Action research on the development of a caring curriculum in Taiwan: Part II

This article presents the development, design, implementation, and evaluation of the third-year course of a caring curriculum being developed for a 5-year associate degree nursing program in Taiwan. The course, titled Application of Caring Concepts, was taught to more than 800 students by 16 instructors recruited from various departments. The instructors attended workshops and seminars on caring and then developed the course materials and teaching strategies. Instructional strategies included role modeling, dialogue, discussions, journaling, simulations, readings, and projects that involved students' applying caring skills outside of the classroom. Students were evaluated by patients in clinical practice using the Caring Behavior Measurement, developed in a previous study, and the course was evaluated by qualitative analysis of student feedback. Student responses to course content and instructional strategies were positive. Patients generally indicated that students always or normally performed caring behaviors. The study showed that with an appropriate curriculum and learning strategies, students can learn caring skills.     

护理本科教育中开设照护课程的实践与效果

目的 探讨在护理本科教育中开设照护课程对教学质量和护生满意度的影响,为进一步课程改革提供依据.方法 自编人性照护理论教材和行为指南,对168名本科护生开设照护课程,用修正后的照护行为质量评价表和自编的护生满意度调查表,分别于课程开设前后进行访谈和测评.结果 开设课程前后护生的照护行为和满意度差异具有统计学意义(P＜0.01).结论 本科护生通过学习照护理论,运用照护行为指南,将照护理念融入日常学习和临床实习工作中,有利于提高其照护行为和对护理工作的满意度.     

Application and evaluation of a caring code in clinical nursing education

This study evaluated the effectiveness of the Caring Code, a tool for teaching caring to nursing students during clinical practice. An experimental, longitudinal design was used. A sample of 480 students from a 5-year junior nursing college program in Taiwan was randomly divided into experimental and control groups. Each member of the experimental group carried a copy of the Caring Code, the content of which was explained by the clinical instructors at the beginning of clinical practice, and about which reminders were provided weekly. A questionnaire was distributed to the patients during the nursing students' 1-year clinical practice, once prior to the implementation of the Caring Code and twice afterwards, to obtain quantitative data on the caring behaviors of the two student groups. Instructors and nursing students were interviewed for their experiences and perceptions of using the Caring Code. The Caring Code had a statistically significant positive effect on student caring behavior.     

Cultivating caring through caring group and ropes course experiences

Caring group and ropes course experiences were integrated into the first semester of an upper-division baccalaureate nursing curriculum to help students learn caring and teamwork. The authors discuss their teaching strategies and outcomes that promoted caring, group cohesion, closeness, trust, teamwork, and support among nursing students.     

Teaching core nursing values.

Nursing is a caring profession. Caring encompasses empathy for and connection with people. Teaching and role-modeling caring is a nursing curriculum challenge. Caring is best demonstrated by a nurse's ability to embody the five core values of professional nursing. Core nursing values essential to baccalaureate education include human dignity, integrity, autonomy, altruism, and social justice. The caring professional nurse integrates these values in clinical practice. Strategies for integrating and teaching core values are outlined and outcomes of value-based nursing education are described. Carefully integrated values education ensures that the legacy of caring behavior embodied by nurses is strengthened for the future nursing workforce.     

An action research on the development of a caring curriculum in Taiwan

The purpose of this study was to plan, develop, implement, and evaluate the effectiveness of the first-year course of a 5-year nursing caring curriculum. An action research method involving participant observation investigated how 18 instructors in a junior college nursing program implemented caring in the course. Data gathered through observation, interviews, and questionnaires were used for evaluation and revision of the course. Results included development of the framework for the caring curriculum and the contents of the first-year course, Introduction to Caring. Course content included the concepts of caring ("love and sincerity," "caring communication," "empathy and respect," "acceptance and trust," and "offering of self"), performance of caring actions ("care of self," "care of family members," and "care of peers"), and caring motivations ("caring reinforcing factors" and "caring restraining factors"). Teaching strategies included role modeling, dialogue, reflection, journaling, and caring groups. Evaluation showed that student caring knowledge, attitudes, and behavior improved after course implementation.     

护理本科生《关怀技巧》课程的设计与实施效果

目的探讨《关怀技巧》课程的设计方法及实施效果。方法通过课程前评估、课程内容设置和课程实施的各个环节,对护理本科生进行关怀教育,并采用关怀能力问卷进行测量比较。结果课程实施前护理本科生的关怀能力得分为（193．80±18．11）分,其中理解和耐心维度得分均低于常模（P〈0．01）;课程实施后护理本科生的关怀能力得分为（206．29±19．23）分,关怀能力总分及理解和鼓励维度得分高于课程实施前（P〈O．01）。结论护理本科生的关怀能力相比国外常模较低,而且在各个维度发展不平衡,《关怀技巧》课程有助于提高护理本科生的关怀能力。     

Caring: its meaning and place in the practice of nursing.

The School of Nursing at which the author is an instructor has decided to revise its curriculum. The new curriculum will use Jean Watson's Theory of Caring as its theoretical base. This qualitative study was undertaken to help clarify the meaning and value of caring in nursing practice as perceived by second-year diploma nursing students. When the data were analyzed, three categories of nurse behaviors emerged that were perceived as caring: giving of self, meeting patients' needs in a timely fashion, and providing comfort measures for patients and their families. The results of this study can be interpreted as a social constructive view of caring in the practice of nursing. These outcomes may help to define and teach caring nurse behaviors in a curriculum based on the Theory of Caring.     

The impact of nurse education on the caring behaviours of nursing students

This study aimed to ascertain whether nursing students' perceptions of caring behaviours as part of nursing practice change over a three-year, pre-registration, undergraduate nursing course. Students are expected to have a predisposition to care with nurse education nurturing and developing this into professional caring behaviour. However, there is some evidence that this process inures rather than develops these behaviours. This was a quantitative, single cross section survey of two nursing student cohorts from one Higher Education Institution (HEI) in Wales, United Kingdom (UK). There were two sample groups; sample group A were 80 first year students and sample group B were 94 third year students. Students completed a questionnaire incorporating the caring behaviors inventory (CBI) [Wolf, Z.R., Colahan, M., Costello, A., Warwick, F., Ambrose, M.S., Giardino, E.R., 1994. Dimensions of nurse caring. Journal of Nursing Scholarship 26 (2), 107-111]. The key finding was a statistically significant difference in the means in caring behaviours between first years and third years with third years scoring lower than first years. This was exaggerated for those under 26 and increased further for those under 26 with no previous experience of caring. Caring is a core nursing value and a desirable attribute in nursing students, but the educational process seemed to reduce their caring behaviours.     

Teachers as researchers: a narrative pedagogical approach to transforming a graduate family and health promotion course

Scholarship of teaching in nursing is illustrated by describing the development, implementation, evaluation, and revision of a family and health promotion course for graduate family nurse practitioner students. A narrative pedagogical approach that combines conventional pedagogy with action research is used. The work, an example of curriculum as dialogue, illustrates how teachers can incorporate research, evaluation, and reflection into their daily teaching practice. Given adequate support, these evaluation and research activities could constitute part of the scholarship of teaching, and, as such, would warrant allocation of time in faculty workloads and formal acknowledgment in annual performance evaluations and promotion and tenure decisions. The importance of increasing the clinical relevance of the scholarship of teaching in a practice discipline such as nursing is also emphasized.     

护理专业大专生临床实习前后人文关怀能力的比较

目的比较护理专业大专生临床实习前后人文关怀能力的变化。方法采用护理专业大学生人文关怀能力量表,分别于临床实习前后,对279名护理专业三年制大专生进行问卷调查。结果临床实习后,学生人文关怀能力总分、人道利他价值观、协助满足基本需求、科学解决健康问题、健康教育维度得分高于临床实习前（P〈0.05或P〈0.01）,而在促进情感交流、提供良好环境、帮助解除困难、灌输信念和希望维度上差异无统计学意义（P〉0.05）。结论护理教育应从课程设置、教学方法等方面加强护理专业学生人文关怀能力,并重视临床实习对培养学生人文关怀能力的重要性。     

Faculty-student interactions and the student-perceived climate for caring.

The identification of caring as a core value for nursing practice elaborates the need to investigate the educational processes through which caring can be learned by those who will assume primary caregiver roles. Using qualitative inquiry, this study was conducted to describe a climate for caring as perceived by 10 junior nursing students and to identify faculty behaviors and faculty-student interactional episodes through which these students experience a climate for caring. Consistent with one researcher's conceptualization of the components of a moral education, the findings from this study suggest that modeling, dialogue, practice, and confirmation are the faculty-student interactional processes through which these students experienced a climate for caring.     

A pilot study to measure the caring efficacy of baccalaureate nursing students

Caring in professional nursing, often described as the essence of nursing, has gained increasing attention over the past several decades. Many programs claim to be based on a caring philosophy and practice. Despite the expectation that graduates of nursing programs will develop relationships with their patients and practice within a caring framework, evaluation of caring competencies is not well developed. The purpose of this pilot study was to measure the self-reported caring competency of baccalaureate nursing students using the Coates Caring Efficacy Scale (CES) (1). Students from prenursing courses to final semester seniors completed the CES (N = 193). Mean scores in this cross-section of students were higher than those reported by Coates for novice student nurses, but slightly lower than those Coates reported for comparable baccalaureate seniors. Final semester seniors identified their families as making the greatest contribution to their development of caring; only a few reported the influence of the nursing curriculum. This study, while limited to students in one program, provides beginning evaluative data of self-reported caring competencies of nursing students.     

Revisiting our roots: caring in nursing curriculum design

It is widely accepted that a caring curriculum is integral to nursing education. Caring as a concept is extensively cited in the literature as a core value in nursing education and nursing practice. What is not evident is the curricular designs used by nurse educators to enable students to internalize caring behaviors. The literature supports the internalization of affective learning through hierarchically structured learning objectives, and the movement from emotional to reflexive responses through critical reflection. Krathwohl, Bloom, and Masia’s (1964) taxonomy of affective objectives and concepts from Mezirow’s (2000) transformational learning theory were used to synthesize the integration of caring affective objectives into the design of the nursing curricula. The expected outcome of such integration is a nursing curriculum that progressively supports the development of nursing students’ caring behaviors that are consistent with the ideals of the profession. Examples of hierarchically leveled caring objectives are provided.     

The process of curriculum redesign for the nursing baccalaureate program: an analysis of teacher actions

The purpose of this study is to define the teacher's actions in the process of developing a new curriculum for the Faculty of Nursing, in National Yang-Ming University. The authors defined three tasks of teachers developing the curriculum: Relocating, strategizing, and reflective practice. Relocating implied reflecting on the dilemmas of nursing education, world trends in nursing education, the experience of medical schools with problem-based learning, and the philosophy of the university. Strategizing meant developing guidelines that included humanistic education, faculty development, and course content of the new curriculum. Reflective practice included intersubject integration, dialogue teaching, and shifting the focus from hospital care to community and family care.     

临床护理教师的角色模范对学生人文关怀能力的影响

目的 探讨护理专业学生人文关怀能力与感知临床护理教师对患者关怀行为的关系,为培养和提高学生人文关怀能力提供依据.方法 采用"学生人文关怀能力量表"和"感知临床护理教师对患者关怀行为问卷"对83名本科学生进行问卷调查,并对两者进行相关性分析.结果 学生人文关怀能力得分(81.74±13.28)分,得分率78%;感知临床护理教师对患者关怀行为得分(2.93±0.46)分,得分率75%;两者之间存在正相关(r=0.620,P=0.000).结论 临床护理教师的角色模范是学生人文关怀能力的重要影响因素,护理教育者应重视临床护理教师对实习学生的潜移默化影响,为培养学生人文关怀能力创造良好的软性环境.     

384名实习护生跨文化护理能力现状及影响因素分析

目的 了解实习护生跨文化护理能力的现状及影响因素,为医学院校跨文化护理教学改革提供借鉴和参考。方法 便利抽取福建省2所医学院校护理专业2018届实习护生384名,采用一般资料问卷和医学情景跨文化交际能力量表进行调查。采用多元线性回归分析影响因素。结果 实习护生的跨文化护理能力得分为（113.91±23.13）分,多元线性回归分析结果显示：受教育程度、课程学习经历、护理外籍病人的经历和跨文化接触途径对实习护生跨文化护理能力的影响具有统计学意义（P<0.05）。结论 实习护生跨文化护理能力处于中等偏下水平,受教育程度、课程学习经历、护理外籍病人的经历及跨文化接触途径对其有重要影响。护理院校需优化课程设置和教师队伍,注重医教协同,增加跨文化接触途径,以提高实习护生跨文化护理能力。     

中医院校护理专业实习生人文关怀能力调查

目的 调查中医院校护理专业实习生人文关怀能力现状,为开展人文素质教育提供依据.方法 采用关怀能力量表,对某中医院校217名护理专业实习生进行问卷调查.结果 学生关怀能力总分为（175.54±15.43）分,低于国外水平.影响学生对患者实施关怀行为的因素包括患者态度（42.40％）、护理工作量（24.88％）、工作环境（12.44％）等.学生获得关怀知识的主要途径是讲座（94.47％）、父母和教师的言传身教（87.56％）、书籍和杂志（87.10％）、网络资源（85.25％）、电视或电影（82.95％）.结论中医院校护理专业实习生人文关怀能力偏低,应加强人文素质教育,提高学生的关怀能力.     

Practices of caring for nursing students: A clinical learning environment

ObjectiveThe purpose of this study was to explore, describe and illuminate nursing students’ best encounters of caring in the clinical learning environment. Caring for nursing students was emphasized and recommendations provided to enhance caring for nursing students within their clinical learning environment.MethodsQualitative data was collected by the researcher using semi-structured individual interviews and an Appreciative Inquiry (AI) methodology. Ten second year nursing students undertaking the bridging course leading to registration as general nurses in terms of Regulation 683 of the South African Nursing Council (SANC) were purposively sampled from 3 private hospitals within the Western Cape. Data was analysed using Giorgi’s method.ResultsThe main theme included the best and ‘least best’ caring practices embedded in the centrality of the heart. The subthemes comprised of the nursing students’ experiences of caring literacy and caring illiteracy. The second theme included the creation of best caring practices within a conducive clinical learning environment. Within this theme, the subthemes comprised of the caring attributes required in reflecting best caring practices, as well the creation of a clinical learning environment to optimise caring.ConclusionsThe significance and necessity of caring for the nursing student were clearly illustrated and confirmed by participants. Caring was equated to the heart as the core to the nursing students’ being. Recommendations for nursing education, management, practice and research were therefore specifically formulated to enhance caring towards nursing students.     

《临床护理技能》精品课程的建设与体会

目的通过对《临床护理技能》精品课程的建设,提高学生的学习效果。方法培养“双师型”素质的教师队伍,构建新的课程体系和教学内容,开展实践教学。结果提高了学生综合能力和素质。结论通过精品课程的建设提高了护理专业学生的教学质量。