Description:
The aim of this study was to investigate whether rural clinical placements for student nurses at a rural university in New South Wales influence their decision to join the rural and remote Registered Nurse workforce. The study utilised a convenience sample of final year Bachelor of Nursing students at a rural university campus, and consisted of two stages of data collection. Stage One employed a pre- and post-clinical placement survey design that elicited both demographic and qualitative data. Stage Two consisted of individual interviews with a sample of final year nursing students while they were on a rural clinical placement. The findings highlight the factors that influence final year students' decisions to seek employment in rural healthcare facilities. These findings will be of interest to nurse academics concerned with ensuring that undergraduate nursing curricula relate to rural nursing practice in Australia and to those involved in recruitment of new graduate RN's to rural nursing practice.
Description:
Background Incorporation of active learning approaches in the preparation of nursing students for future educational roles is an imperative. Reciprocal peer tutoring (RPT) is an active teaching/learning approach, in which individuals from similar academic levels rotate teaching/learning roles. This study aimed to explore the outcomes of RPT on undergraduate nursing students learning. Design/Methods A sequential explanatory mixed methods design, incorporating pre-post intervention surveys and focus groups with a convenience sample of 102 final-year students, from a cohort of 132 (RR = 77.3%), from a regional Australian university campus. Prior to attendance, online resources were provided on teaching fundamentals and two selected clinical skills, namely tracheostomy suctioning and intravenous cannulation. Attending participants were randomly allocated into pairs, rotating teaching and learning roles within clinical skills laboratories. Pre-post intervention survey tools examined knowledge and self-reported attitudes to a peer teaching and clinical teaching preferences (Clinical Teaching Preference Questionnaire). Post-intervention measures included a peer teaching experience (Peer Teaching Experience Questionnaire). Focus group interviews (n = 4) were conducted with 22 participants, to further understand students’ RPT experiences. Results There was positive improvement in attitudes to peer teaching (M = 49.2, SD = 10.0 to M = 52.3, SD = 8.2, p < 0.05, [95% CI = 0.7 to 5.4]). Knowledge scores also increased significantly (M = 6.9, SD = 2.0 to M = 9.7, SD = 1.9), p < 0.05 [95% CI = 2.3 to 3.2]. Aggregate mean knowledge scores increased more for peer teachers (M = 3.3) than they did for peer learners (M = 2.2). Thematic outcomes from focus groups indicated challenging yet beneficial journeys, collective learning outcomes, along with benefits of RPT including enhanced teaching, self-confidence, communication, and independent and collaborative learning. Conclusion This study concludes that RPT is effective in clinical skills teaching and sets a foundation for further research.
Description:
Background Incorporation of active learning approaches in the preparation of nursing students for future educational roles is an imperative. Reciprocal peer tutoring (RPT) is an active teaching/learning approach, in which individuals from similar academic levels rotate teaching/learning roles. This study aimed to explore the outcomes of RPT on undergraduate nursing students learning. Design/Methods A sequential explanatory mixed methods design, incorporating pre-post intervention surveys and focus groups with a convenience sample of 102 final-year students, from a cohort of 132 (RR = 77.3%), from a regional Australian university campus. Prior to attendance, online resources were provided on teaching fundamentals and two selected clinical skills, namely tracheostomy suctioning and intravenous cannulation. Attending participants were randomly allocated into pairs, rotating teaching and learning roles within clinical skills laboratories. Pre-post intervention survey tools examined knowledge and self-reported attitudes to a peer teaching and clinical teaching preferences (Clinical Teaching Preference Questionnaire). Post-intervention measures included a peer teaching experience (Peer Teaching Experience Questionnaire). Focus group interviews (n = 4) were conducted with 22 participants, to further understand students’ RPT experiences. Results There was positive improvement in attitudes to peer teaching (M = 49.2, SD = 10.0 to M = 52.3, SD = 8.2, p < 0.05, [95% CI = 0.7 to 5.4]). Knowledge scores also increased significantly (M = 6.9, SD = 2.0 to M = 9.7, SD = 1.9), p < 0.05 [95% CI = 2.3 to 3.2]. Aggregate mean knowledge scores increased more for peer teachers (M = 3.3) than they did for peer learners (M = 2.2). Thematic outcomes from focus groups indicated challenging yet beneficial journeys, collective learning outcomes, along with benefits of RPT including enhanced teaching, self-confidence, communication, and independent and collaborative learning. Conclusion This study concludes that RPT is effective in clinical skills teaching and sets a foundation for further research.
Description:
Objective This integrative review identified, critically appraised and synthesised the existing evidence on the barriers and enablers to using high-fidelity Human Patient Simulator Manikins (HPSMs) in undergraduate nursing education. Background In nursing education, specifically at the undergraduate level, a range of low to high-fidelity simulations have been used as teaching aids. However, nursing educators encounter challenges when introducing new teaching methods or technology, despite the prevalence of high-fidelity HPSMs in nursing education. Design An integrative review adapted a systematic approach Data source Medline, CINAHL plus, ERIC, PsychINFO, EMBASE, SCOPUS, Science Direct, Cochrane database, Joanna Brigge Institute, ProQuest, California Simulation Alliance, Simulation Innovative Recourses Center and the search engine Google Scholar. Keywords were selected and specific inclusion/exclusion criteria applied. Inclusion criteria The review included all research designs for papers published between 2000 and 2015 that identified the barriers and enablers to using high-fidelity HPSMs in undergraduate nursing education. Review methods Studies were appraised using the Critical Appraisal Skills Programme criteria. Thematic analysis was undertaken and emergent themes were extracted. Results Twenty-one studies were included in the review. These studies adopted quasi-experimental, prospective non-experimental and descriptive designs. Ten barriers were identified, including ‘lack of time’, ‘fear of technology’ and ‘workload issues’. Seven enablers were identified, including ‘faculty training’, ‘administrative support’ and a ‘dedicated simulation coordinator’. Conclusion Barriers to simulation relate specifically to the complex technologies inherent in high-fidelity HPSMs approaches. Strategic approaches that support up-skilling and provide dedicated technological support may overcome these barriers.
Description:
Aim. This is a report of a study investigating processes used by final-year nursing students to recognize and act on clinical cues of deterioration in a simulated environment. Background. Initial decisions about patients who are deteriorating in medical and surgical wards are often made by newly qualified nurses and doctors, increasing the risk of clinical error. There has been an emphasis on the use of teams in simulation; however, signs of deterioration are missed by individual clinicians. Methods. During July 2008, final-year undergraduate nursing students in Australia attended a simulation laboratory for 1Æ5 hours and completed a knowledge questionnaire and two (mannequin-based) scenarios simulating deteriorating patients with hypovolaemic and septic shock. Scenarios were video-recorded and reflective interviews conducted. Additionally, scenarios were stopped around the midpoint to ascertain students’ level of Situation Awareness. Results. Fifty-one students participated in the study, providing a total of 102 videoed scenarios and 51 interviews. Thematic analysis of video data and reflective interviews identified considerable differences in processes used by students to identify cues. Four aspects of cue recognition were evident: initial response, differential recognition of cues, accumulation of signs and diversionary activity. Conclusion. Nursing skills training should emphasize the importance of trends in identifying and acting on deterioration and the need for systematic assessment in stressful situations. Nursing curricula should focus on enhancing the ability to piece information together, including linking pathophysiology with patient assessment, and identify trends, rather than seeing observations as parallel to each other.
Description:
The aim of this study is to evaluate the effect of a mental health clinical placement on student nurses attitudes towards mental illness and mental health nursing. Health holds different definitions for different people. The term health can mean wellness or a state of being. Mental health in our society still is wrought with stigma. It is the use of negative labels to identify someone living with a mental illness. Stigma can be a barrier and may discourage families and individuals from seeking help. In the health care system, these barriers need to be broken, from the first contact with the health profession, these being the nurses. Nurse’s attitudes can develop for many different reasons, these being, and lack of knowledge, stigma, and prior experience with mental illness. As a health care profession, we need to start at the beginning, with assessing and encouraging more understanding and tolerance of mental illness with our student nurses. This study used a longitudinal descriptive pre-post survey design to determine the degree to which a clinical placement with a psychiatric/mental health agency changed student nurses’ attitudes towards mental illness and mental health/psychiatric nursing. Bachelor of nursing students are required to complete a mental health unit of study within the Bachelor of Nursing Degree. This unit of study required student nurses to complete a 4 week clinical placement in a mental health facility. Students were invited to complete a survey before the clinical placement and at the completion of the clinical placement. Of the (n=184) nurses invited to participate in this study, 65 completed the pre and post clinical placement surveys, giving a response rate of 35%.The results show that there is a statistical significance of .001 in the mean attitude scores towards mental illness for pre and post placement. The attitudes towards psychiatric nursing show a statistical significance of .01.Results from this study support recent literature towards a positive change in student nurses attitudes towards mental illness and mental health nursing on the completion of a clinical placement in a mental health facility.
Description:
Recognising and managing clinical deterioration is considered a high priority in health care with ineffective communication being a significant contributing factor to poor clinical outcomes for patients. Nurses are in a unique position to make a difference in influencing improvements in team communication. In Australia, nurse education has become more complicated and demanding with nursing students focus on behaviour skills, such as communication, becoming more difficult in a saturated curriculum. Simulation-based education has provided an experiential way to learn these complex skills. Although there has been much work in the healthcare literature on clinical teamwork, including communication and its intersection with patient safety, there is still a gap in explaining how individuals within the team contribute to communication. The purpose of this study was to explore and explain how nursing students communicate in simulated emergency settings and how factors, such as culture, language, gender, age and power, affect nursing students’ team communication. This study investigated how transitioning nursing students are prepared with the necessary skills to achieve effective team communication at the point of transition to clinical practice as registered nurses. In order to address the aims of the study, a constructivist grounded theory methodology, informed by Kathy Charmaz (2006), was employed. Using purposive sampling, third year nursing students were recruited from one Australian university, to undertake a structured team simulation experience. Participants worked in teams of three or four to experience the team communication whilst working together to care for a deteriorating patient in the form of a mannequin. Simulations were video recorded after which individual, in-depth, semi-structured interviews were conducted with 21 participants. In line with a grounded theory approach, data collection and analysis were conducted concurrently until theoretical saturation was achieved. In response to the central problem of how nursing students communicate in simulated emergency settings, a core process was established that explained the factors that affect team communication. This problem is conceptualised as Navigating uncertainty: Explaining communication of nursing students within an emergency setting. This theoretical construct helps to explain nursing students’ actions and insights into factors that influence their communication within emergency teams. The core process is represented in three transitional stages of the theory comprising: Finding a place in the team, Understanding and working out differences and Looking to the future: Developing strategies to improve communication. This process was mediated by contextual conditions of the student, the simulation and the team. The phases are reinforced by the three main categories of Having a place in the team, Knowing yourself, and Transitioning from student to registered nurse. These categories represent the key activities that nursing students were engaged with that led to the development of the core category and process. The generated findings and theory offer valuable insights into factors that influence team communication skills within emergency settings. The theory raises awareness of social processes undertaken by nursing students during team communication, and highlights obstacles that can assist educators and academics to structure team communication education to better meet the needs of nursing students transitioning to practice settings.
Description:
Recognising and managing clinical deterioration is considered a high priority in health care with ineffective communication being a significant contributing factor to poor clinical outcomes for patients. Nurses are in a unique position to make a difference in influencing improvements in team communication. In Australia, nurse education has become more complicated and demanding with nursing students focus on behaviour skills, such as communication, becoming more difficult in a saturated curriculum. Simulation-based education has provided an experiential way to learn these complex skills. Although there has been much work in the healthcare literature on clinical teamwork, including communication and its intersection with patient safety, there is still a gap in explaining how individuals within the team contribute to communication. The purpose of this study was to explore and explain how nursing students communicate in simulated emergency settings and how factors, such as culture, language, gender, age and power, affect nursing students’ team communication. This study investigated how transitioning nursing students are prepared with the necessary skills to achieve effective team communication at the point of transition to clinical practice as registered nurses. In order to address the aims of the study, a constructivist grounded theory methodology, informed by Kathy Charmaz (2006), was employed. Using purposive sampling, third year nursing students were recruited from one Australian university, to undertake a structured team simulation experience. Participants worked in teams of three or four to experience the team communication whilst working together to care for a deteriorating patient in the form of a mannequin. Simulations were video recorded after which individual, in-depth, semi-structured interviews were conducted with 21 participants. In line with a grounded theory approach, data collection and analysis were conducted concurrently until theoretical saturation was achieved. In response to the central problem of how nursing students communicate in simulated emergency settings, a core process was established that explained the factors that affect team communication. This problem is conceptualised as Navigating uncertainty: Explaining communication of nursing students within an emergency setting. This theoretical construct helps to explain nursing students’ actions and insights into factors that influence their communication within emergency teams. The core process is represented in three transitional stages of the theory comprising: Finding a place in the team, Understanding and working out differences and Looking to the future: Developing strategies to improve communication. This process was mediated by contextual conditions of the student, the simulation and the team. The phases are reinforced by the three main categories of Having a place in the team, Knowing yourself, and Transitioning from student to registered nurse. These categories represent the key activities that nursing students were engaged with that led to the development of the core category and process. The generated findings and theory offer valuable insights into factors that influence team communication skills within emergency settings. The theory raises awareness of social processes undertaken by nursing students during team communication, and highlights obstacles that can assist educators and academics to structure team communication education to better meet the needs of nursing students transitioning to practice settings.