Making explicit the development of PhD-prepared nurses to steward the discipline

Leadership is a core curricular element of PhD programs in nursing. Our PhD faculty began a dialogue about being a leader, a steward of the discipline. We asked ourselves: (a) What expertise do PhD prepared nurse needs to begin to steward the discipline? (b) How do faculty engage PhD nursing students to assume responsibility for stewarding the discipline? Lastly, (c) How do we work with PhD nursing students to create their vision for how their work contributes to stewarding the discipline, from doctoral coursework throughout their career? We support the need for PhD graduates to have the skills to generate knowledge, conserve that which is important, and transform by disseminating new knowledge to a broad audience. Examples of nurses stewarding the discipline when pioneering research, critiquing traditional approaches to inquiry or trends in nursing practice, and developing policy, are highlighted along with examples of how PhD nursing students begin to steward the discipline.     

Enhancing student understanding of nursing inherent requirements using assessment for learning

ProblemWhere misperceptions and a lack of understanding of the realities of the Nursing profession exist, this can result in students entering into Nursing degrees without understanding the academic knowledge, behavioural and physical attributes and other inherent requirements necessary to undertake and succeed in their studies and subsequent career.QuestionCan an ‘Assessment for Learning’ approach result in enhanced student understanding of inherent requirements and their relationship to registered nurse attributes?MethodsThis interpretive study analysed students’ written reflections on two Bachelor of Nursing inherent requirement statements using latent content analysis. Purposive sampling of all 165 students enrolled in an introductory professional nursing unit was undertaken with 162 (98.2%) consenting to provide demographic data and have their reflections analysed following completion of their unit.FindingsFour themes were identified: Eye opening, responding to self-examination, setting goals and effecting change, and affirming beliefs and attributes.DiscussionAnalysis of the students’ reflections on the nursing inherent requirements showed they exhibited enhanced awareness, understanding and acknowledgement of personal areas to be addressed, as well as goal setting and the beginnings of acculturation and movement along the pre-professional identity to professional identity continuum.ConclusionAn assessment for learning approach enhanced beginning students understanding of requirements inherent in undertaking a Bachelor of Nursing degree, enabling them to set goals for their development as they linked the BNIRs to the attributes required of a registered nurse.     

A theoretical framework to promote minority PhD and DNP student success in nursing education

BackgroundNursing PhD and DNP programs lack diversity and cultural responsiveness and, as a result, minority students are underrepresented in these programs. Stressors specific to being a member of a minority population, defined as minority stress, contribute to a range of barriers for ethnic/racial minority, male and LGBTQ PhD and DNP students. There is an urgent need for faculty and administrators to support minority doctoral student success by taking proactive steps to identify and begin to deconstruct these barriers. Doctorally-prepared nursing faculty serve as mentors and role models for doctoral students, provide exemplars for how to use scientific humility to research health inequities, implement evidence-based practice and develop the next generation of nurse scientists. Combating educational inequities for minority doctoral students is a first step in advancing health equity beyond academia.PurposeThe purpose of this paper is to develop a theoretical synthesis to promote minority PhD and DNP student success in academia.Theoretical frameworkThe minority doctoral student success (MDSS) framework was developed using Schneider's attraction-selection-attrition framework, key concepts from the literature, and professional and personal experience to capture the minority doctoral student experience. A systems approach was used to identify multi-level influences on the minority student experience, including antecedents at each stage of the academic journey, and how minority stress and opportunity inherently affect the process.ConclusionsDiversity is essential to reimagine nursing doctoral education. This theoretical framework provides an approach to understanding the minority PhD and DNP student experience and the role of faculty and the academic organization in mediating barriers and creating opportunities to enhance diversity, equity, and inclusion.     

DNP and PhD scholarship: Making the case for collaboration

BackgroundThe Institute of Medicine calls for meaningful collaboration between doctor of nursing practice (DNP)- and doctor of philosophy (PhD)-prepared nurses to improve health outcomes.PurposeThe purpose of this paper is to answer the questions: 1) how do Colleges of Nursing influence DNP and PhD collaboration for faculty and students? 2) how does DNP and PhD collaboration in an academic setting impact health care practices and patient outcomes?MethodsTwo examples of DNP and PhD collaboration (one faculty and one student) are presented.ResultsShared faculty responsibilities and a supportive organizational culture influenced collaboration between faculty and students. Research and practice roles can complement and strengthen each other while improving health outcomes.ConclusionColleges of Nursing should build processes and culture that encourage faculty and students to collaborate across doctoral programs. Successful intraprofessional collaboration has the potential to positively impact healthcare quality, and outcomes, while advancing the nursing profession.     

Gaming and anxiety in the nursing simulation lab: A pilot study of an escape room

BackgroundAnxiety accompanying educational simulations is a complex issue impacting nursing students and their learning. Research has provided evidence that some pre-simulation activities can increase student comfort with the simulation environment and may also reduce anxiety. Studies have also provided evidence of promising outcomes for gaming use in nursing education.PurposeThis pilot study explored a medical-surgical escape room game as an introductory simulation experience for nursing students, particularly focused on determining student anxiety levels, and both faculty and student perception of the experience.MethodsA quasi-experimental one group pretest-posttest design was used with a convenience sample to explore student anxiety levels and perceived enjoyment of the game.ResultsStudent anxiety levels significantly decreased (p = .013); however, anxiety levels remained high at posttest. Students reported high enjoyment of the game and provided positive comments.ConclusionEscape rooms can provide an engaging, interactive way to teach nursing concepts in the simulation environment.     

A lesson involving nursing management of diabetes care: Incorporating simulation in didactic instruction to prepare students for entry-level practice

BackgroundDiabetes is a global health problem requiring nursing students demonstrate a thorough understanding for NCLEX and entry-level practice, although clinical opportunities are increasingly limited, especially for Associate Degree Programs.MethodA Simulation-based Education was incorporated in a didactic lesson to improve diabetes nursing care. Knowledge, confidence, application and relevance were measured using Wilcoxon signed-rank, Chi-square and Kruskal-Wallis analyses.ResultsStudent (n = 46, 85% female) perceived knowledge of glycemic management (post > pre, p < 0.0001), confidence administering insulin (post > pre, p < 0.0001), and clinical relevance improved. Confidence increased among three cohorts per Kruskal Wallis H test (x² = 7.76, p = 0.021). Increased confidence correlated with relevance (x² = 30.965, p = 0.009) and prior understanding of therapy (x² = 26.538, p = 0.033).ConclusionReinforcing didactic content through simulation enhanced student mastery of diabetes nursing care. Additional pedagogical strategies are warranted for NCLEX preparation and entry-level practice.     

Simulation helps equip nursing students to care for patients with dementia

BackgroundTeaching undergraduate students about older adults with dementia remains an area of acute interest in academia. Identifying optimal simulation methodologies to inform dementia education is essential to prepare nursing students to provide care to this population.MethodsSchool of nursing faculty completed a quality improvement project to evaluate the effectiveness of simulation to teach geriatric nursing knowledge and clinical judgment to nursing students. A retrospective review of student journal reflections occurred. The thematic analysis approach was used to analyze the qualitative data collected from narrative journals submitted by nursing students (n = 263).ResultsThree major themes of Consciousness of Self, Consciousness of Time, and Consciousness of Communication were identified.ConclusionFindings have the potential to transform how nursing students view the care needs of geriatric patients. This article provides a resource for nursing educators seeking to integrate simulation-based education to teach concepts of care related to dementia.     

Student Perioperative Experience Supports Recognition of Safety Concepts

PurposeThis study aimed to evaluate student perception of knowledge gained and intent to apply perioperative safety concepts.DesignA mixed-method design analyzed themes from student reflections as well as frequencies of student survey responses after a one day, 10-hour, perioperative observational experience.MethodsStudents participated in a one day, 10-hour, observational clinical experience following patients from the preoperative area to the operating room, postanesthesia care unit, and discharge from a surgery center or admission to a hospital room. After the experience, students completed a survey and a reflection assignment. A modified Delphi method was used for thematic analysis. Frequencies and averages were used to analyze the survey items.FindingsStudents gained knowledge of and reported intent to apply perioperative safety concepts within their nursing practice. Some students noted an interest in perioperative nursing as a career choice.ConclusionsThese findings provide evidence to support implementation of perioperative experiences in nursing programs and reinforce the role of the registered nurse (RN) to ensure safe and quality care. In addition, the perioperative experience may be a recruitment tool for enhancing the perioperative workforce.     

Conflicts Within the Discipline of Nursing: Is There a Looming Paradigm War?

This paper presents a view of the current sources of potential conflicts in the academic discipline of nursing. It suggests that these conflicts could lead, in the Kuhnian sense, to a paradigm war. The differing paradigms underlying the education and traditions of the PhD prepared nurse scientist/researcher/scholar and the DNP prepared nurse practitioner are a challenge for the discipline. DNP programs are swelling and faculty are needed to teach in these programs, and their position with regard to the usual rank and tenure structures of academe are not yet clear. Concern arises when the tenured PhD nurse scientist faculty numbers drop as the DNP faculty numbers increase. The body of nursing science is threatened as fewer students enter PhD programs and faculty retire. The DNP faculty paradigm does not provide for the rigor and preparation need to carry forward the disciplinary scientific knowledge mission. Rather than a fruitless war between the two paradigms, ways are suggested to fully embrace the differences as important to nursing, and to increase the number of PhD prepared nurse scientists.     

Barriers for BSN students to pursue a PhD in nursing and recommendations to address them: A scoping review

BackgroundIncreasing the BSN-PhD pipeline could address the shortage of nursing faculty to conduct research, develop nursing science, and train new nurses and faculty.PurposeTo identify barriers to BSN students’ pursuit of PhD education, and to compile recommendations to increase their numbers.MethodsThis scoping review follows PRISMA guidelines, including articles in English that discussed barriers to BSN students’ pursuit of PhD education and recommendations to address them.FindingsBarriers to pursuing a PhD include misunderstanding PhD education and its impact on population-level health, insufficient funding for PhD studies, and perceived need for clinical experience. BSN program recommendations include education on doctoral and postdoctoral options, mentorship, and hands-on research experiences. PhD programs should be accessible, fully funded, and address students’ perceived need for clinical experience.DiscussionThe nursing profession must take coordinated action across individual, interpersonal, program, policy, and cultural levels to increase the pipeline of well-prepared BSN-PhD students.     

Non-academic admission criterion of certified nursing assistant status for undergraduate nursing programs: A comparative case study

BackgroundThe number of nursing program graduates does not meet the current demand for nurses. Program faculty relies on the predictive power of admission criteria to admit students who will be successful. Non-academic admission criteria, such as Certified Nursing Assistant (CNA) status, should be considered to complement academic criteria.PurposeThis study aimed to explore nursing students' perceptions and clinical faculty of the non-academic prerequisite of CNA status as an admission criterion. First-year students' preparedness for the clinical setting, self-confidence, and anxiety in clinical decision making (CDM) was considered.MethodA multi-methods comparative case study design was utilized. The setting was two undergraduate baccalaureate nursing programs. Nine faculty and 54 students participated in the study. The researcher collected data through interviews with the participants, observations, document analysis, field notes, and self-report on the Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM) scale.ResultsThree themes emerged from the interview data: (a) student preparedness, (b) student learning, and (c) student program success. No statistically significant differences in student anxiety or self-confidence were found in the NASC-CDM scale.ConclusionThe investigation of CNA status could be an essential aspect of the undergraduate nursing program admission process.     

Completion and attrition of nursing PhD students of the 2001 to 2010 matriculating cohorts

PurposeTo examine completion and attrition of students in nursing PhD programs.MethodsTotal 5,391 students who matriculated into nursing PhD programs in 2001 to 2010 were selected from the AACN database.FindingsThe completion rate of the students was 74.2% and the attrition rate was 22.7%. On average, it took 5.7 years for the students to graduate and 3.7 years for the students who left without graduating to drop out. The mean age at matriculation and graduation was 42.4 and 47.5, respectively. Male students, part-time students, students of post-baccalaureate programs, students who were not faculty or held a part-time faculty position, students of the 2001 to 2010 matriculation cohorts, and students in PhD programs with 25% or more of the courses taught online were more likely to experience attrition.ConclusionThe study findings provide useful information for the nursing education community to better address the issue of nursing PhD shortage.     

Factors influencing Māori student nurse retention and success: An integrative literature review

BackgroundImproving indigenous health outcomes requires a strong indigenous nurse presence. Increasing the retention and success of nursing students during their education supports the critical mass needed to implement change in the health workforce to better address indigenous population health needs.ObjectivesTo explore the factors affecting retention and success of Māori undergraduate nursing students in New Zealand.DesignA Kaupapa Māori research framework was utilised within an integrative review design.Data sourcesCINAHL Plus, Scopus, and Google Scholar databases were searched using the keywords Māori, indigenous, nursing, health, education, retention and success.Review methodsAn iterative process was used to integrate and synthesize the literature. Thematic analysis was carried out to establish key concepts present in the literature and to establish gaps.ResultsMāori student identity, institutional support factors and programme factors play a role in Māori student success and retention. Both the university environment and whānau (family) support contribute to a strong sense of identity. The institution's ability to facilitate peer mentoring, provide safe spaces for study and specialised support services also play a role. Finally, programme factors such as faculty culture, teaching practices and curriculum content affect the student's experience and desire to remain in nursing.ConclusionsImproving student retention and success requires an environment which is welcoming and respectful of indigenous values and strengths. Strategies which encourage students to be self-empowered in their learning, ensure equity of opportunity, facilitate working together and enable the development of good relationships will meet the needs of all students, not just Māori.     

The next gen pharmacology classroom: A quality improvement approach to transformation

BackgroundPrelicensure nursing has slowly heeded the call to embrace radical transformation of nursing education. Students’ inability to apply pharmacological knowledge to clinical situations motivated faculty to rethink how pharmacology is taught.MethodFaculty restructured the pharmacology course with an active learning, facilitator-led classroom pedagogy.ResultsStudent study time decreased and students were able to apply pharmacology content to the clinical setting. Faculty satisfaction increased.ConclusionEmploying active learning methods for teaching pharmacology shows promise as evidenced by sustained content recall and application of pharmacology knowledge in entry-level nurse clinical settings.     

Increasing Intent to Vaccinate for Seasonal Influenza

ABSTRACT

Background: The community college student is not currently armed with the resources or prevention information regarding influenza. Less than twenty percent of the college population receives influenza immunization annually.

Purpose: The purpose of the project was to evaluate if an evidenced-based influenza and vaccine education intervention will affect nursing students’ intent to vaccinate for influenza by increasing knowledge of the influenza vaccine using Zingg and Siegrist’s Knowledge Scale.

Methods: Participants were recruited voluntarily from their attendance at orientation for incoming nursing students on a specific date and time. Utilizing a computer survey, all seventy-seven participants completed an online pretest before an educational intervention, and then, the results were compared following the educational intervention with a posttest. Parametric tests such as a paired t-test, Pearson’s correlation coefficient, one-way analysis of variance (ANOVA), and percent change were utilized to determine whether an educational intervention was effective in improving influenza knowledge and whether there was a change in vaccination intention.

Outcomes and Results: The educational intervention in this project resulted in enhancement of influenza knowledge. The implications of this project demonstrated the value of providing an educational intervention to improve knowledge, intent, and willingness to vaccinate for influenza for nursing students at a community college.