Australian nursing students’ clinical experiences in residential aged care: Reports from nurse academics

BackgroundNurses are the largest group of registered healthcare professionals and are fundamental to delivering health and aged care in Australia.AimTo explore how nursing students report clinical experiences when caring for older people as part of a larger study investigating how care of the older person content is included in Australian undergraduate nursing curricula.MethodsA population sample of all Australian nursing schools that offered a Bachelor of Nursing degree (n = 35) in 2019. Nurse academics involved in curriculum development or delivery were recruited. A telephone-assisted survey was used, and qualitative content analysis undertaken.ResultsAll schools of nursing participated in the survey, representing a response rate of 100%. The acute care focus of nursing curricula meant clinical experiences for nursing students related to older person's care commonly occurred in residential aged care facilities in the first year of the degree. Student reports of these experiences varied, with a majority of respondents reporting mixed or negative feedback associated with a lack of preparation and inadequate supervision.ConclusionsThis study highlights the: significance of the timing of nursing students’ clinical placements in residential aged care; the selection of appropriate care homes; and the need for the right clinical teaching staff who can supervise high quality learning experiences for students.     

“Oh,older people,it's boring”: Nurse academics’ reflections on the challenges in teaching older person's care in Australian undergraduate nursing curricula

BackgroundNursing students encounter older people in all health care sectors; however, few choose a career primarily focused on older person's care.AimTo explore the challenges to teaching older person's care to Bachelor of Nursing students and how pre-registration nursing students are prepared to care for older people, part of a large study investigating content on care of older people in Australian nursing curricula.MethodsA purposive sample of Australian nurse academics involved in Bachelor of Nursing curriculum development or delivery completed a telephone-assisted survey. Qualitative content analysis of two open-ended questions was undertaken.ResultsAll Australian schools of nursing participated, and 45 nurse academics were interviewed. Reflecting on the challenges of teaching older person's care to nursing students, most participants felt the curriculum was too crowded and some called for a 4 year degree. In addition, students’ ageist attitudes, fuelled by unrealistic portrayals of nursing in popular culture, were reinforced by curricula being acute care focused and the ageist attitudes of some nurse academics.ConclusionsTeaching older person's care in Australian nursing curricula is challenged by insufficient time and ageism among students and academics. Regulatory bodies need to urgently provide direction so that nursing curricula content aligns with emerging Australian health care priorities, in particular the health care needs of older people.     

A cross-sectional study of domestic violence instruction in nursing and midwifery programs: Out of step with community and student expectations

BackgroundDomestic violence is a global health concern. Nurses and midwives must respond to those who experience domestic violence, although many are not prepared to do this. The World Health Organization recommend that domestic violence content be included in all pre-registration training as a matter of urgency.ObjectivesTo examine self-reported undergraduate student perceptions of domestic violence content in their programs of study and student attitudes and beliefs about domestic violence.DesignA cross-sectional research design with online survey was employed from June to October 2017.MethodsUsing convenience sampling, 1076 students were recruited to the study from a total population sample of just over 6000 undergraduate nursing and midwifery students; a response rate of 17.9%. Survey data reported the nature and frequency of teaching and learning along with student attitudes and beliefs about domestic violence. Open ended responses were examined via thematic analysis.SettingsNine Australian universities offering undergraduate nursing and midwifery degrees.ParticipantsUndergraduate university nursing and midwifery students.ResultsOver half of students surveyed (53.7%, n = 578) reported that domestic violence was not addressed in their program of study. A direct correlation was found between students' perceived preparedness to assess and respond to domestic violence, and the amount of taught content in their program of study.ConclusionThis major gap in curricula has significant implications for professional practice preparedness. Further research should focus on examining the reasons why quality domestic violence content is lacking in undergraduate nursing and midwifery programs and how prioritisation of domestic violence content can be improved.     

Global and public health core competencies for nursing education: A systematic review of essential competencies

ObjectivesNurses are learning and practicing in an increasingly global world. Both nursing schools and nursing students are seeking guidance as they integrate global health into their learning and teaching. This systematic review is intended to identify the most common global and public health core competencies found in the literature and better inform schools of nursing wishing to include global health content in their curricula.DesignSystematic review.Data SourcesAn online search of CINAHL and Medline databases, as well as, inclusion of pertinent gray literature was conducted for articles published before 2013.Review MethodsRelevant literature for global health (GH) and public and community health (PH/CH) competencies was reviewed to determine recommendations of both competencies using a combination of search terms. Studies must have addressed competencies as defined in the literature and must have been pertinent to GH or PH/CH. The databases were systematically searched and after reading the full content of the included studies, key concepts were extracted and synthesized.Results and ConclusionTwenty-five studies were identified and resulted in a list of 14 global health core competencies. These competencies are applicable to a variety of health disciplines, but particularly can inform the efforts of nursing schools to integrate global health concepts into their curricula.     

The financial challenges for Australian nursing students attending placement-based work-integrated learning.

BackgroundMandatory placement-based work-integrated learning (WIL) poses challenges for nursing students who work whilst studying. The financial burden of WIL links to other known direct and indirect challenges, yet no Australian study has quantified the financial challenges resulting from attending mandatory WIL placements. Placement-based WIL costs may preclude some students from completing WIL, which may impact student attrition and the future health workforce.AimTo investigate Australian nursing students’ financial challenges related to mandatory WIL.MethodsAn online cross-sectional survey conducted with nursing students from nine Australian universities across five Australian states. The 28-question survey investigated the location of, and travels to, the most recent WIL placement; and students’ employment, accommodation, financial support, expenses and debts, and financial strain pertaining to WIL placements.ResultsOverall, 2,359 students participated. The majority were employed (84%); 65% of these reported that they were unable to work during WIL, affecting their employment. One-third incurred a financial liability from their placement, 79% reported financial hardship, and 73% found their placement stressful due to financial strain. Financial issues affected 62% of students’ health and wellbeing.DiscussionFinancial pressures related to WIL impact nursing students. While students have strategies to reduce these pressures, universities can also better manage their placement preferencing and support of students to reduce financial impacts of placement-based WIL on students.ConclusionsNursing students face substantial financial challenges related to placement-based WIL. Scholarship programs and other forms of support are required to assist nursing students to undertake WIL.     

Health screening for women with physical disability in Australian general practice: A survey

BackgroundEarly detection of gynaecological issues improves health outcomes and reduces mortality. Such early detection is best achieved via regular, proactive health screening. Like other disadvantaged groups, women with physical disability have much lower gynaecological screening rates than the general population.AimThe aim of this paper is to explore the current role of general practice nurses in women’s health screening for individuals with physical disability.MethodsA national online survey of Australian general practice nurses was conducted.FindingsOne hundred and seventy-eight general practice nurses completed the survey. Sixty-one percent reported having experience in working with people with a physical disability. Around one third of participants reported having completed specific education about physical disability. Most general practices implemented strategies to facilitate physical access for those with disability. However, few general practices had a medical records system that enabled identification of physical disability. Thirty-seven participants reported providing women’s health screening for 89 women with a physical disability in the 4 weeks prior to the survey. A range of strategies were used to support women during these screening procedures. These could be broadly classified into; a) providing practical assistance to facilitate screening, and b) modifying technique and positioning for comfort.ConclusionsThe limited experience with disability amongst an experienced nursing cohort, and the difficulty inherent in identifying those with a disability within recall and reminder systems, adds complexity to the provision of screening for women with a disability. Whilst participants articulated some innovative and creative strategies to assist women with a disability during health screening, enhanced awareness amongst nurses and proactive strategies would likely enhance service accessibility in this vulnerable group.     

Searching for content on female genital cutting/mutilation in curriculums of U.S. Nursing Schools

BackgroundOver 500,000 women and girls in the U.S. are at risk for female genital cutting/mutilation, (FGC/M) because their cultural heritage is from countries where FGC/M is prevalent. Nurses lack knowledge about FGC/M, making them less likely to provide culturally congruent care. Little is known about FGC/M-related information in nursing school curriculums.MethodsA total of 403 schools of nursing (SONs) responded to an anonymous online survey to identify the extent, placement, and educational approaches regarding FGC/M found in curricular content in nursing schools in the U.S.ResultsFifty-seven percent of respondents did not know if nurses cared for FGC/M-affected women in the region where their nursing school was located. Only 27% of responding schools indicated FGC/M was taught in their curriculums, mostly in undergraduate programs, and primarily during classroom lectures, and rarely by simulation. SONs that were aware that nurses in their region provided care to women and girls at risk for FGC/M were more likely to have content on FGC/M in their curriculums.ConclusionThough respondents indicated that this topic is important to global nursing education, it appears that few U.S. nursing students are learning to provide culturally congruent care to women and girls at risk for FGC/M. It is vital that nurse educators include this topic in appropriate places in the curriculum, so that students learn the unique healthcare needs of this population.     

The transition from child to adult health services for young adults with intellectual disabilities: An evaluation of a pilot of an online learning resource for Registered Nurses

AimThis study formed the third phase of a national study on the experience of transition from child to adult health services for young adults with intellectual disabilities. The aim of this phase was to evaluate the accessibility and acceptability of an on-line learning resource for Registered Nurses.BackgroundThe population of young adults with intellectual disabilities and complex needs is increasing. Consequently, more will move from child to adult healthcare, with evidence highlighting that for some their experiences of the transition process is poor. The main study provided contemporary evidence to raise the awareness of Registered Nurses of the needs of young adults with intellectual disabilities and their role in enabling an effective transition from child to adult services.MethodsThe online learning resource was developed and piloted with Registered Nurses involved in the transition from child to adult health services for young adults with intellectual disabilities and complex needs. Data collection involved an online survey and semi-structured interviews.ResultsTwelve Registered Nurses from 2 Scottish NHS Boards completed the questionnaire and 3 participated in a follow-up interview. The findings suggest that the mode of on-line delivery and most of the content of the learning resource were both acceptable and accessible to Registered Nurses across a range of areas of nursing practice. The learning resource was further adapted in response to the participant data.ConclusionThis on-line learning resources offers the potential for Registered Nurses, and potentially other healthcare professionals to undertake evidence-based, structured further education regarding the effective transitions for young adults with intellectual disabilities and their families.Tweetable abstractRegistered Nurses have key contributions to enable the transition from child to adult healthcare for young adults with intellectual disabilities.     

A Survey of Clinicians Evaluating an Online Prelicensure Oncology Nursing Elective

ObjectivesDespite a growing population of individuals with cancer, there is limited oncology content in prelicensure nursing curricula. A distance learning oncology nursing elective course creates an option for integration into nursing programs. The purpose of this article is to describe curriculum development for an online oncology elective course using feedback and expertise from oncology nurses.Data SourcesAn online oncology course curriculum was developed and then shared with 70 oncology nurse experts to elicit feedback on course objectives, content, teaching strategies, and evaluation methods using a survey and open-ended questions.ConclusionExperts agreed course objectives, content, teaching strategies, and evaluation methods were clear and comprehensive. Curriculum revisions were made based on recommendations from expert clinicians. A curriculum table for this proposed course is presented.Nursing Implications for PracticeThere is a need for oncology nursing curriculum in prelicensure programs. Educators should consider innovative ways of increasing academic-practice partnerships in curriculum development.     

Peer learning a pedagogical approach to enhance online learning: A qualitative exploration

BackgroundFlexible online programs are becoming increasingly popular method of education for students, allowing them to complete programs in their own time and cater for lifestyle differences. A mixture of delivery modes is one way which allows for enhanced learning. Peer learning is another method of learning which is shown to foster collaboration and prepare healthcare students for their future careers. This paper reports on a project to combine peer and online learning to teach pharmacology to nursing students.ObjectivesTo explore undergraduate nursing student opinions of working in peer groups for online learning sessions in a pharmacology course.DesignA qualitative study utilising a self-reported questionnaire.SettingA rural campus of an Australian university.ParticipantsSecond year nursing students enrolled in a Bachelor of Nursing Program.MethodsA hard copy questionnaire was distributed to all students who attended the final semester lecture for the course. Content analysis of open-ended survey questions was used to identify themes in the written data.ResultsOf the 61 students enrolled in the nursing subject, 35 students chose to complete the survey (57%). Students reported a mixed view of the benefits and disadvantages of peer online learning. Sixty 6% (66%) of students liked peer online learning, whilst 29% disliked it and 6% were undecided. Convenience and ease of completion were reported as the most common reason to like peer online learning, whilst Information Technology issues, communication and non-preferred learning method were reasons for not liking peer online learning.ConclusionPeer online learning groups’ acted as one further method to facilitate student learning experiences. Blending peer online learning with traditional face-to-face learning increases the variety of learning methods available to students to enhance their overall learning experience.     

Increased adoption of smoke-free policies on campuses with schools of nursing

BackgroundIn 2015, the majority of U.S. American Association of Colleges of Nursing (AACN)-accredited schools of nursing resided on campuses without smoke-free policies.PurposeTo determine the presence of smoke-free policies at AACN-accredited after resolutions from AACN and the American Academy of Nursing, and the creation of online resources.MethodsSmoke-free policies (2015-2017) were determined through listings on the ANRF College Campus Policy Database© and survey responses from nursing deans.ResultsSmoke-free policies for 689 schools of nursing increased from 36% in 2015 to 91% in 2017. There were no significant differences by nursing program types or geographic area. Twenty percent of deans reported using the resources, with over 1700-page views.ConclusionSmoke-free policies increased after support from two national nursing organizations. Learning in a smoke-free environment should be an expectation for nursing students to protect their own health, and to support their future critical role in tobacco control.     

Global health education in Chinese universities and potential for collaboration with schools of nursing: A qualitative study

BackgroundThe Chinese Consortium of Universities for Global Health (CCUGH) was established within schools of public health in 2013 with the goal of enhancing global health in China. Expanding nursing students' exposure to global health curricula is important as nurses are essential actors in the health care system. However, information related to existing global health education within CCUGH-affiliated universities and the current engagement of Chinese schools of nursing in global health remains extremely limited.ObjectiveTo identify and describe the current definitions and conceptualizations of global health education in Chinese universities, with a focus on schools of nursing, in order to explore potential opportunities for strengthened collaboration between global health initiative and schools of nursing in China.MethodsPurposive sampling with snowballing was used to recruit 19 key informants who were critical stakeholders in global health and nursing in China. Key informant interviews were conducted from July 2014 to February 2015, and data were updated in June 2016. Content analysis was used to analyze data via Atlas.ti 7.ResultsThere was a rapid growth in global health education within and beyond CCUGH-affiliated universities with nine universities establishing global health institutes. Translation and definition of global health lacked consistency in Chinese language. Though no course directly related to global health was offered, schools of nursing were gradually participating in global health education and research. Nursing was a critical component of global health, and global health and nursing mutually advanced each other. Nursing education should include global health contents, but at present independent global health curriculum in schools of nursing was not appropriate.ConclusionIncreasingly Chinese universities are promoting global health education through the platform of CCUGH. It is an ideal moment to promote and expand work across the fields of global health and nursing, specifically to highlight opportunities for collaboration across education, research and practice.