Mental health stigma and undergraduate nursing students: A self-determination theory perspective

BackgroundClinical placements are essential in preparing students for professional practice. Given the serious negative impact of stigma on people with lived experiences of mental illness, it is essential to explore whether the educational setting of a clinical placement can influence mental health stigma.AimsUsing a Self-Determination Theory lens, this study aimed to examine whether the educational setting of a clinical placemen influences the stigma of undergraduate nursing students toward people with lived experiences of mental illness.DesignQuasi-experimental; pre-test post-test.MethodsNinety-nine undergraduate students enrolled in an accredited nursing program within Australia completed two surveys pre- and post-clinical placement. The surveys measured the educational setting (learning climate) and mental health stigma (social distance).FindingsStudents who partook in an Autonomy-Supportive mental health clinical placement reported a significant decrease in stigma from pre-to-post placement, whereas the Balanced/Neutral group reported a significant increase in stigma from pre-to-post-placement.DiscussionThe findings of this research have considerable implications for nursing facilitators and preceptors. Those that support autonomy amongst future nursing professionals are more likely to positively influence students’ mental health stigma. Those who do not promote an autonomy-supportive setting may actually worsen mental health stigma.ConclusionThe educational setting in which a clinical placement occurs can influence nursing students’ mental health stigma.     

Peanuts,Popcorn, and Pediatrics: School-Based Carnival for Health Promotion

A carnival themed health fair was designed to enhance a pediatric clinical experience through service learning in an undergraduate Associate degree nursing program. The goal of this pilot was to foster pediatric health promotion by connecting nursing students with elementary students classified as a vulnerable population. Senior nursing students created, designed, and implemented an interactive learning activity for 225 children. Kolb's Experiential Learning Theory was the framework utilized for project organization and development. Nursing faculty guided students in identifying issues specific to contemporary pediatric health concepts, but creative and artistic control was given to the student. Students utilized a web-based learning platform to document the journey for the project from inception to informal evaluation. Students achieved pediatric course and program outcomes by working collaboratively with the community in an innovative format. This school-based carnival offers a valued contribution for collaborative connections utilizing innovation and creative methods.     

Creating and sustaining an academic‐practice Partnership Engagement Model

Public health clinical educators and practicing public health nurses (PHNs) are experiencing challenges in creating meaningful clinical learning experiences for nursing students due to an increase in nursing programs and greater workload responsibilities for both nursing faculty and PHNs. The Henry Street Consortium (HSC), a collaborative group of PHNs and nursing faculty, conducted a project to identify best practices for public health nursing student clinical learning experiences. Project leaders surveyed HSC members about preferences for teaching‐learning strategies, facilitated development of resources and tools to guide learning, organized faculty/PHN pilot teams to test resources and tools with students, and evaluated the pilot team experiences through two focus groups. The analysis of the outcomes of the partnership engagement project led to the development of the Partnership Engagement Model (PEM), which may be used by nursing faculty and their public health practice partners to guide building relationships and sustainable partnerships for educating nursing students.     

The Bucket List: a service-learning approach to community engagement to enhance community health nursing clinical learning

Community health nursing education at the undergraduate level is experiencing new and distinct challenges. Reduction in funding for public health services creates fewer resources and learning opportunities for students. To effectively deal with this problem, it is necessary to reconsider how clinical experiences are implemented. Using a service-learning theoretical framework to engage students in a mutually beneficial relationship with underserved and vulnerable populations could address the issue. The "Bucket List" of service-learning and community engagement activities was developed with the goals of improving quality and comprehension of community health didactic, addressing the need to restructure community health clinical experiences, and meeting projected demands for community health nursing services in partnership with communities.     

Practice nurses experiences of mentoring undergraduate nursing students in Australian general practice

Internationally, the delivery of health services has shifted from secondary to primary care, necessitating an exponential growth of the nursing workforce and expansion of the nursing role in general practice. This growth, and the subsequent need to develop this workforce, has created a need to expose undergraduate nurses to general practice nursing as a viable career option. Concurrently, universities are struggling to find sufficient clinical places for their undergraduate students to gain clinical experience. It is logical, therefore, to increase the number of undergraduate nursing student placements in general practice. Through qualitative research methods, this paper seeks to explore the experiences of practice nurses mentoring undergraduate students on clinical placements within the general practice setting. Findings are presented in the following three themes: (1) Promoting Practice Nursing: We really need to get students in, (2) Mentoring future co-workers: Patience and reassurance, and (3) Reciprocity in learning: It's a bit of a two way street, which show the benefits of such placements. Clinical placements in general practice settings can be mutually beneficial in terms of providing quality teaching and learning experiences for students. Conversely, the experience provides an impetus for practice nurses to maintain currency of their clinical skills and knowledge through mentoring student nurses.     

Collaborative learning among undergraduate students in community health nursing

Teamwork can benefit students, enhancing their ability to think critically, solve problems creatively, and collaborate effectively. We piloted a collaborative learning project with undergraduate community health nursing students (N = 83) that entailed working in teams to explore epidemiologic data, synthesize the literature, and develop an evidence-based plan for nursing intervention and evaluation pertaining to a public health issue. Project evaluation consisted of pre- and post-project surveys by students, peer evaluation, and formative and summative evaluation by faculty. Having students work in teams, while challenging both for faculty and students, may be a viable strategy for preparing the next generation of nurses for inter- and intraprofessional collaboration. Our experience suggests that instituting a collaborative learning experience as part of an undergraduate course in community health nursing can be an effective way to expose students to constructive approaches to teamwork and prepare them for evidence-based nursing practice in the future.     

The shadowing experience: valuing the link between faculty practice and student learning.

Nurse faculty members, engaged in active, clinical practice roles, can enhance student learning through a shadowing experience. A shadowing, or observational, experience was designed by the writer to enhance undergraduate student learning, contribute to student socialization to the profession, and assist students to develop career goals. The shadowing experience linked an undergraduate student with the faculty member in a learning partnership in an advanced practice clinical setting. Fifteen undergraduate nursing students participated in a pilot shadowing experience with a faculty member in her private practice. Both the students and faculty reported that the experience was mutually rewarding. Students reported they were able to learn new information, apply theory from the classroom, and develop interest in graduate school. The shadowing experience provided the faculty member with an opportunity to show the value of her clinical practice within a traditional academic environment. The value of the shadowing experience for the faculty member can be enhanced by formal mechanisms that support faculty clinical practice work.     

Developing an evening clinical experience for baccalaureate community health nursing students

With the ever-changing directions in health care delivery, baccalaureate nursing instructors are being challenged with the task of seeking out innovative approaches to community health nursing clinical experiences. With the focus on "community as client," an evening clinical program was designed and piloted for nontraditional nursing students who, because of daytime employment, were in need of evening courses to further their nursing education. The pilot project incorporated family nursing care, community-centered practice, and observational experiences. The evening community health nursing clinical experience was found to be mutually beneficial to clients and students and served to fill a gap in health teaching within the community.     

Community Health Nursing Student Experience in Nicaragua

International clinical experiences can provide excellent opportunities for nursing students to practice community health nursing, enhance their global perspective, and increase their cultural awareness of vulnerable populations. Selected students from the Georgetown University nursing program spent part of their winter intercession in Nicaragua, working with a vulnerable population in an impoverished community. Students cared for families, worked in clinics, conducted health teaching sessions to large groups in the community, and held a health fair. A community assessment provided an experience in learning about the resources and demographics of the community. The program was feasible through the collaboration with the local Nicaraguan university nursing program.     

Myths and mysteries of mental health: An interagency collaboration

This paper explores a practice learning collaboration between a group of undergraduate mental health nurses (N = 12) and second year high school pupils, (age 13/14 years old). A case study approach is employed as an example of an interagency learning activity in the undergraduate curriculum. Nursing students and high school teachers worked together to develop five three workshops. Each workshop contained five ‘tabletop’ group activities around themes such as confidence building; friendship skills and diet and health. The overall aim of the workshops was to provide an atypical experience for mental health nursing students in which the setting is an everyday environment (school); with young people who were not ‘patients’ or ‘clients’, and that focuses on health rather than ill health. In addition the activity aimed to broaden school pupils understanding and knowledge of mental health and well-being. Outcome: Pupils completed a closed question evaluation at the end of the workshop that demonstrated the workshops were effective in improving understanding. In addition, the nursing students presented their experience of the interagency activity at a national conference. The paper will explore the social and educational benefits of interagency learning, and concludes that further research is required to identify the significant role schools have to play in developing a nursing workforce that is prepared for care that is centred around the concept of health and well-being and that focuses on the community as the principle for setting for intervention.     

Special Features: Education: Challenges and Opportunities Associated with Preceptored Community Health Clinical Experiences

ABSTRACT Preceptored community experiences present challenges different from those of preceptored experiences in the acute care setting. Instead of focusing on psychomotor skills, faculty must address population‐based skills and assess students' abilities to practice these skills. Faculty and preceptors' lack of knowledge to teach these skills further complicate the experiences, an issue indirectly related to faculty and nursing shortages. Although preceptors guide students, faculty are responsible for evaluating students in community preceptored experiences. The Association of Community Health Nursing Educators (ACHNE) Essentials of Baccalaureate Education (Essentials) offers opportunities for guiding and evaluating community health preceptored clinical experiences. Assignments and activities that reflect the ACHNE Essentials provide a firm foundation for the population focus of the course. This focus is validated through faculty visits to students in a variety of community settings. To plan successful community experiences and evaluate students, faculty must be knowledgeable about the population focus of community courses, apply this knowledge to students in a variety of settings, and ask challenging questions to assess student learning.     

Developing cultural competence in nursing students through their experiences with a refugee population

Nursing students in an urban university in southwestern Pennsylvania began visiting newly relocated Somali refugees as part of their community health nursing (CHN) clinical course-work. The purpose of this qualitative study was to relate the students' experiences in their clinical visits with the refugees to the development of cultural competence. Findings identify the many challenges confronted by students and present strategies for resolution. The level of skills needed for the care of vulnerable populations should be considered when assigning undergraduate students to the clinical setting.     

Nursing as universal and recognisable: Nursing students'perceptions of learning outcomes from intercultural peer learning webinars: A qualitative study

BackgroundNursing students need to be prepared for the increasingly culturally diverse health care. Therefore, providing students with international perspectives remains the mission of higher education. However, given the logistic and financial constraints, not all students will be able to travel overseas for their international experiences. A feasible alternative to study abroad is internationalisation-at-home where intercultural dimensions are incorporated into curriculum, without students leaving their home universities. This paper presents findings from a collaboration between nursing programmes in Sweden and Hong Kong. The aim of the project was to explore how undergraduate nursing students' perceived achieved learning outcomes after participating in a web-based intercultural peer-learning intervention.     

International partnerships to promote quality care: faculty groundwork, student projects, and outcomes

Global health care is now considered a component of core knowledge for 21st century professional nursing practice. The authors describe laying the groundwork for an international experience and projects resulting from a partnership with a nursing program in the developing country of Guyana. In addition, the outcomes from undergraduate nursing international learning experiences for students and practicing nurses are reported. These outcomes provide support for the integration of study abroad as a strategy for enhancing the undergraduate nursing curriculum and ultimately professional nursing practice during the early years of practice.     

Clinical placements in general practice: Relationships between practice nurses and tertiary institutions

As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and models of clinical placement. This paper uses qualitative research methods to explore the perspectives of 12 Australian general practice nurses who have experience in facilitating undergraduate clinical placements about the relationships between HEIs and nurses. Findings are presented in the following three themes: (1) Appropriate preparation for placement: They don't know what primary health really means, (2) Seeking greater consultation in the organisation of clinical placements: they’ve got to do it one way for everyone, and (3) Uncertainty and lack of support: I had no contact with the university. Clinical placements in general practice can be an innovative strategy providing non-traditional, yet high quality, teaching and learning experiences for undergraduate nursing students. To optimise the quality of these placements, however, it is essential that HEIs provide appropriate support to the practice nurses mentoring these students.     

Combining community health and psychosocial nursing: a clinical experience with the homeless for generic baccalaureate students

A report is made of a teaching approach which combined community health and psychosocial nursing clinical experiences for senior level, generic, baccalaureate nursing students over a period of two academic quarters. An urban community center and shelter for the homeless was the setting for this unique clinical approach. Areas on which the evaluation of the clinical experience focused included the clinical design, student activities, types of clients seen, and student and faculty views. Strengths and limitations of the experience were identified. The progression of the student group in adapting to the homeless population was described in detail. Faculty concluded that by sharing their clinical expertise in this combination clinical setting with the homeless, generic students were able to maximize and coordinate their academic and clinical activities. The homeless setting is demonstrated to be an excellent arena for student learning when faculty provide structure, support, and guidance.     

Lab mentors in a two-plus-two nursing program: A retrospective evaluation

Peer mentorships improve learning outcomes, student satisfaction, and confidence levels in undergraduate nursing students. In addition, volunteering as a mentor supports leadership development and proficiency in nursing skills. This article retrospectively evaluates an educational intervention using peer mentors in a 2-plus-2 undergraduate nursing program. Students enrolled in this program take prerequisite classes at a community college, then enter the baccalaureate program at the junior level and begin their nursing courses, completing all course work on the community college campus. Senior nursing students mentored the incoming junior students during their first semester as they practiced essential nursing skills in the clinical learning lab. Junior nursing students participating in this mentorship program expressed increased confidence and decreased anxiety levels while practicing clinical skills with mentors. Senior lab mentors valued the opportunity to support junior students in skills practice, and believed participation in the mentorship program improved their own nursing skills. There are several potential benefits of extending peer mentorships to the clinical lab setting for this unique student population as they transition to a baccalaureate nursing program.     

The integrative clinical preceptor model: a new method for teaching undergraduate community health nursing

The Integrative Clinical Preceptor Model was designed to provide a framework for undergraduate clinical education in community health nursing. The model is based on reciprocal collaboration between students, preceptors, and faculty. Implementation of the model has resulted in individualized, population-focused experiences for students based on the principles of service-learning, empowered preceptors who are able to increase their scope of service, and increased productivity for the faculty in research and scholarship. The authors describe the collaborative partnership between a school of nursing and nurses in community health settings that has resulted in excellent clinical experiences for undergraduate nursing students.