Nursing instructors’ and male nursing students’ perceptions of undergraduate, classroom nursing education

Attrition rates of male nursing students exceed those of females yet the experiences of male students in nursing school are poorly understood. This interpretive ethnographic study explored the experiences of male nursing students and female nursing instructors in the context of classroom education. Data collection consisted of participant observation of classroom teaching sessions followed by interviews with six male nursing students who were participants in the classes and six female nursing instructors who taught the classes.Themes resulting from data analysis addressed men’s roles in the nursing classroom and the culture of nursing education. The theme of nursing like a real man was characterized by men’s reliance on roles and behaviours associated with traditional masculinities including leadership, assertiveness and risk-taking. The theme of masculinities in a feminine place captured the gendered culture of nursing education which manifested in stereotypes and a sexualized identity, where men saw themselves as accommodated but not integrated. Diversity between masculine and feminine communicated the incongruity between men’s educational preferences and the techniques that predominate in nursing education. These findings suggest that nursing instructors need to consider gender in their teaching practice, avoid parody or stereotypes of masculinities, and reject assumptions that male students are homogeneous.     

A qualitative exploration of nursing students’ perceptions of the homeless and their care experiences

The health care needs of the homeless are more complex than those of the population at large. The purpose of this qualitative study was to explore undergraduate nursing students’ perceptions of the homeless. Thematic content analysis of responses from 19 undergraduate nursing students yielded four themes describing student experiences with the homeless, their perceptions of homelessness and the health care of the homeless, and their suggestions for best teaching strategies. Students in this study had varying amounts of experience with and knowledge of the homeless. While our participants strongly believed that homeless people deserved compassionate, equitable nursing care, many of their statements suggested an implicit bias toward the homeless. This suggests that student nurses need more comprehensive education concerning the homeless and the health care needs of this vulnerable population. Few interventions aimed at educating student nurses about homelessness and changing their attitudes to mitigate bias are based on research, particularly research conducted from the perspective of the homeless, and few explore the impact of civil interactions on health outcomes. The findings of this study may assist nurse educators in developing education interventions to improve students’ knowledge of homelessness.     

Iranian nursing students’ comprehension and experiences regarding evaluation process: a thematic analysis study

Scand J Caring Sci; 2011; 25; 151–159
Iranian nursing students’ comprehension and experiences regarding evaluation process: a thematic analysis study In this study, a qualitative design based on a thematic analysis approach was employed to explore the comprehension and experiences of Iranian nursing students regarding evaluation process in both classroom and clinical setting. After utilising purposeful sampling to choose 13 bachelor’s degree nursing students, semi‐structured interviews were held for data gathering. During the data analysis, three main themes emerged: ‘definition of evaluation process’, ‘unfair evaluation’ and ‘ideal evaluation’. The second theme consisted of two sub‐themes: ‘problematic process’ and ‘unexpected outcome’. Our study findings showed a gap between what Iranian nursing students depicted as a fair and equitable evaluation and what they experienced during their academic career. There is a need to bring a change to process of evaluation to increase the feeling of fairness and justice regarding evaluation among nursing students. The findings can be helpful for international nurse instructors to be exposed to the unheard perspectives of nursing students and reconsider the weaknesses of evaluation process conducted by them.     

Undergraduate nursing students’ views of mental health nursing in the forensic environment

The literature clearly demonstrates that mental health nursing tends to be viewed negatively by undergraduate nursing students. While positive clinical experiences have been found to encourage more favourable attitudes towards mental health nursing, suitable placements are becoming scarce. An evaluation of clinical placements at the Victorian Institute of Forensic Mental Health (VIFMH) was undertaken to determine whether appropriate learning opportunities were offered, and identify the impact of the placement on students’ attitudes to mental health nursing. The results suggest that VIFMH provides valuable learning experiences to increase students’ understanding of mental health nursing and is effective in producing more positive attitudes towards this area of practice.     

Mental health nursing students’ views on their readiness to address the physical health needs of service users on registration

There is substantial evidence that people (service users) living with a serious mental illness experience poorer physical health than the general population and die prematurely from life‐threatening illnesses. Mental health nurses are best placed to address the physical health needs of service users but evidence points to numerous challenges, including a deficit in their proficiency to meet these needs. Nurse education and mental health services are being reshaped to better equip nurses with the skill set to meet the care needs of service users. The aim of the present study was to gain an in‐depth insight into final‐year mental health nursing students’ views (MHNS) of their preparation to address the physical health needs of service users. Using a qualitative exploratory approach, the views of final‐year MHNS learning experiences of physical care were explored through a focus group and in‐depth interviews. The focus group generated broad issues, which were then explored in semistructured, individual interviews. The transcribed audio‐taped data were analysed using a framework approach to identify the emerging key themes. The themes identified were the comprehensiveness of physical care content, delivery and method of teaching, exposure to physical care in practice, and confidence to address physical health needs. The findings of the present study indicate that there is a need to enhance both the theoretical and practical components of preregistration education for MHNS on physical care.     

‘To be or not to be’– an ethical debate on the not-for-resuscitation (NFR) status of a stroke patient

• ? Nursing has been described as a moral endeavour (Seedhouse, 1988; Berger et al., 1991), the art of dealing with ethical issues of right and wrong.
• ? Within the nursing literature, ethical issues are a major topic for discussion. Berger et al. (1991) explain that this reflects larger societal concerns about ethics in business, industry and government.
• ? The development of advanced technology and life-sustaining treatments such as cardiopulmonary resuscitation (CPR) has heightened the dilemmas of moral decision making. CPR was developed in the 1960s as an emergency life-saving procedure, although it is currently used on anyone who does not have a not-for-resuscitation status (Anon., 1980).
• ? In this paper, an ethical issue involving the decision of whether or not to resuscitate a stroke patient is discussed. An overview of the main ethical theories is presented because they provide a framework for an explication of ethical decision-making. The options available to those involved are then discussed in relation to relevant research. Finally, a conclusion is drawn from the ensuing situation.

     

Implementation of evidence‐based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence‐based practice: A qualitative study

The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence‐based practice in community settings. In the UK, the expansion of health‐care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence‐based practice and mentor student nurses to conceptualize evidence‐based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: ‘our practice is evidence‐based’ as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision‐making, and ‘time’ as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence‐based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses.     

A study on development of a scale to assess nursing students’ performance in clinical settings

Aims. To develop a valid and reliable scale to assess nursing student performance in clinical settings. Background. In nursing education, clinical evaluation is important for students, teachers and patients and there is a need to evaluate with valid and reliable scales. Design. Instrument development. Methods. Data were collected at 2002–2003 and 2003–2004 academic years and 350 evaluations of third and fourth year students formed the study population. In the light of the literature and our experiences, we determined clinical responsibilities of nursing students and wrote 77 items accordingly. These items were discussed twice by 17 teachers at a University School of Nursing and then the items were decreased to 28. Each item was scored between 1 and 10. The structure validity of the scale was evaluated with factor analyses and reliability of the scale with Cronbach’s alpha and item‐to‐total correlation. Results. The item‐to‐total correlation coefficient was 0·40 and items were excluded with item‐to‐total correlation coefficient of lower than 0·40. Cronbach’s alpha was 0·97. Three factors with an eigenvalue greater than one were extracted. These factors were ‘nursing process’, ‘professionalism’ and ‘ethical principles’ and their Cronbach’s alpha values were 0·97, 0·94 and 0·87, respectively. Conclusion. This scale can be used to evaluate nursing students’ performance in clinical settings. Relevance to clinical practice. A valid and reliable tool may allow an objective evaluation of nursing students’ performance in clinical settings.     

The effectiveness of web-based patient education and action and coping plans as an adjunct to patient treatment in physiotherapy: A randomized controlled trial

ABSTRACT

Objective: The study investigated: (1) the effect of combining web-based patient education (WBPE) with action and coping plans on patients’ adherence to physiotherapy and their subsequent functional outcomes; and (2) the participants’ satisfaction with the WBPE program. Methods: One hundred and eight participants enrolled in this 8-week two group randomized controlled trial. They were allocated to either the WBPE planning group or the attention-control group. The WBPE group made action and coping plans and were familiarized with their web-based program. The attention control group was given access to a web-based neutral information program about shoulder injuries and physiotherapy rehabilitation. Throughout the 8-week study physiotherapists measured the participants’ clinic-based adherence and participants recorded their home-based adherence using a self-report diary. Functional outcomes for all participants were measured at the beginning and end of the study. Participants provided feedback about their respective websites. Results: The intervention group had a significantly higher clinic based adherence than the control group (p < 0.04). Both groups had a significant improvement in shoulder function but there was no significant difference between them. Participants in the intervention group were highly satisfied with the WBPE program. The preferred delivery of physiotherapy by 87% of the intervention group was a combination of face-to-face appointments and WBPE. Control participants indicated that they would have appreciated information about shoulder exercises and the shoulder complex in their program. Discussion: The WBPE program was an effective adjunct to physiotherapy in terms of patient satisfaction and clinic-based treatment adherence.     

Lecturers’ and students’ perceptions of portfolios in an English School of Nursing

Aims. This study was aimed at comparing perceptions of portfolios between student nurses at the early and latter stages of their training and how they compare with their lecturers’ perceptions. Background. Portfolios are used widely in nurse education. There has been research into how portfolios are perceived and understood, but there is little evidence into how student nurses and lecturers compare quantitatively in perceptions of portfolio use. Design. Survey. Method. Forty‐eight nursing lecturers and 413 nursing students, from a multi‐centred School of Nursing in the UK, completed a questionnaire. Data were analysed with exploratory factor analysis, varimax rotation of the factor solution, internal consistency analysis, and analysis of variance. Results. Five factors were extracted, which were labelled: (1) portfolios as a means of skills acquisition, (2) other means of teaching and learning beyond using portfolios, (3) processes of showing the portfolio to others, (4) having favourable attitudes towards portfolios and (5) lecturers’ ability to share knowledge about portfolios. Scales developed from these five factors had high levels of internal consistency. Lecturers were the most positive of the three respondent groups in their views of portfolios, whereas third‐ and fourth‐year students were the least positive. There were significant differences between student nurses and their lecturers, concerning how information on portfolios is communicated by the lecturer. Conclusion. There were significant discrepancies between lecturers and student nurses in their views on how portfolios are used. The value of portfolios becomes less salient to student nurses towards the end of their training. Relevance to clinical practice. Lecturers and clinical mentors need to look at students’ perceptions and why some nursing students’ views on portfolios deteriorate. There could be regular discussions with students to see how and why the students begin to see portfolios as less useful for their education and continual professional development.     

Advocacy in nursing – perceptions of practising nurses

• ? This paper reports on a qualitative study which examined the interpretation of patient advocacy by practising nurses.
• ? Focus group interviews, which allowed respondents to recount and share their particular ‘stories’ of patient advocacy, were used to collect data.
• ? Results indicate that a triadic model of advocacy predominated which involved the nurse in a conflict/potential conflict situation. The patient's requests, the patient's fear, the patient's vulnerability or threats to the patient's human rights provoked an advocacy response in the perceptive nurse. The nurse was sustained in the role through patient recognition, the nurse–patient relationship, emotional strength, moral justification and knowledge/expertise legitimacy.
• ? The nurse used direct and indirect means to protect the patient against incompetent/inappropriate practice and/or represent patient/family choice, the advocacy activity resulting in positive or negative outcomes.
• ? In conclusion it is argued that if the triadic conflict model of advocacy outlined by this research is to be sustained by practising nurses, the potential risks involved should be recognized. Professionalization of the role may be the only way forward if the ethical code (United Kingdom Central Council, 1992) continues to make patient advocacy a mandatory activity for the professional nurse.

     

护理专业教育环境与护生人文关怀能力相关性研究

目的：探讨教育环境与学生人文关怀能力的关系,为护理教育者改善教育环境和提高学生人文关怀能力提供依据。方法：采用医学教育环境测量工具和护理专业大学生人文关怀能力量表对护理专业336名本科生进行问卷调查,并进行相关性分析。结果：教育环境总分为（132.16±18.06）分,学生人文关怀能力总分为（3.62±0.64）分,教育环境与人文关怀能力存在正相关（r=0.323,P〈0.01）。结论：护理教育环境与学生的人文关怀能力密切相关,护理教育者应注重改善教育环境,以提高学生的人文关怀能力。