Exploring the meaning of undergraduate nursing students' experiences and confidence in clinical skills using video

BackgroundStudents and health care faculty staff report a lack of confidence in graduating nurses' clinical skills practice. Traditional approaches to support nursing students' clinical skills development have relied on small group, face-to-face, practice-based learning in clinical laboratories. However, with changing curricula, increased numbers of students, and pressure on laboratory timetables and availability, alternate methods of delivery are necessary to ensure students gain confidence in the development of their clinical skills. Video podcasting is an innovative approach that is being used to stimulate active and ongoing learning of clinical skills.DesignA hermeneutic phenomenological approach.MethodData were collected through in-depth interviews with 10 second-year, undergraduate nursing students about their experiences using three clinical skills video podcasts and their perceptions of how this impacted on their learning of these clinical skills and confidence in practice.FindingsThree themes emerged from the data: ‘Accessibility for learning the skill’; ‘Preparation for learning and practice’; and ‘Student-directed learning’. These themes provided an insight into the students' engagement with video podcasts, demonstrating their sense of confidence was increased in clinical skills development.ConclusionThe findings of this study provide an insight into the students' engagement with video podcasts in relation to their confidence in clinical skills development, and indicate that undergraduate nursing students value the use of video podcasts in their learning of clinical skills. However, it was evident that students still value face-to-face delivery to guide their study, which suggests that video podcasts could be used as an adjunct to teaching to support learning.     

Impact of experiential dementia care learning on knowledge,skills and attitudes of nursing students: A systematic literature review

AimThe aim of this systematic review was to synthesize evidence on the effect of clinical experiential learning approaches on pre-licensure nursing students' competence in dementia care and to identify associated challenges.BackgroundAs the prevalence of dementia increases, nurse educators must proactively prepare pre-licensure nursing students to care for people living with dementia. The limited number of physical clinical learning settings, especially during the current COVID-19 pandemic, has caused many nursing programs to use alternative experiential learning approaches.DesignSystematic Literature ReviewMethodsIn accordance with PRISMA guidelines, we conducted a systematic search for the literature in Cumulative Index to Nursing and Allied Health Literature, MEDLINE and ProQuest for relevant peer-reviewed studies published between 2010 and 2021. Using the Boolean operator search approach, the keyword "dementia care" was combined with "AND/OR" and other search terms. In addition, a descendent and an ascendent search were conducted to find other relevant studies.ResultsA total of 17 retrieved articles met the inclusion criteria. Five themes emerged, with the main findings being that face-to-face (in person), virtual and simulated experiential learning approaches increased pre-licensure nursing students' dementia care knowledge. However, the face-to-face experiential learning approach that provides physical contact with people living with dementia and clinical staff had more impact on their skills and attitudes.ConclusionThe evidence in this review could inform curriculum development, teaching methods, experiential learning experiences and clinical placements of pre-licensure nursing students with regards to dementia care. More research is needed to explore further the impact of virtual and simulated experiential learning approaches on pre-licensure nursing students' dementia care skills.Tweetable abstractThis systematic literature review synthesizes evidence of clinical experiential learning on prelicensure nursing students' competence in dementia care per PRISMA guidelines. Five themes emerged #dementia #experientiallearning #prelicensurenursingstudents #clinicalsducation     

Bringing simulation to the classroom using an unfolding video patient scenario: A quasi-experimental study to examine student satisfaction,self-confidence,and perceptions of simulation design

BackgroundTeaching strategies to promote experiential learning in the classroom are important to facilitate students' clinical reasoning abilities. Using video to simulate unfolding patient scenarios in the classroom has the potential to engage students through active learning and to enhance their ability to connect theory to practice.ObjectivesStudy objectives were to: (1) Evaluate nursing students' satisfaction and self-confidence in learning and perceptions of the design of a simulated patient scenario delivered via video in the classroom and (2) Compare findings to students' satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulation experiences in the laboratory.DesignA quasi-experimental approach was used.SettingThe study setting was a nursing classroom at a University in the southeast United States.ParticipantsConvenience sampling was utilized and 54 students in their final semester of a pre-licensure baccalaureate nursing program participated.MethodsThe intervention was an unfolding video patient scenario delivered in the classroom. Prior to the intervention, participants completed two measurement tools to collect information about their satisfaction, self-confidence, and perceptions of the design of prior high-fidelity simulations. After the intervention, these tools were administered again to collect data about the video simulation experience in the classroom.ResultsParticipants had a higher level of satisfaction (p = 0.002) and self-confidence (p < 0.001) following the classroom intervention than for prior high-fidelity simulations in the laboratory. Student perceptions of the simulation design were more favorable for the classroom intervention than for prior laboratory simulations (p < 0.001).ConclusionsUse of unfolding video patient scenarios in the classroom can promote student engagement in learning. Nurse educators should consider this teaching strategy that provides students with opportunities to connect and apply classroom content to patient care.     

Baccalaureate nursing students' experiences with multi-patient,standardized patient simulations using telehealth to collaborate

BackgroundNurse faculty must utilize teaching strategies that promote student achievement of essential competencies, and simulation can provide experiential learning to help prepare students for professional practice.PurposeThe purpose of this phenomenological qualitative study was to explore baccalaureate nursing students' experiences with multi-patient, standardized patient simulations that used telehealth to provide opportunities to learn and practice intra- and interprofessional collaboration. Student perceptions of their ability to utilize lessons from the simulations in clinical practice were also examined.MethodsFocus group interviews were conducted with 27 final-semester baccalaureate nursing students after they had participated in two telehealth-enhanced simulations.ResultsAnalysis revealed five themes: Anxiety due to lack of experience, Improved clinical reasoning, Real world practice, How to communicate effectively, and Application to clinical practice.ConclusionThe use of telehealth helped overcome barriers to implementing collaborative simulations and provided students with experiential learning that addressed essential competencies for safe and effective professional nursing practice.     

Non-academic admission criterion of certified nursing assistant status for undergraduate nursing programs: A comparative case study

BackgroundThe number of nursing program graduates does not meet the current demand for nurses. Program faculty relies on the predictive power of admission criteria to admit students who will be successful. Non-academic admission criteria, such as Certified Nursing Assistant (CNA) status, should be considered to complement academic criteria.PurposeThis study aimed to explore nursing students' perceptions and clinical faculty of the non-academic prerequisite of CNA status as an admission criterion. First-year students' preparedness for the clinical setting, self-confidence, and anxiety in clinical decision making (CDM) was considered.MethodA multi-methods comparative case study design was utilized. The setting was two undergraduate baccalaureate nursing programs. Nine faculty and 54 students participated in the study. The researcher collected data through interviews with the participants, observations, document analysis, field notes, and self-report on the Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM) scale.ResultsThree themes emerged from the interview data: (a) student preparedness, (b) student learning, and (c) student program success. No statistically significant differences in student anxiety or self-confidence were found in the NASC-CDM scale.ConclusionThe investigation of CNA status could be an essential aspect of the undergraduate nursing program admission process.     

Undergraduate nursing students' perceptions of the effectiveness of clinical teaching behaviours in Malaysia: A cross-sectional,correlational survey

BackgroundClinical teachers are a critical determinant of the quality of nursing students' clinical learning experiences. Understanding students' perceptions of clinical teachers' behaviours can provide the basis for recommendations that will help improve the quality of clinical education in clinical settings by developing better clinical teachers.ObjectivesTo understand clinical teaching behaviours and their influence on students' learning from the perspective of undergraduate nursing students.DesignA cross-sectional, correlational survey.SettingA nursing faculty in Kuantan, Pahang, Malaysia.ParticipantsA sample of 120/154 (78%) students from Year 2–Year 4 were recruited according to set criteria.MethodsA self-administered questionnaire was employed to collect demographic data, and students' perceptions of clinical teaching behaviours and their impact on learning using the Nursing Clinical Teaching Effectiveness Inventory (NCTEI).ResultsYear 3 and 4 students perceived faculty clinical teaching behaviours positively. There was a significant association between clinical teaching behaviours and their influence on students' clinical learning. Teachers' competence rated as the most significant influential factor, while teachers' personality rated as least influential.ConclusionParticipants were able to identify the attributes of good clinical teachers and which attributes had the most influence on their learning. Overall, they perceived their teachers as providing good clinical teaching resulting in good clinical learning. Novice clinical teachers and nursing students can use this positive association between teaching behaviours and quality of clinical learning as a guide to clinical teaching and learning.     

Self-reflection during first clinical practice: The experiences of nursing students

BackgroundSelf-reflection can be used as a tool for describing student experiences and have a significant impact on their learning. It enables nursing students to develop the ability to identify and analyse their problems and find possible solutions.ObjectiveTo present students' self- reflection in their first clinical practice as their first stage of our nursing study program.MethodologyThe research was based on a naturalistic philosophical paradigm using a qualitative methodological approach. The research took place at one of the Slovenian universities with an undergraduate nursing education program. Purposive sampling was chosen. The data were obtained through written self-reflection diary entries collected between March and June 2016. A thematic analysis was selected for data analysis. Ensuring that all ethical considerations were covered, seventeen students in the first clinical practice were included.FindingsThree main thematic themes were identified that define the experience of students in their first clinical practice: (1) emotional experience, (2) interpersonal relationships, (3) learning.ConclusionsThe research has found that the experiences and the perceptions of students in the first clinical practice are mainly expressed emotionally. Self-reflection helps students to express emotions and feelings to reliving and to identifying problems and also, to understanding themselves better. Further research should be focused on the importance of the students' self-reflections in their professional and personal growth.     

Nursing students' reflections on the learning experience of a unique mental health clinical placement

IntroductionThere exists a need for innovative thinking to identify new clinical placement opportunities for nursing students. Recovery-based clinical placements for mental health nurse students remain unique and require investigation.AimTo examine the learning experience of Bachelor of Nursing students who undertook an innovative mental health clinical placement known as Recovery Camp.DesignThis study incorporated qualitative analysis of written reflections. Using Braun and Clarke's (2006) six phases of thematic analysis the corpus of student reflections were reviewed by three members of the research team independent to each other.FindingsFour themes emerged. The theme of Pre-placement Expectations incorporates participant foci on pre-conceptions of Recovery Camp. The theme of Student Learning incorporates the ways in which participants recognised the experience of Recovery Camp influenced learning. Reflections themed under the title Placement Setting include discussion of the Recovery Camp as a clinical placement. The theme of Future Practice incorporates students' reflections on how they plan to practice as nurses as a result the learning experiences of Recovery Camp.ConclusionsAn immersive clinical placement such as Recovery Camp can influence students' perceptions of people with mental illness, have a positive impact on student learning and influence students' decisions about future practice. The learning experience of nursing students whom attend unique, recovery-orientated clinical placements can be both positive and educative.     

Doctor of nursing practice students' perceptions of professional change through the DNP program

BackgroundThis thematic analysis study examined how post master's Doctor of Nursing Practice (DNP) students described personal and professional growth in their views of self, healthcare, and clinical practice that evolved as a result of the curriculum and experiences in the DNP program.PurposeThe purpose of this thematic analysis was to describe and discuss perceptions of graduating post master's DNP students regarding personal and professional development that occurred during the DNP program to identify how DNP graduates saw themselves change and grow during the course of the DNP program.MethodA thematic analysis method was used to code, categorize, and summarize data from 42 reflection papers of post master's DNP students into a thematic framework based on the eight DNP Essentials which are the framework upon which DNP programs build their curriculum and design student experiences. The authors systematically analyzed the statements from each student paper and drew interpretation of the students' statements into themes that were congruent with the eight DNP Essentials and one stand-alone category.ResultsData analysis yielded 15 themes that were aligned within eight categories of the DNP Essentials and one stand-alone category.ConclusionsThe eight DNP Essentials provided a framework for the themes which reflected professional growth attributed to the journey through the DNP program. A ninth category entitled Personal Advancements described students' perceptions of their personal and professional development. These dimensions are proposed in the new DNP Essentials currently in development. Increasing understanding of the DNP students' journey serves to inform DNP curriculum development and program experiences, and informs faculty of the influence they have on molding students into a more robust professional role.     

A scholarly concentration program to promote public health nursing for generalist Clinical Nurse Leader students

BackgroundThe number of public health nurses has decreased consistently and significantly since the 1920's. The recent COVID-19 pandemic has put a spotlight on the need for more public health nurses in the workforce. The number of novice nurses entering into public health roles is declining, demonstrating a clear need to mentor pre-licensure nursing students into the public health nursing workforce. Scholarly concentration (SC) programs are a method to explore specialty roles through in-depth scholarly activities, outside of core curriculum. However, SC programs have not been described in the nursing literature. The purpose of this paper is to describe the development of a SC program to engage pre-licensure Clinical Nurse Leader (CNL) students in scholarly activities related to public health nursing.Program overviewThis Public Health Nurse Scholars program was developed in 2014 with the goal of developing a cadre of generalist CNL students with experiences in public health nursing scholarly activities. The program aimed to increase awareness of career and scholarship opportunities through mentorship with public health nursing faculty. Students were encouraged to attend and present at professional conferences, participate in active scholarly projects and conduct quality improvement projects from a public health nursing perspective. The program was designed to foster students' public health nursing leadership and presentation skills and enhance their self-directed learning.ResultsTo date, 46 pre-licensure nursing students were selected as Public Health Nurse Scholars. Sixty-seven percent (n = 31) have graduated as Public Health Nurse Scholars; 33% (n = 15) are current Public Health Nurse Scholars. Twelve public health nursing faculty have served as mentors. As a result of the program 15 scholars attended and 3 scholars presented respectively at community/public health nursing conferences, and several scholars had related professional development opportunities. A majority of Public Health Nurse Scholars have designed and implemented a capstone quality improvement project with a public health nursing perspective, 15 of which were completed at community-based sites.ConclusionsIn the face of our current global, public health crisis, there is a clear need to develop a cadre of novice nurses prepared to enter the public health nursing workforce. The Public Health Nurse Scholars program shows promise towards encouraging an interest in public health nursing scholarship. Schools of nursing may consider the implementation of similar SC programs as an approach to mentor pre-licensure nurses in other specialty areas such as gerontological and neonatal nursing.     

Student Nurses' Experiences of Critical Events in the Clinical Setting: A Grounded Theory

BackgroundNursing students often experience critical events in the clinical setting and clinical instructors may not be prepared to adequately support them. These students often feel alone and abandoned, increasing their risk of psychological distress.PurposeA grounded theory study was conducted to explore pre-licensure nursing students' experiences of critical events in the clinical setting. Specific attention was paid to understanding how they are prepared for and supported before, during, and after critical events, and their experiences of psychological distress and psychological recovery.MethodStrauss and Corbin's Grounded Theory methodology was used for this study.ResultsFourteen undergraduate student nurses from universities in the western United States were interviewed. Ten concepts were identified, and a theory of Student Nurses' Experiences of Critical Events in the Clinical Setting emerged.ConclusionFindings indicate that student nurses need active instructor and/or staff support during critical events, and pre-briefing whenever possible. Debriefing positively affected students' post-event stress response and lack of debrief was associated with post-event psychological distress. Support for students exposed to critical events during clinical experiences should continue in the days, weeks, and months following the event; clinical instructors need to be prepared to provide this support. All faculty members should monitor students for signs of psychological distress and better support students' mental health and emotional wellbeing.     

Nurses' experiences of their competence at mentoring nursing students during clinical practice: A systematic review of qualitative studies

AimTo identify and synthesize the best available evidence on nurse mentors' experiences of their competence in mentoring nursing students during clinical practice.DesignThe research employed a systematic literature review that followed the guidelines of the Joanna Briggs Institute (JBI).Data sourcesThe databases CINAHL, Medline Ovid, Scopus, Eric, Web of Science, Medic, and OATD were systemically searched from 2000 to 2017.Review methodsThe identified studies were screened by title, abstract (n = 3080) and full-text (n = 91) using the following inclusion criteria: registered nurses, nurses' experiences of competence in mentoring nursing students, acute and primary care organizations providing clinical practice for nursing students, qualitative study. Quality appraisal was performed, data extracted and findings from the included studies (n = 21) were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI).ResultsA total of 92 extracted findings were aggregated into 21 categories and then further grouped into five synthesized findings: 1) creating an interactive relationship with the student; 2) developing mentor's characteristics and cooperation with stakeholders; 3) providing goal-oriented mentoring; 4) supporting students' development to nurse profession; 5) supporting the student's learning process.ConclusionsThis review demonstrated that multifaceted mentoring competence is essential to supporting students' learning processes and helping them become confident professionals. For this reason, the findings suggest that healthcare organizations which provide clinical practice for students should emphasize developing the mentoring competence of nurses by offering nurse mentors adequate education, ensuring that the organizational structure affords them sufficient support, and creating a receptive learning atmosphere.     

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.     

South African student nurses' experiences of professional nurses' role-modelling of caring

BackgroundStudent nurses are expected to implement a caring practice in order to become professional nurses. Caring has remained the art and science of nursing, which student nurses learn from professional nurses during clinical practice. The South African Nursing Council mandates professional nurses to teach and supervise student nurses to master the art of caring during clinical practice. Caring is taught through role-modelling of daily nursing activities.Research purposeThis study was performed to gain an understanding of South African student nurses' experiences of professional nurses' role-modelling of caring.MethodsPhenomenological, qualitative research. Purposive sampling of fourth-year student nurses. Data collection: focus groups, observations and field notes. The data were analysed using Giorgi's modified Husserlian five-step method. Ethical principles were respected.ResultsThree themes were identified. Theme 1: inconsistency in the clinical environment; Theme 2: effective and ineffective role-modelling of caring and Theme 3: carelessness cascading.ConclusionsThe study facilitated an understanding of student nurses' experiences of professional nurses' role-modelling of caring. Recommendations to facilitate professional nurses' role-modelling of caring in a public hospital were formulated: Mentorship training, recognition system for professional nurses, clinical support for student nurses, open channels of communication, random nurse leader rounds, employee wellness program, workshops and positive learning environment promotion.