Fourth year nursing students' perceptions of their educational preparation in medication management: An interpretative phenomenological study

BackgroundMedication safety is an integral aspect of patient safety. Nurses, as advocates of patient safety, actively consider medication safety in the course of their daily work. Hence, it is important to consider the educational preparation of nursing students in medication management, as future caregivers. There are inherent links between nurses' undergraduate educational preparation in medication management and patient safety.ObjectiveThis research study identifies fourth-year nursing students' perceptions of their educational preparation in medication management.DesignAn interpretative phenomenological methodological approach underpinned this research study.SettingThis study was conducted at a University in the West of Ireland.ParticipantsParticipants were final year students of three undergraduate nursing programmes, Bachelor of Science in Nursing (General), Bachelor of Science in Nursing (Intellectual Disability) and Bachelor of Science in Nursing (Mental Health).MethodsFourteen semi-structured, face-to-face interviews were conducted with students on a one-to-one basis. Data were analysed using thematic content analysis.ResultsThe voices and interpretations of the participants in this study were fundamental to understanding nursing students' perceptions of their preparation in medication management and provided the foundation for this research. These perceptions were captured in the format of four themes: developing an understanding, embedding knowledge in practice, engaging in practice and accepting professional responsibility.ConclusionsFindings point to the important role of the university and the clinical placement settings in nursing students' medication management education and the need for further collaboration and development across both settings. Teaching and learning strategies which promote the integration of theory and practice throughout the four years of the undergraduate degree programme should be encouraged, such as technology enhanced learning and simulation.     

Nursing students' self-reported experiences and attitudes regarding patient safety: A cross-sectional study comparing the classroom and clinical settings

BackgroundPatient safety education varies in nursing schools and therefore it is crucial to identify the educational needs of students by determining their skills, attitudes, and competencies regarding patient safety and medical errors.AimThis study was conducted to determine nursing students’ patient safety education competencies in the classroom and clinical settings, their attitudes towards medical errors, and the relationship between them.MethodsThis was a cross-sectional questionnaire study conducted with 204 nursing students. The participation rate was 96%. Data were collected using the Health Professional Education in Patient Safety Survey (H-PEPSS_TR), and the Medical Errors Attitude Scale (MEAS). A STROBE checklist was used to report findings.FindingsStudents’ patient safety knowledge and competence scores obtained from the H-PEPSS_TR were the highest for the ‘communicating effectively’ subscale in the classroom and for the ‘culture of safety’ subscale in the clinics while their ‘understanding human and environmental factors’ subscale scores were the lowest. The total H-PEPSS_TR scores in the classroom, ‘working in teams with other health professionals,’ ‘communicating effectively,’ ‘managing safety risks,’ and ‘understanding human and environmental factors’ subscales scores of the students who had positive attitudes according to MEAS were higher (p < 0.05).DiscussionStudents with positive attitudes towards medical errors had higher patient safety knowledge in the classroom; however, it did not affect patient safety competence in the clinical setting.ConclusionNursing students had positive attitudes towards medical errors. Their patient safety knowledge and competencies gained in the classroom were more than that developed in the clinical settings.     

Developing an internship program to support nursing student transition to clinical setting

BackgroundThe largest statewide hospital system collaborated with local nursing schools to provide a patient care internship program for nursing students. The goal was to create a pipeline of future nurses by equipping students for work in the clinical setting and promoting nurse retention.PurposeThe purpose of this project was to determine the correlation between the student nurse internship program on the interns' NLCEX-RN pass rates, retention rates for the local hospitals, cost-savings, students' confidence, and program satisfaction.MethodNursing students (n = 25) were recruited from local nursing schools for unlicensed assistant personnel positions at the system hospitals. The program included a six-week intensive to educate nursing students as non-licensed staff members of hospital units, which continues as a mentored experience during the senior year of their baccalaureate program. Qualitative and quantitative data were collected and analyzed.ResultsThe program had a pass rate of 96% for NCLEX-RN on first attempt. Additionally, 82% of participants were retained at the hospitals. Hospitals saved $216,993. Students reported increased role satisfaction with the program.ConclusionsProgram results suggest benefits of supportive NCLEX-RN pass rates, nurse retention, and cost benefit. Findings can be used to support future program expansion and improve the experience of nursing students as they transition into professional practice.     

Nursing handoff education: An integrative literature review

AimThis integrative review aimed to identify nursing students' experiences of handoff practices and the effects of handoff education in the curriculum on nursing student learning outcomes.BackgroundAppropriate handoff communication skills are essential for nursing students to maintain patient safety and prevent adverse events.MethodA systematic literature search was conducted with keywords related to nursing, student, and handoff in April 2020. Articles should focus on nursing students' handoff education published in English in 2015–2020. Eight articles met the inclusion criteria and were included in this review.ResultsNursing students reported discrepancies in handoff experiences; diverse factors influenced their handoff experiences, such as knowledge, anxiety, confidence, and type of student supervision. Various handoff educations were implemented across studies. Some handoff educations significantly improved nursing students' attitudes toward other disciplinary providers, satisfaction, confidence, quality, and clarity in handoff communication; some did not substantially affect their selected outcomes.ConclusionThis review identified that there are still limited handoff experiences among nursing students and many factors affecting opportunities for their handoff experience. Some handoff education (e.g., structured handoff formats, role-play, simulated scenarios) effectively improved students' communication clarity, confidence levels, and handoff education satisfaction. More handoff education is needed for nursing students to learn safe and quality handoff practices.     

The effects of using high-fidelity simulators and standardized patients on the thorax,lung, and cardiac examination skills of undergraduate nursing students

BackgroundExisting research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety.ObjectivesThe study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences.DesignA mixed-method explanatory sequential design.SettingsThe study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital.ParticipantsFifty-two fourth-year nursing students.MethodsStudents were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator.ResultsKnowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p < 0.001).ConclusionsResults of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups.     

Nursing students' perceptions of caring for dying people,after one year in nursing school

AimTo describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden.MethodsInterviews (n = 17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions.ResultsThe analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives.ConclusionNursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening.     

Use of a flipped classroom “Leadership in Nursing” course on nursing students' achievement and experiences: A quasi-experimental study

BackgroundProviding the undergraduate “Leadership in Nursing” course using an innovative approach is regarded to be very important in terms of enhancing leadership skills.PurposeThe purpose of this study was to evaluate the effect of using the “flipped classroom” strategy on nursing students' learning achievements and to describe their experiences of this technique.MethodThe course of “Leadership in Nursing” was delivered in flipped classroom format for 20 students while another 19 were exposed to traditional teaching methods. Therefore, the study was completed with 39 students. Data was collected using “Student Introductory Information Form”, “Exams (a midterm exam, a final exam and 4 assignments)”, “In-Class Observation Form” and “Student Feedback Form”.FindingsStudents in the flipped classroom group had obtained significantly higher scores than the students in the traditional teaching group regarding the assignments, the final exam, and overall grade. Concerning the flipped classroom, students reported flexibility as the most positive aspect and problems related to the system infrastructure as the most negative aspect.ConclusionThe usage of a flipped classroom for nursing students in the leadership course provided valuable results in terms of the students' exam scores and achieving course objectives. The flipped classroom strategy for the “Leadership in Nursing” course was shown to be effective in improving abilities such as distinguishing leadership skills, visioning, developing a new perspective, willingness to share experiences regarding leadership, also enabling students to work in harmony in group activities and to participate in classroom discussions, which are all essential elements of leadership.     

Professional commitment and attributional style of medical-college nursing students in China: A cross-sectional study

BackgroundThe persistent shortage of nurses has become a common phenomenon around the world. Nursing students' professional commitment affects their decision to choose nursing as a professional career. However, there is little knowledge about the professional commitment of nursing students, especially its relationship with attributional style.ObjectivesTo explore the professional commitment of nursing students and to identify the role of attributional style on nursing students' professional commitment.DesignCross-sectional study design.Settings and ParticipantsThis study was conducted at three different medical colleges in Jinan, Shandong Province, China and included 1230 nursing students. A total of 1223 valid questionnaires were returned, yielding a response rate of 99%.MethodsThe Professional Commitment Scale and the Multidimensional-Multiattributional Causality Scale (MMCS) were used to investigate nursing students' professional commitment and attributional style. Basic demographic information about the nursing students was collected. Stepwise regression analysis was used to analyze the data.ResultsThe mean scores on the Professional Commitment Scale were 3.54 ± 5.29 (mean ± SD). Professional commitment of first year students was higher than that of second year students. Their residence affected their affective commitment, ideal commitment, and continuance commitment which were the sub-dimensions of professional commitment. Effort and ability attribution positively influenced professional commitment; however, context attribution negatively influenced it.ConclusionsIt is imperative to take effective measures to improve nursing students' professional commitment. Our findings indicated that attributional style had a significant effect on professional commitment; thus, effort and ability attribution need to be emphasized.     

Nursing students' changing orientation and attitudes towards nursing during education: A two year longitudinal study

BackgroundPrevious studies have shown that nursing students' perceptions of nursing change over time. Little research has been undertaken in the Netherlands of students entering nursing programmes and of how they progress.ObjectivesThe aims of this study were to explore whether nursing students' orientation and attitudes towards nursing changed over time, when these changes occurred, and what factors influenced the changes. We also aimed to identify the factors which prompted them to consider leaving their programmes, and what factors affected their motivation to stay.DesignThe study used a longitudinal quantitative design.ParticipantsQuestionnaires were administered to all students enrolled in a Bachelor's of Nursing programme at four nursing universities of applied sciences in the Netherlands (n = 1414). The data for this study were collected during the first two years of the programme, from September 2011 to June 2013. A total of 123 respondents completed the survey each year and this group was used to examine changes over time.MethodsAt four time intervals respondents completed a survey consisting of 1) the Nursing Orientation Tool, 2) the Nursing Attitude Questionnaire and 3) background characteristics. Non-parametric tests were used to explore changes in factor scores over time.ResultsThe results showed an improvement in the students' orientation and attitudes towards knowledge, skills and the professional roles of nurses, while empathic behaviour decreased over time. Although the changes showed non-linear patterns over time, the results showed clear effects between the different time points. The reasons for attrition (24%) proved to be related both to problems with the educational programme and to personal problems. An important motivator for students to stay in the course was their passionate desire to become nurses, suggesting that the positive aspects of a nursing career dominated the problems they encountered.ConclusionsTutors and mentors should pay more attention to the individual perceptions and problems of first and second-year students, both in the classroom and during clinical placements. Knowledge of the students' perceptions from the very beginning could be vital to study success.     

Proactive personality,professional self-efficacy and academic burnout in undergraduate nursing students in China

BackgroundAcademic burnout can affect nursing students' academic performance and psychological well-being. Little is known about the associations between proactive personality, professional self-efficacy and academic burnout.PurposeTo assess the prevalence of academic burnout in undergraduate nursing students and to explore the associations between proactive personality, professional self-efficacy and academic burnout among nursing students in China.MethodsThis study used a cross-sectional design. Undergraduate nursing students were recruited from five medical schools in China to participate in an online survey from April to May 2020. The Proactive Personality Scale, Professional Self-Efficacy Scale for Nursing Students and Academic Burnout Scale were used to measure students' proactive personality, professional self-efficacy and academic burnout.ResultsA total of 1219 nursing students completed the questionnaire. The prevalence of academic burnout was 31.5% in nursing students, and improper behaviour showed the highest subscale score. Proactive personality, professional self-efficacy and academic year were negatively associated with nursing students' academic burnout.ConclusionsAcademic burnout is prevalent in undergraduate nursing students in China. This study contributes to the understanding of the associations between proactive personality, professional self-efficacy and academic burnout in nursing students. Nursing educators should develop strategies to enhance students' proactivity and professional self-efficacy to decrease their academic burnout.     

Emotional intelligence increases over time: A longitudinal study of Australian pre-registration nursing students

BackgroundEmotional intelligence (EI) has been associated with positive outcomes for nursing students. Higher EI is associated with personal wellbeing and stress management, higher academic performance, stronger nursing leadership and practice performance, and greater patient safety. While there is an increasing body of evidence on nursing students' EI, there is minimal evidence on EI over time during pre-registration programs.ObjectivesTo measure EI in pre-registration nursing students from program commencement to conclusion to ascertain EI over time and examine the relationship between EI and academic performance.Design and SettingLongitudinal repeated measures study between March 2010–February 2013 at a metropolitan university in Australia.Participants111 nursing students (74.8% female) contributed data on at least two occasions. Participants were enrolled in a pre-registration Master of Nursing degree. Half the cohort (55.0%) comprised Graduate Entry students who completed the course in two years full time. The other 45% were enrolled in an undergraduate degree in arts, science or health science, combined with the same pre-registration Master of Nursing Degree. These students completed their Combined Degree program in four years full time. Participants had a mean age of 24.7 years (SD = 7.36).MethodsEI was measured for commencing students (T1) using the Assessing Emotions Scale (AES), then a further three times: end of first year (T2; 9 months follow up); beginning of second year (12 months follow up; T3) and end of the program (T4; 24/36 months follow up).ResultsStudents' EI was found to increase across the program; one subscale of EI (managing others' emotions) was related to higher academic performance; and there was a significant increase in the Utilising Emotions subscale scores over time.ConclusionsPre-registration nurse education contributes to strengthening students' EI over time. Specific EI education scaffolded throughout programs is recommended in pre-registration curricula.     

Evaluating a patient safety course for undergraduate nursing students: A quasi-experimental study

BackgroundAlthough it has long been recognised that prelicensure education is essential for preparing nurses with the necessary patient safety competencies, patient safety education tends to be inadequately addressed in nursing curricula in South Korea and elsewhere.AimThis study examined the effectiveness of a recently developed 8-week standalone course on patient safety by comparing the patient safety competencies, knowledge, and attitudes of students who attended and did not attend the course, after controlling for baseline levels of each outcome measure.MethodsThe study used a quasi-experimental pretest-posttest design with a non-equivalent comparison group, with 40 undergraduate nursing students in the intervention group, and 67 in the comparison group. Outcomes included the total score and six subscale scores measured with the Health Professional Education in Patients Safety Survey, and the Patient Safety Attitude scale developed by the WHO patient safety program. Additionally, there was an objective measure of patient safety knowledge using 15 multiple-choice questions.FindingsAfter adjusting for baseline scores, Time 2 scores on all outcome measures were significantly higher in the intervention group than the comparison group, indicating the intervention's effectiveness. We found that the largest effect of the course accrued to patient safety knowledge. Overall, the students’ assessment of the course was highly positive.DiscussionOur patient safety course could be a model for teaching patient safety in undergraduate nursing curriculum.ConclusionThis study shows the potential for a standalone patient safety course to increase undergraduate nursing students’ patient safety competencies, knowledge, and attitudes towards patient safety.     

Nursing students' immunisation status and knowledge about viral hepatitis in Turkey: a multi-centre cross-sectional study

Yamazhan T., Durusoy R., Tasbakan M.I., Tokem Y., Pullukcu H., Sipahi O.R., Ulusoy S. & Turkish Nursing Hepatitis Study Group (2011) Nursing students' immunisation status and knowledge about viral hepatitis in Turkey: a multi‐centre cross‐sectional study. International Nursing Review 58 , 181–185 Background: The aims of this multi‐centre cross‐sectional survey were to detect Turkish nursing students' level of knowledge on viral hepatitis, to evaluate their rates of exposure to blood and to find out their hepatitis A (HAV), hepatitis B (HBV) vaccination status. Methods: This multi‐centre cross‐sectional study was conducted in 14 nursing schools located in the seven geographical regions of Turkey. A questionnaire composed of 47 questions on socio‐demographic factors, level of knowledge on HAV, HBV, hepatitis C (HCV) immunisation status, exposure history and attitudes was applied to the study group. Results: A total of 1491 third‐ and fourth‐year nursing students participated with an 89% response rate. The mean age of the participating students was 21.4 ± 1.3. Their mean knowledge score was 23.7 ± 4.6 (71/100) and was significantly higher in fourth‐year students than third‐year students. There were significant differences in mean scores among nursing schools. Among the participants, 85.3% had received HBV vaccine and 9.1% had received HAV vaccine. The percentage of students who signify themselves at increased risk of acquiring viral hepatitis was 97.3%. Of the students, 28.1% had sustained a needle‐stick injury and 5.4% had experienced conjunctival exposure to blood. Conclusions: Curriculum differences among nursing schools have a significant effect on nursing students' level of knowledge. For this reason, nursing schools should organize HBV immunisation programmes for their students to increase vaccination coverage.     

Nursing students' misunderstandings when learning about stroke care: A phenomenographic study

BackgroundConsidering the prevalence and complexity of a stroke, it is necessary to think about how undergraduate nursing students are developing knowledge for stroke care.AimTo obtain a vision of nursing students' learning, exploring difficulties concerning understanding stroke care delivery.DesignA phenomenographic research approach.Locations and ParticipantsThis research is based on written exam papers (n = 126) from third-year nursing students enrolled in the 2015–16 academic year in two Nursing Schools in Spain.ResultsThe analysis revealed four conceptions in which students demonstrated difficulties understanding stroke care delivery: 1) limitation of the neurological assessment to the level of consciousness and use of the Glasgow Coma Scale; 2) association of haemorrhagic stroke with hypovolaemia; 3) justification of the need for appropriate patient positioning and postural changes based solely on preventing pressure ulcers; and 4) assertion that strength exercises help improve spasticity.ConclusionsEmpirical identification of these conceptions among undergraduate nursing students, together with agreed definitions of learning outcomes, in the subject of stroke care delivery will allow educators to design evidence-based teaching-learning strategies.     

Implementing dedicated nursing clinical education unit: Nursing students' and preceptors' perspectives

BackgroundThe Dedicated Education Unit is a clinical learning model designated to deliver more targeted learning opportunities and enhance student nurses learning capacity. It provides students with more opportunities to develop their skills, experience different learning events, consolidate their knowledge, and build their professional nursing identity.MethodsThe study followed a convergent parallel mixed-method design to investigate the nursing students and the nursing preceptors' perceptions of the Dedicated Education Unit model at Mafraq hospital. Quantitative and qualitative data were collected from a sample of sixty-seven nursing students and 20 nursing preceptors from March to May 2019.ResultsThe overall results of the study were positive. Nursing preceptors were confident to communicate and constructively interact, motivate, and facilitate students' learning. However, they requested better support and more free time to supervise and answer students' questions. Nursing students reported positive learning at the dedicated units. However, they requested more support from nursing preceptors.ConclusionImplementing a Dedicated Education Unit model supported the nursing preceptors' role and enhanced nursing students' learning opportunities and hands-on experiences. Achieving a positive effect of the dedicated nursing clinical education unit requires constant collaboration between healthcare facilities and nursing education programs to maximize nursing students learning.     

Student engagement in higher education: A cross-sectional study of nursing students' particpation in college-based education in the republic of Ireland

BackgroundStudent achievement within the Higher Education Sector is predicated upon engagement with college/university life and engagement is identified as having a major impact on the acquisition of knowledge and cognitive growth. Evidence within the higher education sector identifies factors which impact positively and negatively on student engagement. However, the direct application of this evidence to nursing students whose programmes of study are fundamentally different to other non-professional degrees has not, as yet, been examined.ObjectivesTo explore undergraduate nursing students' engagement in college-based education and their perceptions of how their institutions support student engagement.DesignCross-sectional survey design.SettingsFour Higher Education Institutions (HEIs) in the Republic of Ireland.ParticipantsNursing students in first and final year (n = 634) undertaking a four-year Bachelor of Science Nursing (honours degree).MethodsThe National Survey of Student Engagement (NSSE) self-report questionnaire, which collects data on four core areas related to student engagement, was used. The statistical package SPSS version 21 was used to analyse the data. Independent t-tests were used to compare differences in engagement between students, depending on year of study (first and final year), institution type, and age.ResultsStudents engaged most in activities that are considered core to higher education: higher order learning, collaborative learning and effective learning strategies. Although students perceived that lecturers engaged in effective teaching practices, they reported limited out of class interaction with lecturers.ConclusionsThe insight gained from this study of the educational realities of contemporary nursing students will provide clarity for nurse educators, regulators, and policymakers in their efforts to support and enhance student engagement.