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Online Advanced Release
Articles appearing in this "Online Advanced Release" section have been peer-reviewed and accepted for publication in the Journal of Nursing Education and posted online before print publication. Articles appear on this site after copyediting and author corrections, but before final proofing. The content of the article will usually remain unchanged, and possible further corrections are fairly minor. The final published article will specify the issue and page numbers. Once the final version is available in print, the version posted here will be removed from this site.
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Table of Contents
Marie Dacey, EdD; Judy I. Murphy, PhD, RN, CNE; Delia Castro Anderson, PhD; William W. McCloskey, PharmDReceived: December 2, 2009; Accepted: February 3, 2010; Posted: August 31, 2010
Recognizing the importance of interprofessional education, we developed a pilot interprofessional education course at our institution that included a total of 10 nursing, BS health psychology, premedical, and pharmacy students. Course goals were for students to: 1) learn about, practice, and enhance their skills as members of an interprofessional team, and 2) create and deliver a community-based service-learning program to help prevent or slow the progression of cardiovascular disease in older adults. Teaching methods included lecture, role-play, case studies, peer editing, oral and poster presentation, and discussion. Interprofessional student teams created and delivered two different health promotion programs at an older adult care facility. Despite barriers such as scheduling conflicts and various educational experiences, this course enabled students to gain greater respect for the contributions of other professions and made them more patient centered. In addition, interprofessional student teams positively influenced the health attitudes and behaviors of the older adults whom they encountered.
doi:10.3928/01484834-20100831-09
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Patricia D’Antonio, PhD, RN, FAAN; Margaret W. Beal, PhD, CNM; Patricia W. Underwood, PhD, RN, FAAN; Frances Rieth Ward, PhD, RN; Michele McKelvey, MSN, RN; Barbara Guthrie, PhD, RN, FAAN; Deborah Lindell, DNP, PHCNS-BC, CNEReceived: November 11, 2009; Accepted: February 3, 2010; Posted: August 31, 2010
This study analyzes the expectations that incoming students and faculty bring to accelerated prelicensure education programs for second-degree students. Although research supports the congruence of expectations between students and faculty as essential to learning, anecdotal evidence and single case reports suggest there may be important discrepancies in expectations of second-degree students and their faculty. Data are intended to support curriculum review, refinement, and innovation in these programs.
doi:10.3928/01484834-20100831-08
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Teaching Research and Evidence-Based Practice Using a Service-Learning Approach
Karen Balakas, PhD, RN, CNE; Laurie Sparks, PhD, RN, CPNPReceived: August 25, 2009; Accepted: February 11, 2010; Posted: August 31, 2010
Because nurses are expected to engage in evidence-based practice (EBP), nursing students must learn to critically evaluate and apply research findings to prepare for professional practice. To connect research and EBP, the focus of a baccalaureate research course was changed from a traditional format to one of evidence appraisal and synthesis. Using an approach that incorporated service-learning and collaborative learning resulted in a new hybrid course that provided students with an opportunity to apply concepts in the real world. Working with a community partner, students were able to develop PICO (Population, Intervention, Comparison, and Outcome) questions and critically appraise the literature to establish the evidence base for three pediatric programs. Students reported that working with a community partner was a meaningful experience because course assignments had a direct impact on current practice. Research courses taught from an EBP perspective can provide motivation for students to incorporate research into their practice as professional nurses.
doi:10.3928/01484834-20100831-07
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Graduate Nursing Online Orientation Course: Transitioning for Success
Ann K. Carruth, DNS, RN; Paula C. Broussard, DNS, RN, CNE; Valarie P. Waldmeier, PhD, FNP-BC, ANP-BC; Donna M. Gauthier, PhD, RN, CNE; Gina Mixon, RN, BSReceived: April 2, 2009; Accepted: February 11, 2010; Posted: August 31, 2010
Graduate nursing students beginning their graduate education often lack technological preparedness when beginning the journey in a virtual e-learning environment. These gaps in preparedness include lack of understanding course delivery, accessing resources remotely, participating in asynchronous course activities, and use of emerging health care technologies. This article describes an educational innovative online orientation course that simulates course activities so that students get a true perspective of what e-learning entails. With enhanced education through the accelerated learning modules, students became proficient with distance education, which promotes success in an online master’s of science in nursing program.
doi:10.3928/01484834-20100831-06
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Tailoring a Diabetes Nursing Elective Course to Millennial Students
Sharon Lee Strang, DNP, APRN, FNP-BC; Margaret Bagnardi, EdD, ARNP, CCRN; Sharon Williams Utz, PhD, RNReceived: December 16, 2009; Accepted: February 10, 2010; Posted: August 31, 2010
Tailoring classroom teaching to millennial college students who have grown up as active learners is challenging. Interactive, collaborative teaching methods may be effective with such learners. An innovative class using Diabetes Conversation Maps, a patient self-management tool, was taught as an elective course. Students were assigned the role of a person who received a diagnosis of diabetes; the role included the person’s specific age, gender, ethnicity, medication regimen, and predominant emotion. Students were expected to complete the assigned readings to enable them to role-play during five Conversation Map sessions. An updated, modified version of the Michigan Diabetes Research and Training Center’s Brief Diabetes Knowledge Test was used to evaluate knowledge in a pretest-posttest format. The new teaching method resulted in an increased knowledge of diabetes and patient education techniques, as well as high student satisfaction.
doi:10.3928/01484834-20100831-05
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Ways of Seeing: Using the Visual Arts in Nursing Education
Judith Frei, MSN, RN; Sarah E. Alvarez, MA; Michelle B. Alexander, DNP, APN, ACNS-BCReceived: November 11, 2008; Accepted: February 1, 2010; Posted: August 31, 2010
Professional nursing defines its foundation of practice as embedded in the sciences and humanities of a liberal education. This liberal education is commonly alluded to with the phrase “the art and science of nursing.” Yet how do we as nursing educators integrate these two concepts? This article describes a method of integrating the humanities as part of an innovative clinical experience. A defined visual art experience was used to improve professional nursing students’ observational and communication skills, narrative sequencing abilities, and empathy. The nursing and medical literature describing the use of visual art encounters in health care education is reviewed. The incorporation of an art education program into the curriculum of a cohort of accelerated baccalaureate nursing students is described. Qualitative evaluation measures from the students suggest this was an experience that broadened their understanding of patient encounters.
doi:10.3928/01484834-20100831-04
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Andrea McCrink, EdD, WHNP-BC, RNReceived: August 11, 2009; Accepted: February 10, 2010; Posted: August 31, 2010
The purpose of this study was to gain knowledge about academic misconduct in associate degree nursing students enrolled in two nursing programs in the northeastern United States. Study respondents (n = 193) identified the frequency of engagement in behaviors of misconduct in both the classroom and clinical setting and their attitudes toward the identified behaviors of misconduct, neutralization behaviors, ethical standards of the nursing profession, and the ethic of caring within the nursing profession. Findings were consistent with previous research on academic misconduct in baccalaureate nursing students. Analysis of self-reported cultural identities refuted the prevailing literature on academic misconduct across differing cultures and nations.
doi:10.3928/01484834-20100831-03
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Vera G. Kling, DHSc, MSN, RN, BCReceived: July 21, 2009; Accepted: February 10, 2010; Posted: August 31, 2010
Nurse educators seek innovative strategies to maximize student learning in the classroom and clinical settings. Students enrolled in a nursing leadership and management course often find they spend more clinical time observing leaders than practicing the necessary skills to lead others in the provision of nursing care. In addition, opportunities to explore the nurse educator role often do not exist in baccalaureate nursing education, despite the shortage of nurse educators. An experience was developed in a baccalaureate nursing program to give senior students, under supervision of faculty, the opportunity to lead and evaluate lower-level students providing patient care in the clinical setting and to experience the role of nursing faculty. Feedback from senior students was positive, and students noted increased proficiency in leadership ability and critical thinking. Student interest in the nurse educator role was also enhanced. Program expansion and evaluation with faculty, clinical staff, and patients are planned.
doi:10.3928/01484834-20100831-02
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Third-Year Undergraduate Nursing Students’ Perceptions of High-Fidelity Simulation
Karen Wotton, PhD, RN, RM; Jordana Davis, BN, RN; Didy Button, MN, RN; Moira Kelton, MN, RNReceived: July 21, 2009; Accepted: February 10, 2010; Posted: August 31, 2010
High-fidelity simulation, with the potential to enhance cognitive, associative, and autonomous skills, can help students develop clinical reasoning. This study examined third-year students’ (N = 300) perceptions about the implementation of high-fidelity simulation into an existing clinical course. Data were collected using an evaluation form completed by students after the simulation. Students perceived high-fidelity simulation as enjoyable, with an appropriate degree of challenge yet possessing congruency with concepts studied in the course. Students’ transient feelings of confusion were interpreted as a natural component of the problem solving process as they analyzed, clustered, and interpreted cues to respond to rapid changes in the simulated patient’s clinical condition. Debriefing was viewed as an important component and assisted in clarifying students’ knowledge and rationale for practice. Further research is required on the relationship between the degree of confusion and its impact on learning and whether high-fidelity simulation increases the ability to reason in the clinical setting.
doi:10.3928/01484834-20100831-01
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A Mentor-Protégé Program for New Faculty, Part II: Stories of Mentors
Carol B. Wilson, PhD, RN; Jane Brannan, EdD, RN; Anne White, DSN, RNReceived: June 30, 2009; Accepted: February 3, 2010; Posted: July 30, 2010
Mentorship has been identified as an influential factor in retaining new nursing faculty. A mentor-protégé program for novice faculty was implemented to promote development of the protégés in their role as nurse educators. A qualitative research study conducted to illuminate the meaning of experiences of mentors led to the emergence of four patterns: The Significance of the Mentor-Protégé Relationship, Communication as Important Between Mentor and Protégé, The Mentor-Protégé Program—Protégé’s Perspectives, and The Mentoring Role as Expert Educator. The data from the study support the significance of providing mentorship to novice or new nurse educators. The data suggest that mentors benefit from participation in a mentor-protégé program as much as the protégés. Similar programs are needed in nursing if we are to mentor and encourage faculty to begin and remain in the role of educators to combat the future nurse educator shortage.
doi:10.3928/01484834-20100730-08
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Reflective Journal Prompts: A Vehicle for Stimulating Emotional Competence in Nursing
Paula A. Harrison, MSN, RN; Joan L. Fopma-Loy, DNS, RNReceived: July 29, 2009; Accepted: February 10, 2010; Posted: July 30, 2010
This article focuses on the development and pilot-testing of 10 reflective journal prompts designed to stimulate reflection on emotional intelligence competencies. Goleman’s framework of emotional intelligence domains and 18 competencies was used to guide development of the prompts and analysis of student (N = 16) responses. A review of the literature related to emotional intelligence competencies and nursing education and practice is presented, and assumptions derived from the literature and guiding the project are summarized. Journal prompts are presented, and examples of student responses illustrating reflection on competencies are provided. The findings suggest that these progressive journal prompts are useful tools for introducing and stimulating reflection on emotional intelligence competencies in nursing students. Recommendations for use in a variety of nursing courses are discussed.
doi:10.3928/01484834-20100730-07
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Nursing Student Perceptions of Intraprofessional Team Education Using High-Fidelity Simulation
Brenda Leonard, BScN, RN; Elaine L.H. Shuhaibar, BScN, RN; Ruth Chen, MSN, RNReceived: July 10, 2009; Accepted: February 10, 2010; Posted: July 30, 2010
High-fidelity simulation in health professional programs helps educators and students meet the challenges of increasingly complex clinical practice settings. Simulation has been used primarily to train nursing students either in interprofessional teams or within their respective nursing training levels. However, students’ experiences of learning alongside others in different levels or years of the nursing program have not been explored. BSN students (N = 48) were placed in intraprofessional teams (i.e., one student from each nursing level) to manage acute pediatric and adult simulation scenarios. Students were instructed to manage the clinical scenario based on their level of clinical competence and education. Following debriefing, students responded to a satisfaction survey regarding their simulation experiences and their perceptions of learning within an intraprofessional nursing team. Project results suggest that intraprofessional educational experiences provide rich learning opportunities for both third-year and fourth-year nursing students. In addition, simulation provides a context within which to support intraprofessional nursing student education.
doi:10.3928/01484834-20100730-06
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Thea F. van de Mortel, PhD, RN; Jennifer L. Bird, MEdReceived: June 29, 2009; Accepted: February 10, 2010; Posted: July 30, 2010
Higher education institutions have rigorous internal accreditation processes for new courses and typically require thorough course reviews every 5 years. Courses such as nursing must also be accredited by professional registration boards. However, in the years between initial accreditation and formal reaccreditation cycles, the risk of a widening gap between the accredited curriculum and the taught curriculum is real when there is no process to monitor the changes that individual unit assessors make to their subjects as they teach them. This curriculum drift may interfere with the intended development of graduate attributes and the taxonomic structure of assessment tasks across the course. This article describes the implementation of a formative continuous curriculum review process that prevents curriculum drift and enhances the quality of a bachelor of nursing curriculum.
doi:10.3928/01484834-20100730-05
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Bridget Parsh, EdD, RNReceived: June 29, 2009; Accepted: January 13, 2010; Posted: July 30, 2010
Effective clinical nursing instructors are essential for maximizing nursing students’ educational experience. Due to a shortage of clinical placement sites and advancements in technology, nursing students are increasingly learning clinical judgment and decision making in the simulated clinical experience (SCE) with human patient simulators. In this environment, SCE instructors help students acquire knowledge and skills in decision making in a controlled, risk-free, hospital-like clinical environment. Using informal student interviews, this study examined nursing student perceptions of the characteristics of an effective instructor in the simulated clinical experience. To capture information about the characteristics of effective SCE instructors, interviews were conducted with students (N = 8) from two universities in Northern California. All participants had experience working with human patient simulators in the simulation laboratory. Students identified six themes for SCE instructors: Personality, Teaching Ability, Evaluation, Nursing Competence, Interpersonal Relationships, and Realism. Further research on the similarities and differences of this new educational environment is recommended.
doi:10.3928/01484834-20100730-04
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Jean Christoffersen, MS, PMHCNS-BC; Anne-Marie Barron, PhD, PMHCNS-BC; Marla Lynch, MS, PMHCNS-BC; Harlene Caroline, MS, RNReceived: June 17, 2009; Accepted: December 21, 2009; Posted: July 30, 2010
With the increasing acuity levels of hospitalized patients, faculty members struggle with accessing clinical sites for undergraduate students. Teaching students how to interact with patients and their families can often take second place to attending to the many needs and safety issues in caring for acutely ill individuals, particularly in medical-surgical settings. Over the past several years, the psychiatric and medical-surgical faculty members in the nursing department of a college in Boston have struggled with how best to prepare students for both the physical and psychosocial aspects of care. In this article, the evolution of our psychiatric consultation-liaison model is discussed.
doi:10.3928/01484834-20100730-03
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Frameworks for Patient Safety in the Nursing Curriculum
Teri M. Chenot, EdD, RN; Larry G. Daniel, PhDReceived: December 23, 2009; Accepted: March 17, 2010; Posted: July 30, 2010
Patient safety has recently received a great deal of media coverage. Professional and regulatory agencies have indicated that patient safety education should be provided to health care workers to improve health outcomes. This study’s primary purpose was to gain a better understanding of the current status of patient safety awareness among prelicensure nursing students. Data were collected from two samples (N = 150 and 318), and nursing curricula were examined from seven institutions. Measurement integrity studies indicated that patient safety awareness can be measured validly and reliably. Demographic variables were correlated with patient safety awareness. A content analysis found that all of the participating nursing schools included at least three of the six core competencies of the Quality and Safety Education for Nurses (QSEN) (Cronenwett et al., 2007) in their curriculum; one school exhibited all six. Our findings led to conclusions and recommendations for nurse educators and for future research on patient safety education in the nursing curriculum.
doi:10.3928/01484834-20100730-02
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A Bold Adventure in Innovation: An International Off-Campus Master’s Degree Program
Patricia S. Jones, PhD, FAAN; Lois Van Cleve, PhD, FAAN; Helen E. King, PhD; Elizabeth Bossert, DNS; Marilyn M. Herrmann, PhDReceived: July 22, 2009 Accepted: February 10, 2010 Posted: June 30, 2010
In response to the global shortage of nursing faculty, Loma Linda University School of Nursing offered an off-campus master’s degree program to prepare nurse educators who would commit to remain in their home countries following graduation. The program was approved by the Western Association of Schools and Colleges to be offered in both English and Spanish. Students and faculty met for 1 month each year for 4 years at one of two international sites: Thailand or Argentina. Forty-five of 49 students completed the program. The cultural diversity in both cohorts enriched classroom discussions, social interaction, and student-faculty conversations. The program was a life-changing experience for all involved and helped to meet the global need for nursing faculty. The faculty reported that it broadened their world view and opened their minds to the potential for innovation to transform nursing education.
doi:10.3928/01484834-20100630-08
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Development of Simulation Scenarios for an Adolescent Patient with Diabetic Ketoacidosis
Patricia A. Schneider Sarver, MSN, RN, CPN; Elizabeth A. Senczakowicz, MSN, RN, CNOR; Bernadette Murphy Slovensky, MSN, RN, CENReceived: June 9, 2009; Accepted: February 10, 2010; Posted: June 30, 2010
Changes in health care delivery have shifted the care of pediatric patients primarily to the outpatient setting, with the exception of children and adolescents requiring complex, highly acute care. Thus, nurse educators are challenged to provide nursing students with pediatric learning experiences and are further confounded by the relative paucity of available clinical placements. Nurse educators are exploring the use of simulation to provide realistic alternatives to pediatric clinical experiences. The development of simulation scenarios focused on the care of an adolescent patient presenting with diabetic ketoacidosis is discussed. A review of the current literature addressing the use of simulation in nursing education and the advantages and challenges of designing, implementing, and evaluating simulation scenarios are also discussed.
doi:10.3928/01484834-20100630-07
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A Mentor-Protégé Program For New Faculty, Part I: Stories of Protégés
Anne White, DSN, RN; Jane Brannan, EdD, RN; Carol B. Wilson, PhD, RNReceived: June 30, 2009 Accepted: February 3, 2010; Posted: June 30, 2010
With the projected shortage of nursing faculty, formalized programs are needed to provide mentorship programs that will encourage and support faculty as they move from the role of novice to expert educator. The purpose of this qualitative study is to explore the experience of protégés participating in a mentorship program for novice faculty. An interpretive phenomenological research study was conducted to illuminate the meaning of the experiences of the protégés participating in the program. The study of the experience of protégés participating in a mentor-protégé program led to the emergence of three main themes: Creating a Meaningful Mentor-Protégé Relationship, Transitioning as a New Nurse Educator, and the Mentor-Protégé Program—Lessons Learned. Data from the study will provide insight into the meaning of receiving mentorship in the role of novice nurse educator.
doi:10.3928/01484834-20100630-04
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Embracing Multiculturalism in Nursing Learning Environments
Piri W. Ackerman-Barger, MSNReceived: September 17, 2009; Accepted: February 11, 2010; Posted: June 30, 2010
This article outlines the disparities that exist in educational opportunities for ethnic minorities in both higher education and nursing programs. Barriers exist for ethnic minorities that are directly related to students’ circumstances and factors related to faculty and universities. There are multiple strategies that can be implemented by faculty and universities to ameliorate inequities in education, but they are most meaningful when institutions use self-reflection and plan for long-term sustainable changes.
doi:10.3928/01484834-20100630-03
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Drawing from the Outside for Support in Teaching
Karen E. Eifler, PhD; Linda M. Veltri, PhD, RN, MSNReceived: May 19, 2009; Accepted: February 10, 2010 ; Posted: June 30, 2010
Mentoring new nurse educators in their pedagogy is vital to their long-term success and their students’ learning. It is also crucial to build mentoring into ongoing professional development plans because doctoral studies rarely include information on how to be an effective teacher. An overlooked resource on college campuses is the education department. This article describes the processes of a fruitful 2-year mentoring relationship between a new nurse educator and an education professor and offers a virtually no-cost strategy for improving the quality of teaching in schools, departments, and colleges of nursing. Using education faculty as mentors has two advantages over using fellow nursing faculty: pedagogy is their absolute professional expertise and the relationship may be less fraught with the potential baggage of peer evaluation because the mentors and mentees are in different departments. Trust, open communication, and clear goal-setting establish the framework for successful mentoring relationships.
doi:10.3928/01484834-20100630-02
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Expanding Simulation to Teach Family Nursing
Sandra K. Eggenberger, PhD, RN; Mary Regan, PhD, RNReceived: December 21, 2009; Accepted: February 10, 2010; Posted: June 30, 2010
Caring for families during an illness experience is increasingly recognized as a core of nursing practice. Yet research reports deficiencies in the current state of family nursing care. It is possible that these deficiencies are rooted in a lack of integrating family care throughout nursing education and a focus on the biomedical science paradigm. As a relational skill, family care requires different pedagogical approaches to effectively teaching family nursing. Simulation is one such approach. Even though simulation is rapidly moving into nursing education, the primary focus is teaching psychomotor nursing skills, rather than caring and family nursing.
doi:10.3928/01484834-20100630-01
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The Evolution of a Nontraditional Nursing Curriculum in Switzerland
Elizabeth B. Simon, PhD, RN, CCRN, CEN, ANPReceived: June 14, 2009; Accepted: February 10, 2010; Posted: May 28, 2010
This article introduces the transition of Haute Ecole de Santé Genève (HEDS) from Le Bon Secours (LBS). History reveals that unlike many nursing schools in Switzerland, HEDS absorbed the nurse education culture of the United States. HEDS was influenced by the vision of its founder Dr. Champendal, the support and strategies of the Rockefeller Foundation, American nurse education through its past directors, and eventually the European educational reform. Founded in 1905 with a vision to be in constant evolution, HEDS is still making a difference in the local and global community through opportunities for transcontinental presence for its students. The international vision of this school with new English-speaking strategies will lead HEDS to define and develop nursing science research in Western Europe and Switzerland. This article will inspire academics to initiate steps to provide a unique experience for their nursing students.
doi:10.3928/01484834-20100524-07
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Pamela Young Mahon, PhD, RN, NEA-BC; Donna M. Nickitas, PhD, RN, NEA-BC; Kathleen M. Nokes, PhD, RN, FAANReceived: March 18, 2009; Accepted: December 21, 2009; Posted: May 28, 2010
Nursing faculty perceptions of teaching undergraduate nursing students documentation skills using either paper-based or electronic health record systems were explored in this study. Twenty-five nursing faculty in a large urban public school of nursing were interviewed using a 13-item survey questionnaire. Responses were analyzed using the constant comparative method, and four major themes arose: teaching strategies; learning from experts; road from novice to expert; and legal, ethical, and institutional issues. Results demonstrate how faculty overcome myriad obstacles encountered while teaching clinical documentation processes. Self-efficacy theory, with its emphasis on knowledge, skills, and social context, describes how faculty are modeling behaviors necessary to succeed during this transition from paper to electronic documentation. The school of nursing is integrating the findings from this research to further informatics integration across the curricula, and ongoing research is planned to investigate issues of self-efficacy and student and clinical staff perceptions of teaching-learning clinical documentation.
doi:10.3928/01484834-20100524-06
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Faculty Incivility: Effects on Program Satisfaction of BSN Students
Kathleen Marchiondo, MSN, RN, CMSRN, CNE; Lisa A. Marchiondo, MS; Sue Lasiter, PhD, RNReceived: July 24, 2009; Accepted: December 2, 2009; Posted: May 28, 2010
This study examined the effects of faculty incivility on nursing students’ satisfaction with their nursing programs, a topic previously unreported. In addition, incidences of incivility, students’ responses to incivility, and academic location of incivility were explored. A high incidence of perceived faculty incivility was reported by participants, and perceived incivility correlated strongly with nursing student program dissatisfaction. Possible causes of incivility in academia and suggestions for addressing this problem are discussed.
doi:10.3928/01484834-20100524-05
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Transformative Learning as Context for Human Patient Simulation
Brian Parker, RN, RPN, BScN; Florence Myrick, RN, PhDReceived: July 21, 2009; Accepted: September 24, 2009; Posted: March 1, 2010
Nurse educators are charged with the responsibility of empowering novice nurses to become autonomous thinkers with the capacity to cope with the many challenges of modern day practice. Human patient simulation is a powerful technology-based educational tool ideally suited for the application of emancipatory pedagogies that aid in the transformation of individual meaning schemes. Transformative learning theory provides educators with the tools to empower students to challenge their preconceived beliefs, assumptions, and values and socialize them appropriately to thrive in modern day clinical practice. The purpose of this article is to critically analyze the role of clinical scenarios using human patient simulation to promote transformative learning events in undergraduate nursing education. The authors focus on the role of debriefing in the promotion of the critical reflection and social discourse that is integral to the learning process and the implementation of scenarios that provide students with disorientating dilemmas for perspective transformation.
doi:10.3928/01484834-20100224-02
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