Mentorship in nursing in Canada – A scoping review

AimTo review the literature on mentoring of nursing students in Canada.BackgroundMentorship in nursing has been in existence for a long time. Supportive, nurturing guidance by an experienced individual in the profession has been found to have many benefits both to the giver and the receiver. However, there is no uniformity in the length, model, delivery method and evaluation of mentorship programs' impact. The purpose of this scoping review is to appraise the available literature and synthesize knowledge on mentorship in nursing in Canada.DesignScoping ReviewMethodsThe scoping review was guided by the methodological framework developed by Hilary Arksey & Lisa O'Malley and the findings are reported using PRISMA ScR guidelines. A systematic search of MEDLINE, CINAHL, EMBASE and ERIC databases was conducted to identify articles describing nursing mentorship in Canada.ResultsAfter the initial screening, a total of 125 articles were included for a full-text review. Of the 48 items included, 28 were research articles and 20 were other forms of literature. Forty-eight items were included for data extraction.ConclusionThe scoping review revealed several benefits of mentorship. While synthesizing the evidence, it was noted that the components of the mentorship programs, such as the length, models, mode of delivery and the impact, vary with every nursing field.Implications for PracticeBased on the results of the scoping review, it is recommended to consider the unique needs, strengths and challenges of the group for whom the mentorship is planned. One size may not fit all.     

Patients’ involvement in nursing students’ clinical education: A scoping review

BackgroundActual contacts with patients are crucial in developing the skills that students need when working with patients. Patients are accustomed to the presence of students. The concept of learning from patients has emerged recently, shifting the focus from learning from professionals as role models to the relationship between the student and patient.AimWith focus on patients’ perspective in clinical practice placements, this scoping review aims to review and summarize the existing empirical literature regarding patients’ involvement in nursing students’ clinical education.Design and methodA broad search without time limitations was performed in the databases CINAHL, Medline, PsycINFO and ERIC. A manual search was also performed. Only empirical studies describing aspects of patient involvement in nursing education from the patient’s perspective were taken into account. Thirty-two studies published from 1985 to June 2016 met the selection criteria and were analysed using inductive content analysis.ResultsThe perspective of real patients focused on their role in students’ learning and assessment processes. In general, patients appreciated the opportunity to contribute to a student’s learning process and thus enhance the quality of patient care. However, the patients’ approaches varied from active to passive participants, comprising active participants contributing to students’ learning, followers of care and advice, and learning platforms with whom students practiced their skills. Some patients perceived themselves as active participants who facilitated students’ learning by sharing knowledge and experience about their own care and wellbeing as well as assessed students’ performance by providing encouraging feedback.ConclusionThe state and degrees of patient involvement in nursing students’ clinical education were made explicit by the literature reviewed. However, the number of studies examining the involvement of real patients in students’ education in clinical settings is very limited. To understand this untapped resource better and to promote its full realization, recommendations for nursing education and future research are made.     

Does peer-assisted learning improve academic performance? A scoping review

ObjectivesDue to the diverse and ever-changing nature of the healthcare industry, teaching pedagogies such as peer-assisted learning (PAL) are being implemented to align with external competency standards. A scoping review was conducted in order to map the breadth of literature available on PAL and its impact on student performance.MethodThis review used Arksey and O′Malley's six stage scoping methodology. The databases searched included: Cinahl, Ovid Medline, Proquest and Embase as well as grey literature sites and dissertations.Results22 articles were included in this review, 10 of which were mixed methods randomised controlled trials, one retrospective study, four controlled trials, two randomised cross over controlled trial, three prospective randomised controlled trials, one thesis and one comparative research design. Analysis of the included articles identified three major themes outlining student performance. Student teachers themselves showed the most significant improvement in objective outcomes. The predominant healthcare field addressed were medical students with very few studies being completed on other professions.ConclusionsThe search indicated an overall positive response to PAL with the measurable outcome of student tutors being of most significance. Further research is required to determine the relevance for the wider healthcare community.     

A scoping review to understand “leadership” in interprofessional education and practice

This scoping study examined how “leadership” is referred to and used in interprofessional education and practice. A total of 114 refereed articles were reviewed to determine how leadership is defined, conceptualised, and theorised. The review also examined what capabilities were identified for effective interprofessional leadership. The majority of papers were empirical studies undertaken by researchers based in North America. The majority of articles did not refer to a specific leadership approach, nor did they define, describe, or theorise leadership. Moreover, “leadership” capabilities were rarely identified. Articles generally focused on health practitioners and educators or students as leaders with little exploration of leadership at higher levels (e.g. executive, accrediting bodies, government). This review indicates the need for a more critical examination of interprofessional leadership and the capabilities required to lead the changes required in both education and practice settings. The goal of this article is to stimulate discussion and more sophisticated, shared understandings of interprofessional leadership for the professions. Recommendations for future research are required in both education and practice settings.     

Work-integrated learning as a pedagogical tool to integrate theory and practice in nursing education – An integrative literature review

It can be challenging for nursing students to navigate between theory and practice and to implement theoretical knowledge in real work situations and vice-versa. Work-integrated learning can support the students by enabling them to combine theoretical studies with practical work experience during their clinical placement. The aim of this integrative literature review was to identify models for the integration of theory and practice during clinical placements in nursing education by using work-integrated learning. Sixteen articles were found and analyzed using an integrative review method. Three themes were identified: 1) Supervisor support to enable students to develop a professional identity 2) Variety of modalities for teaching and 3) Collaboration between academic lecturers and clinical supervisors aimed at integrating theoretical and practical knowledge. Work-integrated learning enables students to integrate theory and practice, develop skills for knowledge-in-practice and prepares them for working life. It also supports the sharing of experiences between various healthcare professionals. This review identified a need for further research on work-integrated learning as a method for enhancing nursing students’ workplace learning.     

Exploring the contribution and impact of master’s education for leadership development in adult general nursing: A scoping review

AimThe aim of this scoping review was to explore the evidence relating to master’s education for leadership development in adult/general nurses who are not in advanced practice or leadership roles and its impact on practice.BackgroundThe importance of effective, clinical leadership in nursing and health care, has been highlighted following failings reported by Public Inquiries both nationally and internationally. While initiatives have been implemented to address these, the provision of safe, quality care remains problematic. Complex care requires highly skilled professionals to challenge and lead improvements in practice. Master’s education results in graduates with the skills and confidence to make these changes and to become the clinical leaders of the future.MethodsAn a priori scoping review protocol was developed by the review team. This was used to undertake searches across CINAHL Ultimate; Medline (Ovid), Scopus and ProQuest Complete databases, chosen due to their relevance to the subject area. Articles were limited to those in the English Language, peer reviewed and published since 2009. Citation chaining via the reference lists of frequently identified articles were also searched. A further search for relevant grey material using the same relevant keywords and phrases was performed using the limited, Trip Database and Google Scholar.ResultsEight articles were selected for data extraction, and these were published between 2011 and 2019. The articles were predominantly from the UK and Europe, with a focus either on master’s education or on aspects of leadership in nursing and healthcare. Themes identified: a) The need for clinical leadership; b) master’s education for clinical leadership skills; and c) master’s education for professional and organisational outcomes.ConclusionsThe scoping review identified that there is a need for strong clinical leadership in the practice setting. Evidence shows that effective nursing leadership can improve patient outcomes as well as enhancing workplace culture and staff retention. The review has shown that the skills required for clinical leadership are those produced by master’s education. Studies of the impact of master’s education are often self reported and tend to focus on nurses in advanced practice roles. More research is required into master’s education for adult/general nurses not in advanced roles and in examining the link between master’s education and improved patient, professional and organisational outcomes.     

The Internet of Things for basic nursing care—A scoping review

BackgroundThe novel technology of the Internet of Things (IoT) connects objects to the Internet and its most advanced applications refine obtained data for the user. We propose that Internet of Things technology can be used to promote basic nursing care in the hospital environment by improving the quality of care and patient safety.ObjectivesTo introduce the concept of Internet of Things to nursing audience by exploring the state of the art of Internet of Things based technology for basic nursing care in the hospital environment.Data sources and review methodsScoping review methodology following Arksey & O’Malley’s stages from one to five were used to explore the extent, range, and nature of current literature. We searched eight databases using predefined search terms. A total of 5030 retrievals were found which were screened for duplications and relevancy to the study topic. 265 papers were chosen for closer screening of the abstracts and 93 for full text evaluation. 62 papers were selected for the review. The constructs of the papers, the Internet of Things based innovations and the themes of basic nursing care in hospital environment were identified.ResultsMost of the papers included in the review were peer-reviewed proceedings of technological conferences or articles published in technological journals. The Internet of Things based innovations were presented in methodology papers or tested in case studies and usability assessments. Innovations were identified in several topics in four basic nursing care activities: comprehensive assessment, periodical clinical reassessment, activities of daily living and care management.ConclusionsInternet of Things technology is providing innovations for the use of basic nursing care although the innovations are emerging and still in early stages. Internet of things is yet vaguely adopted in nursing. The possibilities of the Internet of Things are not yet exploited as well as they could. Nursing science might benefit from deeper involvement in engineering research in the area of health.     

A review of the literature – The use of interactive puppet simulation in nursing education and children's healthcare

The use of puppets in health care is emerging as a mode of simulation that combines elements of engaging with the child through play whilst at the same time providing education. This review examines the impact when nurses use play therapy or puppets as a simulation modality in nursing education and in the clinical paediatric nursing environment. Electronic search was conducted using CINAHL, PubMed, Scopus, Web of Science and PsycINFO data bases, between 1980 and January 2015 with the combinations of play therapy; puppetry; nursing education; nursing; simulation; health professionals and puppets. Twelve articles were identified that highlight the use of puppet simulation in the education of nursing students and children in the healthcare environment. Puppet modelling and puppet simulation is predominantly adopted in the areas of health education and specifically diabetes education. Identified gaps in the use of puppet simulation in nursing, nurse education and puppet simulation as a three-way communication process; thus identifying the need for further research on puppet simulation and its application and benefits in nursing and nurse education.     

Instruments measuring interprofessional collaboration in healthcare – a scoping review

ABSTRACT

Worldwide there is growing understanding of the importance of interprofessional collaboration in providing well-functioning healthcare. However, little is known about how interprofessional collaboration can be measured between different health-care professionals. In this review, we aim to fill this gap, by identifying and analyzing the existing instruments measuring interprofessional collaboration in healthcare. A scoping review design was applied. A systematic literature search of two electronic databases, Medline (PubMed) and CINAHL, was conducted in 03/2018. The search yielded 1020 studies, of which 35 were selected for the review. The data were analyzed by content analysis. In total, 29 instruments measuring interprofessional collaboration were found. Interprofessional collaboration was measured predominantly between nurses and physicians with different instruments in various health-care settings. Psychometric testing was unsystematic, focusing predominantly on construct and content validity and internal consistency, thus further validation studies with comprehensive testing are suggested. The results of this review can be used to select instruments measuring interprofessional collaboration in practice or research. Future research is needed to strengthen the evidence of reliability and validity of these instruments.     

How are we assessing near-peer teaching in undergraduate health professional education? A systematic review

BackgroundNear Peer teaching (NPT) is reported as an effective pedagogical approach to student learning and performance. Studies in medicine, nursing and health sciences have relied mainly on self-reports to describe its benefits, focusing on psychomotor and cognitive aspects of learning. Despite increasing research reports on peer teaching internationally, little is known about the various domains of learning used in assessment of performance and objective learning outcomes of NPT.ObjectiveTo determine the domains of learning and assessment outcomes used in NPT in undergraduate health professional education.MethodsQuantitative systematic review was conducted in accord with the PRISMA protocol and the Joanna Briggs Institute processes. A wide literature search was conducted for the period 1990–November 2015 of fourteen databases. Grey literature was undertaken from all key research articles. Studies meeting the inclusion criteria were eligible for consideration, including measured learning outcomes of near-peer teaching in undergraduate education in nursing, medicine and health sciences. Set limitations included publications after 1990 (2015 inclusive), English language and objective learning outcomes. A quality appraisal process involving two independent reviewers was used to analyse the data.ResultsOf 212 selected articles, 26 were included in the review. Terminology was confusing and found to be a barrier to the review process. Although some studies demonstrated effective learning outcomes resulting from near-peer teaching, others were inconclusive. Studies focused on cognitive and psychomotor abilities of learners with none assessing metacognition, affective behaviours or learning outcomes from quality of understanding.ConclusionThe studies reviewed focused on cognitive and psychomotor abilities of learners. Even though evidence clearly indicates that metacognition and affective behaviours have direct influence on learning and performance, indicating more research around this topic is warranted. Methodological quality of the studies and lack of theoretical frameworks underpinned by educational psychology may have contributed to inconsistencies in learning outcomes reported.     

Collaboration between first year undergraduate nursing students – A focused ethnographic study

AimThe aim was to explore collaboration between first year undergraduate nursing students in a three-year bachelor program during clinical skills lab practices.BackgroundThe ability to collaborate is important in the nursing profession to ensure patient safety. Thus, efforts supporting nursing students with learning activities emphasizing this ability is crucial in nurse education as a preparation for the requirements of the nursing profession. Collaborative learning models are described as ways that support the students’ interaction during education. However, collaboration between students has shown to have challenges such as negative competition and confrontations. This stresses the need to explore the collaboration between students to find ways to support the interaction.DesignThe study was conducted with a focused ethnographic approach.MethodData were generated by participant observations during one semester, involving 70 h observation of 87 first year nursing students for 6 months and 24 training sessions in clinical skills lab practices. Two focus group discussions were used to elaborate students’ views of collaboration and to provide an opportunity for follow up questions and interpretations from the observations. Field notes and focus group discussions were interpreted as one unit of analysis conducted with thematic network analysis. A global theme were synthesized from organizational and additional basic themes presenting the overall metaphor of the students’ collaboration.ResultThe global theme, Between adaptation and non-conformity, revealed a field of tension in the nursing students’ collaboration. One the one hand, the global theme involved the students’ ability to adopt to new knowledge and to being a nursing student in a clinical skills lab and to others’ perspective. On the other hand, non-conformity creates a collaboration with less reflection between the students and non-synchronized and time-consuming laboratory work.ConclusionCollaborative activities in nurse education fosters and challenges nursing students’ collaboration required for clinical practices and later in the nursing profession. By the presented scaffolding efforts, nurse educators can arrange a learning environment that can support the collaboration between students and facilitate the transition into the profession.     

A clinical supervision model in bachelor nursing education – Purpose,content and evaluation

BackgroundCollaboration between universities and clinical placements has been highlighted as a weak point of the nursing education. To facilitate a good academic learning environment a clinical supervision model had been developed. The aim of this study was to evaluate to what extent the goals of the model were met after one and a half years of utilisation.MethodsA questionnaire was responded to by 30 head nurses, 12 main preceptors, 193 personal preceptors, and 11 clinical nurse lecturers.ResultsMost of the participants perceived that the quality criteria in the model were met to a large extent, the students' individual goals were achieved, and the supervision model contributed to fulfilment of goals, and assessment of the students. The nurse lecturers scored highest and the personal preceptors lowest in most of the questions. The conditions stated in the model were not always fulfilled. The deficiencies found were especially related to education level, time for supervision, and support to the personal preceptors.ConclusionsDespite some shortcomings the supervision model was considered by most participants as a valuable tool to be used in an academic nursing education. Improvements of the model in regard to the findings were suggested.     

The international focus—A neglected curriculum in global undergraduate nursing

International learning in undergraduate global nurse education is recognised for promoting essential cultural competence. This can be addressed both at university; through the increasing use of collaborative technology and in practice, where the impact of international placements has promoted cultural sensitivity and outward student mobility. The authors debate the barriers that impede students’ desire to take up international placements and review initiatives to promote a greater investment in this experience. The complexity and lack of transcultural principles that govern an international placement exchange have been addressed by one initiative to produce a robust pan-European quality audit process for clinical learning environments. In conclusion, the authors call for a greater and evaluated effort to increase global understanding and learning in the context of the COVID-19 response.     

Proctoclysis for rehydration in children – A scoping review and a pilot survey among medical doctors

Although proctoclysis (enema) is a historically proven, safe and cost-effective rehydration method that needs little training for users and can effectively replace intravenous hydration in different care settings, it is an uncommon choice for hydration in children with fever and is often missing in official guidelines. To evaluate the usefulness of proctoclysis, this study provides a scoping review of the existing literature. The matched literature was labelled in 5 categories, identifying 6 indication fields that are emphasized in the literature on rectal rehydration. The analysis showed that proctoclysis is mostly used in the context of diagnostic procedures, constipation or in the treatment of a gastrointestinal disease. It is also described as a quick, safe and cost-effective intervention for fluid replacement in emergency, critical care or resource-scarce settings. There are also socio-cultural variations in its use Additionally, we performed a survey on attitudes and experience of medical doctors towards proctoclysis based on a semi-structured questionnaire. In the survey, we analysed the experience of 35 medical doctors from 8 countries. Although we found a general acceptance of enema as beneficial in both hospitalized patients and in home care, doctors expressed the need for more experience with enema and the need for more education materials in order to effectively perform the procedure. Based on our findings, we suggest that further research is necessary examining the attitude towards proctoclysis among parents, nurses and doctors. Enema can have a considerable clinical advantage during home care for gastroenteritis or other infectious diseases with fever to prevent insufficient oral fluid intake resulting in a negative fluid balance. Risks and safety issues are rare and should be considered. However, due to its low level of social acceptability in order to reduce refusal rate, more education is necessary for both medical providers and parents.     

Can education make a difference to undergraduate nursing students' attitudes to psychiatric nursing?

The introduction of undergraduate nursing education throughout Australia has had serious implications for the position of psychiatric nursing in attracting graduates into this field. There is some evidence from the results of limited research that a more positive view of psychiatric nursing can emerge as the result of education. However, such a relationship has not been found to be strong. This paper reports the findings of a quasi-experimental research study, which compared student nurses' attitudes towards psychiatric nursing as a career option both before and after completing the psychiatric nursing component of the course. The post-test results demonstrate a strong and statistically significant increase in the popularity of psychiatric nursing. Analysis of the open-ended responses suggests that exposure to the theory and practice of psychiatric nursing has dispelled many myths regarding this area of practice. The possible impact of problem-based learning on these results is discussed.