one was a cross-sectional study, one was a pilot study, and one was a prospective study. The provided information describes various interventions and educational programs related to stroke awareness, prevention, and management. The intervention subjects were categorized as awareness of warning signs and symptoms of stroke (n = 14), comprehensive awareness campaigns (n = 5), multilevel strategies for stroke education (n = 4), community-based nursing education and rehabilitation program (n = 5), multimedia campaign for 9-1-1 awareness (n = 3), and self-management interventions (n = 1). The categorized interventions, addressing awareness of warning signs and symptoms, comprehensive awareness campaigns, multilevel strategies, community-based nursing education and rehabilitation programs, multimedia campaigns for 9-1-1 awareness, and self-management interventions, collectively enrich our understanding of the multifaceted approaches to stroke education.

Implementing a Trauma-Informed Approach in Undergraduate Nursing Student Clinical Education: Strategies for Clinical Nurse Educators

AimTo discuss strategies for clinical nurse educators to integrate a trauma-informed approach while supporting undergraduate nursing students’ learning in the clinical environment. BackgroundUndergraduate nursing students’ risk of exposure to clinical related critical incidents coupled with their higher rates of personal traumas such as adverse childhood experiences, adds to the complexity of experiential learning. Clinical related critical incidents may compromise nursing students’ academic abilities and their well-being. The implications of clinical related critical incidents may extend to future nurse retention and recruitment as students question the perception of the profession’s identity. The cumulative effect from trauma may impact nursing students’ mental health making them vulnerable to trauma-related symptoms and disorders. DesignA discussion paper is used to support the application of a trauma-informed approach throughout clinical learning experiences. MethodWith relevant literature, a trauma-informed approach is emphasized for developing and maintaining safe environments that foster learning and optimize the health and well-being of nursing students. ResultsThe key assumptions and principles of a trauma-informed approach as outlined by the Substance Abuse and Mental Health Services Administration underpinned the proposed strategies that clinical nurse educators may use while preparing for clinical, during and after experiences. ConclusionA trauma-informed approach may encourage undergraduate nursing students to adopt key tenets into their future clinical practices so they can effectively support patients, families and their colleagues.

Development of Qualified Items for Nursing Education Assessment: The Progress Testing Experience

Aimto analyze the psychometric characteristics of items in the nursing inter-institutional progress testing for the years 2019, 2021, 2022 and 2023. BackgroundProgress testing is a validated method for evaluating professional undergraduate education, aimed at identifying knowledge gain in a continuous and progressive manner, with potential benefits for nursing education. However, for its results to be useful, the evaluation items used in the test must have good psychometric performance. Designa cross-sectional study. Methodsa sample of 377 items (multiple-choice questions) was applied to 4,678 students in four years of progress testing. The difficulty and discrimination indexes were analyzed using descriptive statistics, ANOVA and simple linear regression. ResultsThe average difficulty index of the test items ranged between 0.39 and 0.46. The areas of child and adolescent health, women's health and adult health had the most difficult items, while the areas of management, mental health and public health had the least difficult items. Discrimination index ranged from 0.35 to 0.43. There was a difference between discrimination index between the years of application (p<0.001), with a significant increase in the discrimination index (p<0.001) in the trend analysis. Students in the final years showed lower levels of difficulty and discrimination when compared with students in the initial years, demonstrating that the test is easier and there is less dispersion of performance among students in the final years. ConclusionsThe items are not difficult and have good discrimination. A gradual annual increase in the discrimination index of the items was observed. This study provides useful information for the psychometric analysis and quality assurance of knowledge assessment items, both for the implementation of similar PT experiences and in the use of multiple-choice questions for other knowledge assessment purposes.

Nursing Care and Postgraduate Education of Nephrology and Dialysis Nurses in Italy.

Introduction. Patients with chronic kidney disease undergoing renal replacement therapy have complex care needs. To address this, nephrology and dialysis nurses must possess expertise in advanced specialist and disciplinary skills. The aim of this review is to analyze post-graduate academic training pathways and clinical-care training in the field of nephrology and dialysis nursing in the Italian context. Methodology. A narrative review of the literature was conducted in May 2024, using databases such as CINAHL and Medline-PubMed, with a selection criterion limited to primary and secondary studies published in Italian and English. To supplement the search, particularly within the Italian context, grey literature sources were consulted. Results. Post-graduate nephrology nursing education in Italy is mainly offered through First-Level Masters, as well as Second Level Masters and specialization courses, which are provided at various academic institutions. Analysis of the educational programs revealed the presence of common "core" teachings across all pathways, covering renal disease pathophysiology, hemodialysis, peritoneal dialysis, and dialysis nursing care, alongside significant heterogeneity in other proposed teachings. Clinical-care training emerged as a fundamental aspect in both post-graduate education, professional integration for newcomers, and continuous professional development. Conclusions. The growing healthcare need for specialist skills suggests the necessity of integrating field-based training with standardized post-graduate academic pathways, possibly in collaboration with relevant Nursing Scientific Societies. This synergy would not only promote the enhancement of nursing competencies but also ensure a high quality of care delivery.

국내 간호대학생의 핵심간호술 교육 중재의 효과: 체계적 고찰

Objectives This study systematically reviewed the effectiveness of core nursing skill training intervention programs for nursing students in Korea. Methods Literature searches were conducted using the databases RISS, KISS, DBpia, and KCI for papers published up to June 2024, with the keyword ‘core nursing skills’. A total of 130 papers were identified, and ultimately, 14 papers were selected for the literature review. Results The literature review revealed that among the research designs, 1 was randomized and 13 were nonrandomized. Core nursing skill training interventions included studies using various methods of retraining and evaluation (10 papers) and studies using various methods of self-practice and evaluation (4 papers). Retraining and evaluation methods included traditional retraining, STEPS Model retraining, senior mentoring retraining, multimedia retraining, and online learning retraining, while self-practice and evaluation methods included traditional self-practice, scenario-based self-practice, Virtual Reality-based self-practice, and self-observation methods. The most frequently applied core nursing skill was subcutaneous injection, appearing in 10 studies, followed by vital signs measurement, intramuscular injection, intermittent gastric tube feeding, and foley catheterization, each appearing in 8 studies. Outcome variables of core nursing skill training programs showed significant effects on confidence in performance (9 papers), clinical performance ability (4 papers), self-efficacy (3 papers), and knowledge (3 papers). Conclusions Korean nursing colleges have researched various intervention programs to achieve core nursing skill competency levels in accordance with the Nursing Education Evaluation Criteria. These programs have shown significant effects on performance confidence, clinical performance ability, and self-efficacy. Therefore, there is a need to develop and utilize diverse intervention programs to enhance learning motivation and satisfaction among nursing students.

The effect of peer tutoring on pediatric nursing education: a systematic review.

This study aimed to systematically review studies on the effect of peer tutoring on pediatric nursing education for nursing students and identify its contents and characteristics. A comprehensive search was conducted from November to December 2023 across databases including PubMed, Embase, CENTRAL, CINAHL, ProQuest, and others. We included both published and unpublished literature in English or Korean. Three reviewers independently screened and selected eligible studies that involved undergraduate nursing students participating in peer tutoring programs focused on pediatric nursing education. We analyzed quantitative outcomes related to learning effects and learner responses. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials and the risk of bias assessment tool for non-randomized studies. Five studies were reviewed, encompassing randomized controlled trials, a non-randomized controlled trial, a cohort study, and a before-after study. These interventions were conducted in school settings or pediatric clinical environments and featured different forms of peer teaching: horizontal, near-peer, and reciprocal. The tutor-to-tutee ratios ranged from 1:3 to 1:36.5. The educational content covered nursing care for major neonatal diseases, communication skills, medication administration, and resuscitation techniques. Significant improvements in cognitive knowledge and communication skills were observed among nursing students. However, there was noticeable variability in the design and reporting of the studies. Peer tutoring programs can effectively enhance pediatric nursing education by improving nursing students' knowledge and skills. For future meta-analyses, more studies in this field reported according to reporting guidelines are needed.

SIFT-ing Through Misinformation

Background: The COVID-19 infodemic revealed nurses are not immune from disseminating health misinformation. Furthermore, the 2021 American Association of Colleges of Nursing (AACN) Essentials require competency in social media literacy. Nurse educators need to prepare students to identify credible information online for safe and ethical practice. Problem: Vertical reading, a traditional evaluation strategy used in nursing education, is insufficient for identifying online health misinformation. Approach: A librarian and nursing faculty member developed an innovative reflection notebook assignment to teach lateral reading—a professional fact-checking technique—and facilitate critical self-reflection among RN-to-BSN students. Outcomes: Reflection notebook responses demonstrated that students use online information in various ways; online information habits require active, ongoing professional development; and lateral reading can promote a more compassionate approach to patient education. Conclusions: The reflection notebooks equip students with critical knowledge, skills, and attitudes to practice safely and ethically while demonstrating some of the AACN Essentials requirements.

Self-Leadership and Associated Factors in Nursing Students

Background: Nurse leaders face high pressure, but self-leadership can help them thrive. Nursing students, therefore, should develop this skill before graduation. Purpose: To investigate nursing students’ self-leadership perceptions and associated factors, and to reveal when and how self-leadership strategies are utilized. Methods: An explanatory sequential mixed-methods design with interpretative description; 943 nursing students were surveyed and 13 were selected for qualitative analysis. Descriptive data were collected, and self-leadership was assessed using the Revised Self-Leadership Questionnaire. Focus group interviews were analyzed through thematic and content analysis. Results: Students who were employed, were involved in student clubs or organizations, held managerial roles, and had career goals exhibited higher self-leadership perceptions. Qualitative findings revealed that staying in comfort zones, overthinking, and procrastination hinder self-leadership, while self-respect, self-awareness, and self-determination enhance it. Conclusions: Nurse educators should design interventions that enable students to take on planning roles, advance at their own pace, and engage in opportunities to develop their self-leadership skills.

Norwegian Public Health Nursing Students’ Experiences with the Transition from Classroom to Online Lectures: Benefits and Challenges

The integration of technology in higher education increased online courses available to students, although traditional face-to-face interaction remains dominant. The COVID-19 pandemic forced a rapid transition to emergency remote teaching (ERT), impacting public health nursing (PHN) education in Norway, which primarily consists of adult learners. The impact of the transition to online-only lectures on these students remains largely unexplored. The aim of this study is to examine how Norwegian PHN students experienced the transition from traditional classroom lectures to online-only lectures during the global pandemic. It also identifies the self-reported advantages and challenges associated with online-only lectures and whether this transition affected their perceived learning outcome. A cross-sectional sample of public health nursing (PHN) students (n = 275) participated in a survey in from May to November 2020. The questionnaire was specifically developed for this study and covers student motivation, perceived benefits and challenges of transitioning to online lectures, peer collaboration, and self-assessed learning outcomes. It was distributed to the PHN students via their respective education’s LMS system. Most PHN students managed the technical aspects of the abrupt transition to online-only lectures effectively. They reported high digital competence, found the transition relatively easy, and remained motivated to continue their studies. Despite these positives, students reported a reduction in learning outcomes compared to classroom lectures. Challenges included the missing face-to-face interaction with peers, difficulties in managing childcare, and issues with structuring their studies.

Enhancing nurse faculty resilience through self-leadership: guidelines for resource mobilization in dynamic academic environments.

The purpose of the study was to develop guidelines for the facilitation of self-leadership in nurse faculty. Of the 12 guidelines developed, this paper discusses the two related to resilience through self-leadership practices, namely: encouraging reliance on internal sources for self-preservation; and strengthening the positive self-image of nurse faculty through management and peer support. An exploratory, sequential mixed-methods design was used to guide the development of guidelines. Enhancing nurse faculty resilience can be achieved by promoting engagement in self-leadership activities. These activities contribute to faculty members' profound satisfaction, confidence in their knowledge, and overall competence. Resilience is enriched through practicing self-leadership in a supportive work environment and plays a crucial role in adapting to significant changes in the work environment. It has been identified as a key factor that facilitates the ability to persist against struggles and challenges in the workplace. The implementation of higher education reforms in South Africa has brought about increased workload, stress, and uncertainties to an already overwhelmed nurse faculty workforce, consisting of mainly female faculty. It is prudent that a supportive environment that empowers nurse faculty well-being and resilience be facilitated to ensure adaptation to a dynamic and competitive nursing education environment.

Exploring Empathy Dynamics in Virtual Patient Training

Abstract Background This study investigates the manifestation of empathy among nursing students and teachers during virtual patient training with VR glasses at the Medical Simulation Training Centre of Medical University - Plovdiv. The pilot training, conducted from March 22 to April 12, 2024, was part of the Erasmus+ project ‘Caring violent child safely in child psychiatric and residential units (Safe4Child) 2021-1-FI01-KA220-HED-000032106.’ Participants were divided into two focus groups: third-year nursing students and lecturers teaching specialized academic disciplines in nursing. Results A total of 34 participants partook in the study, comprising 16 instructors with basic nursing education and 16 third-year nursing students. Students exhibited considerable empathy towards the virtual child patient, expressing an inclination to provide assistance, acknowledging the necessity for personalized care, and displaying a curiosity about the patient’s experiences. They conveyed sentiments such as ‘I felt the need to help the child/patient’, ‘the child needs individual work with a nurse’ and ‘I want to understand the child’s experiences.’ In contrast, instructors demonstrated more reserved emotional responses, characterized by professionalism and a focus on offering comfort. They expressed, ‘Normal feelings...but you want to hug the child and comfort him.’ Conclusions The study unveiled a marked difference in empathy expression between students and instructors, with students displaying stronger emotional reactions. These findings underscore the need to recognize and address individual variances in empathy expression within nursing education. Tailored strategies should be devised to bolster empathy development in both students and instructors during virtual patient training. Further investigation is warranted to explore effective methodologies for optimizing empathy development and fostering compassionate patient care in nursing education. Key messages • A Comparative Analysis of Nursing Students and Instructors Using VR Glasses. • Erasmus+ project (Safe4Child) 2021-1-FI01-KA220-HED-000032106.

Knowledge, opinions and experiences of nurses and nursing students in Portugal regarding the use of medical Cannabis

BackgroundThe opening up of the laws to medicinal cannabis in recent years is a key factor in the growth of this therapy, but there is little information about what nurses know and think about it. The present paper seeks to analyze the knowledge, opinions, and experiences of nurses and nursing students in Portugal regarding the use of cannabis and to understand gender differences.MethodsA self-completion questionnaire was drawn up and published online. It received face and content validity and was approved by the Ethics Committee. The instrument includes socio-demographic data, questions about knowledge, opinions, experiences, and training in cannabis. The data was collected and processed by applying descriptive and inferential statistics using the chi-square test and Fisher’s exact test on the SPSS platform.ResultsThe majority of the 610 participants were women. The therapeutic benefits of medical cannabis were appreciated by 79,6% of nurses and 84,3% of students. When asked about the functions of the endocannabinoid system, 71,7% of nurses and 79,5% of students had never heard of it. There is a statistically significant gender difference concerning personal experience of cannabis use to treat symptoms or illnesses.ConclusionsAs the levels of knowledge were low and a minority had education on medical cannabis, there is a need for further education of nurses and for this emerging area to be included in the curricula.

Opportunities for nursing and midwifery research in Bulgaria

Abstract Background The training of nurses and midwives today is at university level and follows established standards. The 2009 Global Standards for the basic nursing and midwifery education of the World Health Organization requires that the curricula should include basic knowledge and skills for scientific research to implement evidence-based health care. In Bulgaria, scientific research among nurses and midwives began in 2000 and has seen more serious development in the last 5 years. Methods A content analysis of normative documents was carried out, to regulate the conduct of scientific studies and the curricula for the two specialties. Results In all documents on the activities of graduate nurses and midwives, activities related to conducting scientific studies are regulated. No mandatory discipline for these competencies is included in the basic education. In Bulgaria, there is a bachelor’s and master’s program only in Health Care Management, in which sociology, statistics, and research methodology are studied. From 2000 to 2016 nurses and midwives defended doctoral dissertations in a program for medical doctors. The first doctoral program for nurses and midwives is from 2016. There are no legal norms for stimulating and provide conducting clinical research, and to ensure evidence-based practice by nurses and midwives. Conclusions The normative regulation of scientific activity among nurses and midwives in Bulgaria corresponds to international and European requirements, but the opportunities for training are limited. The responsibility of nurses and midwives to modern society is to ensure high quality in health care provided by: a. providing opportunities for clinical studies; b. implementation of evidence-based health care and practice; c. developing programs for training for research in health care. Key messages • In Bulgaria, there is a legal norms for conducting nursing research, but not for evidence-based practice. • There is a need for more opportunities to train and encourage clinical nursing research.

Virtual Children’s Hospital for Learning Pediatric Nursing

Abstract Background In the context of a funded Erasmus+ program, a platform of a Virtual Children’s Hospital for Learning Pediatric Nursing - VLPN is being developed. The education of nurses working with children, adolescents and families, needs to include specialized knowledge, skills, attitudes and behaviors that will empower them to provide optimal and high-quality care. The virtual platform enables the improvement of pediatric nursing competences of the nursing students through interactive and self-paced activities and content. Objectives 1. To develop an immersive and interactive virtual reality learning environment (VRLE), a virtual children’s hospital and new teaching and learning methods and practices, utilizing virtual reality and simulation in teaching. 2. To promote the international collaboration of students and lecturers through the VRLE Results The results are preliminary. 1. The VRLE includes educational materials developed to be integrated in the pediatric nursing studies, easy to access and use by the students and teachers with innovative self-pace learning material i.e. videos, 3D-models, interactive tests. Digital patients can react to the provided care with speech, movement, facial expressions and gestures, something that is not possible with the manikins in the Labs. 2. Nursing students and lecturers from different countries can participate in joint remote seminars or workshops in the VRLE, sharing and comparing their country and culture-specific differences and similarities in the nursing practices. VRLE and digital materials enables synchronous and asynchronous learning. Conclusions VRLE is highly conducive to clinical and procedure-focused training by enabling simulation. VR methods offer nursing students the opportunity to practice skills in a safe and risk-free environment in an immersive way. It can be accessed by multiple students, teachers or nurses at the same time from different locations in different countries. Key messages • New innovative VRLE enhances nursing students’ knowledge and skills that are needed when working with sick children and their families. • International collaboration, interaction and mobilization are enabled by using a virtual platform instead of traveling, thus strengthening the co-operation in European higher educational institutes.

Early Warning System Education for Nurses Regarding Emergencies in Hospitals

Abstract Background: The success of first aid in dealing with patient emergencies is very dependent on the speed and accuracy of initial detection which determines the success of nursing care for patient emergencies. Early detection of emergencies can use the Early Warning System (EWS). The aim is to provide early warning system education to nurses in hospitals in emergencies. Method. This service was carried out at the Palembang Muhamamdiyah Hospital for 33 nurses. The activity stages are implementation meetings, preparing materials and participants, education and demonstration of the EWS application. Results: It was found that there was an increase in nurses' knowledge regarding EWS. Conclusion: the EWS application makes it easier for nurses to carry out early detection of emergencies. Key words: early warning system, nurse

Innovation and Technology in Nursing Education: Challenges and Opportunities

This comment responds to the recently published article on online learning methods during the COVID-19 pandemic. The article describes the challenges, methods, and opportunities of online learning. The authors consider this topic to be very current, interesting, and highly relevant, as the impact that technology will have on the future of nursing education will be significant. However, the challenge posed by the implementation of advanced technologies such as virtual reality (VR) or e-learning requires special attention. These technologies not only enrich students’ educational experiences but can be important in adequately and comprehensively preparing students to meet real-world clinical challenges.

Using Mortality and Morbidity Conferences in Advanced Practice Nurse Education to Enhance Student Self-Efficacy.

The integration of morbidity and mortality (M and M) conferences into advanced practice nurse (APN) nursing curricula is a novel approach aimed at enhancing education, reflective learning, and continuous improvement. M and M conferences have traditionally been a standard practice for medical specialties, yet a gap exists in their utilization within APN education. A quasiexperimental pilot study with 20 student registered nurse anesthetists was conducted at a large urban academic center. The General Self-Efficacy Scale was utilized to evaluate student self-efficacy and confidence in managing adverse events. Significant improvement in self-efficacy scores (p = .003) postintervention indicated the educational benefits of M and M conferences. All participants reported increased confidence in navigating unexpected events. The M and M conference is a valuable tool within APN education for cultivating self-efficacy and confidence in navigating adverse events. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Axiological reflection for nursing ethics education: The missing link in understanding value conflicts.

Texts from various areas of the world highlight the importance of moral values like compassion and integrity in healthcare. Such values are held in high esteem by healthcare organisations and are actively 'taught' within nursing ethics education to ensure their presence within the future workforce. With such an emphasis, it is easy to overlook that moral values are not the only values that people, including nurses, hold. Other personal values - which may or may not conflict with moral values - are simultaneously present within individuals. Therefore, moral behaviour cannot be predicted solely by the presence/absence of certain moral values. Instead, it depends on how these integrate into an individual's broader values system.Using Schwartz's axiological Theory of Basic Human Values as a framework, I argue that moral values are but one part of an individual's greater personal values spectrum, which also includes, for instance, hedonism, achievement, and power. Within this spectrum, values are ordered hierarchically, influencing behaviour based on relative priority. When a conflict arises between moral and other personal values, the prioritisation of moral values is a requirement for moral behaviour.I discuss how socialisation in suboptimal clinical practice environments can cause moral values to be deprioritised and argue that the development of practical reasoning skills is paramount to learning to balance one's values and guide decision-making. I advocate for the integration of (meta-)axiological reflection - characterised by introspection and aimed at developing a deeper understanding of one's personal values spectrum - within nursing ethics education. This involves exploring the origin, meaning, and perceived relative importance of one's different personal values. By incorporating specific reflective exercises, students can increase self-awareness/insight and enhance their ability to recognise situations where conflicts between their moral values and other personal values may occur, which is likely to benefit moral decision-making in clinical practice.

Developing and validating a self-assessment tool for assessing confidence of nurse-midwives against competency domains of the International Confederation of Midwives, in India.

While midwives are recognized as primary care-providers for maternal and new-born care in many parts of the world, India is transitioning to professional midwifery. The pathway to midwifery in India has been through integrated nursing and midwifery education. Since 2018, India has introduced an 18-month post nursing midwifery education programme. To establish a baseline for midwives' competence and measure progress, there is a need for a quick, easy-to-administer and low-cost tool that can be used at scale to guide programme efforts. This paper describes the process of validation and testing of a tool to assess the confidence of practicing nurse-midwives as a proxy indicator for competence against the seven competency domains of the International Confederation of Midwives (2013). A total of 2198 nurse-midwives, providing maternal and new-born services at the time of the study, from 442 public and private hospitals across six states in India, responded to a self-administered questionnaire. The tool is psychometrically sound and can potentially be used in low-middle-income countries to measure confidence of midwives and nurse-midwives against international competence standards. It is suitable for quick large-scale programmatic assessments within a short time period, providing evidence to inform midwifery strengthening initiatives. The tool can be contextualized to suit specific country contexts. Since it was tested in India, where a distinct cadre of midwives is not yet established and nurse-midwives provide maternity care, the tool can be easily adapted for use in other countries in the South East Asia Region with similar contexts.

Exploring the concepts of diversity, equity, and inclusion in nursing curricula through an integrative review

Objective: The aim of this review was to explore the concepts of diversity, equity, inclusion within nursing education. Moving forward with the new AACN Essentials, nursing professors will be required to integrate these concepts into the curriculum, therefore it is important to understand what is currently available in the literature.Methods: An exhaustive review of the literature revealed that among the original 3,107 articles found, only 24 were included because of the narrowed IR focus on curriculum. Articles were then evaluated for suggested learning activities.Results: This IR reviews 24 articles in total. Some of the articles reviewed contained more than one concept. Of the articles reviewed, 18 focused on inclusion, 8 on equity, and 13 on diversity.Conclusions: The findings first and foremost indicate the need to incorporate teaching and learning practices related to the concepts of diversity, equity, and inclusion and secondly the need to publish additional best practices and exemplars.