Teachers' experiences of teaching in a blended learning environment

This paper considers teachers' experiences of teaching undergraduate nursing students in a blended learning environment. The basic idea of the study programme was to support students to reflect on theory and practice, and provide with access to expert and professional knowledge in real-life problem-solving and decision making. Learning was organised to support learning in and about work: students worked full-time and this provided excellent opportunities for learning both in practice, online and face-to-face sessions. The aim of the study was to describe teachers' experiences of planning and implementing teaching and learning in a blended-learning-based adult nursing programme.The research method was qualitative, and the data were collected by three focus group interviews, each with four to six participants. The data were analysed using qualitative content analysis.The results show that the blended learning environment constructed by the combination of face-to-face learning and learning in practice with technology-mediated learning creates challenges that must be taken into consideration when planning and implementing blended teaching and learning. However, it provides good opportunities to enhance students' learning in and about work. This is because such programmes support student motivation through the presence of “real-life” and their relevance to the students’ own places of work. Nevertheless, teachers require knowledge of different pedagogical approaches; they need professional development support in redesigning teaching and learning.     

Nursing first year of practice, past, present and future: documenting the journey in New Zealand

Aim  Documenting the journey of graduate nurse support in New Zealand from local programmes to a nationally consistent framework.
Background  Education of nurses in New Zealand has changed over the decades, from apprenticeship-style hospital-based training to academically prepared registered nurses. Newly graduated nurses require time to become confident within the clinical setting. To achieve this, a well-supported graduate nurse programme is required.
Evaluation  The authors utilized historical reviews of nursing education within New Zealand and current work being undertaken by a national working party to implement a nationally consistent graduate nurse programme.
Key issues  Disparity between locally delivered graduate programmes. Lack of funding to provide a well-structured programme and the impact on the recruitment and retention of new nurses.
Conclusions  It was identified that there was a strong need to ensure graduate nurse programmes were consistent across New Zealand in order to support graduate nurses and retain them in the workforce.
Implications for nursing management  The first year of practice remains a challenging transition time with a need for a well-structured and supported programme. Key needs include learning activities grounded in practice experience, robust programme coordination, skilled clinical educators, preceptors, and a structured learning framework.     

Postgraduate education for nurses: the Middlesex model

Nurse education has been subject to many changes and much debate and criticism over recent years. What has become increasingly evident is that with the changing nature of nursing within society, nursing curricula have to be more flexible and dynamic if they are to meet a multiplicity of needs. There is also a need to recognize that many levels of curricula will be required to prepare the nurses of the future. At Middlesex University the development of specialist practice programmes at postgraduate diploma level, and preparation of nurses for a higher level of practice at masters level has required the development of a new curriculum model which allows both the individualization of academic programmes to meet the needs of nurses, their clients and the organization in which they work, and the integration of development and learning through practice. This model is built on the results of an evaluation of an existing postgraduate programme in interprofessional health care. Key features of the curriculum development include a structured collaboration between student, practice mentor and academic supervisor, and the use of a professional development portfolio to individualize the academic programme and facilitate autonomous learning.     

Action learning sets in a nursing and midwifery practice learning context: A realistic evaluation

Action learning sets (ALS) are used widely for organisational and workforce development, including in nursing (Anderson and Thorpe, 2004, Pounder, 2009, Young et al., 2010). In the United Kingdom, a multi-faceted educational Pilot programme for new nurses and midwives was implemented to accelerate their clinical practice and leadership development (NHS Education Scotland, 2010). Action Learning Sets were provided for peer support and personal development. The Realistic Evaluation study reported in this paper explored issues of context, mechanism and outcome (Pawson and Tilley, 1997) influencing the action learning experiences of: programme participants (recently qualified nurses and midwives, from different practice settings); and programme supporters. A range of data were collected via: online questionnaires from 66 participants and 29 supporters; three focus groups, each comprising between eight and 10 programme participants; and one focus group with three action learning facilitators. The qualitative data pertaining to the ALS are presented in this paper. Thematic data analysis of context, mechanism and outcome configurations, generated five themes: creating and sustaining a collective learning environment; challenging constructively; collective support; the role of feedback; and effectiveness of ALS. Study outcomes suggest nursing and midwifery action learning should (a) be facilitated positively to improve participants' experience; (b) be renamed to avoid learning methodology confusion; and (c) be outcome focused to evidence impact on practice.     

Using the patchwork text assessment as a vehicle for evaluating students' perceptions of their clinical leadership development

A shift in universities world wide in providing theoretical post graduate programmes of study underpinned by traditional assessment strategies to work based learning programmes supported by innovative assessment strategies is required if Higher education institutions are to effectively educate contemporary healthcare leaders. Concurrently generating the evidence to evaluate the effectiveness of educational programmes is required by commissioners of healthcare education (DH, 2010).This paper reports on the perceptions of twelve post graduate students attending a clinical leadership masters programme of their leadership development through analysis of the critical commentary provided by students as part of assessment strategy that utilised the Patchwork Text Assessment.Following a thematic content analysis six themes emerged: programme philosophy and its impact on the success of the Patchwork Text Assessment; leadership development targeted against leadership frameworks; application and applicability of learning to the students own healthcare organisation; integrating theory to practice through theoretical development and work based activities; the value of networking; and the importance of multi-professional reflective groups.This study has clearly demonstrated how the success of the Patchwork Text Assessment in promoting deep learning is determined by its integration into the overall philosophy of the programme. Concurrently systems needed to be in place to ensure that Patchwork text Assessment is operationalised effectively and embedded within the day to day management of the programme.     

What is it that matters most in the practice of nursing children?

This article discusses the results of a workshop designed as an action research cycle to ascertain what matters most in the practice of nursing children in South Africa today. The workshop was convened at the University of Cape Town (UCT), in order to guide and direct the newly established post-basic, children's nursing pathway in the Bachelor of Nursing for Registered nurses [BN(RN)] programme. The participants were eight experienced paediatric nurses, currently practising in a variety of settings in the Western Cape. The results show that the participants move from their original task- and procedure-based perspective to a more processive one in which the focus of the learning is relational, emphasising the family and culture of the child.     

Opening up to learning spiritual care of patients: a grounded theory study of nursing students

Aim. To determine undergraduate nursing students’ perspectives on spiritual care and how they learn to assess and provide spiritual care to patients. Background. Nursing is concerned with holistic care. Systematic teaching and supervision of students to prepare them to assist patients spiritually is a growing focus. However, there is limited consensus about the competences students need to develop and little is written related to students learning processes. Design. Grounded theory was used to identify students’ main concern and develop a substantive grounded theory. Method. Data collected during semi‐structured interviews at three Norwegian University Colleges in eight focus groups with 42 undergraduate nursing students were analysed through constant comparison of transcribed interviews until categories were saturated. Results. The participants’ main concern was ‘How to create a professional relationship with patients and maintain rapport when spiritual concerns were recognised’. Participants resolved this by ‘Opening up to learning spiritual care’. This basic social process has three iterative phases that develop as a spiral throughout the nursing programme: ‘Preparing for connection’, ‘Connecting with and supporting patients’ and ‘Reflecting on experiences’. Conclusion. Nurses need a wide range of competences to fulfil the nursing focus on holistic patient care. Nursing education should prepare students to recognise and act on spiritual cues. A trusting relationship and respectful and sensitive communication assist students to discover what is important to patients. An educational focus on spiritual and existential themes throughout the nursing programme will assist students to integrate theoretical learning into clinical practice. Relevance to clinical practice. Study participants reported seeing few role models in clinical settings. Making spiritual assessment and interventions more visible and explicit would facilitate student learning in clinical practice. Evaluative discussions in clinical settings that include spiritual concerns will enhance holistic care.     

Using computer-assisted learning to gain knowledge about child death and bereavement

Computer-assisted learning (CAL) can be a useful tool in helping nurses to learn about child death and bereavement. A CAL package on the care of children with life-limited illnesses and their families has been designed, developed and evaluated with students on the diploma in nursing (child) programme. Early indications are that CAL, in conjunction with teacher support, can offer a means to allow individuals to work at their own pace, apply learning and explore new learning in a non-threatening environment. This article argues that the skills required to care holistically for children with life-threatening illnesses and their families are complex. Extensive applications of previously learnt transferable skills, as well as a good grasp of multidisciplinary working, are needed. In turn, these skills are transferable and applicable in almost any other professional situation. CAL combines different learning styles, such as factual information giving, enquiry-based and practice-based learning; therefore, integrating learning about child death and bereavement both in theory and in practice.     

Clinical exchange: one model to achieve culturally sensitive care

This paper reports on a clinical exchange programme that formed part of a pre-registration European nursing degree run by three collaborating institutions in England, Holland and Spain. The course included: common and shared learning including two summer schools; and the development of a second language before the students went on a three-month clinical placement in one of the other base institutions' clinical environments. The aim of the course was to enable students to become culturally sensitive carers. This was achieved by developing a programme based on transcultural nursing principles in theory and practice. Data were gathered by interview, focus groups, and questionnaires from 79 exchange students, fostering the strategies of illuminative evaluation. The paper examines: how the aims of the course were met; the factors that inhibited the attainment of certain goals; and how the acquisition of a second language influenced the students' learning about nursing. A model is presented to illustrate the process of transformative learning from the exchange experience.     

Integration of research and nursing experiential learning: a case study

Teaching research to undergraduates has it own challenges and involving undergraduates in research practical experience is just one of those challenges. As nursing students are in the process of becoming professional nurses, knowledge and skills in research are specific outcomes of the curriculum. One of the outcomes of the B Tech Nursing Science programme offered by the Tshwane University of Technology states that for the baccalaureate nursing programme include analysis, interpretation and utilisation of a range of research findings in scientific nursing and midwifery care as well as the development of a research protocol in a given context. In an effort to ensure that students would experience research as an essential part of their daily activities, an integrated approach is suggested whereby the nursing experiential learning opportunities are also research experiential learning opportunities. Using the integration strategy, research theory come 'alive' for the students. The integration approach is uncomplicated and transferable to any other discipline. The case study presented is the second year nursing students using school nursing experiential learning as a research project. The second year nursing students have a community focus during their second year and one of the experiential learning opportunities is school health nursing in a primary school in Tshwane. The results of the school health survey are presented. The students developed a health education intervention based on the research results.     

Involving people with learning disabilities in nurse education: towards an inclusive approach

There is limited evidence that explores how to effectively include people with learning disabilities in nurse education in the U.K. The majority of reported work relates to mental health nursing and social work training (Morgan and Jones, 2009). This paper specifically reports on the processes and activities undertaken by the authors with people with learning disabilities in the development of a new BSc learning disability nursing programme, a specific branch of nursing in the U.K. In doing so, findings and discussion from two separate projects involving students and people with learning disabilities will be integrated into the paper. EPICURE (Engagement, Processing, Interpretation, Critique, Usefulness, Relevance and Ethics (Stige et al. 2009) is adopted as a qualitative framework throughout the paper to evaluate the reported work that took place between September 2006 and October 2010. Suggestions are therefore made regarding the benefits and challenges of striving towards an inclusive approach to user involvement in nurse education, with particular reference to learning disability. The work presented in the paper demonstrates how through careful involvement of this population, deeper learning opportunities for all nursing students can be created.     

The need for specialist nurses to work with older people

This article is based on a comprehensive literature review undertaken by the Royal College of Nursing gerontological nursing programme on the development of specialist gerontological nursing practice (Schofield et al, 1998). The scope of the original review covered the development of specialist nursing, frameworks for practice, accreditation and regulation, role components and competencies, methods of evaluating the specialist role and fields of practice. The literature review's purpose was to inform work on the development of a specialist gerontological nursing BSc (Hons) degree by distance learning. This article focuses on the key findings of the literature review, setting out the potential for the introduction of specialist gerontological nurses in the UK.     

Teaching information literacy skills: an evaluation

This paper describes an evaluation of a curriculum-integrated information literacy programme in an undergraduate nursing course. The aim of the programme was to provide students with an awareness of the discipline's literature and the skills to locate and retrieve the literature. A multidimensional process for determining nursing students' development was utilised in the evaluation of the programme. Pre- and post-programme questionnaires were distributed to a cohort of students who undertook the programme. A cohort of more senior students who had not undertaken the information literacy programme was utilised as a comparison group. Questionnaire results were analysed using a range of inferential statistics. This paper will focus on two main findings related to objective measures of information literacy skills. These include pre-programme/post-programme change in student performance and differences in student performance between those who undertook the programme and those who did not. The programme demonstrated its effectiveness in developing information literacy skills, however the challenge remains for both academics and students to ensure that these skills are consolidated and extended for effective life-long learning.     

Evaluation of students' satisfaction with nursing education in Norway

BACKGROUND: The use of standardized questionnaires for measuring student satisfaction in higher education is motivated by theories predicting a close relationship between students' satisfaction and learning outcomes. The reliability and validity of the Course Experience Questionnaire as an indicator of teaching performance have been established by factor analysis in earlier studies from several countries. The Nursing Clinical Facilitators Questionnaire has been used for measuring satisfaction with clinical practice. AIMS: The aims of this study were (1) to find out how satisfied nursing students in their last semester were with their clinical practice and the nursing programme as a whole, and (2) to measure the reliability and validity of the two standardized questionnaires. METHODS: The data were collected using the two standard questionnaires, combined with some background items, in a survey design. Exploratory factor analysis was performed. FINDINGS: A total of 276 nursing students from three university colleges in Western Norway answered the questionnaire in 1999/2000. The scores indicated slight overall dissatisfaction with the nursing programme, but general satisfaction with clinical practice. Furthermore, 70% of the students who expressed dissatisfaction with the quality of the nursing programme were nevertheless satisfied with clinical practice. The broad constituent structure of the Course Experience Questionnaire was replicated, with some deviation for the appropriate assessment scale. The Nursing Clinical Facilitators Questionnaire turned out to have two subscales, representing supportive and challenging behaviour, with satisfactory internal reliability. CONCLUSION: Annual evaluations using the two standardized questionnaires may result in greater focus being given to students' satisfaction with the nursing programmes and clinical practice in Norwegian nursing education departments. Comparative studies with the same instruments in other countries would also be of interest.     

A multi-professional full-scale simulation course in the recognition and management of deteriorating hospital patients

Introduction

Recognition and management of deteriorating patients is often suboptimal, resulting in adverse events that may be avoided if a unified understanding of the signs and needs of deteriorating patients is secured through the education of staff. This paper describes the planning and evaluation of a multi-professional, full-scale simulation-based course for hospital professionals.

Methods

A systematic approach to course development was used and the programme was introduced on four general wards in a university hospital. Experts from the wards were trained as educators and participated in the course development. A needs assessment consisting of an observational study, questionnaires and interviews resulted in the creation of learning objectives to provide the road map for content and teaching methods. A 1-day multi-professional ward-specific educational programme with full-scale simulations, mini-lectures, case discussions and practical training was planned. Course material, a manual for educators and questionnaires for evaluation of the course were developed.

Results

A 1-day full-scale simulation-based educational programme was developed and 50% of the medical staff and 70% of the nursing staff on four wards were trained in a 5-month period. The course was highly rated in terms of content and teaching methods.

Discussion

The systematic approach for developing the course resulted in a relevant, highly rated course, deeply rooted in the wards, implying the opportunity to facilitate local improvements and adjust the content to local needs.

Conclusion

The use of a systematic approach was successful in the development of this multi-professional full-scale simulation-based educational programme, which has proven to be easily applicable and usable.     

A framework for recognition of prior learning within a Postgraduate Diploma of Nursing Management in South Africa

jooste k. & jasper m. (2010) Journal of Nursing Management  18, 704–714
A framework for recognition of prior learning within a Postgraduate Diploma of Nursing Management in South Africa Aims The present study focuses on the development of an initial framework to guide educators in nursing management in designing a portfolio for the recognition of prior learning for accreditation of competencies within a postgraduate diploma in South Africa. Background In South Africa, there is a unique educational need, arising from the legacy of apartheid and previous political regimes, to facilitate educational development in groups previously unable to access higher education. Awareness of the need for continuous professional development in nursing management practice and recognition of prior learning in the educational environment has presented the possibility of using one means to accomplish both aims. Evaluation Although the content of the present study is pertinent to staff development of nurse managers, it is primarily written for nurse educators in the field of nursing management. Key issues The findings identify focus areas to be addressed in a recognition of prior learning portfolio to comply with the programme specific outcomes of Nursing Service Management. Further work to refine these focus areas to criteria that specify the level of performance required to demonstrate achievement is needed. Conclusion and implications for nurse managers Managers need to facilitate continuous professional development through portfolio compilation which acknowledges the learning opportunities within the workplace and can be used as recognition of prior learning.     

Shared teaching in health care ethics: a report on the beginning of an idea

In the majority of academic institutions nursing and medical students receive a traditional education, the content of which tends to be specific to their future roles as health care professionals. In essence, each curriculum design is independent of each course. Over the last decade, however, interest has been accumulating in relation to interprofessional and multi-professional learning at student level. With the view that learning together during their student training would not only encourage and strengthen future collaboration in practice settings but also enhance patient care, the University of Dundee decided to run a pilot study to explore shared teaching in ethics between medical and nursing students. This article presents a report on the reasons for selecting health care ethics as a precursor for shared teaching, the educational tool used for the sessions, and the results of student and facilitator evaluation of the short course. Overall, despite problems such as poor attendance by some students, and facilitation and timetable difficulties, most of the feedback from students and facilitators has been positive. In essence the 'idea' has gone from strength to strength and there are now three levels of shared teaching in ethics between nursing and medical students, with plans to include further sessions with students from other disciplines. Within the text, 'health care ethics' will be referred to as 'ethics'; nursing students/nurses encompasses midwifery students/midwives.     

Views of the effectiveness of problem-based learning

AIM: To obtain the opinions of a group of mental health students on the effectiveness of problem-based learning (PBL) within a pre-registration nursing pathway. METHOD: Focus groups were used to generate data and the sample consisted of 14 mental health branch students who, within the pre-registration nursing programme, formed a PBL group. The group met on an annual basis at key junctures during the three-year diploma programme. The focus groups were tape-recorded and the data interpreted and organised by utilising an adapted form of content analysis. RESULTS: Four themes were identified regarding the use of PBL: the students' initial adjustment to PBL; the impact of PBL on their secondment status; the application of PBL in clinical practice; and the students' reflective critique of PBL. CONCLUSION: The discussion of the findings makes suggestions for the utilisation of PBL in future reviews of nursing curricula and outlines the implications for clinical practice. This includes the need to carefully plan the students' initial placement experiences and provide extra support at this stage. In addition, mentor preparation on the use of PBL in practice needs to be extended to ensure flexibility in the PBL process. It should be balanced with formal student support and courses must be planned to incorporate the learning needs of all discipline groups.     

Nursing students' perceptions of learning in the clinical setting of the Dedicated Education Unit

AIM: This paper reports a study to explore nursing students' experience of learning in the clinical setting of a Dedicated Education Unit using a communities of practice framework. BACKGROUND: The Bachelor of Nursing curriculum at the University of Canberra is clinically focused, recognizing the importance of learning to be a nurse in and from practice. A communities of practice framework underpins the philosophy of the Dedicated Education Unit model of clinical practicum. METHOD: In this exploratory qualitative study, a convenience sample of 25 second and third year nursing students participated in focus group discussions, conducted in 2004, to share their views of learning in the Dedicated Education Unit, a newly established model of clinical education. FINDINGS: Three major themes were identified: acceptance, learning and reciprocity, and accountability. Acceptance of students by clinicians assisted students to engage in nursing work. Students acknowledged the importance of peer learning in sharing experiences, reinforcing knowledge and enhancing confidence. Students accepted responsibility for their work and they valued this responsibility, but some questioned whether participation in all aspects of work constituted a learning opportunity. CONCLUSION: Engagement and participation in the clinical workplace are valuable for nursing students. Strategies to support learning in the workplace can be shared with students and clinicians. Further research to test the theoretical premises of the communities of practice framework in clinical nursing education is required.