Undergraduate Nursing Education Programs Research Articles

Crisis Response in Nursing Education: An Integrative Review of Nursing Program Adaptation to COVID-19.

This integrative review sought to systematically examine and synthesize published research on crisis response to identify ways in which undergraduate nursing education programs in various countries adapted to the coronavirus disease 2019 (COVID-19) pandemic. A computerized search of CINAHL, Science Direct, and Web of Science databases was performed. The literature search, review, and data extraction process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format of identification, screening, eligibility, and inclusion. Digital learning technology platforms were used in undergraduate nursing education in various ways to adapt to the teaching and learning challenges of the COVID-19 pandemic. Teaching and learning methodologies identified included online lectures and webinars; interactive virtual learning experiences, such as videos, presentations, quizzes, games, and other web-based interactive forms of multimedia files and textual content; and virtual simulations for nursing skills and tele-health experience. [J Nurs Educ. 2024;63(7):445-451.].

Using Mixed Reality to Practice Difficult Conversations

Background/IntroductionNursing students often learn effective communication through observational and varied clinical opportunities. Role play can be helpful, however, limited by the engagement and commitment of those participating. Literature ReviewWhile nursing has limited data on the use of mixed reality (MR) to support learner development of effective communication skills, teacher education programs have successfully integrated MR to support professional role development. Innovation in SimulationMR simulation in an undergraduate nursing education program provided an innovative teaching-learning strategy to practice difficult conversations aligned to realistic healthcare experiences. DiscussionAs nursing students prepare for the complex healthcare environment, MR appears to be a promising method for development of communication skills and confidence in practice.

Enhancing the care of neuro-oncological patients: Fundamental and useful concepts for nurses who specialize in neurorehabilitation

Due to the variety of neurological abnormalities that these patients experience, the neuro-oncological population effectively conveys the complexity of neurological disability. Also, because of treatment advancements, patients with brain tumors live longer and need rehabilitation services. Even if their importance in this environment is acknowledged and their role is growing, the nurse's position in the interdisciplinary specialty of neurorehabilitation is not precisely defined. The study aims to determine the fundamental skills that neurorehabilitation nurses should possess, which might be taught in a specialty course. According to the literature, advancing medical professionals' scientific and practical knowledge is necessary for the growth of rehabilitation. This organized training curriculum could be included in graduate nurse continuing education programs and undergraduate nursing education programs. For nurses to provide better overall care and care management for patients with extremely complex disabilities, such as those affected by brain tumors, they must become experts in neuro-rehabilitation. The next step will be to begin debating the creation of a specialization program in neurorehabilitation nursing at the level of scientific associations related to neurorehabilitation and cancer.

The Effects of Clinical Immersion on Readiness for Nursing Practice.

Traditional clinical education does not prepare future nurses well for practice. Clinical immersion models are recommended to enhance critical thinking, clinical judgment, and confidence with nursing roles and skills. This study explored the effects of implementing an innovative clinical immersion model on readiness for nursing practice for accelerated Bachelor of Science in nursing students. The Casey-Fink readiness for practice survey was used to determine graduate students' confidence and comfort with nursing roles and skills based on descriptive statistics for each survey question. Study results indicated students who experienced the clinical immersion model had high levels of confidence with nursing roles and felt prepared for practice. Nursing programs should consider implementing clinical immersion models in undergraduate nursing education programs. [J Nurs Educ. 2023;62(1):47-50.].

Nurse Educators' Perceptions of Ecoliteracy in Undergraduate Nursing Education

Introduction: Increased human health concerns related to the natural environment and climate change are having a growing impact on nursing practice. This past year in Canada, for example, British Columbia reported the highest number of heat related deaths, followed by devasting forest fires in many provinces that have disproportionately impacted Indigenous Peoples. Nurses are well positioned to address the direct health impacts associated with climate change. As a result, nurses require an increased level of ecoliteracy to address the health impacts linked to climate change. The role of the nurse in addressing the health impacts of climate change are vast, ranging from direct patient care, education and advocacy, their role includes supporting individuals, communities, and populations to mitigate, adapt and build resiliency in the face of a changing climate. Background: Regulatory and professional associations support the professional emphasis on the significance of ecoliteracy yet there is insufficient understanding of the resistance to the content in nursing curricula. Although current literature supports an increased emphasis on the integration of ecosystem health concerns and the impact on human health within undergraduate nursing education, there is a paucity of empirical evidence regarding nursing educators’ perspectives on the subject. This study is a first step in gaining a greater understanding of the perspectives of nurse educators on ecoliteracy within undergraduate nursing education programs in one Canadian province. Methods: This qualitative research study included 13 nurse educators from three diverse academic settings. Data were collected using semi-structured, open-ended interview questions, followed by content analysis of the data. Results: Data analysis revealed five key themes: 1) Importance of ecoliteracy in undergraduate nursing programs; 2) Current integration of ecoliteracy concepts in curricula; 3) Future considerations for ecoliteracy content; 4) Barriers to the inclusion of content supportive of ecoliteracy in curricula; 5) Strategies to address barriers. While educators feel that ecoliteracy is important in undergraduate nursing, they noted that the current integration of climate content in the curriculum is uneven. Barriers and potential strategies to integrating this content are identified. Conclusion: The findings of this study can be used for curriculum revision and to stimulate innovation and research in nursing education. This study creates the opportunity for a larger scale replication study, pilot studies of the integration of concepts that would support ecoliteracy, and further research on the topic. This study identified that many complexities are involved in achieving ecoliteracy in nursing education and suggest that while threading of content can address the urgent need, further research is required to identify entry to practice requirements for undergraduate nursing programs.

Use of simulation-based learning in Japanese undergraduate nursing education: National survey results

Introduction: Simulation-based learning (SBL) is a practical and efficient learning method that involves the replacement of a portion of clinical education with quality simulation experiences. It has been utilised in various countries, such as the United States, Canada, and South Korea. However, based on current regulations in Japan, clinical education cannot be replaced with simulation experience. For future curriculum integration, it is necessary to clarify the current use of SBL and tackle systematic educational strategies of SBL. Therefore, this national survey aimed to clarify the prevalence and practices of SBL in undergraduate nursing education programs in Japan. Methods: This article presents the results of our national survey in Japan. It presents the questionnaire based on the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice and demonstrates the use of simulation-based learning in Japanese undergraduate nursing programs. Results: Overall, the schools using simulation-based education (SBE) comprised 346 schools (82.4%) of the sample. Those equipped with high-fidelity simulators were 146 schools (27.6%); the rest owned medium-fidelity simulators. Almost all undergraduate nursing education systems were equipped with simulators, however, the frequency of use was low. SBL was incorporated into the curriculum at many undergraduate nursing education institutions, and awareness of the INACSL Standard of Best Practice: SimulationSM was extremely low. Conclusion: This study shows that SBL is not properly utilised in undergraduate nursing programs, even though many schools are equipped with simulators. Thus, further study on barriers to simulator use is needed.

Academic Success of Online Learning in Undergraduate Nursing Education Programs in the COVID-19 Pandemic Era

BackgroundThis study aimed to investigate predictors for academic success, including satisfaction with online class and academic achievement, in the coronavirus disease 19 (COVID-19) pandemic era.PurposeTo obtain basic data needed to improve the quality and outcomes of online learning in lectures for nursing students.MethodA cross-sectional, descriptive, nationwide online survey in South Korea was performed using structured questionnaires. Participants were 200 nursing students taking online-based learning at universities in 2020. Data were analyzed using descriptive statistics and hierarchical multiple regression with SPSS WIN 26.0 program.ResultsCyber-class flow (β = 0.65, p < 0.001) was a significant predictor of satisfaction with online class. Self-directed learning (β = 0.18, p = 0.014) and satisfaction with online class (β = 0.19, p = 0.035) were significant predictors of academic achievement.ConclusionTo achieve academic success from online learning, self-directed learning should be prioritized and satisfaction with online class needs to be managed by nursing educators. To improve satisfaction with online class, cyber-class flow should be considered when designing teaching and learning methods for undergraduate nursing education programs.

The impact of cultural immersion international learning experiences on cultural competence of nursing students: A critical integrative review.

Cultural immersion international learning experiences (CIILEs) are commonly offered in undergraduate nursing education programs worldwide, often with the goal to enhance students' cultural competence. The purpose of this integrative review was to explore the most recent existing literature concerning the impact of CIILEs on nursing students' cultural competence and to cast a critical eye on the findings. We searched the CINAHL database for articles published from 2015 to 2019 and found 30 that met inclusion criteria. The majority of the studies were descriptive or qualitative designs and reported positive overall student cultural competence outcomes. The findings support the use of CIILEs with a critical eye for potential negative consequences. The authors recommend further longitudinal, observational studies to identify factors that facilitate substantial long-term positive outcomes.

A Phenomenological Study to Explore the Challenges in Mental Health Nursing OSCE pattern of examination among B. Sc. Nursing III year students in Dhanvantri College of Nursing at Namakkal

Context: During recent years, Objective structured clinical examination (OSCE) has been used in nursing education and other health care professions. It is considered as the “Gold Standard” for assessing the clinical skills. Objective evaluation of clinical competencies is a key component of undergraduate nursing education programs. Methods: We conducted a qualitative phenomenological study to explore the challenges in OSCE and also to identify the themes based on challenges in OSCE. All interviews were recorded and transcribed for the III year B.Sc Nursing students who had faced challenges in mental health nursing OSCE pattern of examination with the help of vignettes. Colaizzi seven steps analysis framework was used to identify major themes in the collected data. Results: We identified 2 challenges and themes in mental health nursing OSCE pattern of examination Viz the anxiety related to OSCE and the time confinement in manned stations.

Newly Graduate Registered Nurses’ Experiences of Transition to Clinical Practice: A Systematic Review

New graduate registered nurses encounter many difficulties such as unexpected role, stress and lack of support. Therefore, many of them consider leaving their nursing roles. This systematic review aims to explore the experiences of newly graduate registered nurses about the transition from student nurse to graduate nurse in clinical practice. A qualitative systematic review was conducted using inclusion and exclusion criteria and PRISMA guideline. Twenty-three studies are included in the review and analysed using thematic analysis. The four researchers managed quality appraisal and data extraction. Of 23 studies included in the review, 22 were qualitative studies, and one was mixed methods. Following the thematic analysis, four themes were identified: (i) the impact of the undergraduate experience (ii) mental stress and coping strategies (iii) Existing knowledge of organizational support and (iv) professional accountability and competency. Findings show that newly graduate registered nurses experience high levels of turnover due to work stress, lack of support and inadequate undergraduate preparation. The successful transition is influenced by educational preparation, hospital orientation, and organizational support. Further research is required to explore the experiences of newly graduate registered nurses in developing countries, as there is limited research, which has considered nursing education, healthcare facilities, and cultural influences in these countries. New graduate registered nurses play a significant role in the provision of patient care and enhancing patient safety. This review explored their experiences about the transition from student to registered nurses to recommend comprehensive practical guidelines to support their involvement in patient safety and to provide insight for nurse’s leaders to understand the retention issues for new nurses. In addition to helping undergraduate nursing education programs to improve their strategies in preparing graduates for entry into professional practice.

Educators' strategies for engaging diverse students in undergraduate nursing education programs: a scoping review protocol.

The objective of this scoping review is to identify and chart teaching strategies that educators use in classroom settings to engage diverse students in undergraduate nursing education programs. Student engagement is critical to facilitating academic success and significant learning experiences for undergraduate nursing students. However, students from diverse backgrounds face challenges in undergraduate nursing programs, and these challenges impact their academic engagement and sense of belonging and inclusion. Creating conditions in nursing education that foster engagement by meeting the learning needs of diverse learners could facilitate their success, which ultimately might strengthen the nursing workforce diversity. This review will consider papers on how educators engage undergraduate nursing students from diverse backgrounds in classroom settings, including online, face-to-face, and blended formats, irrespective of the country. Evidence obtained from all sources including qualitative, quantitative, and mixed methods studies, systematic reviews, as well as gray literature will be considered for inclusion. JBI methodology for scoping reviews, which includes a three-step search strategy, will be employed. First, keywords will be identified from relevant articles in CINAHL and ERIC. Second, another search using the identified keywords and index terms across select databases will be conducted. Third, the reference lists of all identified articles will be screened for additional papers. Titles and abstracts will be screened by two independent reviewers, and then followed by the full text review of included articles against the inclusion criteria by two independent reviewers. Data will be extracted from included articles and the findings will be presented in tables, figures, and narratively as appropriate. Open Science Framework https://osf.io/7bv5p/.

Comparing student nurse knowledge and performance of basic life support algorithm actions: An observational post-retention test design study

This study aims to identify which basic life support skills of student nurses deteriorate in a period of four months. Secondly, it investigates the link between a specific cognitive skill and its corresponding motor skill in BLS. The population for this study consisted of 169 general nursing students within the first year cohort of a three-year undergraduate nursing education program. Following a BLS course, a multiple-choice questionnaire and a BLS performance test on a manikin was administered two weeks (post) and four months (retention) after the course. Seven BLS subcomponents were compared. In both the post and retention test, knowledge was better than the corresponding motor skill for five of the seven subcomponents. Two weeks after training, more than 50% of the students failed to perform ‘time to check respiration’, ‘ventilation volume’, ‘compression depth’ and ‘compression frequency’ correctly. Four months after training, significantly more students reached a correct ‘ventilation volume’ but performed it incorrectly. Nurse educators are recommended to spend more time on hands-on skills practice than on theory. Special attention should be given to the performance of a correct ventilation technique, a sufficiently deep chest compression and a correct compression frequency.

Effectiveness of High-Fidelity Simulation in Nursing Education for End-of-Life Care: A Quasi-experimental Design.

Background:Providing end of life (EOL) care is a component of palliative care but dealing with dying patients and their family members is stressful for the healthcare providers. To prepare them for providing EOL care, the high-fidelity simulation could be used as a pedagogy in which real-life scenarios are used on the computerized manikins mimicking the real patients.Aims:The aim of this study was to measure the effectiveness of high-fidelity simulation to teach EOL care in the palliative nursing course in the undergraduate nursing education program at the School of Nursing and Midwifery at Aga Khan University which is private university in Karachi, Pakistan.Methods:This study was approved by the ethics review committee of Aga Khan University. It was hypothesized that exposure to high-fidelity simulation will lead to an increased positive attitude in participants towards the care of dying. A quasi-experimental design was used. In line with the design, there was no control group. The same group of students (n = 42) were assessed through Frommelt Attitudes Toward Care of the Dying (FATCOD) Part B assessment tool. Permission for using this tool was obtained from Dr. Katherine Frommelt, the author of this tool. Research participants filled this tool before and after the intervention, i.e., providing EOL care to a patient in a high-fidelity simulation lab.Results:Out of 30-FATCOD items, significant attitude change was detected on 11-items of which 8 were positively worded statements and 3 were negatively worded statements. As per the hypothesis, it was expected for the positively worded statements that the mean score for the posttest would be significantly greater than the pretest mean score (pretest score < posttest score). The hypothesis was proved for items 1, 4, 10, 18, 22, 25, 27, and 30 as their t-value was significant at 0.05 alpha value (one-tailed). For the negatively worded statements, it was expected that the mean score for the posttest would be significantly lower than the pretest (pretest score > posttest score). The hypothesis was proved for items 5, 6, and 11 as their t-value was significant at 0.05 alpha value (one-tailed).Conclusion:In this research teaching, EOL care through high-fidelity simulation had improved the attitudes of students toward providing care. This pedagogy also provided the participants with a learning opportunity to deal with their own emotions. These findings provide a way forward for teaching EOL and other complex skills of clinical practice.

The Changing Landscape of Simulation-Based Education.

: Once considered solely as an educational tool in undergraduate education, simulation-based education (SBE) now has many uses. SBE is now embedded in both graduate and undergraduate nursing education programs and has become increasingly accepted practice in hospital orientation and transition-to-practice programs. Newer applications include ongoing professional education, just-in-time training, teamwork development, and systems testing. This article highlights the changing landscape of SBE and describes elements critical to its successful use, including facilitator competencies, the necessity of providing a psychologically safe environment to enable learning, and the importance of addressing other safety concerns, such as the possibility of accidentally introducing simulated equipment and medications into real patient care.

Nursing students' experiences of repeating units in an undergraduate program: A qualitative study

BackgroundAcademic failure in undergraduate nursing education programs is a growing concern globally. While some students choose to continue with their nursing course by repeating units of study, others discontinue from their respective nursing programs contributing to a marked increase in nursing attrition rates. This academic failure can be attributed to competing demands of paid employment and family commitments. AimThe aim of this study was to explore first year students' experiences of repeating a unit of study in the undergraduate nursing program. MethodsA descriptive qualitative design informed this study which involved undergraduate nursing students enrolled at a large metropolitan multi-campus nursing school in Australia. Data were collected from nine nursing students who had repeated one or more units of study using face-to-face and telephone interviews and data were analysed used thematic analysis. FindingsFour themes emerged from the data ‘struggling to meet workload expectations’, ‘making the adjustment’, ‘utilising academic supports and resources’ and ‘the strength to carry on’. The struggles faced by nursing students repeating units of study included the university's academic environment, heavy workload and issues encountered to meet academic writing standards, juggling to balance the demands of paid employment and personal commitments. Participants demonstrated strength and resilience in their quest to fulfil their dreams and goals of becoming a Registered Nurse, and some reassessed their financial situations to make changes to paid employment hours or reduce study workload to part-time. While peer support was valued, participants expressed their desire for further tutor support to consolidate learning. ConclusionsSupport strategies tailored for students repeating nursing units are needed to ensure students continue successfully with their nursing programs.

Self-reflection during first clinical practice: The experiences of nursing students

BackgroundSelf-reflection can be used as a tool for describing student experiences and have a significant impact on their learning. It enables nursing students to develop the ability to identify and analyse their problems and find possible solutions. ObjectiveTo present students' self- reflection in their first clinical practice as their first stage of our nursing study program. MethodologyThe research was based on a naturalistic philosophical paradigm using a qualitative methodological approach. The research took place at one of the Slovenian universities with an undergraduate nursing education program. Purposive sampling was chosen. The data were obtained through written self-reflection diary entries collected between March and June 2016. A thematic analysis was selected for data analysis. Ensuring that all ethical considerations were covered, seventeen students in the first clinical practice were included. FindingsThree main thematic themes were identified that define the experience of students in their first clinical practice: (1) emotional experience, (2) interpersonal relationships, (3) learning. ConclusionsThe research has found that the experiences and the perceptions of students in the first clinical practice are mainly expressed emotionally. Self-reflection helps students to express emotions and feelings to reliving and to identifying problems and also, to understanding themselves better. Further research should be focused on the importance of the students' self-reflections in their professional and personal growth.

Mitigating the Challenges of Objective Structured Clinical Examination (OSCE) in Nursing Education: A Phenomenological Research Study

BackgroundObjective evaluation of clinical competencies is a key component of undergraduate nursing education programs. Objective Structured Clinical Examination (OSCE), widely used in nursing education internationally has limited utilization in undergraduate nursing programs in the United States. The efficacy of OSCE as a valuable method of objective evaluation of students' clinical competencies is not so much the problem for the nursing faculty; overcoming the impediments of its implementation is a much greater challenge. ObjectiveTo explore the strategies for mitigating the challenges of OSCE in baccalaureate nursing education program. Design/Participants/SettingIn this descriptive phenomenological research study, 10 undergraduate nursing faculty participated in semi-structured interviews at a public university in the North-Eastern region of United States. MethodObservations and semi-structured interviews were conducted. All interviews were recorded and transcribed. Colaizzi seven steps analysis framework was used to identify major themes in the collected data. The clear, detailed, and sequential procedural processes in both data collection and analysis ensured rigorous and trustworthy results. ResultsFive mitigating OSCE strategies utilized by the faculty included: administrative and technical supports, use of clinical instructors during evaluation, faculty OSCE education, limitation of validation to the required skills essential for professional practice, and collaboration among all course faculty members. ConclusionUtilization of OSCE as an objective evaluation method is feasible in United States undergraduate nursing education programs if creative strategies are determined to mitigate its challenges.

Effectiveness of Peripheral Intravenous Skill Continuing Education Using Low-Fidelity Simulation Among Nurses in India.

Many nurses have limited opportunities to practice peripheral intravenous (IV) skill access until they begin their nursing career, particularly in limited resource settings. Continuing nursing education is needed for practicing nurses to build nurse capacity and skill accuracy in IV access globally. A pretest-posttest design was used to measure effectiveness of peripheral IV continuing education among 180 nurses in India. A skills checklist was used to observe for skill accuracy using low-fidelity simulation. A statistically significant improvement in knowledge regarding peripheral IV skill access and care was found (p < .001), and 95% of nurse participants successfully simulated IV access accuracy after the continuing education intervention. Findings support the need for continuing nursing education to improve peripheral IV access and care knowledge and skill among nurses, particularly in low- and middle-income countries or other settings where hands-on experience is limited during undergraduate nursing education programs. J Contin Educ Nurs. 2018;49(6):255-261.

Entry-to-practice public health nursing competencies: A Delphi method and knowledge translation strategy

BackgroundSustaining and strengthening nurses ‘contributions to public and population health in the 21st century depends in part on nursing education. Clearly articulated entry-to-practice competencies will contribute to the capacity of undergraduate nursing education programs to prepare graduates to promote local, national and global population health. ObjectivesThe Canadian Association of Schools of Nursing created the Public Health Task Force to develop consensus on core, national entry-to-practice competencies in public health nursing for undergraduate nursing students and to support these competencies with corresponding online teaching strategies. DesignDelphi approach. ParticipantsNurses with public health experience in education and practice, and representatives from other public health professional organizations across Canada. MethodThe three-phased competency development included: 1) an environmental scan; 2) an iterative process to draft competencies; and 3) a modified Delphi process to confirm the final competency framework using face to face consultations and a survey. The knowledge translation strategy involved soliciting submissions of teaching strategies for peer-review and subsequent inclusion in an interactive online resource. Results242 public health educators and practitioners participated in the consensus consultation. The final document outlined five competency statements with 19 accompanying indicators. A total of 123 teaching strategies were submitted for the online resource, of which 50 were accepted as exemplary teaching strategies. ConclusionThis competency development process can provide guidance for the development of competencies in other countries, thus strengthening public health nursing education globally. The decision to intentionally level the competencies to entry-to-practice, as opposed to an advanced level, enhanced their application to undergraduate nursing education. The development of the additional inventory of teaching strategies created a sustainable innovative resource for public health nursing educators and practitioners world-wide to support the adoption of entry-to-practice public health nursing competencies.

Status survey on curriculum setting of undergraduate nursing education in Tibet area

Objective To investigate the curriculum setting of undergraduate nursing education of three universities (Tibet University, Xizang Minzu University, and Tibet Medical College) in Tibet, so as to provide reference foundation for the reform of undergraduate nursing education system in Tibet. Methods Cross-sectional study and content analysis were conducted by collecting ongoing undergraduate nursing education programs from three universities that we referred above and comparing with approval standards and related literature, and then we analyzed similarities and differences as well as deficiencies by obtained current curriculum setting status from February to April 2016. Results The curriculum setting of undergraduate nursing education in Tibet met the professional certification standards, however, it was necessary to increase some courses and the teaching hours of some courses. The average percentage of course modules of three universities in Tibet were given as: 36% for public basic courses, 25.66% for professional basic courses, 35.16% for professional required course, and 3.2% for humanities and social sciences. Conclusions It is recommended to improve the curriculum setting of undergraduate nursing education system in Tibet, reduce the ratio of public basic courses, and increase the ratio of humanities and social sciences. Furthermore, the nursing and Tibetan local features should also be considered in the curriculum setting. Key words: Education, nursing; Tibet; Curriculum; Undergraduate