An integrative review of humanities-based activities in baccalaureate nursing education

PurposeThe American Association of the Colleges of Nursing has stressed the importance of the liberal arts as a foundation of nursing education that supports the development of clinical reasoning and judgments in their recently updated essentials for professional nursing education. The purpose of this research was to conduct an integrative review of the literature to explore the use of the humanities in baccalaureate nursing programs.Research questionAmong undergraduate nursing programs, what types of humanities interventions were used in nursing courses and what were the outcomes of these interventions?Theoretical frameworkThis research was guided by the Aesthetic Knowing and Knowledge conceptual model by Chinn and Kramer, which is based on the Fundamental Patterns of Knowing in Nursing by Carper.MethodsAn integrative review method, as outlined by Whittemore and Knafl, was used for this research.ResultsAfter analysis of 227 titles, 19 studies were selected. Studies used art, literature, music and dance-based interventions. A key theme in examining the use of humanities in nursing education is its connection to aesthetic knowing in nursing. This included moral/ethical comportment, therapeutic use of self and scientific competence, as outlined in the Aesthetic Knowing and Knowledge conceptual model by Chinn and Kramer. Additionally, several other common themes emerged across the studies as nursing students reflected on the impact of the inclusion of humanities in their nursing curricula. Nursing student-recognized benefits included enhanced learning, emotional development, communication and new insights into best nursing practices.ConclusionsHumanities-based interventions are a useful addition to undergraduate nursing education. Future research should use randomized controlled designs to strengthen the body of literature regarding this topic.     

Students' perceptions of interventions designed to foster empathy: An integrative review

ObjectiveEmpathy is assumed to be an important element of nursing care, and nursing educators are attempting to find ways to effectively foster empathy in their students. The purpose of this review is to gain a deeper grasp of what undergraduate nursing students are learning from interventions educators have designed to cultivate empathy by synthesizing qualitative data.Review methodsUtilizing the review methodology proposed by Whittemore and Knafl, a survey of the CINAHL, Web of Science, PubMed, and PsychINFO databases was undertaken to answer the question: What are undergraduate nursing students' perceptions of interventions designed to foster empathy?ResultsA thematic synthesis of the students' perceptions from the 17 articles meeting inclusion criteria revealed five themes: Understanding the other's experience, embodying the other's experience, becoming aware of self, informing the role of the nurse, and learning or transforming.ConclusionsAlthough additional conceptual work remains to create a coherent, complete, and parsimonious definition of empathy, the results indicate that the students are gaining many of the facets assumed to be part of the concept of empathy through these educational interventions. Immersive simulations that put students in the role of the “other” were particularly impactful, especially if they created a disorienting dilemma followed by guided reflection. These findings can help nursing educators tailor their interventions for their specific intended learning outcomes.     

Bringing us back to our creative senses: Fostering creativity in graduate-level nursing education: A literary review

ObjectivesThe purpose of this paper is to explore empirical findings of five studies related to graduate-level nurse educators' and nursing students' perceptions about the roles of creativity and creative problem-solving in traditional and innovative pedagogies, and examines conceptual differences in the value of creativity from teacher and student viewpoints.Data sourcesFive peer-reviewed scholarly articles; professional nursing organizations; conceptual frameworks of noted scholars specializing in creativity and creative problem-solving; business-related sources; primary and secondary sources of esteemed nurse scholars.Review methodsQuantitative and qualitative studies were examined that used a variety of methodologies, including surveys, focus groups, 1:1 interviews, and convenience sampling of both nursing and non-nursing college students and faculty.ResultsInnovative teaching strategies supported student creativity and creative problem-solving development. Teacher personality traits and teaching styles receptive to students' needs led to greater student success in creative development. Adequate time allocation and perceived usefulness of creativity and creative problem-solving by graduate-level nurse educators must be reflected in classroom activities and course design.ConclusionsFindings indicated conservative teaching norms, evident in graduate nursing education today, should be revised to promote creativity and creative problem-solving development in graduate-level nursing students for best practice outcomes.     

Efficacy of teaching methods used to develop critical thinking in nursing and midwifery undergraduate students: A systematic review of the literature

BackgroundThe value and importance of incorporating strategies that promote critical thinking in nursing and midwifery undergraduate programmes are well documented. However, relatively little is known about the effectiveness of teaching strategies in promoting CT. Evaluating effectiveness is important to promote ‘best practise’ in teaching.ObjectiveTo evaluate the efficacy of teaching methods used to develop critical thinking skills in nursing and midwifery undergraduate students.Data SourcesThe following six databases; CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus were searched and resulted in the retrieval of 1315 papers.Review MethodsAfter screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme tool. Twenty-eight studies met the inclusion criteria and quality appraisal.ResultsTwelve different teaching interventions were tested in 8 countries. Results varied, with little consistency across studies using the same type of intervention or outcome tool. Sixteen tools were used to measure the efficacy of teaching in developing critical thinking. Seventeen studies identified a significant increase in critical thinking, while nine studies found no increases, and two found unexplained decreases in CT when using a similar educational intervention.ConclusionsWhilst this review aimed to identify effective teaching strategies that promote and develop critical thinking, flaws in methodology and outcome measures contributed to inconsistent findings. The continued use of generalised CT tools is unlikely to help identify appropriate teaching methods that will improve CT abilities of midwifery and nursing students and prepare them for practise. The review was limited to empirical studies published in English that used measures of critical thinking with midwifery and nursing students. Discipline specific strategies and tools that measure students' abilities to apply CT in practise are needed.     

Team teaching in undergraduate nursing programs: A scoping review

AimTo explore studies related to team teaching in undergraduate nursing education and to identify its implications for practice.BackgroundTeam teaching is a pedagogical approach that has been used in a wide variety of settings since the mid-twentieth century. This approach aims to encourage critical thinking through exposure to a multifocal teaching approach. Incorporating various teaching approaches is crucial to cultivating knowledge and practical ability among future nurses. Despite its apparent potential as a pedagogy, peer-reviewed literature contains little evidence regarding the implementation of team teaching in undergraduate nursing education.DesignScoping review strategy was used in this review to examine the extent and range of available literature on team teaching in undergraduate nursing education.Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was used as the reporting guideline for this review. Literature search was conducted using six databases in addition to grey literature search.ResultsSix papers met the inclusion criteria, and all were conducted in high income countries. Four main themes were evident in included studies. These were study approach, student perspectives, teacher perspectives and broad recommendations. The majority (96%) of participants in the studies were students. Positive findings revealed that team teaching is of benefit to students’ active learning, reflection skills, leadership skills, and student-teacher bonding. Team teaching that pairs academics with frontline clinicians was also suggested as one way to address the gap between theory and practice often cited as a weakness of modern-day nursing training. Challenges identified by studies included, students' experiences observing personality clashes between teachers, and extra time demands being placed on teachers due to intensive planning.ConclusionsThis review highlights that any level of teaming and/or collaboration is better, in many aspects, than solo teaching in undergraduate nursing education. A clear need was identified for research exploring the perspective of nurse educators and managers regarding their perceptions of team teaching.     

Graduate students as preceptors: Effects on clinical teaching outcomes of medical nursing

PurposeTo explore the feasibility of using graduate students as preceptors in the clinical education of medical nursing students.MethodsFive second-year graduate nursing students were recruited to participate in the clinical teaching of medical nursing for 38 undergraduates in the first semester of the 2010–2011 academic year, divided into two groups. The first group first received clinical teaching in caring for respiratory diseases from graduate preceptors for six weeks followed by clinical teaching in caring for circulatory diseases from nurse preceptors for six weeks. The second group received clinical teaching in the reverse order, from the nurse preceptors followed by the graduate student preceptors. Following training, all students were examined with a written test and scores were compared. In addition, review meetings were held to evaluate the teaching outcomes.ResultsNo significant differences in test scores were observed between the two teaching groups. Undergraduate student feedback indicated that the training provided by the graduate students was satisfactory, and the medical nursing course leader was satisfied with the teaching outcome with a few exceptions.ConclusionThese data indicate that graduate students are capable of training undergraduates in medical nursing, although some areas can be improved.     

Nursing students learning transfer from classroom to clinical practice: An integrative review

AimThe aim of this integrative review was to examine the theoretical, qualitative, quantitative and mixed-methods literature focused on how nursing students transfer learning from theory courses into clinical practice.BackgroundAs nursing curriculum aligns with the growing body of nursing knowledge, nursing students continue to develop their knowledge base and skill sets to prepare for future nursing practice. The bulk of this preparation involves developing connections between classroom/lab knowledge and further demonstrating those connections in clinical practice. However, the extant state of evidence on undergraduate nursing students’ learning transfer has not yet been synthesized.DesignThis integrative review was conducted using the Whittemore and Knafl framework.Review methodsEight databases were searched in June 2022: MEDLINE, APA PsycInfo, EMBASE, Web of Science, CINAHL, ERIC, Academic Search Complete and Education Research Complete. Literature was included if it focused on undergraduate nursing students who have participated in at least one clinical practicum and reported on learning transfer in clinical settings. Only English-language, peer-reviewed literature was included. Two researchers independently assessed the eligibility of articles at the title-and-abstract level and at the full-text level, followed by an assessment of methodological quality. The Joanna Briggs Institute’s critical appraisal checklists were used to assess theoretical papers and literature reviews and the mixed-methods appraisal tool (MMAT) was used to appraise all studies. Reference lists of included articles were searched for additional relevant literature. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines.ResultsTwenty-eight articles met our inclusion criteria and were included in this review, including 20 qualitative studies, one quantitative study, three mixed-methods studies, three theoretical articles and one integrative review. The results of this review highlighted that numerous facilitators and barriers influence nursing students’ ability to transfer learning within clinical learning environments. Facilitators included having knowledgeable and supportive educators and nursing staff, using strategies to promote connections, fostering reflection and aligning theory and practice. Barriers included unclear connections between course content, incongruencies between classroom and practice, lack of nurse role models, lack of real-world applicability and unsupportive nurse educators.ConclusionsThe information generated from this integrative review provides evidence about barriers that can be mitigated and facilitators that can be leveraged to facilitate undergraduate nursing students’ learning transfer into clinical practice. The findings also highlighted gaps in evidence surrounding the need to understand how nursing students transfer learning from classroom settings to clinical practice settings.     

Knowledge and teaching-learning methods regarding venous leg ulcers in nursing professionals and students: A scoping review

AimAccording to our scoping review questions, three aims were formulated to synthesize the evidence published on: (1) the content (2) the best or most appropriate teaching-learning methods for training nurses and undergraduate nursing students in venous leg ulcer care, and (3) to identify the level of knowledge in nurses and undergraduate nursing students about venous leg ulcer care.BackgroundA venous leg ulcer can be defined as a skin lesion on the leg or foot that occurs in an area affected by ambulatory venous hypertension. Hence, nurse visits are the main driver of Venous Leg Ulcer-related healthcare costs. Optimal levels of knowledge obtained with appropriate methodologies tend to improve care. Nonetheless, the time devoted to chronic wound education in undergraduate nursing curricula has been considered insufficient and inadequate.MethodsFor this scoping review, a search was performed in January 2021. To identify sources of evidence, a systematic search was conducted in MEDLINE, Embase, CINAHL, Web of Science, Scopus, Cuiden, ERIC and ScienceDirect. All types of evidence associated with knowledge, teaching and/or learning methods regarding venous leg ulcers in nursing were included.ResultsFinally, 19 documents were included. In these articles, the content mostly widely included in teaching-learning methods was compression therapy (14/19), anatomy, physiology, aetiology and/or pathophysiology (10/19) and topical treatment and care (8/19); various other topics were mentioned but less frequently. Teaching/learning methods and interventions were heterogeneous in modality, content, and duration but the majority showed better results after implementation. When looking at knowledge level, studies mainly focused on nursing staff. In general, it seems that there is a lack of knowledge and skills.ConclusionsRegarding our three pivotal questions: (1) There is no uniform type of content over the studies analysed and the most referred was compression therapy. (2) The educational interventions studied have demonstrated effectiveness, but there is insufficient data to determine which is the most effective. (3) This scoping review has highlighted the lack of knowledge among nurses and nursing students about venous leg ulcer care. Additionally, we felt that there is no ideal assessment tool to quantify knowledge, skills, attitude, confidence, and commitment in this context.Tweetable abstractA scoping review that synthesise the evidence on the level of knowledge and teaching-learning methods in nursing regarding of people with venous leg ulcers shows lack of knowledge and variability in programs.     

Experiences of nursing students during clinical education in mental health clinics: A phenomenological qualitative study

AimNursing students have both positive and negative experiences during clinical education. This study was conducted to identify experiences of nursing students during clinical education in mental health clinics.DesignThis phenomenological qualitative design study was conducted with 4th year undergraduate nursing students from a university in Turkey to identify their experiences specifically in mental health clinics.MethodsThe data were collected using focus groups interviews with 40 nursing students and assessed with the 7-stage phenomenological analysis method described by Colaizzi.ResultsThree main themes were determined: (i) the need for supportive interventions to cope with negative emotions; (ii) difficulty in translating theoretical knowledge into practice; and (iii) the lack of role model nurses and teaching staff.ConclusionsThe results of this study indicate that supportive interventions should be given to nursing students before clinical education. Also, the duration of clinical education, the teaching methods to be used and role model nurses and teaching staff effectiveness in clinical education should be planned carefully.     

Critical thinking among institutional academic advisors and sociodemographic,professional and academic variables: A multicenter correlation study

BackgroundIn nursing education, essential skills include Critical Thinking (CT). There is scant evidence on how nurse educators could promote CT in students in a clinical context.ObjectiveTo analyse the level of CT and correlated variables in healthcare nurses overseeing the clinicals of nursing undergraduates.MethodsThe study population were all nurse educators for clinicals at hospitals with nursing undergraduates. To evaluate the CT skills of nurses the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 practice) was administered. Frequencies, percentages and measures of central tendency and scatter were obtained. A bivariate analysis was performed to analyze the correlation between the nurse educators’ CT level and the sociodemographic, professional and academic levels. The nonparametric Mann-Whitney and Kruskal-Wallis tests were used to compare two independent groups. Statistical significance was defined as P < .05.ResultsThe total number of participants was 639. The highest mean CT level was seen in clinical nurses involved in undergraduate nursing instruction and with experience of up to 10 years (mean CT score = 372 (33.3), p = .007). Global CT levels were similar in women and men (mean CT score: 364 (31.9) in women and 358 (40.5) in men, p = .187), with statistically significant differences only observed in the intellectual and cognitive indicator (P = .022).ConclusionsCT levels are high in teaching healthcare professionals in the clinical environment.     

A cross-sectional study of domestic violence instruction in nursing and midwifery programs: Out of step with community and student expectations

BackgroundDomestic violence is a global health concern. Nurses and midwives must respond to those who experience domestic violence, although many are not prepared to do this. The World Health Organization recommend that domestic violence content be included in all pre-registration training as a matter of urgency.ObjectivesTo examine self-reported undergraduate student perceptions of domestic violence content in their programs of study and student attitudes and beliefs about domestic violence.DesignA cross-sectional research design with online survey was employed from June to October 2017.MethodsUsing convenience sampling, 1076 students were recruited to the study from a total population sample of just over 6000 undergraduate nursing and midwifery students; a response rate of 17.9%. Survey data reported the nature and frequency of teaching and learning along with student attitudes and beliefs about domestic violence. Open ended responses were examined via thematic analysis.SettingsNine Australian universities offering undergraduate nursing and midwifery degrees.ParticipantsUndergraduate university nursing and midwifery students.ResultsOver half of students surveyed (53.7%, n = 578) reported that domestic violence was not addressed in their program of study. A direct correlation was found between students' perceived preparedness to assess and respond to domestic violence, and the amount of taught content in their program of study.ConclusionThis major gap in curricula has significant implications for professional practice preparedness. Further research should focus on examining the reasons why quality domestic violence content is lacking in undergraduate nursing and midwifery programs and how prioritisation of domestic violence content can be improved.     

The next gen pharmacology classroom: A quality improvement approach to transformation

BackgroundPrelicensure nursing has slowly heeded the call to embrace radical transformation of nursing education. Students’ inability to apply pharmacological knowledge to clinical situations motivated faculty to rethink how pharmacology is taught.MethodFaculty restructured the pharmacology course with an active learning, facilitator-led classroom pedagogy.ResultsStudent study time decreased and students were able to apply pharmacology content to the clinical setting. Faculty satisfaction increased.ConclusionEmploying active learning methods for teaching pharmacology shows promise as evidenced by sustained content recall and application of pharmacology knowledge in entry-level nurse clinical settings.