Journal of Professional Nursing最新文献

Background

Undergraduate nursing students are at risk of exposure to clinical related critical incidents. The impact on nursing students and the use of coping mechanisms and processes to make meaning of these distressing experiences are poorly understood.

Purpose

The aim of this study was to provide a theoretical understanding of the processes that undergraduate nursing students use to make meaning of clinical related critical incidents.

Method

Following the constructivist grounded theory method, a purposive sample was used to recruit 15 students enrolled in a Canadian university baccalaureate nursing program. Data were collected using semi-structured interviews over 12 months. Interviews were transcribed and analyzed using constant comparison and concurrent data collection and coding.

Results

Three theoretical categories emerged from the data to explain the processes used by nursing students to make meaning of their critical incidents: distress, identity shift, and moving forward. The processes described were characterized by an overarching category of “Pushing Through.”

Conclusion

The resulting theory of “Pushing Through” can be used as a lens for students and nurse educators to navigate making meaning of clinical related critical incidents. This theory highlights the significance of students' self-understanding as they explore and assemble individualized strategies and coping skills. Educators who teach in the clinical setting should prioritize the development of a trauma-informed learning environment by establishing connections and transparent expectations with learners.

Background

Growing awareness of social inequities and injustices in education highlights the urgent need to address harmful mechanisms, policies, and norms within health education curricula and systems.

Purpose

This study examines inclusivity and exclusivity content in four fundamental nursing textbooks and contributes to the broader discourse on fostering equitable health education.

Methods

A Directed Qualitative Content Analysis on 32 chapters from four fundamental nursing textbooks was systematically conducted. Seven codes within inclusivity and exclusivity themes were deductively developed from the literature. Inclusivity codes included equity language and contextualized race-based prevalence. Exclusivity codes included normalizing Whiteness in assessment, stigmatizing and negative descriptors, race-based prevalence without context, cisgenderism, and othering. Two trained analysts independently reviewed the chapters, assigning texts to these codes. Discrepancies were resolved by team consensus.

Results

A total of 118 inclusivity instances: equity language (n = 109) and race-based prevalence with context (n = 9). Exclusivity codes were more prevalent (n = 642), including normalizing Whiteness (n = 398), stigmatizing descriptors (n = 106), cisgenderism (n = 59), and othering (n = 32).

Conclusion

The study highlights inclusive language in fundamental nursing textbooks but reveals significant exclusive language perpetuating negative generalizations, including marginalized identities and race prevalence without context. This content undermines person-centered care and hinders understanding the complex interplay between intersectionality, social justice, and social determinants of health.

Background

Nursing education has seen a shift towards simulation-based education (SBE) to meet the demands of a rapidly evolving healthcare landscape. Maryland's Clinical Simulation Resource Consortium (MCSRC) aimed to enhance SBE utilization; however, noted a decline in SBE usage post pandemic, prompting an investigation into nurse administrators' perspectives on replacing clinical hours with SBE.

Methods

This descriptive quality improvement study was informed by Rogers' Diffusion of Innovation (DOI) Theory. Semi-structured interviews were conducted with four academic nurse administrators from various pre-licensure nursing programs in Maryland. The data collected were analyzed using thematic analysis.

Results

Nurse administrators who value SBE as a safe learning space are integral when building and maintaining infrastructure to support simulation usage. Identified barriers related to faculty buy-in, workload, and inadequate human resources to deliver high-quality simulations can hinder sustained adoption of clinical simulation.

Conclusions

This study highlights the necessity of continuous faculty training in SBE and dedicated resources to support simulation infrastructure. Recommendations include sustained investment in faculty development, creating specialized roles for simulation champions, and fostering collaborations to strengthen simulation integration. The findings emphasize the pivotal role of nurse administrators in navigating challenges and maximizing SBE's potential to replace clinical hours in nursing education, urging ongoing support and strategic planning for successful integration.

Background

The movement toward competency-based education (CBE), endorsed by AACN, has highlighted the need for nursing programs to engage in curriculum revisions. Best practice Writing Across the Curriculum instructional strategies may play a key role in revising courses to meet CBE criteria.

Problem

Faculty may not feel prepared to modify or develop courses to meet the CBE standards detailed in the AACN 2021 Essentials and may not recognize how Writing Across the Curriculum strategies can be utilized to meet CBE requirements.

Approach

Evidence-based Writing Across the Curriculum strategies can be easily incorporated into courses to enhance students' critical thinking abilities, clinical skills, and leadership proficiencies.

Conclusions

Writing Across the Curriculum strategies can be used during course revisions to address CBE. Nursing faculty should be familiar with best practices for incorporating writing into nursing assignments to allow students to demonstrate competency of learned knowledge.

Prior to the COVID-19 pandemic, the University of San Francisco (UCSF) School of Nursing (SON) is a historically in person graduate program that immediately transitioned to remote learning at the start of the pandemic. In 2022, upon emerging from the pandemic, the need to intentionally determine the teaching and learning modality of the UCSF SON became apparent. This is a report of the process of our institutions transition from an in person to a hybrid school. A task force was formed and charged with identifying the school's approach to the teaching and learning modality moving forward. A group think activity identified needs assessment for the task force's approach. The task force agreed upon definitions for in person, hybrid, online and hyflex learning, conducted a literature review, re-examined internal survey results from both faculty and learners regarding teaching and learning modality preferences and compared top graduate nursing programs teaching and learning modalities. The literature review revealed that hybrid learning was not inferior to in person learning and may improve educational outcomes. The faculty and learner survey results identified a preference toward hybrid learning and teaching. The task force recommended that the school change its public-facing information to identify as a hybrid school with specialty specific flexible design. This transition allows the school to carry out the mission of educating diverse health leaders.

Background

Open educational resources (OER) are associated with several positive outcomes for undergraduate and graduate students, both financially and academically. Financial benefits include a reduction in student debt and costs of attending college. Academic benefits include improved academic success, especially for students from populations historically underserved by higher education.

Purpose

This article reviews strategies and lessons learned from an academic multi-campus school of nursing (SON) initiative on implementing OER.

Approach

A team representing undergraduate and graduate nursing faculty, the library, and the Teaching and Learning Center set forth to improve faculty awareness of and interest in adopting OER and develop resource sites for disseminating information about OER. The team collaborated with partners within the university and with external academic partners to achieve our goals.

Outcomes

Presentations to SON faculty on OER identified faculty interested in adopting these resources. Two Masters of Nursing Education (MNE) students identified and shared resources; completed a student textbook survey; and, reported results and recommendations to SON faculty. A university resource site was created on OER. Further collaboration with university librarians to identify and implement OER for specific courses is ongoing.

Conclusions

Students identified cost as one barrier for pursuing higher education. Efforts to reduce cost through utilizing OER may eliminate this barrier, thus enhancing student enrollment and persistence in higher education. Adopting OER is a social justice action that has the potential to address educational inequities by allowing students to attend to their basic human needs such as housing and food.

Background

Methods

Results

Conclusions

The Doctor of Nursing Practice (DNP) Program curriculum must address the challenge of developing Competency Based Education (CBE) curriculum for DNP Scholarly Projects tailored to meet variations in nursing learner preparation and practice, from novice bachelor's entry level and master's advanced nurse practice expert entry level pathways. The recent Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity report by the National Academy of Medicine advocates that competency-based education (CBE) approaches in nursing schools should focus upon the advanced practice nursing population within collaborative academic practice partnerships. This article describes an innovative DNP Scholarly Project Curriculum model at an academic health science center that integrates academic partnerships and CBE strategies that have been developed for second degree Bachelor's direct entry to nursing (direct entry), post BS in nursing to DNP (BS to DNP), Post Master's to DNP (PM DNP) entry levels of preparation. The DNP Scholarly Project Curriculum utilizes an innovative, scaffolded approach to fostering CBE for the assessment of learning activities at the doctoral level. The DNP Scholarly Project Curriculum includes domains of quality improvement, critical appraisal of the literature, evidence-based practice models, implementation practice models, policy analysis, and process/outcome evaluations. Preliminary alumni and stakeholder feedback suggests that these projects are not only impacting practice but improving learner competency in quality improvement science. Implementation of this model has led to enhanced CBE-driven curriculum teaching and learning strategies, and sustainable collaborative academic partnerships.

Background

The American Association of Colleges of Nursing (AACN) and National Organization of Nurse Practitioner Faculties (NONPF) emphasize the role of clinical reasoning in nurse practitioner (NP) competencies. Evidence-based clinical reasoning is vital to patient safety. Collaborative technology tools can aid in assessing progress towards achieving clinical reasoning competency.

Purpose/aims

The purpose of this article is to describe an electronic, collaborative learning framework to teach and assess second year NP students in systematically selecting and eliminating diagnoses and forming treatment plans.

Design/methods

Post gap analysis, the collaborative learning framework was created. This visual, collaborative resource was scaffolded across two sequential advanced NP second year clinical synthesis courses and embedded with evolving case studies. Students identified pertinent positives and negatives from the history, physical, and diagnostic findings. Each student developed a unique differential diagnosis and plan of care and critiqued their peers.

Result/findings

The tool exceeded expectations. Faculty were able to visualize data, provide clarification on interpretation of data and pharmacology, and grade in small groups.

Conclusion

The collaborative learning framework provided real-time visualization of students' work in clinical reasoning. It was easy to use and integrate into second year NP courses to meet learning objectives and assess clinical reasoning competency.