Patient safety competencies in undergraduate nursing students: a rapid evidence assessment

Aims To identify patient safety competencies, and determine the clinical learning environments that facilitate the development of patient safety competencies in nursing students. Background Patient safety in nursing education is of key importance for health professional environments, settings, and care systems. To be effective, safe nursing practice requires a good integration between increasing knowledge and the different clinical practice settings. Nurse educators have the responsibility to develop effective learning processes and ensure patient safety. Design Rapid Evidence Assessment. Data Sources MEDLINE, CINAHL, SCOPUS, and ERIC were searched, yielding 500 citations published between 1 January 2004 - 30 September 2014. Review Methods Following the Rapid Evidence Assessment process, 17 studies were included in this review. Hawker's (2002) quality assessment tool was used to assess the quality of the selected studies. Results Undergraduate nursing students need to develop competencies to ensure patient safety. The quality of the pedagogical atmosphere in the clinical setting has an important impact on the students’ overall level of competence. Active student engagement in clinical processes stimulates their critical reasoning, improves interpersonal communication, and facilitates adequate supervision and feedback. Conclusion Few studies describe the nursing students’ patient safety competencies and exactly what they need to learn. In addition, studies describe only briefly which clinical learning environments facilitate the development of patient safety competencies in nursing students. Further research is needed to identify additional pedagogical strategies and the specific characteristics of the clinical learning environments that encourage the development of nursing students’ patient safety competencies

Nursing on the edge: nursing identity in liminal spaces

This contextual statement is focussed on nursing in clinical practice and higher education encapsulated in a selected body of published work, illustrating a career of over thirty years. This journey spans a political and policy context that includes the expansion of higher education in the 1970s, the closure of the Victorian psychiatric hospitals in the 1990’s, the move of nursing from apprentice-style training into higher education in 1995, and the partial decoupling of nurse education from the NHS. Drawing on theories of liminality and Michael Lipsky’s Street Level Bureaucracy, the statement proposes innovative approaches to raising the profile of nursing, beyond a liminal position. The public works are produced from liminal spaces in clinical practice to the liminal space occupied by nursing in higher education. Whilst accepting the essence of nursing as a caring profession, the statement suggests how societal views about nursing are stereotyped and heavily influenced by the position of women generally. This is compounded by the reluctance of feminism to embrace nursing, and nostalgic views about the profession portrayed in the media and articulated at all levels, including in government. The works indicate how this has contributed to nursing occupying a liminal space in higher education. Focussing on nursing at the margins of society, early papers cover the period of deinstitutionalisation from the large psychiatric hospitals. Further papers focus on influencing the education, identity, and values of nurses, including how the rise of service user involvement can transform curricula. Later papers consider the views and experiences of nurse academics and students about professional identity and how this is expressed in learning and teaching; with insight into how identity and values are shaped by both clinical and educational experiences. The liminal experience of nursing in higher education is explored, alongside the dual identity experienced by nurses who move from clinical practice to the academy. The final group of papers examine the place of work-based learning in higher education, with the paradoxical discovery that although learning in healthcare is abundant, identifying learning opportunities can be elusive. Produced on the margins of clinical and academic practice, the works illuminate hidden areas that are not sufficiently valued. The statement and works provide a platform to raise the position and profile of nursing overall

Nursing student–nurse teacher cooperation using mobile technology during the clinical practicum

The purpose of this three-phase study was to describe the use of mobile devices in nursing student–nurse teacher cooperation during the clinical practicum, to develop a novel alternative called mobile cooperation intervention (MCI) for this cooperation and to evaluate its effectiveness on the students’ clinical learning outcomes and acceptability from the perspective of nursing students. The ultimate goal is to improve the quality of nursing education and thus the outcomes of patient care. In Phase I, an integrative review of use of the mobile devices in nursing student–nurse teacher cooperation during the clinical practicum was conducted. In Phase II, the CLES+T scale was further developed. Additionally, a mobile application called Study@CampusPro (App) and a mobile cooperation intervention (MCI) were developed. In Phase III, a randomised controlled trial design was used to evaluate the effectiveness of the MCI on nursing students’ clinical learning outcomes, i.e. the individual outcomes (competence and self-efficacy) and contextual outcomes (quality of the clinical learning environment). Data were collected using three instruments (1) the Nurse Competence Scale (NCS), (2) the Self-efficacy in Clinical Performance instrument (SECP) and (3) the Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T2). Eligible nursing students (n=102) were randomly allocated to an intervention group (n=52) with mobile cooperation and a control group (n=50) with standard cooperation. The congruence between the nursing students’ self-assessed competence and the mentors’ assessments of the students’ competence was examined by comparing the nursing students’ self-assessments and their mentors’ (n=95) assessments. Moreover, a process evaluation was conducted by examining the students’ acceptability of the MCI by using a process evaluation questionnaire (Peq) developed for this study and the System Usability Scale (SUS) and student essays. The methods of analysis used in this study were critical appraisal, thematic and content analysis as well as descriptive statistics and statistical modelling. There have been only a few studies (n=17) on nursing student–nurse teacher mobile cooperation and their methodological weaknesses are evident. The MCI was found to be significantly effective in facilitating nursing student–nurse teacher cooperation and as effective as standard cooperation in improving the clinical learning outcomes of nursing students. The older age was shown to be significantly associated with improvements in the competence in the whole study population. Students’ self-assessed theoretical knowledge and practical skills prior to the clinical practicum were also shown to be significantly associated with the quality experienced of the clinical learning environment. In the control group, the students’ self-assessed competence showed a weak but significant congruence with their mentors’ assessments. The MCI was given a high degree of acceptance among students and the App’s usability was rated as rather good. The items developed for the T -subscale of the CLES+T scale, on which the CLES+T2 scale were based, demonstrated an appropriate level of content validity and good internal consistency. This study suggests there is potential in the MCI to improve the quality of the nurse teacher’s pedagogical cooperation with students and for being used as an alternative cooperation method in supporting students’ clinical learning outcomes.Hoitotyön opiskelijan ja opettajan välinen mobiiliteknologia-avusteinen ohjaus harjoittelun aikana Tämän kolmivaiheisen tutkimuksen tarkoituksena oli kuvata mobiililaitteiden käyttöä opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa, kehittää mobiiliohjausinterventio (MCI) tähän ohjaukseen ja arvioida intervention vaikuttavuutta opiskelijan kliinisiin oppimistuloksiin ja intervention hyväksyttävyyttä opiskelijoiden näkökulmasta. Tutkimuksen tavoitteena on edistää hoitotyön koulutuksen laatua ja siten hoitotyön tuloksia. Vaiheessa I tehtiin integratiivinen katsaus mobiililaitteiden käytöstä hoitotyön opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa. Vaiheessa II jatkokehitettiin kliininen oppimisympäristö, ohjaus ja opettaja (CLES+T) -mittaria sekä kehitettiin mobiiliapplikaatio Study@CampusPro (App) ja mobiiliohjausinterventio (MCI). Vaiheessa III toteutettiin satunnaistettu kontrolloitu tutkimus, jossa mitattiin mobiiliohjausintervention vaikuttavuutta hoitotyön opiskelijoiden kliinisiin oppimistuloksiin, yksilösidonnaisiin (kompetenssi ja minäpystyvyys) ja kontekstisidonnaisiin (kliinisen oppimisympäristön laatu) seuraavilla mittareilla: (1) Sairaanhoitajien ammattipätevyysmittari (NCS), (2) Self-efficacy in Clinical Performance (SECP) -mittari ja (3) CLES+T2 -mittari. Tutkimukseen soveltuvat hoitotyön opiskelijat (n=102) satunnaistettiin mobiiliohjausta saavaan interventioryhmään (n=52) ja standardiohjausta saavaan kontrolliryhmään (n=50). Opiskelijoiden kompetenssin itsearviointien vastaavuutta ohjaajien arvioimaan opiskelijoiden kompetenssiin tarkasteltiin vertaamalla opiskelijoiden itsearviointeja ohjaajien (n=95) arviointeihin. Lisäksi toteutettiin prosessievaluaatio, jossa selvitettiin opiskelijoiden mobiiliohjausintervention hyväksyttävyyttä tätä tutkimusta varten kehitetyllä prosessievaluaatiokyselyllä (Peq), SUS -mittarilla ja opiskelijoiden esseillä. Analyysimenetelminä olivat kriittinen arviointi, temaattinen ja sisällön analyysi sekä kuvailevat tilastolliset menetelmät ja tilastollinen mallintaminen. Mobiililaitteiden käytöstä hoitotyön opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa on rajoitetusti aikaisempia tutkimuksia (n=17) ja niissä on havaittavissa menetelmällisiä heikkouksia. Mobiiliohjausinterventio osoittautui tehokkaaksi menetelmäksi hoitotyön opiskelijan ja opettajan välisessä harjoittelun aikaisessa ohjauksessa sekä yhtä tehokkaaksi edistämään opiskelijoiden kliinisiä oppimistuloksia kuin standardiohjaus. Opiskelijan korkeammalla iällä ja kompetenssin kasvulla oli merkitsevä yhteys koko tutkimuspopulaatiossa. Opiskelijoiden itsearvioimilla teoreettisilla tiedoilla ja käytännön taidoilla ennen harjoittelua sekä koetulla kliinisen oppimisympäristön laadulla oli merkitsevä yhteys. Kontrolliryhmässä oli heikko vastaavuus opiskelijoiden ja ohjaajien arvioiman opiskelijoiden kompetenssin välillä. Mobiiliohjausinterventio oli erittäin hyväksyttävä ja mobiiliapplikaation käytettävyys oli melko hyvä opiskelijoiden arvioimana. CLES+T -mittariin kehitetyt uudet T2 -osion väittämät, jotka olivat perustana CLES+T2 -mittarille, olivat sisällöllisesti valideja ja johdonmukaisia. Tämä tutkimus osoittaa mobiiliohjausinterventiolla olevan potentiaalia edistää hoitotyön opettajan pedagogisen ohjauksen laatua ja se soveltuu vaihtoehtoiseksi ohjausmenetelmäksi tukemaan opiskelijan kliinisiä oppimistuloksia

Emerging Areas of Nursing Science and PhD Education for The 21\u3csup\u3est\u3c/sup\u3e Century: Response to Commentaries

We respond to commentaries from the American Academy of Nursing, the American Association of Colleges of Nursing, and the National Institute of Nursing Research on our thoughts about integrating emerging areas of science into nursing PhD programs. We identify areas of agreement and focus our response on cross-cutting issues arising from cautions about the unique focus of nursing science and how best to proceed with incorporation of emerging areas of science into nursing PhD programs

Informal mobile learning in nurse education and practice in remote areas-a case study from rural South Africa

BACKGROUND: With the proliferation of portable digital technology, mobile learning is becoming increasingly popular in nursing education and practice. Most of the research in this field has been concentrated on small-scale projects in high income countries. Very little is known about the ways in which nurses and midwives use mobile technology in remote and resource poor areas in informal learning contexts in low and middle income countries. OBJECTIVES: To address this gap, this study investigates whether nurses use mobile phones as effective educational tools in marginalized and remote areas, and if so, how and why. SETTING AND METHODS: In rural South Africa, 16 nurses who attended an advanced midwifery education program, facilitators and clinical managers were interviewed about their use of digital mobile technology for learning. Techniques of qualitative content analysis were used to examine the data. RESULTS: Several rich “organically-grown”, learning practices were identified: mobile phone usage facilitated (1) authentic problem solving; (2) reflective practice; (3) emotional support and belongingness; (4) the realization of unpredictable teaching situations; and (5) life-long learning. CONCLUSIONS: It is concluded that mobile phones, and the convergence of mobile phones and social media, in particular, change learning environments. In addition, these tools are suitable to connect learners and learning distributed in marginalized areas. Finally, a few suggestions are made about how these insights from informal settings can inform the development of more systematic mobile learning formats.Web of Scienc

Information technology in nursing education: perspectives of student nurses

The purpose of this study was to explain and describe the perspectives of student nurses at a private nursing education institution (NEI) in the province of KwaZulu-Natal (KZN), South Africa, on the use of information technology (IT) in nursing education. A quantitative, non-experimental descriptive research design was selected to determine the respondents’ perspectives on IT and identify challenges that they encountered. The target population included all student nurses registered at the private NEI for the Bridging Programme for Enrolled Nurses leading to registration as a General Nurse (R683) and the Advanced Diploma in Medical and Surgical Nursing Science with specialization in either Critical Care, Trauma and Emergency, or Perioperative Nursing (R212). The researcher developed and used a structured self-administered questionnaire for data collection. Data was analysed using descriptive and inferential statistics. The study highlighted that the respondents acknowledged the importance and benefits of IT in nursing education and the profession, but encountered challenges in using IT. The study found that the respondents owned at least one IT device, used IT frequently for study and work purposes, reported IT competence, and had positive attitudes to IT. The researcher made recommendations to improve the use of IT in nursing education and for further study.Health StudiesM.A. (Nursing Science

Nurses’ Learning and Conceptualization of Technology used in Practice

How nurses conceptualize and learn about health technology used in practice was examined in this qualitative, interpretive-descriptive study. Traditionally, conceptualizations of technology used in the nursing profession have been viewed from either socially- or technically- centric perspectives that have clouded the real nature of nurse-technology interactions. For instance, current perspectives examining nurses’ use of technology typically ignore or minimize socio-technical considerations impacting technology acceptance and adoption by nurses. A research approach that embraced the mingling of social and material (sociomaterial) actors was used to address the following research questions: (a) How do nurses conceptualize health technology used in practice?, and, (b) How do nurses learn about health technology used in practice? The theoretical lens of Actor-Network Theory (ANT) provided the overall perspective and guided elements of data collection and analysis. ANT is aligned to a relational ontology, whereby both human and non-human participants (or actors) are viewed in symmetry (or as equals) during data analysis. Privilege during the analysis was, therefore, not automatically prescribed to either the human or non-human actors. Interviews, documents, and direct observation of nurses constituted the majority of the data collected for this study. Using an iterative data analysis process, themes were generated related to nurses’ conceptualization of and learning about technology used in practice. Technology was conceptualized by nurses to possess variation in naming, roles, and also engendered notions of action or praxis. Learning technology by nurses possessed elements resembling both processes and products. From these learning processes and products, salient strategies (e.g., indispensability, semblance, habituation) were developed by nurses in order to negotiate and use various health technologies for practice. Ultimately, learning of health technology by nurses appeared to actively influence, modify, and shape the role of health technology, and its subsequent use by human actors. Therefore, how nurses learn about technology should be considered during the planning, development, and evaluation of future technologies. End-users, like nurses, will rarely use a health technology to its fullest capability unless learning is congruent with the environmental context surrounding the technological actor. In light of these findings, recommendations for nursing education and professional practice related to the role and interpretation of health technology used by nurses in 2013 is also discussed, along with implications for future research

Digital learning for breaking bad news in clinical training and practice

Introduction Good communication and the ability to break bad news are essential skills for clinicians but are underemphasised in training programmes. In recent years, digital learning has come to the forefront in healthcare education. However, the evidence for its use in breaking bad new (BBN) training is limited. This thesis explores clinicians’ digital learning needs, highlights pre-existing curricular requirements for BBN training, and examines how this translates into clinical practice. Methods Digital learning needs and curricular requirements for BBN training were established through (i) a systematic review and narrative synthesis of the literature, (ii) a thematic analysis of semi-structured interviews exploring clinicians’ perceptions, and (iii) a content analysis of UK postgraduate medical and nursing curricula. From this, a novel digital learning framework for BBN training was presented and used to evaluate pre-existing digital learning resources (DLRs). The acceptability of one DLR and its impact on confidence in BBN was tested with clinicians in a pre-post mixed-methods pilot study. Results Three digital learning needs were identified from the narrative synthesis of a heterogenous group of 26 studies, including positioning the learner as an active participant in a safe digital environment. Five learning needs were extracted from interviews with doctors (n=16) and nurses (n=16), including accessibility and catering to learning preferences. Thirty-one pre-existing curriculum requirements were identified from the content analysis of curricula. The learning needs and curriculum requirements were collated to form a digital learning framework. In the pilot study, a mobile learning application (VitalTips) proved to enable skills acquisition and improve confidence in BBN, as it was user-friendly, emulated clinical practice, and highlighted challenges for learning in the workplace. Conclusions The research presented in this thesis showcases the requirements for and effectiveness of digital learning for BBN training. Though it may not replace learning through clinical practice, digital learning can be a powerful adjunct. As digital learning develops, there will be exciting future advancements in this field of education.Open Acces