Nursing Practice Course Research Articles

Application of clinical case-guided, task-driven escape room teaching in nursing education: A quasi-experimental study

BackgroundIn the new era, the professional ability requirements for nursing personnel are no longer limited to traditional nursing knowledge and skills, but pay more attention to the cultivation and enhancement of their diversified abilities, such as humanistic caring ability, creative thinking, and so on. As a new type of education model that integrates gamification, flipped learning, and problem-based learning, escape room teaching plays an important role in effectively developing and stimulating students' humanistic care ability and creative thinking. PurposeTo investigate the effectiveness of an Escape Room teaching approach, clinical cases (C) as guide (G) and task (T) as driver (D) , within the CGTD model in the undergraduate Adult Nursing course. MethodUsing purposive sampling, 108 undergraduate nursing students in the class of 2020 were selected as the study subjects, and 11 innovative escape room teaching activities were conducted. Real clinical cases were selected, so that the student teams were immersed in clinical scenarios to complete the escape room game focusing on circulatory care, and the humanistic caring and creative thinking of the students in the two groups were compared before and after the intervention. ResultsNursing students' humanistic care and creative thinking scores at the end of the instruction were significantly better than those before the escape room instruction (P<0.05). ConclusionThe use of the CGTD-based escape room teaching method applied to adult nursing practice courses is an innovative teaching strategy that integrates theoretical knowledge into the game, which can significantly improve undergraduate nursing students' humanistic caring ability and creative thinking.

Development of an evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships: A Delphi study

AimTo develop an evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships. BackgroundAcademic-practice partnerships could play a crucial role in bridging theory-practice gap in evidence-based nursing education. However, there is a lack of evidence-based nursing practice course framework for undergraduate nursing students from a perspective of academic-practice partnerships. DesignA Delphi study. MethodsThe Delphi study was conducted by literature analysis, qualitative interview and Delphi expert consultation to develop this course framework. 15 and 12 experts were involved in round one and round two of Delphi expert consultation, respectively. The consensus threshold of two-round Delphi expert consultation was described by expert's positive coefficient (≥ 50 %), positive coefficient (≥ 70 %), expert authority coefficient (≥ 0.7), coefficient of variation (<0.25) and full score frequency (>20 %). ResultsThe final course framework includes learning objectives (17 items); teaching chapters of theoretical classes (five items); teaching contents (30 items), methods (12 items) and class hours (9 items) of theoretical classes; and the responsibilities of academic teachers (11 items) and clinical teachers (11 items) in practical classes. ConclusionThe course framework developed by this study could provide guidance for evidence-based nursing education of undergraduate nursing students. The effectiveness of this course framework should be verified through further experimental studies in the future.

Understanding Clinical Learning Quality Aspects in Mental Health Nursing Practice Course among Students: A Comprehensive Examination.

There is a growing demand for comprehensive evaluations of the clinical learning quality of nursing education and the necessity to establish robust predictors and mediators for enhancing its outcomes within the context of mental health practice. This study is threefold: 1. Evaluating nursing students' clinical learning quality before and after mental health nursing practice; 2. Establish if the grade of a theoretical course in mental health nursing and the student's perception of their theoretical knowledge level predicts the grade of mental health nursing practice; 3. Explore how model learning opportunities, self-directed learning, safety, and nursing care quality mediate learning environment quality and tutorial strategies quality following mental health nursing practice. Using a before and after the study, 107 undergraduate nursing students at an Israeli university completed a questionnaire and the Clinical Learning Quality Evaluation Index tool to assess their perceptions of clinical learning quality before and after mental health nursing practice. The results showed a decline in students' perceptions of tutorial strategy quality following mental health practical learning in clinical settings, with the theoretical course grade predicting the practical experience grade and underscoring the mediating role of learning opportunities between the learning environment and tutorial strategies. The study's findings emphasize the importance of an adaptive learning environment and a solid theoretical foundation in fostering effective tutorial strategies and enhancing the overall learning outcomes for nursing students in mental health education.

Evaluation of antenatal simulation-based learning on satisfaction and self-confidence levels among Thai undergraduate nursing students during the COVID-19 pandemic: a mixed-method study

BackgroundDuring the COVID-19 pandemic, simulation-based learning (SBL) serves as an alternative teaching strategy for nursing students facing restricted access to antenatal clinical practicum. However, the factors predicting nursing students’ satisfaction, self-confidence, and their learning experiences remain unclear.ObjectiveTo identify factors predict satisfaction and self-confidence and explore the learning experiences of antenatal SBL.MethodsA Mixed methods research of the cross-sectional study design and descriptive qualitative research was conducted. A total of 100 third year nursing students who finished the Maternity-Newborn Nursing and Midwifery Practice course using antenatal simulation-based learning were invited to complete the online questionnaires. A total of seven questionnaires were administered, including a demographic questionnaire, the Attitude Scale toward Simulation-Based Education (SBE), the Professional Identity Scale for Nursing Students, the Perceived Stress Scale, the Evaluation of Teaching Competencies Scale, the Simulation Design Scale: Student Version, and the Student Satisfaction and Self-Confidence in Learning. The 20 nursing students who completed survey were asked to participate a qualitative focus group discussion. Multiple regression analysis was performed to investigate predictors, while qualitative data were analyzed using content analysis.ResultsThe quantitative results showed high levels of satisfaction (mean = 20.55, SD = 3.17) and self-confidence (mean = 32.44, SD = 4.76) after completing the antenatal SBL. In regression analysis, attitude toward SBE (Beta = 0.473, t = 5.376, p < 0.001) and attitude toward antenatal care simulation design (Beta = 0.338, t = 2.611, p < 0.011) were significantly associated with a high level of satisfaction with antenatal SBL, which accounted for 44.0% of the variance explained in satisfaction. Only attitude toward SBE was significantly associated with a high level of self-confidence in antenatal SBL (Beta = 0.331, t = 3.773, p < 0.001), which accounted for 45.0% of the variance explained in self-confidence. The qualitative results generated four themes: (1) positive attitude toward antenatal simulation; (2) turning reassurance into confidence; (3) I am really happy to learn; and (4) being a good nurse motivates and stresses me.ConclusionsAntenatal SBL is an effective teaching strategy that can support nursing students to build clinical confidence. Creating a positive learning environment allows students to have a positive attitude and experience with simulations.

The effectiveness of using situational awareness and case-based seminars in a comprehensive nursing skill practice course for undergraduate nursing students: a quasi-experimental study

BackgroundNurses play an important role in healthcare development. The increasing demands for nurses mean that nursing schools at the undergraduate level have the responsibility to ensure patient safety and quality care through a well-designed curriculum. This research aimed to evaluate the effect of the teaching method combined with situational awareness and case-based seminars in a comprehensive nursing skills practice course on the level of self-directed learning, professional identity, academic self-efficacy, theoretical scores, practical scores, teaching satisfaction, and student competence among nursing students.MethodsThe research population comprised was of the grades of 2019 and 2020 at Wannan Medical College in Anhui Province, China (n = 169, response rate 77.88%). The observation group from grade 2020 used the teaching method combined with situational awareness and case-based seminars, whereas the control group from grade 2019 used the traditional teaching mode. General information, self-directed learning, a professional identity, and academic self-efficacy were compared between the two groups. This research used means and standard deviations, chi-square, the Shapiro–Wilk test, and an independent sample t-test for statistical analyses.ResultsCompared with the control group, the total scores for self-directed learning, professional identity, and academic self-efficacy were higher in the observation group (78.80 ± 7.89 vs 60.21 ± 7.44, 63.39 ± 7.87 vs 52.35 ± 7.68, and 22.31 ± 3.30 vs 21.28 ± 2.31, respectively, with P < 0.05 for all scores). More significant improvements were made in the observation group on the level of theoretical scores (81.39 ± 3.32 vs 76.28 ± 5.90) and practical scores (93.32 ± 4.70 vs 90.67 ± 5.09) (P < 0.05). Meanwhile, teaching satisfaction, which includes teaching method (66/18 vs 32/53) and teacher-student interaction (72/12 vs 34/51), and student competence, which includes team cooperation (67/17 vs 39/46), critical thinking (60/24 vs 31/54), and communication skills (67/17 vs 38/47) after the intervention (P < 0.05). There was no significant difference in social persuasion (P > 0.05).ConclusionThe teaching method combined with situational awareness and case-based seminars in a comprehensive nursing skills practice course has the potential to improve the level of self-directed learning, professional identity, and academic self-efficacy, and it increases theoretical scores, practical scores, teaching satisfaction, and student competence.

Effects of Game-Based Learning in Caring for Patients with Intercostal Drainage on Knowledge, Practical Skills, and Satisfaction in Nursing Students

Introduction In the 21st century, the pedagogy of teaching and learning has transitioned towards self-directed learning, aiming to motivate learners while enhancing the link between theoretical knowledge, and clinical practice skills. Gamification, known as game-based learning, is increasingly emerging as a strategy to complement simulation-based approaches. Proficiency in caring for patients with intercostal drainage is vital for both life-saving and acute care, highlighting the need for effective teaching, and learning methodologies. Objectives This study aimed to examine the effect of game-based learning on knowledge and skills related to caring for patients undergoing thoracic drainage, and satisfaction with game-based learning in nursing students. Design This research employed a one-group pretest-posttest quasi-experimental design, using cognitive constructivism, and game-based learning as the research framework. Method A total of 108 third-year nursing students voluntarily participated in a one-month game-based computer-assisted learning program titled “Fun Games: Awakening ICD Knowledge.” The research instruments included a knowledge questionnaire (CVI =.99, KR-20 =.70), an objective structured clinical examination (OSCE) (CVI =.99, Inter-rater reliability = 1.0), and a questionnaire on satisfaction with game-based learning (CVI =.99, Cronbach’s alpha coefficient =.90). Data were analyzed using descriptive statistics and Paired t-tests. Results After the game-based learning, knowledge scores (M = 7.01, SD = 1.14) were significantly higher than pre-test scores (M = 5.12, SD = 1.77, t=-10.153, p &lt; .001). All nursing students successfully passed the OSCE examination. Overall satisfaction with game-based learning was at a high level (M = 4.37, SD = 0.62). Recommendation Game-based learning facilitates nursing students in acquiring knowledge and skills related to caring for patients with intercostal drainage, and their satisfaction reflects the need for an enhanced strategic pedagogical approach that aligns with current educational trends. It is recommended to further utilize and develop this learning method as an integrated approach to bridge theoretical knowledge with nursing practice courses.

The effects of introducing virtual reality communication simulation in students' learning in a fundamentals of nursing practicum: A pragmatic randomized control trials

AimThis study was conducted to examine the effectiveness of a virtual reality communication simulation (VRCS) in teaching communication skills in fundamentals of nursing practicum. BackgroundEffective communication skills are an integral part of the nursing profession and the foundation of high-quality nursing care. Effective communication not only addresses the needs of patients but is also necessary for maintaining patient safety. Many studies have reported the inadequacy of nursing students in communicating with patients. Nursing students often experience stress due to their lack of adequate skills to communicate effectively with patients and their family members. DesignA pragmatic randomized controlled trial research with four within-subjects assessments (at the baseline (T0), 1st week (T1) and 3rd week (T2) of the clinical practice and 1 week after the end of the clinical practice (T3)) and between-subjects assessments. Settings and participantsEighty-four nursing students at a university of Science and Technology in central Taiwan. MethodsThe students were randomly assigned to an experimental group (n = 42) and a control group (n = 42). The experimental group received a VRCS, whereas the control group received the nurse–patient communication teaching video. The data were collected from April 2022 to August 2022. The Kalamazoo Essential Element Communication Checklist, Communication Self-Assessment Scale, Learning Satisfaction Questionnaire and Stress Scale for Nursing Students in Clinical Practice were used for data collection. ResultsAt baseline, the control group had higher scores on communication ability and confidence compared with the experimental group (t = −3.91, p <.001; and t = −2.35, p =.021). In the first week of clinical practice, the experimental group had significantly higher mean scores for communication ability compared with the control group (β = 15.99, 95 % confidence interval [CI] 13.79, 18.18) and communication confidence and learning satisfaction compared with controls at T1, T2 and T3 of the clinical practice (all, p <.001). The clinical practice stress scores of the experimental group were significantly lower than those of the control group at T1, T2 and T3 of the clinical practice (all, p <.05). ConclusionsThe newly developed VRCS is acceptable and worthwhile for training nursing students to develop communication abilities. This study suggests that VRCS practice should be arranged as early as possible in fundamentals of nursing practice courses and before the fundamentals of nursing practicum so as to facilitate the learning of effective communication. Follow-up research is needed to evaluate the long-term effects of virtual reality education in nursing practice.

Effective interventions for improvement of moral sensitivity among nursing students: A systematic review

The present research was carried out to look into the optimal interventions for raising moral sensitivity in nursing students. International electronic databases like Scopus, PubMed, and Web of Science were searched systematically from the earliest date to August 2, 2022, via keywords like "Morals", "Moral sensitivity", "Ethical sensitivity", and "Nursing students". Additionally, Iranian databases like Iranmedex were looked up. Randomized control trials (RCTs) and quasi-experimental studies' quality was evaluated using the Joanna Briggs Institute's (JBI) critical assessment checklist. A total of 756 nursing students were enrolled in nine studies. Of the nursing students, 54.87% were female and 70.63% were in the intervention group. The mean age of participants was 22.83 (SD=1.31) years. Mean study duration, intervention, and follow-up were 10, 5.41, and 6.68 weeks, respectively. It was shown that “education based on the visual, auditory, kinaesthetic (VAK) model”, “the spirituality training sessions”, “case-based method of education”, “the spirituality training sessions”, “nursing codes of ethics lecture”, and “the spiritual care training sessions” were enhanced moral sensitivity. Additionally, the “professional nursing practice course”, “nursing ethics education”, and “debate-based ethics education”, did not affect the nursing students' moral sensitivity. It is recommended that university administrators and policymakers plan and implement appropriate educational initiatives with moral and spiritual content in the form of educational workshops.

Community of inquiry Framework Combined With Podcast Media in Nursing Education innovation During Covid-19 Pandemic: An Evaluative Study.

The COVID-19 pandemic has not researched inquiry methods much, other than that it has never been combined with podcast media to better refine students' abilities. The purpose of this study was to determine student satisfaction with basic nursing theory and practice courses taught using the Community of Inquiry framework using podcast media. This evaluation was done at a university using a validated Community of Inquiry survey (n = 54) and interviews (n = 20). A convenience sample of 54 graduate students enrolled in a core research field comprised the study participants. The quantitative data were analyzed descriptively and the qualitative data were thematically coded. Five major themes emerged: It was a new experience, and fun to learn; it is challenging to learn; it is an ongoing enthusiasm; it is well known, and useful to others. Overall, student satisfaction was high, especially in the cognitive presence (critical thinking) and instructor presence (mostly related to pedagogy) categories. Student perspectives on developing "social presence" vary, but the framework is generally effective for stimulating inquiry and fostering a sense of community. Students can gain thorough knowledge of the learning goals they wish to pursue. Formation of an "investigation community" through the use of the media of podcasts. This framework has significant potential for use in the teaching of nursing research subjects; satisfaction is high when students report learning not only theory and practice, but also how to "make" character changes through the formation of professional and intellectual communities.

Collaborating With Community Partners to Address Population Health in an Online Advanced Nursing Practice Course.

Engaging in effective community partnerships is a core competency for advanced nursing practice. To describe a semester-long population health project that involved collaboration with a community partner in an online and asynchronous advanced nursing practice course and to evaluate students' perceptions of their community partner collaboration. At the beginning of the course, students selected health topics and community partners. Perceptions of the collaboration were evaluated in a survey. Data were analyzed using descriptive statistics and content analysis. Approximately 59% of the students found the community partnership was very valuable. Barriers for working with community partners included reluctancy, feeling like a burden, and challenges with scheduling. Facilitators for working with community partners included receiving support on the project, gaining new perspectives, and the collaborative relationship. Community partnership assignments on population health projects can support students in obtaining skills on effective community partnerships while they are in their education programs.

Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

A qualitative exploration of nursing undergraduates\u2019 perceptions towards scaffolding in the flipped classroom of the Fundamental Nursing Practice Course: a qualitative study

BackgroundAlthough the benefits of using a flipped classroom in nursing education have been reported, there are few published studies attempting to understand students’ subjective experiences with scaffolding in a flipped classroom and the challenges they face as a result of this type of educational change. The purpose of this study was to describe students’ perspectives of scaffolding in the Flipped Classroom of the Fundamental Nursing Practice Course (FNPC-FC).MethodsThirty-four undergraduates were recruited and separated into four groups in the study. The data was collected through semi-structured focus group interviews. Thematic analysis was conducted to analyze the data in order to determine the themes in the interview transcriptions.ResultsThe research revealed two primary themes with associated sub-themes: 1) challenging learning experience, and 2) teacher-student interaction.ConclusionsStudents will confront substantial challenges as scaffolding strategies are implemented in the flipped classroom. On the other hand, scaffolding in the flipped classroom can successfully train students to be self-directed learners and equip them with nursing skills when students are given appropriate support.

A STUDY ON PATIENT SAFETY MANAGEMENT’S KNOWLEDGE, ATTITUDE, CONFIDENCE IN PERFORMANCE, AND PRACTICE DURING PEDIATRIC-ADOLESCENT NURSING CLINICAL PRACTICE

This descriptive study was conducted to investigate nursing college students’ level of patient safety management during the pediatric-adolescent nursing clinical practice courses. This study aimed to provide a baseline data for developing systematic nursing educational curriculum for the enhancement of competence in nursing college students’ fundamental patient safety nursing intervention. The participants consisted of 372 senior nursing college students who have had clinical practice at a nursing college in G metropolitan city. The data was collected from December 1 to 28th, 2019 at the end point of their clinical training education in nursing college, and convenience sampling method was used. The results of this study indicated that the ratio of correct answers of PSM-K was 7.30 out of 10, PSM-A was 3.76, PSM-CP was 3.92, and PSM-P was 4.21 out of 5 points. In terms of the correlations between PSM-K, PSM-A, PSM-CP, and PSM-P, significant positive correlations existed between PSM-K and PSM-A(r=.28, p&lt;.001), PSM-CP and PSM-K(r=.19, p&lt;.001), PSM-CP and PSM-A(r=.48, p&lt;.001), PSM-P and PSM-A(r=.37, p&lt;.001), and PSM-CP and PSM-P(r=.36, p&lt;.001). Therefore, to enhance the nursing college students’ competence in patient safety nursing intervention, nursing college students must experience various exercises and training for patient safety management during the clinical practicum as well as with scenario-based simulation. The nursing education facilities should develop educational contents about patient safety for nursing college students.

The systems psychodynamic role identity of nursing students during their preceptorship

BackgroundExisting research on nursing students' preceptorship experiences focusses mainly on conscious and rational behaviour, evidencing experiences of personal and professional development. This study argues that the exploration of their unconscious experiences could add important information towards an in-depth understanding of their role identity during this experience. ObjectiveThe research objective was to describe the unconscious role identity of nursing students during their preceptorship from a systems psychodynamic stance. DesignA qualitative design, a collective case study and hermeneutic phenomenology were utilised as methodologies. SettingSet in the School of Nursing of a Canadian University, the research focussed on students in the fourth year Consolidation in Nursing Practice Course. ParticipantsThe sample included 41 nursing students, 37 females, 22–28 years of age. FindingsThe manifesting themes were high levels of anxiety, defensive structures, boundary and authority matters, and role dynamics. The nursing students experienced high levels and different kinds of anxiety, which they defended against using introjections, projections and regression to their child ego state. They experienced the preceptorship as being in a middle position between past and future as well as between knowing and not knowing. The discussion was presented in relation to the macro (organisational), meso (group), and micro (individual) levels. ConclusionsUnconsciously, the nursing students experienced difficulty in effectively taking up their professional role. They defended against their discomfort by splitting their experiences into what they introjected and projected. They introjected incompetence in coping with the emotional demands of the role and projected their anger onto authority figures. Their professional role identity got stuck in a de-authorised position where they could survive but not develop their selves in their new role. These experiences inhibited their authenticity and learning ability.

Designing video based learning for nursing skills procedures video

Blended Learning is a learning that combines face-to-face and online learning. In nursing practice courses, learning media about basic skills action procedures in nursing that can be accessed online is needed. Thus, it is necessary to design an instructional media containing action instructions for basic skills in nursing. The purpose of this research was to make video-based learning media as a guide to nursing procedures and to find out the results of the video-based learning media test. There were eight (8) stages in designing instructional media, namely: (1) writing video scripts, (2) taking video images, (3) editing videos, (4) validating, (5) revising, (6) uploading videos, (7) presenting videos to students, and (8) evaluating. This research was expected to produce teaching materials in the form of instructional video to support the lecturing process. The result of this study showed that the videos are very worthy.

Planting seeds of community-engaged pedagogy: Community health nursing practice in an intergenerational campus-community gardening program

As part of a participatory action research (PAR) study, nursing student participants collaborated with faculty, along with older adults, people with mixed abilities, and preschool aged children in order to ‘sow the seeds of social change’ and grow a campus community gardening project. The focus of this article is on the community-engaged pedagogy within a community health nursing practice course that supported student learning. Insights were gleaned over the course of four academic semesters (and four student cohort groups) with students as co-developers of the campus-community garden and participants in the PAR. Key themes emerged from student participants in the PAR process including: (1) planning in community to “think global, act local”; (2) discovering ‘the people in your neighbourhood’ as socially just partnerships; (3) revisiting landscapes of social inclusion; and (4) reflecting on “humble togetherness” across generational gaps. The findings showcased here attest to how community-engaged pedagogy, in conjunction with PAR, can facilitate student learning outside of traditional settings and grow social inclusion, intergenerational connection, and social justice.

Informatics Experience Can Help Predict Doctor of Nursing Practice Student Mastery of Informatics Competencies.

With information technology increasingly guiding nursing practice, Doctor of Nursing Practice students must be prepared to use informatics to optimize patient outcomes despite their varied experience and education. Understanding how students' baseline experience affects their mastery of informatics competencies could help faculty design Doctor of Nursing Practice course content. Therefore, the aim of this retrospective descriptive study was to evaluate whether Doctor of Nursing Practice students' baseline informatics experience affected their mastery of four competencies: meaningful use, datasets, e-health, and clinical support systems. Participants were Doctor of Nursing Practice students (n = 55) enrolled in an online informatics course. Participant experience was compared to competency mastery using χ tests. Logistic regression was performed to assess the effect of experience and highest degree obtained on competency mastery. Analysis revealed that participants with meaningful use experience were significantly more likely to master the meaningful use competency than were those without it. Relevant experience did not predict mastery of dataset competencies. Participants with e-health experience were significantly more likely to master the e-health competency (applying e-health resources to vulnerable patients' learning needs). While not significant, a greater percentage of students with clinical support systems experience mastered the clinical support systems competency. Informatics courses might need to be designed to address students' needs based on their experience.

Effect of Prior Learning Method on Nursing Students' Practical Capacity

We looked at how the practical capacity of nursing students was affected by the application of the Prior Learning Method in the fundamentals of nursing practice course. In order to compare practical capacity, self-efficacy, self-directed learning ability, and learning satisfaction were set as variables and results were calculated using SPSS 18.0. Comparing results after applying the Prior Learning Method to only the experimental group by classifying it as a group of experimental and control group, the results showed that self-efficacy in the experimental group was increased and learning satisfaction was high. There was a meaningful result of applying the Priority Learning Method to the demanding practical class, gaining satisfaction, and increasing confidence. It is necessary to verify it through repeated research and develop it into a better teaching method.

Adaawk: Thinking and being in our hearts--Sharing the reflections of Otsin, Gitxsan rural indigenous nursing practice

Adaawk is oral history shared through the reflections of the first offering of a Gitxsan rural nursing practice course in follow up to the publication Otsin: Sharing the spirit of an indigenous nursing practice course development. In the spirit of adaawk, the Gitxsan’s reflections of the Gitxsan nursing practice course are themed using the metaphor of a totem pole. Each concept, and partnerships are integral to the development of a totem that reflects the adaawk. The purpose of this article is to demonstrate how the co-creation of relational concepts with the community strengthens preceptor, student and community partnerships for improved preceptor support and student learning outcomes. The author’s reflections demonstrate how the rural Gitxsan nursing practice experience informs the co-creation of cultural safety knowledge. Further, the experience provides a safe forum for students to practice cultural safety and relational practice. It allows students to co-create innovative patient outcomes within rural and community nursing practice context reflecting a two-eyed seeing approach. Students give back to communities through facilitated student placements in leadership/community health nursing for a fourth year nursing practice project with Gitxsan and rural communities in follow up to their third year practice. Authentic community partnerships and co-creation are foundational to enacting relational practice to nursing practice course development, consultation, and cultural safety practice. Learning outcomes of the course are revised to strengthen the parts of the totem and ultimately the essence of adaawk.

Fundamentals of Nursing Practice and the Culturally Diverse ESL Nursing Students: The Students’ Perspectives for Teaching and Learning in Nursing

English as-a-Second Language (ESL) nursing students who enroll in the Fundamentals of Nursing Practice course have been known to experience multiple challenges in nursing programs around the country. The central challenge ESL students experience is acclimating to the American education system, a system which differs from the education system in their countries of origin. This results in a high attrition rate, particularly in the Fundamentals of Nursing Practice course which is the entry-level course. This study explored the experiences and challenges of a group of culturally diverse ESL nursing students in an Associate Degree Nursing (ADN) program in the Northeastern United States, who passed the course. The purpose of the study was to uncover what helped the participants succeed. The goal was to utilize the participants’ recommendations to improve the teaching and learning needs of ESL nursing students’, and to reduce high attrition rates. A descriptive phenomenological approach utilizing bracketing was used to explore the challenges the participants experienced. The common challenges encountered by the participants were: language barriers, a lack of faculty support and mentorship, difficulty with teaching and learning styles, and a lack of critical thinking and application skills. Also, difficulty with concepts and applications in clinical practice, and racism and discrimination in the learning environment were contributors to their learning challenges. Findings showed that the language barrier was particularly detrimental when it came to the participants’ reading, comprehension, and communication. Further findings encompassed the knowledge deficit about critical thinking, concepts, and application of concepts in clinical practice. Additional findings revealed that the participants struggled to balance school, work, and the challenges of being an immigrant, all of which effected their learning.