Graduate radiographers’ experience of learning MRI practice: A pilot study using constructivist grounded theory methodology

IntroductionTraditionally radiographers, specialising in MRI practice, would have first worked in a general imaging department, however due to the shortage of MRI radiographers within the UK, opportunities have now arisen for graduate radiographers to enter MRI practice directly. There are no requirements to undertake formal MRI qualifications or competency frameworks for UK MRI practitioners. Consequently, training is often conducted in house by other MRI practitioners and is not regulated or audited. The aim of this pilot study was to explore graduate radiographers’ experiences of learning MRI practice.MethodsA constructivist grounded theory methodology was implemented.  Purposeful sampling was employed, and participants were recruited via social media. Participants (n3) had all entered MRI practice directly from graduation within the last 5 years and were currently working in the UK. Data was collected through semi-structured interviews, undertaken virtually and audio recorded. Analysis of the data was conducted using the constructivist grounded theory process, as set out by Charmaz and NVivo software was used to manage the data.ResultsFive core categories emerged from the data, 1) aspirations to enter MRI practice, 2) engaging in the learning process, 3) influences of the learning environment, 4) confidence in competence, 5) identification of the need for further learning. These core categories describe the stages of the participants' experience of learning MRI practice.ConclusionThe results of this pilot study demonstrate the pathway taken by graduate MRI radiographers through their MRI educational experience. Undergraduate placements, within MRI, influenced their choice to enter MRI practice, however it did not sufficiently prepare them and further education was necessary. All the participants were provided with a structure to their learning and assessment of competence was required, although the complexity of which varied between participants. Despite feeling competent to undertake MRI imaging examinations all participants sought out opportunities to engage with more formalised MRI radiographer education. Consequently, there may be a need for a standardised national training programme for MRI radiographers to ensure consistency of training and assessment. Further research with a larger participant size is required to consolidate these findings.     

Pre-registration nursing students’ perceptions and experience of intentional rounding: A cross-sectional study

This paper examines pre-registration nursing students’ perceptions of the practice of intentional rounding and perceived benefits for nurses and patients.Intentional rounding was developed to ensure nursing staff regularly check on patients to ensure that all care needs are met. It has been linked to a reduction in falls and call bell use, and an increase in patient safety. No previous studies have examined pre-registration nursing students’ role in the practice of intentional rounding during clinical placements nor the perceptions of rounding practices, important from a future workforce perspective.A cross-sectional multisite study was undertaken, and pre-registration nursing students completed the Nurses’ Perceptions of Patient Rounding Scale between August 2017– June 2018, distributed using online education platforms and email. Strobe reporting guidelines were used to report findings.Participants perceived positive benefits in intentional rounding for nurses and patients. Mixed opinions surrounded the sufficiency of education received around the intervention. Previous nursing experience was linked to opposing opinions of intentional rounding, depending on education levels.Participants had a positive perception of intentional rounding practices overall. Education surrounding intentional rounding needs to be consistent, and introduced before students are expected to actively participate in the practice of rounding on clinical placement.     

Educators’ perceptions of their experiences of transnational education in nursing: A grounded theory study

AimThe study aim was to explore educators’ perceptions of their experiences of participating in transnational education in nursing.BackgroundIn an increasingly globalised world, involvement with the delivery of transnational education has become commonplace across the international higher education sector. In recent years, transnational education within the academic discipline of nursing has developed at pace, evolving in response to a global need to invest in nurse education, address nursing shortages and strengthen nursing leadership. However, despite acknowledgement that transnational education is a complex activity that needs to be more fully understood, research specifically exploring transnational education in nursing is scarce, as previous studies predominantly focus on other academic disciplines. The study addresses this knowledge gap, advancing understanding of transnational education in the context of nursing.DesignThe study was positioned within the interpretivist paradigm and underpinned by a constructivist grounded theory methodological design, acknowledging the prior knowledge and experience of the research team in relation to phenomenon under investigation.MethodsEthical approval was obtained before the study commenced, ensuring adherence to key ethical principles. The study was conducted during May to August 2020, in a university in the North of England that provides undergraduate and postgraduate nurse education in the United Kingdom and transnational context. Participants were recruited via e mail and invited to complete a brief questionnaire, informing a preliminary theoretical sampling strategy. Ten educators with experience of transnational education across a diverse range of international locations participated in individual, semi-structured, online interviews that were recorded and transcribed verbatim. Data were analysed using initial and focused coding, constant comparison, theoretical memos and diagrams.FindingsThe findings uncovered three overarching data categories, each of which were crucial to supporting effective transnational education in nursing. Prepare- involved developing an understanding of the context of healthcare and education, being supported and collaborating with transnational partners. Perform- involved recognising language and cultural influences, adapting to the environment and implementing responsive educational pedagogies. Progress- involved recognition of personal development at individual level and valuing the benefits at organisational level.ConclusionsAlthough transnational education in nursing can be challenging and complex, it can offer worthwhile advantages for all stakeholders. However, effective transnational education in nursing is dependent on strategies which prepare educators appropriately and enable them to perform effectively, thereby promoting successful outcomes at individual, organisational and transnational partner level and facilitating advancement in future potential collaborative activity.     

“Finding My Own Way”: The lived experience of undergraduate nursing students learning psychomotor skills during COVID-19

BackgroundLittle is known about how nursing students learned psychomotor skills during the COVID-19 pandemic.AimsWhat is the lived experience of undergraduate nursing students learning psychomotor skills during the COVID-19 pandemic?MethodsUsing a phenomenological approach, eight undergraduate nursing students were interviewed about their experiences learning psychomotor skills during the pandemic.ResultsThematic analysis revealed three main themes. “Finding My Own Way” described adapting learning styles and advocacy for learning. Sub-themes included perseverance and comradery. “Learning the Skills” described modifications to skills learning. Sub-themes included grace by professors, smaller group sizes, less practice, and “my brain is split in half,” describing the challenges of giving dual attention to COVID-19 and skills learning. “Stress of the Pandemic” described the stress of quarantine, isolation and online learning.DiscussionFindings of this study may help nurse educators understand the challenges of learning skills during the pandemic. Implications are discussed.     

A “Co-CREATES” framework to foster a positive learning environment for nursing students’ professional development in Rwanda

AimThe future of the nursing profession in Rwanda in large part depends on the students who join the workforce and the education they have received. Preparing students with the necessary knowledge, values and judgement requires practice settings to be learner-centered. This study aimed at exploring strategies that might improve the current practice-based learning environment.DesignA focused ethnographic approach was used.MethodsNursing students, staff nurses, clinical instructors and nurse leaders from three hospitals and an educational program participated in individual interviews.ResultsFive key areas of improvement emanated from study data: 1) strengthening institutional support; 2) improving school-hospital collaboration; 3) building the capacity of nurses and clinical instructors; 4) restructuring clinical placement; and 5) reviewing the current supervision model. Based on these findings a “Co-CREATES” framework grounded in the actions of collaboration, care, recognizing, empowering, actively engaging, transforming, enhancement and support was developed. The framework offers a collaborative approach that engages every stakeholder in “cocreating” conditions that build positive practice environments which are conducive to preparing students as professional nurses.ConclusionThe positive outcomes stemming from such a collaborative approach can further enhance a positive culture of collaboration in nursing education and practice.     

The paradox of an expected level: The assessment of nursing students during clinical practice – A qualitative study

AimThe aim of this study is to increase knowledge about the assessment of nursing students’ clinical practice, particularly concerning how teachers and clinical supervisors identify and assess the expected level of competence in mid-term evaluations and students, teachers and supervisors’ experiences of mid-term assessment. Assessment is important to assure the quality of students’ clinical competence and studies show that further research on this topic is required.DesignThis study has an explorative qualitative design.MethodsThirty semi-structured interviews were conducted with nursing students, teachers and clinical supervisors along with 16 observations of mid-term assessments during clinical practice, as part of a bachelor’s programme in nursing.ResultsTwo main challenges concerning establishing an expected level of competence were identified from the analysis of the interviews and observations: 1) a general formulation of learning outcomes and 2) vague expectations of what is the expected level of achievements at different points in time. Both challenges were at institutional level. Furthermore, at performance level, certain patterns were identified related to these challenges, such as teachers and supervisors needing to concretise the general formulation of learning outcomes and their discretion to set the expected level. Additionally, non-verbal language during mid-term assessment seemed to affect how the assessment situation was perceived.ConclusionWe suggest that the institutional guidelines need to be critically reviewed to include greater focus on clarifying what students are expected to achieve, as well as what constitutes the expected level. We have emphasised that discretion is a necessary premise to identify an expected level of clinical competence at mid-term assessment, in particular when there is lack of a clear standard and the assessment form is vague, but also when there is no clear definition of the expected level of competence at different points in time. The consequences are that the student feel insecure about how the assessment ought to be perceived, what level they are at in their learning process, and subsequently, their level in the process of developing necessary clinical competence.     

Pre-registration nursing and occupational therapy students’ experience of interprofessional simulation training designed to develop communication and team-work skills: A mixed methods study

To bridge the gap between university and the clinical environment, the university where this study was conducted incorporated interprofessional simulation sessions into the curricula for pre-registration nursing and occupational therapy students. The purpose of the study was to evaluate the effectiveness of simulation training to support the development of students’ interprofessional communication and teamwork skills. Study participants were first-year students. A mixed methods study design was used that included: (1) a cross-sectional survey, (using the Interprofessional Education Collaborative Competency Self-Assessment tool), before and after the simulation session; and (2) two focus groups with students and one with academic staff. A total of 91 students and 5 staff participated. All students increased their self-perceived skills in interprofessional interactions. Two major themes were identified: ‘Communication and Teamwork’, with four sub-themes, (1) ‘Significance of Communication in teamwork’; (2) ‘Learning about, from and with each other’; (3) ‘Professional role identification and collaborative practice’; and (4) ‘Clinical leadership facilitated collaboration’ and ‘Lessons learnt from the simulation session’, with three subthemes: (1) ‘enhanced preparation for clinical placement’; (2) ‘the experience of interacting with a simulated patient’; and (3) ‘holistic patient care’. The results from the study demonstrated that interprofessional simulation sessions are an effective approach to introducing and developing collaborative clinical practice.     

First-year nursing students’ collaboration using peer learning during clinical practice education: An observational study

The purpose of this observational study was to describe the collaboration between first-year nursing students using peer learning during their first clinical practice education. In earlier, predominantly interview studies, peer learning has been described as a model with several positive outcomes. However, no studies on how students act in collaboration in a real-life context have been found. The present study observed sixteen arbitrarily paired nursing students (eight pairs) on three to five occasions per pair, in total 164 h from September 2015 to March 2016. Repeated unstructured observations including informal conversations were used. Using qualitative content analysis, one theme ‘Involuntary collaboration leads to growth in different competencies’ emerged and three categories ‘Practising nursing skills and abilities when working together’, ‘Establishing knowledge by helping each other to understand’ and ‘Sharing thoughts, feelings, and knowledge and put them into words’. In conclusion, nursing students using peer learning were observed practising several competencies, some of them not so easily elicited according to earlier research as organization, nursing leadership, teaching, and supervision.     

First year nursing students’ evaluation of Kahoot! to facilitate learning and testing knowledge. A pilot study in Ireland and Italy

BackgroundKahoot! was implemented as a strategy to help students in two programs meet problem-solving competencies. Kahoot! is an on online interactive quiz which utilizes competitiveness, music and count down clocks as motivational engagement for students in learning, and provides opportunity to enhance skills such as problem-solving and thinking in time-sensitive situations. There is a paucity of evidence about nursing students’ evaluation of using Kahoot! both for learning and testing knowledge.MethodsA single stage observational cross-sectional study was performed in Ireland and in Italy to evaluate first-year nursing students’ experience of Kahoot to evaluate their knowledge before skills laboratories.ResultsFirst-year nursing students (n = 83) were involved in this study, 41 in Dublin and 42 in Rome, respectively. About 66.19% of students reported strong agreement with the tool's utility.ConclusionsFindings show that students found Kahoot easy to use, helpful for learning especially in relation to formative assessment and impactful in preparing them for the practical part of the course. Educators could use game-based learning to engage students especially for the practical laboratories that are an important part of the nursing course.     

Countries’ cultures and professional nursing values: Cross-cultural evidence from Spanish and Colombian nursing students

This study aimed to identify countries' cultural values associated with the importance given to certain professional nursing values by nursing students from Spain and Colombia. Weis and Schank's Nurses Professional Values Scale-Revised (NPVS-R) in its Spanish version and the Hofstede cultural classification were used for this purpose. The sample was composed of 880 nursing students. Nursing students from both countries showed a greater importance for professional nursing values compared to evidence from other countries. Significant differences were also found in the total score, dimensions, and items, always being higher for Colombian students. Based on regression results, the impact that the academic year had on the importance given to NPVS-R is non-linear (U-inverted). Both groups of students gave the highest importance to the same group of items. Those showing the largest difference in the rankings were associated with country culture differences based on the scores identified by Hofstede. Colombian and Spanish societies present similarities in Power Distance and Uncertainty Avoidance, as well as differences in the other cultural dimensions.     

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.     

Undergraduate nursing students’ perceptions on nursing education during the 2020 COVID-19 pandemic: A national sample

BackgroundIn 2020, nursing educational programs were abruptly interrupted and largely moved online due to the COVID-19 pandemic.PurposeTo explore nursing students’ perspectives about the effects of the pandemic on their education and intention to join the nursing workforce.MethodsUndergraduate nursing students from 5 universities across 5 United States regions were invited to participate in an online survey to elicit both quantitative and qualitative data.FindingsThe final sample included quantitative data on 772 students and qualitative data on 540 students. Largely (65.1%), students reported that the pandemic strengthened their desire to become a nurse; only 11% had considered withdrawing from school. Qualitatively, students described the effect of the pandemic on their psychosocial wellbeing, adjustment to online learning, and challenges to clinical experiences.ConclusionFindings highlighted the need to develop emergency education preparedness plans that address student wellbeing and novel collaborative partnerships between schools and clinical partners.