Nursing informatics in undergraduate nursing education in Australia before COVID-19: A scoping review

BackgroundTechnology can support transformational outcomes of high quality and evidenced-based care and education. Embedding nursing informatics into the undergraduate nursing curriculum enhances nursing students’ digital health literacy, whilst preparing them to use health information systems and technological innovations to support their learning both at university and in the clinical environment.AimThis scoping review aimed to provide an overview of the published literature on how nursing informatics was embedded and integrated into the undergraduate nursing curriculum in Australia before coronavirus disease (COVID-19).MethodologyA scoping review approach guided this study using the Levac, Colquhoun, and O'Brien framework, and the following databases were searched: CINAHL Plus, EMCARE, MEDLINE Ovid, Scopus, ERIC ProQuest, and Web of Science. A total of 26 articles were included: Five quantitative studies, eight qualitative studies and 13 mixed-methods studies.FindingsFew studies focused on the concept of nursing informatics itself, and only two studies described the process of developing curricula that contain nursing informatics competencies and their implementation: the educational scaffolding and modular development approach and a Community of Inquiry Framework (COI). Most studies centred on nursing informatics tools to facilitate teaching and learning in classrooms and skills laboratories. The reported pedagogical strategies were online learning, blended learning, and technology-enabled simulations. Hindrances to nursing informatics being integrated into undergraduate curricula were disparities of the informatics content, a lack of guidelines and/or frameworks, and poor digital literacy.ConclusionThis study provided a baseline perspective of how nursing informatics was embedded and integrated into nursing education in Australia before COVID-19. Overwhelmingly, the focus of research to date was found to be mainly on the utilisation of technological tools to support learning and teaching.     

Blended learning in undergraduate nursing education – A scoping review

ObjectivesTo provide a comprehensive scoping review of the existing literature regarding the use of blended learning in undergraduate nursing education. To align the varied educational terms and definitions with the broad definition of blended learning.DesignScoping review following established methodology.Data sourcesIn consultation with library services, the academic literature was searched. Electronic databases searched included ERIC (OVID), Medline (OVID), PubMed, Nursing and Allied Health, and CINAHL Plus.Review methodsA total of 189 potentially relevant nursing research articles published between the years of 2009 and 2019. Three reviewers independently reviewed the articles, leaving 37 relevant primary articles in the nursing field to be included in the scoping review.ResultsNursing content delivered using blended learning approaches were organized into 8 themes. Themes include Professional Nursing Skills; Mental Health Nursing; Bioscience; Pharmacology, Specialty Populations; Nursing Assessment; Acute Care Nursing; and the Art of Nursing. A variety of blended learning approaches are being utilized in Undergraduate nursing education, the majority of which are happening in the classroom.ConclusionThis scoping review presents explicit the degrees to which blended learning is referred to in the nursing education literature and expanded the definition of blended learning to encompass the terminology associated with distributed, decentralized, hybrid, and flexible learning. There is a wide, varied, and expanding number of blended learning approaches currently being utilized in nursing education to teach a wide range of nursing content and skills. An expanded scoping review focused on blended learning in psychiatric nursing, licenced practical nursing, nurse practitioners, and all graduate level nursing education programs is recommended as is additional research into the use of blended learning in the lab or clinical setting.     

Ageism in nursing education: A review of the literature

This literature review defines ageism, discusses attitudes of ageism and factors related to attitudes of ageism among nurses and student nurses, and describes educational interventions aimed at addressing ageism among undergraduate nursing students. A major gap in the literature was identified as no studies included associate degree nursing students or students in Registered Nurse to Bachelor of Science in Nursing bridge programs. Nurse educators can use evidence to address ageism in programs of nursing. Additional research is needed in underrepresented populations.     

Transitioning through a Bachelor of Nursing program: The enrolled nurse experience

ProblemA lack of understanding of the challenges that Enrolled Nurses experience as they transition to Registered Nurse may prevent the development of resources and strategies necessary to ensure their success in the program.QuestionWhat are the experiences of nursing students who are enrolled in a Bachelor of Nursing program as they transition from Enrolled Nurse to Registered Nurse?MethodsA qualitative interpretive approach, influenced by phenomenology and underpinned by Schlossberg’s Transition theory, was used in this study. Data was collected from Enrolled Nurses (n = 7) using individual interviews and enriched with additional context from a focus group of nursing academics (n = 4).FindingsFive themes were identified: ‘Standing out from the crowd’, ‘struggling with the academic demands’, ‘seeking personal and professional balance’, ‘moving beyond the constraints of being an EN’ and ‘growing within the program’.DiscussionThe challenges experienced by the Enrolled Nurses, such as adapting to the requirements of the tertiary program and balancing study with their other life responsibilities, were identified as being exacerbated by the 12 months of advanced standing that they receive. Strategies to overcome these challenges included accessing academic and personal resources. Success within the program was discussed by these students as empowering their personal and professional lives.ConclusionThe challenges the Enrolled Nurses encountered and strategies they employed to succeed in the program are identified in this study. Recommendations to improve the transition of Enrolled Nurses through a Bachelor of Nursing program are proposed.     

Teaching and learning about dementia care among undergraduate nursing students: A scoping review

AimReview available evidence on teaching methods and learning outcomes among undergraduate nursing students regarding care for people with dementia. Background: The debilitating nature and the rapidly growing number of dementia cases will cause significant increase in the demand of healthcare services. Nurses play an essential role in improving the quality of care for people with dementia, although some evidence suggests that training in dementia care among nurses is poor.DesignA scoping review of the literature. following the Joanna Briggs Institute methodology for scoping reviews. The source of evidence selection adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review.MethodsData sources were Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Education Resources Information Centre and Scopus. Inclusion criteria were studies found through database search up to 15th December 2020, published in English or Spanish with data regarding any method used for dementia education among undergraduate nursing students.Results19 studies were included in this review. The identified methods were simulation (n = 5), awareness-raising activities (n = 4), placement (n = 3), home visits (n = 3), combined activities (n = 3) and service learning (n = 1). Learning outcomes were measured in terms of knowledge, attitudes, preparedness, empathy, self-confidence, self-efficacy, awareness and students´ perceptions.ConclusionsThis scoping review has found high heterogeneity among dementia education programs and learning outcomes. Nursing education can be enhanced by designing and measuring effective and evidence-based educational interventions so that nursing students develop competencies which make it easier to deliver quality care for people with dementia.     

Fourth year nursing students' perceptions of their educational preparation in medication management: An interpretative phenomenological study

BackgroundMedication safety is an integral aspect of patient safety. Nurses, as advocates of patient safety, actively consider medication safety in the course of their daily work. Hence, it is important to consider the educational preparation of nursing students in medication management, as future caregivers. There are inherent links between nurses' undergraduate educational preparation in medication management and patient safety.ObjectiveThis research study identifies fourth-year nursing students' perceptions of their educational preparation in medication management.DesignAn interpretative phenomenological methodological approach underpinned this research study.SettingThis study was conducted at a University in the West of Ireland.ParticipantsParticipants were final year students of three undergraduate nursing programmes, Bachelor of Science in Nursing (General), Bachelor of Science in Nursing (Intellectual Disability) and Bachelor of Science in Nursing (Mental Health).MethodsFourteen semi-structured, face-to-face interviews were conducted with students on a one-to-one basis. Data were analysed using thematic content analysis.ResultsThe voices and interpretations of the participants in this study were fundamental to understanding nursing students' perceptions of their preparation in medication management and provided the foundation for this research. These perceptions were captured in the format of four themes: developing an understanding, embedding knowledge in practice, engaging in practice and accepting professional responsibility.ConclusionsFindings point to the important role of the university and the clinical placement settings in nursing students' medication management education and the need for further collaboration and development across both settings. Teaching and learning strategies which promote the integration of theory and practice throughout the four years of the undergraduate degree programme should be encouraged, such as technology enhanced learning and simulation.     

Undergraduate registered nursing students working as assistants in nursing within the acute care environment: Program development and discussion

BackgroundMost pre-registration nursing students require employment during their studies which may entail undertaking another qualification.This paper describes how one university developed a program whereby undergraduate nursing students complete the national vocational education – HLT33115 Assistant in Nursing qualification through recognition of prior learning, a self-directed education package and completion of an objective structured clinical examination.ObjectiveTo discuss the development of an ‘Assistant in Nursing’ in the acute care environment program for pre-registration undergraduate nursing degree students using the national vocational education framework.DesignThis program maps the national ‘Assistant in Nursing- Acute Care’ vocational qualification to the pre-registration registered nurse degree. Upon successful completion of this program students can work as Assistants in Nursing within the acute care environment.ConclusionsThis program enables student nurses to work as Assistants in Nursing within the acute care environment. This provides employment in a health facility and opportunities for students to immerse themselves in the clinical environment whilst continuing their studies. This may assist students to gain a deeper insight into their future role as a nurse, build networks within the nursing community and assimilate into the clinical environment. This program design may prove useful as a template for other nursing faculties wishing to implement a similar program.     

Creating a quadruple aim model for nursing education

Baccalaureate nursing education is moving to adopt the new American Association of Colleges of Nursing Essentials for Professional Nursing Education. As identified in two of the six domains of the essentials, graduates need to be prepared to address population health and utilize informatics and healthcare technologies. Community/public health nursing also has eight domains for generalist nurses linked to population health which will help prepare a skilled nursing workforce for the 21st century. The Institute for Healthcare Improvement's Triple Aim which evolved into the Quadruple Aim is focused on improving health outcomes within healthcare delivery. Through a literature review, a need for a Quadruple Aim model for nursing education was identified. Mirroring the Institute for Healthcare Improvement's Triple Aim for healthcare delivery, a Quadruple Aim for Nursing Education Model was developed. The model dimensions include (1) Population-focused Care, (2) Maximize Student Learning Experience, (3) Cost-effective Pedagogy, and (4) Nurse Educator Well-being. The Quadruple Aim for Nursing Education Model supports nursing education to prepare future nurses effectively and efficiently bridging population health concepts and issues with nursing informatics. Nurse educators are encouraged to utilize the model to transform nursing education.     

Integrating informatics into undergraduate nursing education: A case study using a spiral learning approach

A gap in informatics expertise amongst nursing students, practising staff and faculty has been noted globally, which reduces the potential for nurses to utilise technology to enhance patient care. National nursing education strategies and recommendations from professional associations have identified digital health as an area that needs investment. This case study describes how health informatics is being integrated into a Bachelor of Nursing programme in the United Kingdom. An international collaboration with a US-UK Fulbright Specialist Scholar enabled individual learning units corresponding to key health informatics competencies to be designed and incorporated into a pedagogic framework grounded in the spiral learning approach. This approach is proposed as one way to integrate informatics into nursing education, so students can become competent clinicians that are able to deliver technology enabled care in the health service.     

Models of collaboration and dissemination for nursing informatics innovations in the 21st century

BackgroundNursing informatics innovations are constantly adapting to a rapidly changing health care environment.PurposeThis study aims to present the lessons learned from 4 nursing informatics projects and rationale for development decisions to inform future informatics innovations.MethodsUsing a comparative cross-case analysis, four case studies of informatics projects led by nurse scientists were described and analyzed through the lens of the Informatics Research Organizing Model which was modified to include policy and interoperability contexts.FindingsThe comparison analysis examined dynamic relationships between processes and constructs in nursing informatics interventions and also highlighted the scientific, intellectual property, technical, and policy challenges encountered among the four case studies.DiscussionThe analysis provided implications for future intervention development and implementation in consideration of multiple contexts for nursing informatics innovations.     

A protocol for a scoping review of the use of mental simulation and full-scale simulation in practising healthcare decision-making skills of undergraduate nursing students

AimThis scoping review aims to explore the effect of FSS and mental simulation on the decision-making skills of nursing students.BackgroundFull-scale simulation (FSS) has been the most used simulation modality in nursing education due to its applicability to enhance both technical and non-technical skills. However, FSS can be excessively costly and other factors such as technophobia and lack of trained staff and support make FSS less accessible, especially for nursing education. Therefore, a novel mental simulation that is interactive and supported by visual elements can be a substitute for FSS, at least for some of the skills, such as clinical decision-making. Reviews comparing the effectiveness of FSS and mental simulation on decision-making skills in nursing students are lacking. Further knowledge on the effectiveness of these two modalities on decision-making skills for nursing students is needed to inform the nursing education curriculum and to decide between the two modalities.DesignThis protocol adheres to the guidelines outlined in the PRISMA extension for scoping reviews (PRISMA-scr) checklist.MethodThe methodological framework for scoping reviews will be followed for this scoping review. Scopus, EBSCOhost the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE and for the grey literature ERIC and BASE will be searched for related studies. The search will be limited to January 2008 and April 2023 (up-to-date) and English. A detailed search strategy was developed with an experienced research information manager and this strategy will be adapted to each database. A single screening will be performed by an author who will screen all abstracts and titles and full-text publications. After the study selection step of the framework, the data from the included studies will be charted using a data extraction form. The data will be synthesised by comparing the effect of FSS and mental simulation on decision-making skills.ConclusionA synopsis of the publication on FSS and mental simulation on nurse students’ decision-making skills will be useful for stakeholders when choosing between two modalities to deliver decision-making skills to nursing students and also help to inform the nursing education and simulation practice.Scoping Review RegistrationProtocols.io (doi: 10.17504/protocols.io.e6nvw57y7vmk/v1)     

Career in mental health still an unlikely career choice for nursing graduates: A replicated longitudinal study

The lack of qualified mental health nurses is at critical level with the problem likely to worsen as the aging mental health nursing workforce retires. This study investigates the career preferences of undergraduate nursing students by comparing preferences at the start, middle, and end of the Bachelor of Nursing program. The comparison of the cohorts gave an indication of the change in preferences over the intervening years. It replicates research completed in 1992, 1997, and 2001, and develops a profile of nursing career preferences and the rationale underpinning those preferences in a cohort of students (n = 150) who began their Bachelor of Nursing studies in 2007 and completed in 2009. The main findings included that, like the previous studies, mental health nursing is one of the least desirable career choices for most nurses at the start of their course and remains so as they approach graduation. The reasons change but the outcome remains the same. The current system of using the Bachelor of Nursing award to produce mental health nurses in Australia does not encourage nurses to consider a career in mental health nursing. Which begs the question: where will mental health nurses in the future come from?     

Teaching and learning activities to educate nursing students for interprofessional collaboration: A scoping review

To prepare new graduates with the knowledge, skills, and attitudes to engage in effective interprofessional collaboration (IPC) in practice, healthcare professional programmes need to ensure their curriculum provides opportunities for interprofessional education (IPE) and IPC. To strengthen IPE within an undergraduate curriculum and meet the professional requirements set out by regulatory bodies to prepare new graduate nurses to achieve IPC competencies, a curriculum initiative was developed to expand IPE across the four years of the Baccalaureate of Science in Nursing (BSN) programme. The purpose of this scoping review was to identify published teaching-learning activities in undergraduate nursing programmes to inform the development and integration of IPE curricula. The literature included was identified by searching the following electronic databases: EMBASE and EBSCO (CINAHL, Medline, Education Research Complete, ERIC). The search was limited to articles with abstracts published between 2008 and 2016 in the English language. All ten studies that met inclusion criteria reported students’ perceived interprofessional education as valuable in facilitating their achievement of IPC competencies. Interprofessional education is an approach for preparing nursing students with knowledge, skills, and attitudes to achieve IPC competencies and therefore, urgently needs to become more prevalent in nursing curricula. Educators can use a variety of IPE teaching-learning activities to support students’ achievement of IPC competencies in order to prepare new practitioners to engage in effective IPC in a variety of healthcare milieus. Nurse educators are encouraged to intentionally integrate learning opportunities into current and future undergraduate nursing education to prepare collaborative ready graduate nurses.     

Mental health literacy of Australian Bachelor of Nursing students: a longitudinal study

Many students have poor mental health literacy when they finish Bachelor of Nursing courses. This paper presents the findings of a longitudinal study of Australian Bachelor of Nursing students' mental health literacy about the effectiveness of interventions for people with schizophrenia. The 'Attitudes and Beliefs about Mental Health Problems: Professional and Public Views' questionnaire was used with a non-probability sample of nursing students. A time series approach to data collection was used, with data collected on three occasions between 2005 and 2007. Ethics approval was obtained from a university ethics committee. Data were analysed using SPSS Version 15.0. The students' views about the helpfulness of interventions showed a significant and positive improvement as they progressed through the course. There were significant differences over time in their views about the helpfulness of professional and lay interventions, their opinions about the helpfulness of mental health and other medications, and the usefulness of activity and non-pharmacological interventions. Because nursing students need to be mental health literate when they complete their course, mental health nursing content should be incorporated earlier in comprehensive undergraduate curricula and incrementally increased in each year of study.     

Undergraduate nursing program admission criteria: A scoping review of the literature

ObjectiveTo provide a broad overview of literature related to undergraduate nursing program admission criteria used by faculty and administrators in the United States to predict student program success.DesignA scoping review of literature.Review methodsReview was guided by the framework for a scoping review suggested by Arksey and O'Malley (2007).Data sourcesCinahl; ERIC; Google Scholar; ARHQ; Medline; ProQuest; Sigma Literature Search.ResultsThirty-five relevant articles were selected for full review, including 25 published research studies and 10 doctoral theses. Three themes emerged in the charted literature representing criteria used to predict student program success: academic program admission criteria, nonacademic program admission criteria, and admission criteria formulas or scoring systems. The traditional academic criterion of cumulative pre-nursing GPA was the criterion most commonly cited as being used to predict student success in a nursing program. No one criteria or combination of criteria emerged as most predictive of student program success.ConclusionSignificant gaps in the literature exist regarding standards or benchmarks for determining program admission criteria, including nonacademic criteria such as CNA status or previous healthcare experience, that adequately predict student success in an undergraduate nursing program.     

Factors contributing to undergraduate nursing students' satisfaction with a video assessment of clinical skills

BackgroundClinical skill assessment via Objective Structured Clinical Assessment (OSCA) has many challenges for undergraduate nursing students. These include high levels of anxiety that can compromise performance during the assessment, inconsistency with assessor reliability and is inconsistent with clinical skills performance in the real world. The implementation of a Video Assessment of Clinical Skills (VACS) that integrates formative feedback may be a way to address the challenges posed by OSCA assessment.ObjectivesThe aim of this study was to examine the acceptability, utility, and nursing student satisfaction with a formative feedback strategy – the Video Assessment of a Clinical Skill (VACS).DesignA cross sectional survey.SettingsUndergraduate Bachelor of Nursing degree students from a large Australian University.ParticipantsThird year undergraduate nursing students (final year) enrolled in a Bachelor of Nursing Program.MethodsParticipants were recruited via purposive sampling. A pre-survey (prior to VACs assessment) and post-survey (after VACS assessment) were completed. This paper reports on the open-ended responses in the post-survey that explored students' insights and perceptions into formative feedback and its impact on their learning for the VACS assessment.ResultsA total of 731 open-ended responses were analysed with findings being organised into 3 major themes; (i) Flexibility and reflexivity, (ii) Editing and repeated attempts, and (iii) Working together.ConclusionsVideo Assessment of a Clinical Skill has demonstrated good utility, acceptability, and satisfaction among undergraduate nursing students.