Enhancing cultural competence: Trans‐Atlantic experiences of European and Canadian nursing students

This paper describes the enhancement of cultural competence through trans‐Atlantic rural community experiences of European and Canadian nursing students using critical incident technique (CIT) as the students' reflective writing method. The data generated from 48 students' recordings about 134 critical incidents over a 2‐year project were analysed by qualitative content analysis. Five main learning categories were identified as: cross‐cultural ethical issues; cultural and social differences; health‐care inequalities; population health concerns; and personal and professional awareness. Four emergent cultural perspectives for the health sector that became apparent from the reflections were: health promotion realm; sensitivity to social and cultural aspects of people's lives; channels between the health sector and society; cultural language and stories of local people. CIT was successfully used to foster European and Canadian undergraduate students' cultural reflections resulting in considerations and suggestions for future endeavours to enhance cultural competence in nursing education.     

跨文化护理背景下的护理学专业人才培养模式的改革与实践

目的构建跨文化护理背景下的护理学专业人才培养模式。方法树立专业教师跨文化护理教育理念,提高其跨文化护理教育能力;建设具有跨文化护理特色的课程体系模块;编写具有跨文化护理特色的教材;采用有利于提升本科护理学生跨文化护理能力的教学方法和手段;建立连续性的跨文化护理教学评价体系。结果教师的跨文化教学能力不断提高;就业单位和考研学校的档次迅速提升;学生对培养模式满意度高;用人单位普遍反映学生的跨文化护理能力较强。结论改革后的护理学专业人才培养模式有利于培养学生的跨文化护理能力。     

A critical analysis of undergraduate students' cultural immersion experiences

HARROWING J.N., GREGORY D.M., O'SULLIVAN P.S., LEE B. & DOOLITTLE L. (2012) A critical analysis of undergraduate students' cultural immersion experiences. International Nursing Review Purpose: This paper is concerned with the impact of an international health promotion experience on the understanding of culture among university students. Such immersion experiences are often cited as a strategy to prepare nurses for culturally appropriate practice. We describe students' epistemic movements over time with respect to cultural perspectives prior to, during and after a field study in Malawi. Design: Data were collected at three time points from students in undergraduate nursing (n = 14) and non‐nursing (n = 8) programs at a Canadian university. Two essays narrating participants' understanding of culture were submitted by consenting class members. A subgroup of nine participants (four nursing students, five from other disciplines) completed a third narrative following a subsequent field study course in Malawi. Method: Using narrative analysis, themes and structures in the participants' writing were identified and located within a constructivist or essentialist paradigm of cultural understanding. Findings: Overwhelmingly, students' narratives were initially portrayed and informed by an essentialist understanding of culture. Later narratives demonstrated varying degrees of epistemic movement towards more constructivist viewpoints. Narratives that initially exhibited constructivist characteristics tended to display strengthened convictions in that paradigm. Conclusion: We challenge the claim that an international immersion experience immediately transforms participants into cultural experts; our evidence suggests that students experienced existential growth, but their understanding of culture did not change as a result of their brief stay in a different cultural context. Cultural immersion is a phenomenon that requires more critical analysis and systematic investigation to determine how such experiences contribute to learning about culture among nursing students.     

翻转课堂联合案例模式在护理本科生医学统计学教学中的应用研究

目的探讨翻转课堂联合案例模式在护理本科生医学统计学教学中的应用效果。方法选取158名护理本科生为实验组,149名护理本科生为对照组,对照组沿用传统教学法进行医学统计学教学,实验组采用翻转课堂联合案例模式,包括组建教学师资、制订教学大纲及实施教学方案。教学完成后,比较两组护理本科生的考核成绩和对教学效果的满意度。结果两组护理本科生的理论、操作考核成绩及对教学效果的满意度有显著差异,实验组优于对照组(P0.01或P0.05)。结论翻转课堂联合案例教学法的教学效果良好,护理本科生的医学统计学理论知识和应用能力均得到提高。     

The effect of prosocial behaviours on Chinese undergraduate nursing students' subjective well-being: The mediating role of psychological resilience and coping styles

This study aimed to explore the effect of prosocial behaviours on Chinese undergraduate nursing students' subjective well-being (SWB) and examine the roles of psychological resilience and coping styles. The sample for this study included 683 nursing students from two undergraduate universities in Henan Province, China. SWB, prosocial behaviours, psychological resilience, and coping styles were assessed by the Index of Well-Being, the Prosocial Behavioural Tendency Scale, the Connor-Davidson Resilience Scale, and the Simplified Coping Style Questionnaire, respectively. We adopted Pearson's correlation analysis and the PROCESS Macro Model 81 in regression analysis to explore the relationships among prosocial behaviours, psychological resilience, coping styles, and SWB. Prosocial behaviours of undergraduate nursing students had a positive predictive effect on SWB; psychological resilience and coping styles both were the mediating variable between prosocial behaviours and undergraduate nursing students' SWB; psychological resilience and coping styles played a chain mediating role between the prosocial behaviours and SWB of undergraduate nursing students. The results indicated that prosocial behaviours not only directly affected the SWB of undergraduate nursing students but also affected the SWB of undergraduate nursing students via psychological resilience and coping styles. These results offer certain theoretical support and guidance for the research and improvement of undergraduate nursing students' SWB and emphasize the importance of interventions to increase prosocial behaviours, improve psychological resilience, promote positive coping styles, and address negative coping styles.     

Experiences of nursing students and educators during the co-construction of clinical nursing leadership learning activities: A qualitative research and development study

BackgroundStudent voice posits that students' unique perspectives on teaching and learning can be used in conjunction with those of educators to create meaningful educational activities.ObjectiveThe study aimed to describe nursing students' and educators' experiences during the co-construction of educational activities involving clinical nursing leadership.DesignQualitative research and development model.SettingThe study was conducted at a French-Canadian nursing faculty that provides a 3-year undergraduate program.ParticipantsFive undergraduate nursing students, four nursing educators, and the principal investigator formed the co-construction team.MethodsData collected included all documents (written and audio) related to the co-construction process: three 2-hour team meetings, PI's fieldnotes and a focus group discussion that occurred once the co-construction process was completed. Thematic analysis was performed guided by Paillé and Muchielli's (2010) method.ResultsData analysis revealed two interrelated themes: (1) unique, purposeful collaboration and (2) change that makes a difference. A space described as safe, without hierarchy and that included the “right” people helped the team achieve their objective of creating new educational activities on clinical nursing leadership. The two new learning activities developed by the team were perceived as useful for future nursing students. At the individual level, team members appreciated how co-construction helped them understand teaching and learning from new perspectives.ConclusionsA structured, efficient co-construction process contributed to positive changes in the nursing program and participants. Additional research is required to enhance understanding of the factors that facilitate and hinder student-educator collaboration outside the classroom.     

The effect of structured empathy education on empathy competency of undergraduate nursing interns: A quasi-experimental study

BackgroundEmpathy is a crucial element in fostering a positive relationship between nurses and patients. Recent research indicates that the degree of empathy in nursing students declines as they gain education or experience. A number of teaching strategies have been used to improve nursing students' empathy competence levels. However, little is currently known about how empathy is best taught or enhanced in senior nursing students in China.ObjectivesTo implement a structured empathy educational program as developed from the Delphi technique, as well as to evaluate its effects on empathy competence among undergraduate nursing interns.DesignThis study is quasi-experimental, with two-group comparison.ParticipantsUndergraduate nursing students in their fourth year (n = 118) were recruited from an affiliated teaching hospital in Wuhan, Central Part of China, between January 2018 and March 2018.MethodsA convenience sample of 118 undergraduate nursing interns were recruited from a teaching hospital in Wuhan and assigned to either the intervention or the control group according to their preference. Participants in the intervention group had received a 2-week, 12-hour structured empathy-related educational program (two sessions per week, 3 h per session), whereas the control group received no intervention. The Jefferson Scale of Empathy-Health Providers (JSE-HPs) was used to assess students' empathy levels before and after the intervention.ResultsAn independent samples t-test revealed that scores of empathy competence levels in the intervention group were significantly higher than those in the control group following the intervention. Three domains of empathy competence level were also significantly higher in the intervention group after the two weeks' training relative to the control group, namely: perspective taking, compassionate care, and standing in the patient's shoes.ConclusionsThis modified empathy educational program may prove beneficial in improving the empathy competence level of undergraduate nursing interns.     

Transitioning a bachelor of science in nursing program to blended learning: Successes,challenges & outcomes

To help address the challenges of providing undergraduate nursing education in an accelerated time frame, the Teaching and Transforming through Technology (T3) project was funded to transition a second-degree ABSN program to a blended learning format. The project has explored the use of blended learning to: enable flexible solutions to support teaching goals and address course challenges; provide students with new types of independent learning activities outside of the traditional classroom; increase opportunities for active learning in the classroom; and improve students' digital literacy and lifelong learning skills. Program evaluation included quality reviews of the redesigned courses, surveys of student perceptions, pre- and post-program assessment of students' digital literacy and interviews with faculty about their experiences with the new teaching methods. Adopting an established quality framework to guide course design and evaluation for quality contributed to the efficient and effective development of a high-quality undergraduate blended nursing program. Program outcomes and lessons learned are presented to inform future teaching innovation and research related to blended learning in undergraduate nursing education.     

Queering nursing curricula: Understanding and increasing attention to LGBTQIA+ health needs

BackgroundThe LGBTQIA+ community has a long history of marginalization, disenfranchisement, and structural violence within the healthcare sector. Sexual and gender minority individuals may be wary of disclosing sexuality-related information to providers, and providers may not have received education on creating therapeutic relationships with these individuals.PurposeThis paper explores factors that shape LGBTQIA+ individuals' daily lives and how these may influence care encounters. We argue for broadening nursing education to incorporate more specific and efficacious LGBTQIA+ education.DiscussionWe propose that consideration of LGBTQIA+ care in nursing education is an important means of meeting the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education for Professional Nursing. We further suggest specific strategies for so doing.ConclusionAttending to the inclusion of LGBTQIA+ populations when developing and planning nursing education activities assures that newly-graduated nurses can be safe, effective, and nonjudgmental providers of care to a variety of populations.     

Using an Academic‐Community Partnership Model and Blended Learning to Advance Community Health Nursing Pedagogy

This article describes a model of teaching community health nursing that evolved from a long‐term partnership with a community with limited existing health programs. The partnership supported RN–BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face‐to‐face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community‐based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery.     

Influencing Undergraduate Nursing Students' Attitudes Toward Mental Health Nursing: Acknowledging the Role of Theory

Most research designed to explore undergraduate nursing students' attitudes towards mental health nursing tends to uphold clinical experience as the decisive factor, with much less attention paid to the theoretical component. This paper presents the findings of a state-wide study conducted with undergraduate nursing students in Victoria, Australia. A pre- and post-test design was used to measure students' attitudes toward people with a mental illness and toward mental health nursing and their sense of preparedness for mental health practice. A questionnaire was administered at two time points; the first time point was following completion of the mental health nursing theoretical component, and the second was following the completion of clinical experience. An additional scale was added at the second time point to evaluate students' opinions about their clinical placement. The findings indicated significantly different attitudes and opinions depending on the university students attended. The amount of theory undertaken in the course accounts for some, but not all, of this variance. However, generally the students taking courses with a larger theoretical component tended to demonstrate higher scores (suggestive of more favourable attitudes) on all of the subscales, and that these differences were sustained following the completion of the clinical placement. These findings suggest that the amount of theory students receive in mental health nursing may be more influential than the relevant literature suggests.     

Preparing culturally competent practitioners.

Preparing culturally competent practitioners is critical, and evaluating the effect of experiences intended to move students toward cultural competence is important. This research study explored the relationship among short-term international nursing clinical immersion experiences, cultural self-efficacy, and cultural competence. A triangulated research design was used to explore the relationship among the variables with 200 senior undergraduate and graduate nursing students from a university in New England. Quantitative analysis found statistically significant differences in the achievement of cultural self-efficacy for the participants who completed the international clinical experiences versus those who remained in the United States. Qualitative analysis, used to further explain the quantitative results, found that the differences were related to international students' ability to overcome their ethnocentrism, experience a transformative perspective about being culturally aware and sensitive, as well as understand and integrate the patients' cultural practices and beliefs into the students' Western health care practices. It became apparent that something other than cultural self-efficacy had occurred for participants in the international immersion experiences. The students believed they had entered the arena of cultural competence. Short-term clinical cultural immersion experiences have relevance for assisting faculty to move nursing students toward an understanding and achievement of cultural competence in ways currently not possible with nonimmersion community cultural experiences.     

Contributors to the development of intercultural competence in nursing students

Nurses deal more effectively with cultural diversity when they have an ethnorelative orientation toward cultural difference and commonality on the Intercultural Development Continuum, which was the theoretical framework of this study. Scholarly literature shows limited knowledge on what fosters nurses' intercultural development. Thus, this quantitative, retrospective study was the first investigation in health care in Switzerland conducted on nursing students' orientation on the Intercultural Development Inventory (IDI). The sample consisted of the IDI results from nursing students enrolled between 2010 and 2016 at the largest Nursing College in Switzerland (N = 1.112 students in 40 cohorts) where the systematic integration of the development of intercultural competence into the curriculum began in 2010. The aim was to examine to what extent the orientation toward cultural difference and commonality on the Intercultural Development Continuum of nursing students in Switzerland differs from the start- to the end-point of their nursing education. The paired samples t-test demonstrated a higher end of program developmental orientation (p = .01) compared to beginning developmental orientation scores, suggesting the program provided challenges that met the students' level of readiness for cultural development. Educators can use the knowledge provided in this study and implement intercultural competence as a central element within the curriculum following the example of the Nursing College included in this study.     

In-situ simulation for nursing students' professional competence development in postanesthesia care: A quasi-experimental study

AimTo evaluate the differences in professional competence development between nursing students in routine clinical practice and those who experienced four additional in-situ simulations.BackgroundThe amount of clinical practice time available to nursing students is limited. Occasionally, clinical settings do not provide all of the content that nursing students are expected to acquire. In high-risk clinical scenarios, such as the postanesthesia care unit, clinical practice may not provide sufficient context for students to develop the professional competence.DesignThis was a non-blinded, non-randomized, quasi-experimental study. The study was conducted in the postanesthesia care unit of a tertiary hospital in China between April 2021 and December 2022. Nursing students' self-assessed professional competence development and faculty-assessed clinical judgment were used as indicators.MethodsA total of 30 final year undergraduate nursing students were divided into two groups according to the time they arrived at the unit for their clinical practice. Nursing students in the control group followed the routine teaching protocol of the unit. Students in the simulation group received four additional in-situ simulations during the second and third weeks of their practice in addition to the routine program. Nursing students self-assessed their postanesthesia care unit professional competence at the end of the first and fourth weeks. At the end of the fourth week, the nursing students were evaluated on their clinical judgment.ResultsNursing students in both groups scored higher on the professional competence at the end of the fourth week than at the end of the first week and there was a trend of higher competence improvement in the simulation group than in the control group. For clinical judgment, nursing students in the simulation group scored higher than the control group.ConclusionsIn-situ simulation contributes to the development of professional competence and clinical judgment of nursing students during their clinical practice in the postanesthesia care unit.