Cultural Norms of Clinical Simulation in Undergraduate Nursing Education

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a rich contextualization of the relationships, beliefs, practices, environmental factors, and theoretical underpinnings encoded in cultural norms of the students’ situated practice within simulation. Our findings add to the evidence linking learning in simulation to the development of broad practice-based skills and clinical reasoning for undergraduate nursing students

The composite first person narrative: Texture, structure, and meaning in writing phenomenological descriptions

This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The method's applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting weight control, chronically ill male parolees, and midlife women experiencing distress during menopause. Within current research, these four phenomena have been predominantly described and understood through quantified articulations that give the reader a structural understanding of the phenomena, but the more embodied or “contextual” human qualities of the phenomena are often not visible. The “what is it like” or the “unsaid” aspects of such human phenomena are not clear to the reader when proxies are used to “account for” a variety of situated conditions. This novel method is employed to re-present narrative data and findings from research through first person accounts that blend the voices of the participants with those of the researcher, emphasizing the connectedness, the “we” among all participants, researchers, and listeners. These re-presentations allow readers to develop more embodied understandings of both the texture and structure of each of the phenomena and illustrate the use of the composite account as a way for researchers to better understand and convey the wholeness of the experience of any phenomenon under inquiry

Formation in an accelerated nursing program: Learning existential skills of nursing practice

AbstractFORMATION IN AN ACCELERATED PROGRAM: TAKING UP EXISTENTIAL SKILLS OF THE PRACTICESusan McNieshIn response to increasing concerns over the national shortage of nurses, schools of nursing, public and private health funding agencies, and health care service organizations have joined forces to offer solutions to the increasing demand for nurses. One solution is to tap into a new population of potential students, those with undergraduate degrees in disciplines other than nursing. There has been little research on accelerated nursing programs and many schools have not yet tailored their curricula to meet the needs of this richly experienced group. The goal of this qualitative research study was to articulate the background understanding of how students in an accelerated master's entry program experientially take up the practice of nursing. Specific aims included: What pivotal formative experiences do students identify as helping them develop and differentiate their clinical practice? How does "the press of the situation" affect the student's performance? How do previous life experiences, education, and career choices influence the experience of second degree students? What potential effects does condensing and accelerating the curriculum have on learning in second degree programs?Data from clinical observations and a combination of small group and individual interviews (N=19) were analyzed using interpretive phenomenological methods. Two lines of inquiry were revealed. The first includes an articulation of the layering of factors that co-constitute to form the background of intensity in an accelerated program. A second line of inquiry articulates the pivotal and formative skills learned through the independent care of a patient. By experiencing the responsibility and action from within the body and from within concrete situations the student is transformed and develops a new understanding that literally changes the individual's embodied ways of perceiving and orienting to the situation, as well as his or her skills and set to act.This research extends the horizon of what can be seen of the background that grounds the taking up of nursing practice in accelerated learning environments. Further research could uncover additional aspects of this rich learning community including relationships among students, with clinical instructors, and with the nurses that facilitate the students' journey