Nursing educators’ and undergraduate nursing students’ beliefs and perceptions on evidence-based practice,evidence implementation,organizational readiness and culture: An exploratory cross-sectional study

AimsTo describe the undergraduate nursing students’ and nursing educators' evidence-based practice beliefs, their extent of evidence-based practice implementation and their perspectives regarding organizational culture for evidence-based practice. To identify any relationship between the mentioned variables.BackgroundThe integration of evidence-based practice in nursing curricula is crucial to educate nursing students to incorporate evidence-based practice in their future clinical practice. Therefore, to promote its integration within nursing education, it is important to deeply understand how prepared academic institutions are for teaching about and supporting evidence-based practice integration.DesignCross-sectional study.MethodsNursing educators and undergraduate nursing students from nine Portuguese nursing schools were invited to participate in this study through an electronic survey comprising socio-demographic questions and the scales.ResultsSixty-eight nursing educators replied to the survey. Most were female, have PhD and have evidence-based practice training. They showed mean scores of 88.92 ± 8.18 for evidence-based practice beliefs, 40.20 ± 18.93 for evidence-based practice implementation and 80.59 ± 17.52 for evidence-based practice organizational culture and readiness. Concerning nursing educator sample, there were moderate and statistically significant relationship between: evidence-based practice beliefs and implementation; and evidence-based practice beliefs and organizational culture and readiness for school-wide integration of evidence-based practice. Between evidence-based practice implementation and organizational culture and readiness for school-wide integration of evidence-based practice, there was a small relationship.One hundred and sixty-seven undergraduate nursing students answered the survey. Mostly, they were female and were in third or fourth year of their nursing degree. Similarly, to educators, students showed mean scores of 58.69 ± 6.92 for evidence-based practice beliefs, 32.37 ± 16.97 for evidence-based practice implementation and 84.20 ± 23.48 for evidence-based practice organizational culture and readiness. Regarding undergraduate nursing student sample, there were moderate and statistically significant relationship between the different variables.ConclusionsBoth nursing educators and undergraduate nursing students had strong evidence-based practice beliefs, but low levels of evidence-based practice implementation. In nursing educators’ and undergraduate nursing students’ perspectives, there were opportunities in their schools for the development of an evidence-based practice culture. Based on results, support for development and testing of interventions, specifically tailored for promoting evidence-based practice implementation in nursing educational contexts, is recommended.     

Impact of the nurse-related information through social media use on undergraduate nursing students’ professional identity in nursing: A mixed-methods study

AimTo understand the impact of nurse-related information, through social media usage on undergraduate nursing students’ professional identity.BackgroundPrevious research has addressed professional knowledge and practice that affect the development of undergraduate nursing students’ professional identities. As an increasingly crucial factor in the internet age, social media needs to be explored in-depth for its influence on the professional identity in nursing.DesignSequential explanatory mixed method was used in this study.MethodsIn this quantitative study, participants (N = 698) completed an e-questionnaire survey between June and July of 2020. The relationship between main variables was analyzed by linear regression using SPSS 20.0. Then, face-to-face semi-structured and audio-recorded interviews were carried out among participants (N = 16) between January and March of 2021.ResultsThe quantitative findings indicated that the mean score of professional identity was 93.07 ± 11.96 in participants. The results of the linear regression showed that the year in school, whether nursing was the first choice, online time per day, frequency of reading official accounts related nursing on WeChat and appraisal of the online nurse-related information and so on explained 49.0 % of the variance in professional identity. Four major themes emerged from the qualitative study: 1) increased concern; 2) few and non-professional information; 3) encouraged by positive information; 4) limited impact of negative information.ConclusionsNurse-related information on social media has the potential to have an impact on undergraduate nursing students’ professional identity. Nursing educators should guide undergraduate nursing students to use social media appropriately and assist them in developing their professional identity with it.     

Development of the professional competence and professional self-concept of undergraduate nursing students during the clinical practice period: A cross-lagged panel analysis

AimTo explore the relationship of the development of professional competence and professional self-concept of undergraduate nursing students during the clinical practice period.BackgroundClinical practice is one of the most important aspects of nursing education. Nursing students combine theoretical knowledge, psychomotor skills and emotions in a professional socialization process through clinical practice sessions.DesignA two-time point longitudinal design was performed. A cross-lagged model was employed to analyze the relationship between the development of professional competence and professional self-concept of undergraduate nursing students during their clinical practice period.MethodsA total of 210 undergraduate nursing students were included in this study. The questionnaire was distributed two months and six months after their clinical practice started. Professional Self Concept of Nurses Instrument and Professional Competence Scale for Undergraduate Nursing Students were the two main instruments.ResultsBoth the professional competence and professional self-concept of Undergraduate nursing students increase at the end of the sixth month compared with the end of the second month after their clinical practice started. The results of the cross-lagged analysis showed that the professional self-concept was partially responsible for the development of professional competence. The effect of professional competence on the development of professional self-concept, in contrast, was not found in this study.ConclusionsClinical nursing educators should pay greater attention to the development of the professional self-concept of undergraduate nursing students. More attention should be paid to creating a supportive clinical learning environment to facilitate the improvement of undergraduate nursing students’ professional self-concept and professional competence.     

Investigation of the teaching cognition and capabilities of clinical advisers for masters degree level nursing specialty graduate students

PurposeTo assess the culturing cognition and teaching of core capabilities of clinical advisers for masters degree level nursing graduate students in order to provide criteria for selecting and training clinical advisers, and to monitor clinical teaching quality.MethodsA questionnaire was completed by 66 nursing specialty clinical advisers. The questionnaire was divided into three sections: basic condition, culturing cognition of the nursing specialty graduate students, and self-evaluation of teaching core capabilities as measured by the Clinical Nursing Teachers Core Capabilities Graphic Rating Scale.ResultsForty-five of the surveyed advisers served undergraduate level students (68.18%), and seven of them (10.61%) had experience advising graduate nursing students. The advisers, in general, had limited knowledge regarding guidance for nursing specialty graduate students. The self evaluation total score for core capabilities teaching was (120.55 ± 7.37), containing professional capability (4.47 ± 0.34), leadership capability (4.01 ± 0.22), problem solving capability (3.89 ± 0.30), and education teaching capability (3.65 ± 0.23). The highest scored item was the capability to assess and handle a patients' condition (4.44 ± 0.56), while the lowest scored item was the capability to do scientific research (3.29 ± 0.89).ConclusionClinical advisers for nursing specialty graduate students in our survey were generally inexperienced with regarding to training and culturing nursing graduate students. These advisers were prepared for core teaching competency, but were not qualified to conduct scientific research. Based on these results, it would be beneficial to provide the clinical advisers more training on teaching cognition for graduate students and improve their competency to perform scientific research.     

Undergraduate nursing students' pharmacology knowledge and risk of error estimate

BackgroundIn the United States alone, medication error causes injury to approximately 1.3 million people every year. Frequently, nurses have been blamed for the high rates of medication administration errors. Factors associated with medication error by nurses are categorized as personal, contextual and knowledge-based. There is evidence in the literature that showed nurses have insufficient knowledge in pharmacology.PurposeThe overall purpose of this study was to estimate the risk of error based on the combined scores on pharmacology knowledge and self-rated certainty scores of undergraduate nursing students.MethodA cross-sectional and correlational study was conducted. Students enrolled in an undergraduate nursing program who completed or were currently taking the pharmacology course were eligible for the study. Based on power analysis, a sample of 156 students was needed to reach 80% power with a level of significance of 0.05. A 42-item Pharmacology Knowledge Questionnaire (PKQ) test was administered, and students were asked to provide their level of certainty for each of their answers. Risk of error was calculated based on the combined scores in PKQ and self-rated certainty scores.Results147 nursing students, 83% females with a mean age of 24 (SD = 5) years, participated in the study. Mean score in the PKQ was 25 (SD = 3.51) out of 42 items, which is equivalent to a grade of 60% (with a calculated weighted mean grade of 56%). Drug calculation was the subject area where students had the lowest mean score. Mean overall risk of error for all 42 items in the PKQ was 1.7 (SD = 0.14), on a scale of 0–3. This means that, on average, high risk of error was noted in 14% of the students who rated incorrect answers with high certainty. Positive correlations were noted between age and pharmacology score, and between when pharmacology course was last taken and risk of error. A negative correlation was noted between when pharmacology course was last taken and pharmacology score.     

Advancing student nurse knowledge of the biomedical sciences: A mixed methods study

BackgroundNursing students' ability to learn, integrate and apply bioscience knowledge to their clinical practice remains a concern.ObjectivesTo evaluate the implementation, influence, and student perspective of a team-teaching workshop to integrate bioscience theory with clinical nursing practice.DesignThe team-teaching workshop was offered prior to commencement of the university semester as a refresher course at an Australian university. This study employed a sequential explanatory mixed methods design incorporating both quantitative and qualitative items.MethodsAn evaluation survey with quantitative and qualitative items and a focus group were employed. The qualitative data were analysed using a thematic approach. The quantitative data was combined with the emergent themes in the qualitative data.ParticipantsParticipants were final year nursing students. Nine students attended the workshop. All students completed the evaluation (N = 9) and 44.4% (N = 4) attended the focus group.ResultsThe results revealed six themes: (1) lectures are an inadequate teaching strategy for bioscience; (2) teaching strategies which incorporate active learning engage students; (3) the team-teaching workshop provides an effective learning environment; (4) the workshop content should be expanded; (5) pharmacology should relate to bioscience, and bioscience should relate to nursing; and (6) team-teaching was effective in integrating pharmacology with bioscience, and then translating this into nursing practice. Students had felt there was disjointedness between pharmacology and bioscience, and between bioscience and nursing care within their undergraduate studies. The workshop that was based on team-teaching bridged those gaps, utilised active learning strategies and provided an effective learning environment.ConclusionTeam-teaching that employs active learning strategies is an effective approach to assist nursing students to integrate bioscience knowledge into their nursing practice.     

Knowledge,attitude and practice regarding nursing interruptions among Chinese nurses: A nationwide cross-sectional survey

ObjectivesTo explore the knowledge, attitude and practice of Chinese nurses regarding nursing interruptions and related factors.MethodsA total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge, Attitude and Practice (KAP) Questionnaire of Nursing Interruptions. The questionnaire consists of three dimensions, knowledge, attitude and practice, containing 10, 9 and 7 items, with full score of 50, 45 and 28, respectively.ResultsThe mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05 ± 16.65 (range: 26–123), with scores for the knowledge, attitude, and practice component being 21.74 ± 9.80, 34.83 ± 6.98, and 17.49 ± 4.97, respectively. Among the nurses, 70.8% of them experienced an average level of KAP toward nursing interruptions while 15.5% were at a poor level. The knowledge, attitude, and practice of nursing interruptions were better in chief nurses, managers, nurses with a master degree or above, nurses ever received training, and nurses with a strong agreement to leadership compared to nurses in other groups (P < 0.05). In addition, employment type, professional title, position, standardized training and leaders’ attention were predictors of KAP in nurses.ConclusionChinese nurses have a moderate level of KAP regarding nursing interruptions. Leaders’ attention, standardized training, position, professional title and employment type could predict nurses’ KAP state of nursing interruptions. Thus, a targeted training program should be implemented for clinical nurses by nursing leaders, with a particular focus on feasibility and professionalism.     

Validating the Nurse Professional Competence Scale with Australian baccalaureate nursing students

BackgroundProfessional competence is necessary to enhance patients’ quality of care and safety, however not much is known about nursing students’ perceptions of their professional competence at the point of graduation, particularly in the Australian context.AimTo validate the Nurse Professional Competence (NPC) Scale in the Australian context and explore graduating nursing students’ perceptions of their own competence and their suggestions to improve their learning experience.MethodA cross-sectional survey incorporating the NPC Scale was conducted with nursing students at the point of graduation at one large Australian University.ResultsFifty-six graduating nursing students completed the NPC Scale. Scale reliability measured via Cronbach’s alpha was 0.96. Almost 80% of students felt confident with their nursing skills and felt that the nursing program had prepared them for a graduate position as a registered nurse. Students reported their highest competence was in Value-based Nursing Care (m = 89.4) and Documentation & Administration of Nursing Care (m = 86.7), and the lowest were Development, Leadership & Organisation of Nursing Care (m = 80.9) and Care Pedagogy (m = 83.0). Students’ most common suggestion to improve the learning experience was to provide additional clinical workplace experience.DiscussionThe NPC Scale demonstrated excellent reliability in the Australian context. The areas that scored highest and lowest on the NPC were congruent with findings using this instrument in other countries.ConclusionFurther validation of the NPC Scale should include a larger sample that includes both graduating nursing students from multiple universities as well as registered nurses and incorporates confirmatory factor analysis.     

Nursing students’ knowledge and attitude toward diabetic ulcer care and their contributing factors in Indonesia

ObjectiveThe prevalence of diabetic foot ulcer in Indonesia is far greater than the global prevalence. Nursing students are expected to have good knowledge and positive attitudes regarding diabetic ulcer care in order to deliver high-quality wound care during clinical practice. This study aimed to assess nursing students’ knowledge and attitudes toward diabetic ulcer care and to investigate the factors related to them.MethodsA cross-sectional study was conducted on 396 academic and clinical phases in three nursing schools in Indonesia from September 2021 to February 2022. Participants completed a survey including a questionnaire about knowledge and attitudes regarding diabetic ulcer care. The data were analyzed using a Chi-square test and multivariate logistic regression analysis.ResultsThe results show that 43.2% (171/396) of nursing students had inadequate knowledge of diabetic ulcer care. However, 88.9% (352/396) had a favorable attitude toward the topic. Nursing students lacked knowledge about the characteristics of diabetic ulcers, diabetic neuropathy, wound infection, and adjunctive therapy for diabetic ulcers, and many of them believe that diabetic ulcer care is too time-consuming to carry out. Students in the clinical phase of their studies had significantly better knowledge than those in the academic phase (aOR = 9.99, 95% CI 4.96–20.08, P < 0.001). Male nursing students were significantly less likely to have positive attitude toward the topic than female students (aOR = 0.42, 95% CI 0.19–0.96, P = 0.048), and students accustomed to sharing with peers as a source of knowledge had better attitudes than those who were not (aOR = 2.76, 95% CI 1.40–5.41, P = 0.003).ConclusionFindings show that almost half of the nursing students have insufficient knowledge of diabetic ulcer care. Curriculum developers and educators need to improve the curriculum regarding diabetic wound care and provide strategic programs to improve students’ knowledge and attitudes based on the factors discovered in this study.     

Effects of blended versus offline case-centred learning on the academic performance and critical thinking ability of undergraduate nursing students: A cluster randomised controlled trial

ObjectiveThis study aimed to compare the effect of blended and offline case-centred learning on medical nursing education for undergraduate nursing students.BackgroundTechnological advancements are rapidly changing nursing education in higher educational settings. Educational reform, especially regarding methods of teaching, has been the focus of nursing educators in recent years.DesignThe research was conducted between September 2018 and July 2019 in China.MethodsSecond-year undergraduate nursing students in two classes were enrolled for this study by cluster sampling. The study outcomes were academic performance and critical thinking ability, measured using the Critical Thinking Disposition Inventory-Chinese Version.ResultsStudents in the experimental class showed significantly higher improvements in academic performance than those in the control class. Compared with the control class, the pre-post difference in competency in critical thinking self-confidence in the experimental class was significantly greater (p = 0.037). In the experimental class, there was a significant improvement over the baseline in the dimension of critical thinking self-confidence (p = 0.022). In the control class, there was a significant improvement over the baseline in the total score (p = 0.029) and two of the seven dimensions: truth-seeking (p = 0.016) and systematicity (p = 0.005).ConclusionsThe use of blended case-centred learning showed promising results in improving students’ academic performance. Both blended and offline case-centred learning were indicated to be effective educational approaches to improve the critical thinking ability of undergraduate nursing students and could be implemented for other nursing subjects in the future.     

Nursing degree students’ clinical placement experiences in Australia: A survey design

AimThis study aimed to evaluate Australian nursing students’ views of placements at seven tertiary education institutions with the use of the Placement Evaluation Tool (PET).BackgroundClinical placements are a core element of healthcare education programs around the world (Chuan and Barnett, 2012) with undergraduate nursing students required to complete a prescribed number of hours as part of their degree. The quality of nursing clinical placements varies with a range of positive and negative learning experiences.DesignA survey design was used with a contemporary survey tool– the Placement Evaluation Tool (PET). Using Qualtrics software (Qualtrics, 2005) the on-line survey was distributed to approximately 6265 undergraduate nursing students at six Australian universities and one Technical and Further Education (TAFE) college where Bachelor of Nursing degree students were enrolled. Three Australian States were covered. Sites were selected where a project team member was employed.MethodsA total of 1263 nursing students completed the Placement Evaluation Tool (PET) − 19 items (rated 1–5), one global rating (rated 1–10) − following placement in three Australian States (July 2019−February 2020). Most - 618 (48.9%) completed a placement in acute care with placements positively rated overall.ResultsThe total PET mean score was 78.3% with 29.8% being ‘extremely satisfied’ (10 out of 10 – Item 20). However, 11.0% were dissatisfied with global ratings of four or less, whilst ratings between States differed significantly (p = <0.001). One third of respondents answered a free text statement relating to placement experiences, with significantly more comments from older students (p = <0.001) and from those with ratings in the lower range (p = <0.001). Three core themes emerged: 1. Staff Attitudes to Students, 2. Environment and 3. Lifestyle.ConclusionsWhilst students’ clinical experiences in Australia tend to be positive a minority reported exposure to negative staff attitudes, in unsafe environments, with lifestyle detriments. Further work is required to understand and enhance student experiences.     

Nursing students' knowledge and attitudes toward urinary incontinence: A cross-sectional survey

BackgroundNurses must have adequate knowledge to manage the complexities of urinary incontinence. Nursing students are the nurses of the future, yet little is known about urinary incontinence education in undergraduate nursing programs.ObjectivesThe aim of this study was (a) to assess the knowledge and attitudes of urinary incontinence held by undergraduate nursing students in China and (b) to explore the relationship between knowledge, attitudes and socio-demographic characteristics.DesignA cross-sectional survey using cluster random sampling.SettingsUndergraduate departments of Nursing within the Faculty of Health Sciences at six Universities, located in different areas of China.ParticipantsA random selection of 6 faculties with a total of 1313 full time undergraduate nursing students completed the survey.MethodsSelf-reported data were collected using two validated questionnaires, the Urinary Incontinence Knowledge Scale and the Urinary Incontinence Attitude Scale, to access students' knowledge and attitudes toward urinary incontinence.ResultsOverall urinary incontinence knowledge was poor (49.9%, 15.0/30) and attitudes about urinary incontinence were generally positive (71.7%, 43.0/60). A high level of interest in learning more about urinary incontinence was found. There was a weak correlation between urinary incontinence knowledge and attitudes (r = 0.135, p < 0.01). There was also a significant positive correlation between urinary incontinence knowledge and attitudes and nursing students' year of study, urinary incontinence education and training, and formal clinical practicum experience in urology (p < 0.05).ConclusionsChinese nursing students showed poor urinary incontinence knowledge but generally positive attitudes toward urinary incontinence. This study suggests there is a need to examine urinary incontinence content throughout undergraduate nursing curricula in China.     

Comparison of the effectiveness of two styles of case-based learning implemented in lectures for developing nursing students’ critical thinking ability: A randomized controlled trial

PurposeTo explore and compare the effectiveness of two styles of case-based learning methods, unfolding nursing case and usual nursing case, implemented in lectures for developing nursing students’ critical thinking ability.Methods122 undergraduate nursing students in four classes were taught the subject of medical nursing for one year. Two classes were randomly assigned as the experimental group and the other two the control group. The experimental group received the lectures presenting unfolding nursing cases and the control group was taught the usual cases. Nineteen case-based lectures were provided in 8 months in two semesters to each group.ResultsThe two groups started with a similar level of critical thinking ability as tested by the instrument of Critical Thinking Disposition Inventory—Chinese version (CTDI-CV). After receiving 19 case-based learning lectures for 8 months, both groups of students significantly improved their critical thinking ability. The improvement in the experimental group was significantly higher than that in the control group (with the average total score of 303.77 ± 15.24 vs. 288.34 ± 13.94, p < 0.05). The experimental group also had significantly better improvement in six out of seven dimensions whereas the control group showed improvement in only three out of seven dimensions of CTDI-CV.ConclusionsThe study suggests the feasibility of implementing case-based learning in lectures. Unfolding nursing cases appear to be significantly more effective than the usual nursing cases in developing undergraduate nursing students’ critical thinking ability in the subject of medical nursing. Further research can implement the unfolding nursing cases in other nursing subjects.