High-fidelity simulation and legal/ethical concepts: a transformational learning experience

Students in an undergraduate legal and ethical issues course continually told the authors that they did not have time to study for the course because they were busy studying for their clinical courses. Faculty became concerned that students were failing to realize the value of legal and ethical concepts as applicable to clinical practice. This led the authors to implement a transformational learning experience in which students applied legal and ethical course content in a high-fidelity human simulation (HFHS) scenario. A preliminary evaluation compared the new HFHS experience with in-person and online student groups using the same case. Based on both student and faculty perceptions, the HFHS was identified as the best of the three approaches for providing a transformational learning experience regarding legal and ethical content.     

Discussion paper: Conceptual comparison of student and therapeutic engagement

Nurses as faculty teaching undergraduate students, require a diversity of skills to ensure that students engage in achieving the desired qualification. While it is anticipated that students have a degree of motivation to reach this goal, their varied backgrounds often mean they require additional support to assist them to engage with the learning process. It is anticipated that the tertiary institution or learning environment will have strategies to support the student from a broader perspective, but much of the engagement relies on the skill and knowledge of the nurse faculty.This discussion paper aims to promote an understanding of student engagement and argues that using aspects of therapeutic engagement can support nurse faculty to enhance the students' learning experience. Key concepts from both student and therapeutic engagement will be reviewed to provide implications, particularly for novice nurse faculty.     

Increasing competence in wound care: A cross-sectional study to evaluate use of a virtual patient by undergraduate student nurses

Concerns have arisen internationally over the competency of student nurses to perform wound care. A global shortage of nursing faculty and clinical practice opportunities is regarded as a contributing factor. Virtual simulation offers a possible solution.The aim of this study was to describe the development and educational evaluation of a virtual patient to supplement undergraduate learning of wound care. The National League for Nursing Jeffries model informed the design of the media. Evaluation of the virtual patient by penultimate year nursing students (n = 148) was conducted using a survey design. Findings are presented from statistical and directed content analyses.Most students rated the educational value of the virtual patient and its support of learning highly. They reported a perceived increase in confidence and ability to meet wound care competency outcomes. The virtual patient also provided students with opportunities to develop their clinical reasoning skills.This study provides evidence that virtual patient simulation is an effective pedagogy to increase clinical competence in wound care. It allows nursing students the opportunity to practice skills and utilise theory repetitively in a safe environment, unhampered by a lack of resources such as clinical placement availability and a declining faculty.     

Clinical Faculty Preceptors and Mental Health Reflections: Learning Through Journaling

Evolving practice environments have increased the need for advanced practice nurses to serve as clinical faculty preceptors at both the undergraduate and graduate levels. Guided clinical journaling allows students to reflect and retain their clinical experiences and become an active participant in the learning process. The journal presents opportunities for both evaluation and critical reflection of clinical performance and previously held assumptions related to mental health. Through careful consideration of components, clinical educators have the opportunity to ensure that student learning has occurred as well as provide prompts for guided reflection of the learning experience.     

Volunteering in Cambodia

In August 2004, three undergraduate nursing students from the University of Toronto's faculty of nursing travelled to Cambodia to volunteer as student nurses. Being immersed in another culture helped to develop the students' cultural competence, enhance their understanding of primary health care and strengthen clinical skills. Given the growing cultural diversity in Canada, developing s kills in these areas is particularly important. In this article, the author reflects on her experiences in Cambodia and explores the unique value that international placements offer.     

Clinical education and student satisfaction: An integrative literature review

The clinical component of undergraduate clinical education is a critical area in nursing programs. Faculty shortages have made recruitment of clinical faculty and clinical teaching more challenging. As such, alternate models of clinical faculty assignments are being explored to address faculty shortages. This article contains an extensive literature review conducted to survey models of clinical education and student satisfaction with the clinical environment. The purpose of this paper is to examine student satisfaction in the clinical learning environment using articles employing the Clinical Learning Environment Inventory (CLEI) along with examining the use of alternate clinical staffing models in differing levels of undergraduate nursing students. A literature search focusing on studies published between 2002 and 2015 was conducted from 5 electronic databases. Thirty-five articles were reviewed and 22 were selected for this literature review. The studies reviewed concluded that students favored a more positive and favorable clinical environment than they perceived as being actually present. A supportive clinical learning environment is of paramount importance in securing positive teaching learning outcomes. Nurse educators can apply the results of this review in order to develop and maintain quality clinical teaching and to promote a positive, student-centric, clinical learning environment.     

Evaluating a conceptual model-based assignment

Although all faculty evaluate student assignments, fewer tackle the difficult issue of evaluating its actual usefulness. Wanting to know how their undergraduate community health nursing students were understanding and using a conceptual model in clinical practice, the authors used student journal assignments to evaluate learning and application of the model. They discuss the project's outcomes and subsequent strategies implemented to enhance their own understanding of the model and facilitate improved student learning.     

Preparing nursing students for the future: An innovative approach to clinical education

A clinical education model was developed and implemented by nursing faculty in the Oregon Consortium for Nursing Education undergraduate curriculum to improve clinical learning for preparation of nurses to practice in the 21st century. This clinical education model, developed though collaborative work by nursing practice and education representatives throughout the state, moves away from a “random access opportunity” model of clinical education reliant on “total patient care” experiences to an intentional design of clinical learning activities based on course competencies appropriate to student level. Five elements of the model were proposed: case-based, concept-based, intervention skill-based, focused direct client care and integrative experiences. Different elements are dominant in early, middle and late clinical experiences to best support the developmental level of the student. Expectations for faculty, students and clinical staff were also developed to enhance best practices in clinical learning. Preparation of clinical partners for a change in clinical learning and student accountability are essential for optimal learning. This paper provides an overview of the model with clinical application examples for each element with a particular emphasis on case-based, concept-based and integrative clinical experiences.     

Comparative study of baccalaureate nursing student self-efficacy before and after simulation

Evaluation of learning and the development of prelicensure nursing education include an exploration of new teaching models and techniques for student learning assessment. The utilization of high-fidelity human simulation in nursing provides nursing faculty and students the opportunity to expand the boundaries of conventional learning from an instructional paradigm to a blending of modalities that enrich the student experience and provide an avenue for self-determined learning. The inception of computer-generated high-fidelity human simulation technology into the undergraduate nursing curriculum generated this correlation study, which examined two separate groups of senior baccalaureate nursing students' reported self-efficacy for providing family-centered care. This research examined each group of students' reported self-efficacy on the first day of the pediatric semester before and after simulation and on the last day of the pediatric semester before and after simulation. In addition, the relationship between two senior baccalaureate nursing student groups' reported self-efficacy at four data points was examined. The concluding data identified that senior baccalaureate nursing students have unrealistic self-assessments of their clinical knowledge and nursing performance capabilities before simulation scenario participation. The perceived ability of undergraduate students to self-identify their previously acquired knowledge and transferable clinical reasoning to family-centered situations is inaccurate. Human simulators are an effective teaching and learning modality in measuring factors that affect student outcomes.     

The student experience of clinical supervision across health disciplines – Perspectives and remedies to enhance clinical placement

Effective clinical practice supervision for health students is essential prior to commencing their respective professions. Students require adequate preparation before their clinical practice event with an experienced clinical supervisor able to impart professional ‘know how’ and skills to students. The purpose of this study was to describe final year health students' perspectives and experiences of clinical supervision, and to develop an interprofessional model of clinical supervision. Focus groups and semi-structured interviews were conducted with undergraduate health students across a range of disciplines. Some students provided email comments. Qualitative data was analysed thematically using NVivo (V11). Six key themes and their various sub-themes (refer Table 1) were identified: (1) undergraduate learning valued by the CP provider; (2) effective connections (communications) between student, CS, CP provider and university; (3) undergraduate student learning not being valued; (4) ineffective connections; (5) mitigating factors for students; and (6) the impact of increasing student numbers. Undergraduate health student clinical placement requires careful educational preparation, structuring and adequate support for both the student undergoing the practice event and for the clinical supervisor stewarding the undergraduate health professional. A prospective plan to ensure an excellent experience is required (Fig. 1).     

Enhancing the undergraduate nursing education experience with clinical elective courses

The nursing faculty, in concert with the University's vision of personalized learning for undergraduate students, sought creative opportunities for nursing students to explore distinctive career specialty paths. The development, implementation, and evaluation of three undergraduate clinical electives developed by a School of Nursing (SON) is described here, in collaboration with three clinical practice partners. These nursing elective courses were designed to meet student requests for additional content in specialty nursing practice areas, enhance new nurse career readiness, and meet practice partner staffing needs for nurses with additional knowledge and skills in specific identified specialties. These nursing specialties included perioperative nursing, neonatal intensive care nursing, and oncology nursing. The SON faculty and each practice partner co-developed unique specialty-nursing elective courses that provide foundational specialty knowledge and skills in each practice arena. Project outcomes include enhanced relationships between the SON and practice partners, high levels of satisfaction of students and employers, and subsequent recruitment and employment of these students as new graduate nurses by our practice partners.     

Does problem-based learning in Nursing Education Empower Learning?

In this discussion paper, we explored our experiences with the integration of problem-based learning and use of evaluation tools in an undergraduate nursing research class. Six content areas in the course were adapted to problem-based learning. Understanding of concepts and being able to link concepts to the real world of practice can be achieved when nursing students actively engage to construct and reconstruct their knowledge. This journey has demonstrated to us the importance of reflecting on practice as faculty and student. We encourage discussion among nursing faculty to more deeply understand the significance of moving from traditional didactic towards learner-centered approaches that enhance critical thinking.     

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.     

A discussion of concepts for promoting nursing core competencies

The nursing curriculum model has evolved from the previous "content-based approach" to an "outcomes-based approach." As such, nursing faculty should pay to particular attention to changes in the working environment that their graduates can be expected to face. This paper developed a competency-oriented curriculum framework to address school and profession objectives. Concept analysis was used to clarify the characteristics of each competency and related concepts. Then, nursing faculties identified outcomes and desired target levels in line with student learning needs. Finally, teaching strategies and learning activities for class and clinical practice were developed. Competencies are not nurtured separately. Nursing faculty should provide adequate learning opportunities for their students in order to help students integrate healthcare knowledge, skills and attitudes successfully. In addition, the nursing faculty is responsible to guide students to emphasize quality of care and examine the association of such with professional competencies. Accumulating clinical experience and reflection will assist students to develop integrity and life-long learning abilities and graduate with solid professional competencies.     

Integrating on campus problem based learning and practice based learning: issues and challenges in using computer mediated communication

The Faculty of Nursing, University of Newcastle, Australia, has been keen to initiate strategies that enhance student learning and nursing practice. Two strategies are problem based learning (PBL) and clinical practice. The Faculty has maintained a comparatively high proportion of the undergraduate hours in the clinical setting in times when financial constraints suggest that simulations and on campus laboratory experiences may be less expensive.Increasingly, computer based technologies are becoming sufficiently refined to support the exploration of nursing practice in a non-traditional lecture/tutorial environment. In 1998, a group of faculty members proposed that computer mediated instruction would provide an opportunity for partnership between students, academics and clinicians that would promote more positive outcomes for all and maintain the integrity of the PBL approach. This paper discusses the similarities between problem based and practice based learning and presents the findings of an evaluative study of the implementation of a practice based learning model that uses computer mediated communication to promote integration of practice experiences with the broader goals of the undergraduate curriculum.     

Benefits and costs of integrating technology into undergraduate nursing programs

Advances in technology over the last decade have resulted in increased opportunities for educators to become more innovative in classroom and clinical teaching. These innovations have allowed students and faculty to access essential clinical information at the point of care/need. By capitalizing on technologies such as personal digital assistants and course delivery shells, faculty and students have both portable and remote access to information that can guide practice and learning activities in clinical, classroom, and distance settings. For instance, a student can use a personal digital assistant to research a patient's new medication at the bedside, study course information, access references during class in response to a question, or download clinical materials from home. Although the benefits of having ready access to information seem obvious, there are costs and strategic planning activities associated with implementing these projects. Clearly, the objective of any academic nursing program is to develop skills among students so they can efficiently access information and use that information to guide their nursing practice. To do so, academic nursing administrators must have the forethought to envision how new technologies can support achieving this goal as well as the ability to put in place the infrastructure supports needed for success. This article presents a case study of how one institution developed the necessary infrastructure and garnished the appropriate resources to implement an ambitious technology initiative integrated throughout a large undergraduate nursing program. In addition, how the integration of technology, online and mobile, can enhance clinical learning will be discussed.