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Effectiveness synchronous e-learning in nursing education: A meta-analysis and subgroup analysis 护理教育中同步电子学习的有效性:荟萃分析和分组分析。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104029
Songxian Jin, Jung-Hee Kim

Aim

This study aimed to identify the best available evidence of the effects of synchronous e-learning in nursing education through a meta-analysis and to compare mean effect sizes between study subgroups.

Background

With the rapid development of synchronous e-learning, adequate preparation is essential, as the formulation of effective educational strategies is crucial for learners’ success. However, rather than focusing solely on using technology to implement e-learning, instructors should design education programs that meet learning objectives while considering appropriate technologies and types of interactions.

Design

A meta-analysis and a subgroup analysis were conducted.

Methods

English and Chinese databases including PubMed, Embase, CINAHL, Web of Science, Cochrane Library and China National Knowledge Infrastructure were searched for relevant articles published between the inception of these databases through May 2023. The search included the establishment of these databases up until May 2023. Using a search strategy, we identified 3273 potentially relevant articles. Ten primary studies were included in the final analysis. We used random effect models to synthesize effect size (ES) and accommodate heterogeneity for the main effect. Sub-group analyses were conducted to analyze the variations in effect size to investigate possible causes of heterogeneity.

Results

We found synchronous e-learning to be more effective compared with the control groups, with a pooled random-effects standardized mean difference of 0.51, which is a medium effect size. Regarding learning outcomes, the effect size of reactions to learning (ES = 0.91, confidence interval [CI] = 0.14, 1.67) was higher than that of the psychomotor domain (ES = 0.57, CI = 0.17, 0.98), cognitive domain (ES = 0.63, CI = 0.11, 1.15) and affective domain (ES = 0.40, CI = 0.03, 0.76). In terms of interaction types and study characteristics were more effective if the studies included learner–learner interaction (ES = 0.83, CI = 0.36, 1.29), developed regions (ES = 0.55, CI = 0.17, 0.94), undergraduate nursing students (ES = 0.56, CI = 0.32, 0.80), no randomization (ES = 0.75, CI = 0.40, 1.10) and funding support (ES = 0.78, CI = 0.41, 1.16).

Conclusions

Well-designed synchronous e-learning courses should consider learners’ motivations and self-directed learning abilities by providing diverse learning resources and environments. Nurse educators should develop synchronous e-learning teaching strategies that include peer interaction. The affective domain of learning in synchronous e-learning needs to be developed and considered in future research.

目的:本研究旨在通过荟萃分析确定同步电子学习在护理教育中的效果的现有最佳证据,并比较不同研究分组的平均效果大小:背景:随着同步电子学习的快速发展,充分的准备工作至关重要,因为制定有效的教育策略对学习者的成功至关重要。然而,教师不应只关注使用技术来实施电子学习,而应在考虑适当的技术和互动类型的同时,设计符合学习目标的教育计划:设计:进行荟萃分析和分组分析:检索了包括 PubMed、Embase、CINAHL、Web of Science、Cochrane Library 和中国国家知识基础设施在内的中英文数据库,以查找自这些数据库建立至 2023 年 5 月期间发表的相关文章。检索范围包括这些数据库建立至 2023 年 5 月期间发表的相关文章。通过使用检索策略,我们确定了 3273 篇潜在的相关文章。最终分析纳入了 10 项主要研究。我们使用随机效应模型来综合效应大小 (ES) 并考虑主效应的异质性。我们还进行了分组分析,以分析效应大小的变化,研究异质性的可能原因:我们发现,与对照组相比,同步电子学习的效果更好,汇总的随机效应标准化平均差为 0.51,属于中等效应规模。在学习结果方面,学习反应的效应大小(ES = 0.91,置信区间 [CI] = 0.14,1.67)高于心理运动领域(ES = 0.57,CI = 0.17,0.98)、认知领域(ES = 0.63,CI = 0.11,1.15)和情感领域(ES = 0.40,CI = 0.03,0.76)。在互动类型和研究特点方面,如果研究包括学习者与学习者之间的互动(ES = 0.83,CI = 0.36,1.29)、发达地区(ES = 0.55,CI = 0.17,0.94)、护理专业本科生(ES = 0.56,CI = 0.32,0.80)、无随机化(ES = 0.75,CI = 0.40,1.10)和资金支持(ES = 0.78,CI = 0.41,1.16),则更有效:设计良好的同步电子学习课程应考虑学习者的动机和自主学习能力,提供多样化的学习资源和环境。护士教育者应制定包含同伴互动的同步电子学习教学策略。同步电子学习中学习的情感领域需要在未来的研究中加以发展和考虑。
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引用次数: 0
Teaching global interdependence to health professions students during the Anthropocene epoch: Findings from documentary analysis of an interprofessional education course 在人类纪元向卫生专业学生传授全球相互依存性:跨专业教育课程的文献分析结果
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104025
Sarah Oerther , Anthony Breitbach , David Pole

Aim(s)

To examine the effects of new course material that incorporated the Anthropocene and The Centers for Disease Control's (CDC) 'Climate Effects on Health' framework into an IPE course to enhance students' understanding global interdependence.

Background

Teaching global interdependence with a suitable framework and relevant content in an introductory Interprofessional Education course in undergraduate programs is challenging when these early learners who do not have significant clinical experience. Therefore, it is necessary to adapt these courses to provide a framework that all students can relate to regardless of previous experience.

Design

The design for this study was qualitative document analysis.

Method

The required introductory IPE course was for students on the programs offered by the College of Health Sciences and the School of Nursing. Students (n = 142) from seven health professions programs, including athletic training (n=9), nursing (n=70), nutrition and dietetics (n=8), occupational therapy (n=15), physical therapy (n=31), radiation therapy (n=2) and magnetic resonance imaging and pre-professional students from other majors (n=5) were enrolled in this IPE course. The study used data derived from the final reflections submitted by the students. The CQI analysis focused on students enrolled in a dedicated interprofessional course related to health professions.

Results

Ways interprofessional teams can address global challenges like the Anthropocene, climate-related illnesses and severe weather events were revealed in student responses. Three themes that emerged from the student responses included: public health collaborations, holistic health promotion and policy advocacy.

Conclusion

Incorporating the concept of Anthropocene and the 'Climate Effects on Health' framework into an IPE course can be a promising approach to shaping students' perception and enhancing their knowledge about global interdependence. By doing so, students can gain a deeper understanding of how human activities have an impact on the climate and ecology of the planet and how severe weather can lead to various health problems.

背景在本科专业的跨专业教育入门课程中,以合适的框架和相关内容教授全球相互依存关系,对于这些没有丰富临床经验的早期学习者来说,具有挑战性。因此,有必要对这些课程进行调整,以提供一个框架,让所有学生都能与之产生共鸣,而不论其以往的经验如何。来自运动训练(9 人)、护理(70 人)、营养与饮食学(8 人)、职业治疗(15 人)、物理治疗(31 人)、放射治疗(2 人)、磁共振成像等 7 个健康专业的学生(142 人)以及其他专业的预科生(5 人)参加了这门 IPE 课程。研究使用的数据来自学生提交的期末反思。CQI分析的重点是修读与健康专业相关的跨专业专门课程的学生。结果跨专业团队应对人类世、气候相关疾病和恶劣天气事件等全球性挑战的方式在学生的回答中得到了揭示。结论将 "人类世 "的概念和 "气候对健康的影响 "框架纳入 IPE 课程,是塑造学生的观念和增强他们对全球相互依存关系的认识的一种有前途的方法。通过这样做,学生可以更深入地了解人类活动如何影响地球的气候和生态,以及恶劣天气如何导致各种健康问题。
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引用次数: 0
Ensuring robust OSCE assessments: A reflective account from a Scottish school of nursing 确保健全的 OSCE 评估:苏格兰护理学院的反思性报告
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104021
Sandra Sharp, Austyn Snowden, Ian Stables, Ruth Paterson

Aim

This paper reflects on the experience of one Scottish University in conducting a face-to-face Objective Structured Examination (OSCE) for large cohorts of student nurses. It outlines the challenges experienced and learning gained.

Borton’s model of reflection frames this work due to its simplicity, ease of application and cyclical nature.

Background

The theoretical framework for the OSCE is critical thinking, enabling students to apply those skills authentically. OSCE’s are designed to transfer classroom knowledge to clinical practice and offer an authentic work-based assessment.

Design

Validity and robustness are key considerations in any assessment and in OSCE, the number of stations that students encounter is important and debated. We used a case-study based OSCE approach initially over four stations and following reflection, changed to one long station with four phases.

Results

In OSCE examinations, interrater reliability is a necessity, and students expect equity of approach. We identified that despite clear marking criteria, marks were polarised, with students achieving high or low marks with little middle ground. Review of examination papers highlighted that although students’ overall performance was good, some had failed in at least one station, suggesting a four-station approach may skew results. On reflection we hypothesised that using a one station case study-based, phased approach enabled the examiner to build up a more holistic picture of student knowledge and skills. It also provided the student opportunity to develop a rapport with the examiner and standardised patient, thereby putting them more at ease. We argue that this approach is holistic, authentic and student centred.

Conclusions

Our experience highlights that a single station, four phase OSCE is preferrable, enabling students to integrate all aspects of the assessment and provides a holistic view of clinical skills and knowledge.

目的 本文反思了苏格兰一所大学为大批护士学生举办面对面客观结构化考试(OSCE)的经验。由于 Borton 的反思模型简单、易于应用且具有循环性,因此该模型为本研究提供了框架。 背景 OSCE 的理论框架是批判性思维,使学生能够真实地应用这些技能。OSCE旨在将课堂知识转移到临床实践中,并提供真实的基于工作的评估。设计在任何评估中,有效性和稳健性都是关键的考虑因素,而在OSCE中,学生遇到的站点数量是重要的,也是有争议的。在 OSCE 考试中,评分者之间的可靠性是必要条件,学生也期望评分方法公平。我们发现,尽管评分标准明确,但分数却呈现两极分化,学生的分数有高有低,几乎没有中间值。对试卷的审查表明,虽然学生的整体表现良好,但有些学生至少有一个测站不及格,这表明四测站法可能会使结果出现偏差。经过反思,我们假设采用基于案例研究的单站分阶段方法,可以让考官更全面地了解学生的知识和技能。它还为学生提供了与考官和标准化病人建立融洽关系的机会,从而使他们更加从容。我们认为,这种方法是全面、真实和以学生为中心的。结论我们的经验突出表明,单站、四阶段的 OSCE 是可取的,它能让学生整合评估的所有方面,并提供临床技能和知识的整体视图。
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引用次数: 0
Factors associated with self-directed learning among undergraduate nursing students in Vietnam 越南护理专业本科生自主学习的相关因素。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104031
Nguyen Ho Anh Thu , Ha Lai Thi , Nguyen Thi Hoai Nhi , Vu Thi Quynh Chi , Tran Thi My

Aim

This study purposed to determine nursing students' self-directed learning abilities and related factors.

Background

Self-directed learning is a significant and practical approach for nursing students in their lifelong learning.

Design

In this study, a descriptive cross-sectional study was used to assess the level of SDL undergraduate of 411 undergraduate nursing students from four academic years.

Methods

The Self-directed Learning Abilities and Related Factors Questionnaire was used to measure the Self-directed Learning Abilities of the Nursing Students. Descriptive statistics were used to analyze the data and a logistic regression analysis was performed to evaluate the factors influencing self-directed learning abilities.

Results

Of the 411 nursing students, most belonged to the female group. Moreover, most of the nursing students have permanent residence in rural areas. The average score of general self-directed learning abilities of nursing students was 3.88 ± 0.3. Only 33.8 % of the respondents had a high level (mean score ≥ 4) of self-directed learning abilities. There was a significant relationship between place of residence, grade obtained in previous level education, current grade point average, academic workload, assessment methods, learning resources and self-directed learning abilities (p<0.05).

Conclusions

The self-directed learning ability level was low in this nursing student sample. Therefore, this study may increase nursing educators' attention to designing appropriate strategies to improve students’ self-directed learning abilities.

目的:本研究旨在了解护理专业学生的自主学习能力及相关因素:背景:自主学习是护理专业学生终身学习的一种重要而实用的方法:本研究采用描述性横断面研究,对四个学年411名护理专业本科生的自主学习能力水平进行评估:方法:采用自我导向学习能力及相关因素问卷来测量护理专业学生的自我导向学习能力。采用描述性统计对数据进行分析,并进行逻辑回归分析以评估影响自主学习能力的因素:结果:在 411 名护理专业学生中,大部分为女生。此外,大多数护理专业学生常住地为农村。护生一般自主学习能力的平均得分为(3.88±0.3)分。只有 33.8%的受访者具有较高的自主学习能力(平均分≥4 分)。居住地、上一级教育所获成绩、当前平均学分绩点、学业负担、评估方法、学习资源与自主学习能力之间存在显着关系(p 结论:自主学习能力水平与居住地、上一级教育所获成绩、当前平均学分绩点、学业负担、评估方法、学习资源之间存在显着关系:本护理学生样本的自主学习能力水平较低。因此,本研究可提高护理教育者对设计适当策略以提高学生自主学习能力的关注。
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引用次数: 0
Unveiling CPR training challenges in nursing education: Pedagogical strategies for success 揭示护理教育中心肺复苏培训的挑战:成功的教学策略。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104040
Masoomeh Habibi Baghi , Mahmood Abolghasemi , Masoumeh Zakerimoghadam , Morteza Rezaiezadeh , Mojtaba Vahidi Asl

Aim

This study explored the challenges nursing students face while learning CPR and identified experiential learning strategies to address these challenges.

Background

Nursing students often experience challenges and anxiety during clinical learning, including CPR training. Given the experimental nature of CPR training, experiential learning models like mARC can significantly enhance the learning experience by addressing these prevalent challenges.

Design

This study adopts an interpretivist approach within a qualitative methodology and uses a phenomenological design.

Method

Semi-structured interviews and the Delphi method were used to gather firsthand experiences from 37 educational supervisors, nursing professors and nursing students undergoing CPR clinical training at five public medical universities.

Results

Four main challenges and eighteen sub-challenges of CPR training were identified, elaborated and modeled. Additionally, thirteen experiential learning strategies, based on the mARC experiential learning model (more Authentic, Reflective, Collaborative), were mapped to address these challenges.

Conclusions

Among the four main challenges of CPR training identified by this study, the lack of pedagogy appears to be the underlying cause of the other three. This underscores the significance of integrating effective pedagogical approaches into nurse education strategies and initiatives.

目的:本研究探讨了护理专业学生在学习心肺复苏术时面临的挑战,并确定了应对这些挑战的体验式学习策略:背景:护理专业学生在临床学习(包括心肺复苏术培训)过程中经常会遇到挑战和焦虑。鉴于心肺复苏术培训的实验性质,像 mARC 这样的体验式学习模式可以通过解决这些普遍存在的挑战来显著增强学习体验:本研究采用定性方法中的解释学方法,并使用现象学设计:方法:采用半结构式访谈和德尔菲法,从五所公立医科大学的 37 名教育督导、护理教授和正在接受心肺复苏临床培训的护理学生那里收集第一手经验:结果:确定了心肺复苏培训的四个主要挑战和十八个次要挑战,并对其进行了阐述和示范。此外,还根据 mARC 体验式学习模式(更真实、更反思、更协作)绘制了十三种体验式学习策略,以应对这些挑战:在本研究确定的心肺复苏培训的四大挑战中,缺乏教学法似乎是其他三个挑战的根本原因。这强调了将有效的教学方法纳入护士教育战略和举措的重要性。
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引用次数: 0
Review of the Australian nurse teacher professional practice standards: An e-Delphi study 澳大利亚护士教师职业实践标准审查:电子德尔菲研究。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104045
Christine Taylor , Creina Mitchell , Hellen Kaneko , Belinda Foley , Julie Shaw

Aim

The aim of the study was to review the 2010 Australian nurse teacher professional practice standards (‘the Standards’) to see if they were still relevant to current nursing educator practice in any practice setting, such as academia or clinical settings.

Background

It has been over 10 years since ‘the Standards have been reviewed. Nurse education practice has met many challenges in the past decade, so it is timely to evaluate whether the Standards are still relevant to nursing educators today.

Design

A modified Delphi technique was used for this study.

Methods

Delphi surveys were used to obtain consensus on the relevance of the Standards’ statements to any nursing educator. Links to two electronic surveys were sent to an expert panel of nursing educator leaders. Also, two online focus groups of nursing educators from any practice setting or level of experience were held. Results from the first survey and focus groups led to word changes and additional statements, which were included in the second Delphi survey.

Results

Forty participants responded to the first survey and 38 to the second. Fifteen nursing educators attended the focus groups. There was ≥85 % agreement on all statements in the first survey. with similar high agreement responses in the second survey. Changes in the Standards included language used around culture, inclusion of ‘sustainability of the program’ and ‘demonstrates knowledge and expertise in teaching and educational practice’.

Conclusions

The Australian nurse teacher professional practice standards remain highly relevant to nursing educators across all practice settings. In response to feedback from nursing educators some changes to language and additional standard statements were included in the revised standards.

目的:本研究旨在回顾 2010 年澳大利亚护理教师职业实践标准("标准"),以了解这些标准是否仍与当前护理教育工作者在任何实践环境(如学术界或临床环境)中的实践相关:背景:自 "标准 "修订以来,已经过去了 10 多年。背景:"标准 "已经有 10 多年没有进行过审查了。在过去的 10 年中,护理教育实践遇到了许多挑战,因此,现在是评估 "标准 "是否仍然适用于当今护理教育者的时候了:本研究采用改良的德尔菲技术:德尔菲调查用于就《标准》的声明对任何护理教育者的相关性达成共识。向护理教育者领导专家小组发送了两个电子调查的链接。此外,还举行了两次在线焦点小组讨论,参与者包括来自任何实践环境或经验水平的护理教育者。第一次调查和焦点小组讨论的结果导致了用词的改变和额外的陈述,这些都被纳入了第二次德尔菲调查:40 名参与者对第一次调查做出了回应,38 名参与者对第二次调查做出了回应。15 名护理教育工作者参加了焦点小组。在第一次调查中,所有陈述的一致率≥85%,第二次调查中的一致率也很高。标准中的变化包括围绕文化使用的语言、纳入 "项目的可持续性 "以及 "展示教学和教育实践方面的知识和专长":澳大利亚护理教师职业实践标准对所有实践环境中的护理教育者都具有高度相关性。根据护理教育者的反馈意见,修订后的标准对语言进行了一些修改,并增加了一些标准说明。
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引用次数: 0
Achieving a representative sample in health research 在健康研究中实现样本的代表性。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.103986
Mousa Alavi , Fateme Lohrasbi , Deependra Kaji Thapa , Erik Biros , Claudia Lai , Michelle Cleary
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引用次数: 0
The influence of supervisory support on clinical learning as experienced by Czech Nursing and health professional students in the context of patient safety events: A qualitative study 病人安全事件背景下捷克护理和健康专业学生体验到的督导支持对临床学习的影响:定性研究。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104041
Daniela Javornická , Helena Kisvetrová , Eva Prušová , Renáta Váverková , Peta J Greaves , Alison Steven

Aim

To explore the influence of supervisory and mentoring relationships on the clinical learning experiences of Czech Nursing and health professional students in the context of patient safety events

Background

Clinical experience is integral to healthcare education, shaping skills, behaviours, values and professional identity. During clinical placements, students may encounter memorable patient safety events and experience varied reactions from mentors/supervisors/others. Some research has highlighted challenges faced by students on clinical placement. Few studies involve multiple professions, most emanating from Western Europe, the UK, the USA and Australia with little relating to central European countries such as the Czech Republic.

Design

Two stage interpretivist qualitative study based in social constructionism

Methods

Convenience sample across 13 undergraduate and 18 postgraduate health professions courses. Stage 1 (2022): using SLIPPS Learning Event Recording Tool translated into Czech. 20 students’ (Midwifery=11, Nursing=1, Paramedic=1, Occupational therapy =7) submitted 21 patient safety learning event narratives. Stage 2 (2022): Focus group with 2 nursing and nine midwifery students. Phased thematic analysis involving multiple researchers.

Results

Three themes illustrate the circumstances and impact of placement mentoring/supervision experiences, conceptualised as: ‘Clinical and Emotional Companionship’, ‘Clinical and Emotional Abandonment’ and ‘Sense of agency - Professional and personal growth’. ‘Companionship’ reflected the students’ feelings of being welcomed, respected, heard, trusted and supported. Conversely ‘abandonment’ emerged from feelings of being unheard, vulnerable, humiliated, afraid, leaving students feeling abandoned, lonely and ‘useless’. Notwithstanding these conditions, students showed the ability to identify patient safety issues with agency evident in reactions such as stepping-in to try to ameliorate a situation, rather than speaking-up. Professional and personal growth was also apparent in their narratives and a conceptual diagram illustrates the students’ learning journeys in a patient safety context.

Conclusion

The findings and new conceptualisations around abandonment and companionship emerging from this study expand the evidence base regarding the profound impact of clinical experience and mentorship/supervision on learning and students’ emotional wellbeing. A sense of companionship appears to play a buffering role even in challenging circumstances of involvement in or witnessing compromised patients’ safety. Allowing students a sense of belonging, to vent, grow, feel supported and safe to ask/learn - contributing to ‘emotional safety for learning’, promotes students’ behaviour that may prevent/minimize hazards or ameliorate the aftermath. However, we must not simply bla

目的:探讨在患者安全事件的背景下,督导和指导关系对捷克护理和健康专业学生临床学习经历的影响 背景:临床经历是医疗保健教育不可或缺的一部分,它塑造了学生的技能、行为、价值观和专业身份。在临床实习期间,学生可能会遇到令人难忘的患者安全事件,导师/督导/其他人也会做出不同的反应。一些研究强调了学生在临床实习中面临的挑战。涉及多个专业的研究很少,大多数研究来自西欧、英国、美国和澳大利亚,与捷克共和国等中欧国家相关的研究很少:设计:基于社会建构主义的两阶段解释主义定性研究 方法:对 13 个本科生和 18 个研究生健康专业课程进行方便抽样。第一阶段(2022 年):使用翻译成捷克语的 SLIPPS 学习事件记录工具。20名学生(助产=11,护理=1,辅助医务人员=1,职业治疗=7)提交了21份患者安全学习事件叙述。第二阶段(2022 年):与 2 名护理专业学生和 9 名助产专业学生进行焦点小组讨论。多位研究人员参与的分阶段主题分析:三个主题说明了实习指导/监督经历的情况和影响,概念化为临床和情感陪伴"、"临床和情感放弃 "和 "代理感--专业和个人成长"。陪伴 "反映了学生受到欢迎、尊重、倾听、信任和支持的感受。相反,"被遗弃 "则来自于被忽视、脆弱、羞辱和恐惧的感觉,让学生感到被遗弃、孤独和 "无用"。尽管存在这些情况,学生们还是表现出了识别病人安全问题的能力,并在反应中表现出了自己的能动性,如介入以试图改善情况,而不是大声疾呼。专业和个人成长在他们的叙述中也很明显,一个概念图说明了学生在患者安全背景下的学习历程:本研究围绕放弃和陪伴的发现和新概念拓展了临床经验和导师/督导对学习和学生情感健康的深远影响的证据基础。即使在参与或目睹患者安全受损的挑战性环境中,陪伴感似乎也能起到缓冲作用。让学生有归属感,能够发泄、成长、感受到支持并安全地提问/学习--有助于 "学习的情感安全",促进学生的行为,从而预防/减少危害或改善后果。然而,我们不能简单地责怪导师/督导、教职员工或学生本身--他们只是职业教育中更大的复杂环境的一部分,其中包括隐性课程、权力动态和职业社会化。
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引用次数: 0
The second victim phenomenon: A qualitative study among bachelor’s degree nursing students within the clinical learning environment 第二受害者现象:在临床学习环境中对护理学士学位学生进行的定性研究。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-07-01 DOI: 10.1016/j.nepr.2024.104038
Andrea Albert-Galbis , Rosa M. Pérez-Cañaveras , Mojtaba Vaismoradi , M. Flores Vizcaya-Moreno

Aim

This study explores and describes the second victim phenomenon in nursing students in association with the characteristics of the clinical learning environment and the clinical supervision process.

Design

Qualitative design using conventional content analysis and summative content analysis approaches.

Methods

From September 2022 to July 2023, in-depth semi-structured individual interviews were conducted with a purposive sample of 10 undergraduate nursing students.

Results

Six main themes were developed: ‘defining the physical and psychological responses after the most significant patient safety incident’, ‘analyzing the characteristics of patient safety incidents’, ‘creating a safe learning environment to provide the best care for patients’, ‘developing mentorship capabilities and qualities for an ideal follow up of students as a second victim’, ‘providing resources and integrating support structures to second victim nursing students during their clinical learning’, and ‘considering the cooperation and coordination between the health institution and the higher education institutions.’

Conclusion

Nursing students become second victims during their clinical placement. The clinical learning environment and mentoring characteristics influence the second victim experience.

目的:本研究探讨并描述护理专业学生的二次伤害现象与临床学习环境和临床督导过程的特点之间的关系:采用常规内容分析法和总结性内容分析法进行定性设计:2022年9月至2023年7月,对10名护理专业本科生进行了有目的的半结构式个人深度访谈:结果:形成了 "界定最重大患者安全事件后的生理和心理反应"、"分析患者安全事件的特点"、"创造安全的学习环境,为患者提供最好的护理"、"培养导师能力和素质,为作为第二受害者的学生提供理想的随访"、"为第二受害者护生在临床学习期间提供资源和整合支持结构"、"考虑卫生机构和高等院校之间的合作与协调 "六大主题:护生在临床实习期间成为第二受害者。临床学习环境和指导特点会影响第二受害者的体验。
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引用次数: 0
Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) – A mixed methods evaluation 医护专业学生在学生主导的临床学习环境(SLCLE)中的临床学习经验 - 一项混合方法评估。
IF 3.3 3区 医学 Q1 NURSING Pub Date : 2024-06-30 DOI: 10.1016/j.nepr.2024.104035
Sunita Channa , Annie Topping , Carol Willis , Teresa Melody , Ruth Pearce

Aim

To evaluate healthcare professional (HCP) students clinical learning experiences’ whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence.

Background

The English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions.

Design

A mixed methods convergent design.

Methods

An online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method.

Results

Undergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations.

Conclusions

The SLCLE allocation enhanced students’ confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students’ professional development. The format and method for providing pre-placement inf

目的:评估医疗保健专业(HCP)学生在学生主导的临床学习环境(SLCLE)中实习时的临床学习体验,以及自我报告的信心评级的任何变化:背景:英国国家医疗服务体系的长期劳动力计划(2023 年)强调,需要扩大国内的卫生保健人员教育,以解决劳动力短缺问题。在全球范围内,对高质量临床实习的需求仍是一个挑战,以支持培养 HCP 学生。一种创造性的解决方案是在医疗保健机构中发展以学生为主导的临床学习环境。SLCLE 提供高质量的学习体验,提高临床实习能力,同时保持病人护理标准。一家多地点的国家医疗服务系统信托公司采用了这一模式,因为有证据表明,医护人员学生在获得资格后将为承担注册执业医师的专业责任做好更充分的准备。该模式已被整合到一家大型教学医院的三个院区,为不同人群提供护理服务,并可容纳来自不同卫生保健学科和高等教育机构的学生:设计:混合方法聚合设计:方法:对分配到 SLCLE 的护理和联合健康专业(AHP)本科生和研究生一年级、二年级和三年级学生(n=132)进行在线调查。对参与调查的学生(人数=80)进行了面对面的焦点小组/个人访谈,以评估他们在南大学习中心的临床学习经历。调查数据采用描述性统计和配对 t 检验法进行分析,访谈数据采用框架法进行分析:来自英国四所大学的本科生和研究生完成了调查(n=132),103名学生(78%)做出了回应。大多数学生是二年级学生(n=43/42 %),攻读护理课程(n=82/80 %)。大多数人认为南亚护理实习符合他们的期望(n=76/74 %),实习后自信心增强(n=84/82 %),感到得到了教职员工(n=80/78 %)、同学(n=93/90 %)和临床教育者(n=93/90 %)的支持。自我报告的信心分数在 SLCLE 后明显高于 SLCLE 前。在线就职前信息很少被获取,但却被认为是一个疏漏。确定了四个主题(i) 先入为主和最初的焦虑;(ii) 授权、成长和独特的学习体验;(iii) 跨专业协作学习和支持;以及 (iv) 见解和预期:SLCLE分配增强了学生的信心和知识。临床教育工作者、病房工作人员和医生的支持对于营造积极的学习文化非常宝贵。同龄人的支持和领导护理工作的机会促进了学生的专业发展。提供实习前信息的格式和方法需要重新审查,避免延误完成评估文件的策略也需要重新审查。总之,作为一个培养卫生保健专业学生的有效学习环境,SLCLE 的经验具有很大的潜力。
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引用次数: 0
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Nurse Education in Practice
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