<p> The need for a more highly educated nurse workforce has never been more evident as researchers are beginning to examine the effect of higher levels of nursing education and skill mix on nurse-specific indicators of patient care. National organizations along with preeminent nurse scholars agree that increasing the number of baccalaureate-prepared registered nurses is critical, at this time more so than ever before. This increase is due to the challenging and complex health care environments in which nurses function and the evolving and dynamic nature of the United States Health Care System. Despite the numerous interventions aimed at reducing attrition and increasing retention in nursing programs, graduation rates have remained virtually unchanged. There is a gap in the literature on attrition decisions and experiences of registered nurses, who voluntarily withdraw from RN-BSN programs prior to completion. Embedded in the significance of this study are the critical needs to understand the experiences of RN-BSN student non-completers, examine influences on RN-BSN students&rsquo; decisions to voluntarily withdraw from nursing school, and understand the interplay among such influences so that barriers to degree completion may be eliminated. A Heideggerian hermeneutic approach was used to interpret the meaning of the experiences of RNs, who prematurely withdraw from their BSN programs. Two overarching patterns of understanding emerged: <i> Withdrawing as Revisiting Failure</i> and <i>Withdrawing as Impasse: On One Side of the Divide.</i></p><p> The factors that influence whether or not a nurse finishes a BSN program are many, but the effect on dignity and well-being are immeasurable. Place-bound and stuck, these incompletions affect not only the nurse but also the profession, leaving a deficit. Understanding the meaning of withdrawing from a RN-BSN program is the first step toward interpreting extant data in the context of experience and is expected to guide improvements in nursing education, research, and practice.</p>

<p> The purpose of the correlational research study was to examine if there was a relationship between the nurse educator mentor&rsquo;s perception of their mentoring effectiveness and a mentee's perception of a mentor&rsquo;s mentoring effectiveness. An extensive review of the literature revealed that it was unknown if the perception of effectiveness of mentoring in nursing education was congruent between the nurse educator mentor and the new nurse educator mentee. By understanding relationships in the perception of the effectiveness of mentoring between both mentors and mentees and focusing the research on a potential gap in perceptions of mentoring effectiveness, nursing academia can have useful scientific knowledge to improve the mentoring process for new nurse educators. Bandura&rsquo;s social cognitive theory formed the theoretical framework supporting the research in identifying relationships in this study. A convenience sample of 119 nurse educator mentors and mentees that were currently employed full-time nursing faculty in the United States and its territories completed the Principles of Adult Mentoring Inventory via SurveyMonkey^&reg;. Cronbach&rsquo;s alpha results indicated reliability of the Principles of Adult Mentoring Inventory instrument. Correlational statistics yielded statistically significant relationships in the mentoring behaviors <i>relationship emphasis</i> and <i>confrontive focus. </i> Although only two statistically significant relationships were determined, it was a noteworthy point that the mentor role competency profile indicated that mentors consistently rated themselves higher than did the mentees. Further exploration was recommended, as there was little research in the perceptions of mentoring effectiveness among nurse educator mentors and mentees. The findings could prove beneficial to nursing education by providing additional research on mentor-mentee perceptions of their mentoring experiences.</p>

<p> Nurse managers are central figures in the delivery of safe and high quality nursing care (Cathcart et al., 2010; IOM, 2010; Rouse, 2009; Squires, et al., 2010). It is estimated that the majority of nurse managers are educationally underprepared and have little initial training or continuing development for the role (Kleinman, 2003; USDHHS, 2010). Transformational leadership skills of nurse managers have been linked to patient, staff, and organizational outcomes including, increased staff empowerment, job satisfaction, staff retention, productivity, and organizational commitment (Cummings et al., 2010; Pillay, 2010). Patient outcomes of satisfaction, adverse events, and 30-day mortality are also positively correlated with TL skills of nurse managers (Germain &amp; Cummings, 2010; Kleinman, 2004; Kramer et al., 2010; Squires et al., 2010). Therefore, nurse managers&rsquo; transformational leadership skills development is needed to improve the quality, safety, and cost associated with health care delivery. </p><p> The purpose of this study was to determine whether the use of a simulation-based leadership development program develops new transformational leadership skills and/or improves the quality and frequency of transformational leadership skills used over time in a sample of nurse managers, thus, developing and/or improving the corresponding leader outcomes that include follower satisfaction and extra effort, and leader effectiveness, as measured by the Multifactor Leadership Questionnaire (MLQ). (Abstract shortened by ProQuest.)</p>

<p> <i><b>Background:</b></i> Ongoing educational development is essential to ensure the effectiveness of professional nurses&rsquo; learning experiences. Understanding the ways in which workplace learning occurs is fundamental to enabling nurse educators to deliver that knowledge. Induced hypothermia was introduced as a new treatment modality in 2005 and education surrounding the care of the hypothermia patient is lacking in the literature. <i><b> Purpose:</b></i> The purpose of this study is to illuminate how nurses learn new knowledge in the clinical setting. <i><b>Theoretical Framework: </b></i> The learning theory chosen for this study is the three dimensions of learning by Illeris (2004). <i><b>Methods:</b></i> Semistructured interviews were conducted with each participant in one individual, face-to-face session to examine the lived experiences of nurses providing care to induced hypothermia patients. A hermeneutic phenomenology method was chosen based on the work of van Manen. Hycner&rsquo;s methodological approach was utilized to analyze data. <i><b>Results:</b></i> In this study, four learning areas emerged which corresponded to Illeris&rsquo; (2003b) three dimensions of learning, including cognitive, emotional, and environmental-social dimensions. The main theme described by every nurse interviewed was the necessity to have hands-on experience to feel competent in their care for induced hypothermia patients. The unit had a special identity because of their unique work of providing hypothermia care and one nurse explained, &ldquo;We are making history.&rdquo; <i><b> Conclusions:</b></i> Nurses preferred hands-on learning or experiential learning and they helped construct their learning environment. Nurse educators and nurse leaders fueled this synergetic learning process. </p>

<p> The purpose of this research was to explore, describe and analyze the experience of a group of nursing faculty that teach Evidence-Based Practice (EBP) in an undergraduate nursing program in Puerto Rico. The main question in this study was: What is the experience of a group of nursing faculty who adopt the EBP competence in their curriculum? The research was based on the qualitative paradigm and the design consisted of a case study. The techniques to collect the information consisted of: two semi-structured interviews, two non-participatory observations and document analysis provided by the nursing program participants from a nursing program.</p><p> Based on the research findings it was concluded that the participants consider important the development of EBP in their students, because it enables them to make clinical decisions aimed at achieving the patient care outcomes. In order to develop this competence in their students, faculty use a variety of teaching strategies to foster effective student performance. The interviews, non-participatory observations and collected documents analysis revealed some of the main difficulties and challenges that are faced by nursing faculty when integrating EBP in the curriculum. Among the most important challenge is that students perceive EBP relevant to their practice, because in most practice settings EBP is not carried out, nor is there a culture that supports its use. A key suggestion from the participants was that collaborative links be established between the nursing schools and the health agencies in order to promote the implementation of the EBP. </p><p> This study highlights the need to make joint efforts between the academia, practice settings and the administration of health care systems to promote nursing research and the implementation of EBP in the Puerto Rican sociocultural context. It is suggested that further research be done to study the knowledge and attitudes that nursing teachers should have when teaching EBP.</p>

Introduction: Nursing students in a lecture-based learning (LBL) programme, referred to as a traditional curriculum in this study are assumed to be less prepared for self-directed learning (SDL), since little emphasis is placed on (SDL) skill acquisition during their learning process. On the other hand, SDL skills are well described in Problem-Based Learning (PBL), designed to develop students’ self-directedness. In this study context, no baseline data exist about students’ readiness to take responsibility for their learning with respect to their attitude, abilities and/or behaviours necessary for SDL. Purpose: The purpose of this study was to compare the SDL readiness of undergraduate nursing students who are prepared through PBL and LBL curricula in two universities in Johannesburg. Methodology: A descriptive, cross-sectional, comparative design was used to examine and describe the differences between the two groups. Of the total population of 200 nursing students (N=200) 159 responded and comprised the final sample (n=159). A 40-item structured questionnaire, the Self- Directed Learning Readiness Scale (SDLRS) was used to collect data, in the subscales: selfmanagement, desire for learning and self-control. Results: Both groups reported almost equal and acceptable levels (>150) of readiness for SDL, as indicated by similar mean scores in the combined subscales; the difference in their overall readiness was not significant (p=0.69). Students in the PBL group reported higher scores in self-management than the LBL group in the final year Y4; the difference though, was not statistically significant (p=0.82). Students in both groups were similar in their desire for learning at the beginning of the course (Y1), declining sharply in year two (Y2); the PBL group reported a greater desire to learn than the LBL group, in Y4. This difference was not statistically significant (0.90). The PBL group reported a lesser ability for self-control than their LBL counterparts in the junior years, but showed noticeable educational growth in Y4, exceeding that of the LBL group; the LBL group showed no growth at all. Statistically, this difference was not significant (p=0.82). Conclusion: Recommendations were made for the utilization of progressive, less didactic methods in nurse education, based on the SDL readiness levels reported. It was further recommended that future research make use of bigger samples and that practical significance as opposed to statistical significance be used to draw inferences.

An analysis of the educational processes of graduate nurses followed anecdotal reports from stakeholders in Malawi on low levels of clinical performance and poor patient management skills among graduate nurses. Stakeholder observations pointed to issues around the educational preparation of graduate nurses. Learning for practice in nursing education is an absolute requirement for positive client outcomes in healthcare delivery. If graduate nurses’ level of performance is in question the educational processes must be examined because the educational level makes a difference on how nurses practice, the stakeholders’ observations of and concerns around graduate nurses must be taken into account and explored in terms of the educational processes deployed. This requirement gave an impetus to a two-phased, cross sectional, sequential explanatory mixed study, guided by pragmatic philosophical assumptions. Pragmatism emphasizes the fact that knowledge as social reality is based on beliefs and habits that are socially constructed. The study population consisted of nurse educators (N=50) from the Kamuzu College of Nursing (KCN) and graduate nurses (N=235) from various clinical settings in Malawi who were invited to participate. In phase one all educators and graduate nurses were invited to complete questionnaires that aimed at determining the teaching styles of educators, learning styles and approaches, and critical thinking levels among graduate nurses. In phase two purposive sampling was used to select nurse educators and graduate nurses for in- depth interviews to determine their perceptions of the educational process and learning experiences respectively. Qualitative evaluation of twenty-one subjects (n=21) in the BSN curriculum provided evidence of curriculum quality in accordance with the Malawi Nurses and Midwives Council standards. Data analysis, in phase one was conducted using the statistical package SPSS Version 16.0. Descriptive statistics were run for frequencies, means and standard deviation. Content analysis was used for the qualitative data analysis in phase two. The results of the study indicate that there in no diversity in the use of teaching styles among the educators; the Expert Teaching Style is the most preferred teaching style ( xˉ = 4.02 and SD = 1.06). The Facilitator Teaching Style was the least preferred method indicating lesser use of facilitative skills among the educators. The lecture method is the dominant and most preferred teaching method among educators; graduate nurses indicated that interactive teaching strategies had enhanced their learning and that they learnt most from those teachers who taught with passion and used examples. The Personal Model Teaching Style was not preferred despite graduates’ preference for this style. Learning diversity was also lacking among the learners where the Competitive Learning Style was the most preferred learning style (xˉ =3.93 and SD 0.54). The Independent Learning Style was the least preferred learning style (xˉ =2.84 and SD=0.80). This result concurs with the findings on learner dependence from the qualitative results. Curriculum evaluation showed that there were no small group teaching methods embedded in the BSN curriculum to reinforce interactive teaching methods. Despite educators stating that their teaching tasks were well planned there was no learner involvement in the teaching activities. The perceived challenges in the teaching tasks were in the form of information access, interconnectivity and physical resources that educators indicated influenced their choices of teaching methods. Despite the mismatch of the teaching and learning styles, a deep approach to learning was reportedly prevalent among graduate nurses ( xˉ = 3.98 and SD 0.77) while surface approach was low at (xˉ =3.24 and SD=1.00). The majority (65%) of graduate nurses reflected low levels of critical thinking abilities (xˉ = 2.94 and SD= 0.95) despite the high scores in deep approach to learning. Curriculum evaluation revealed there were partial standards on the benchmarks for the process and tools for students’ interest, learning styles and self-directedness (62.5%); assessing students’ prior knowledge (87.5%) and transparency in curriculum document (50%). The educational processes in BSN program are mandated by the Malawi Nurses and Midwives Council standards and as such, the partial standards on the curriculum brings into question the quality of education offered. Therefore, based on these findings, recommendations are made for the improvement of nursing education practice in Malawi. The BSN curriculum benchmarks must reflect the integration of the four learning pillars with cross-cutting competencies to promote transformative learning and interdependence in education. There must be enhancement of the curriculum standards to foster the development of reasoning, thinking, imagination, confidence among the graduate nurses and future research is recommended for educational reforms in nursing.

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Health Sciences, 1992.

Provision of a positive clinical learning environment for nursing students is and should be a critical focus area for any healthcare organisation and nursing education institution and the leadership thereof. How students are, or the lack thereof, supported and guided to become competent qualified nurse practitioners, relates to the outputs in this profession. In light of this statement it was important to determine which aspects influence nursing students‘ educational and clinical learning outcomes, and how they would impact on the quality of nursing care. The purpose of this study was to: Explore and describe the perceptions of final year nursing students registered on the Bridging Course leading to registration as a General Nurse (R682), with a Private Nursing Education Institution in Johannesburg, South Africa, who had been placed in accredited Private Hospitals (clinical facilities) with regards to the Clinical Learning Environment, Supervision and Clinical Facilitation. A cross-sectional survey was conducted using the CLES+T (Clinical Learning Environment Supervision and Teaching) questionnaire developed by Saarikoski & Leino-Kilpi (2008). Information was obtained that will provide a basis to improve the quality of educational and clinical outcomes for nursing students in the Clinical Learning Environment, through policy development in the future. Key points highlighted in the study is that the supervision in the clinical learning environment is significantly compromised and possibly as result thereof group supervision has been identified as favourable. The critical importance of clinical facilitators to students; their role and the impact they are able to have within the hospitals as a whole has also been highlighted. This is pivotal to take note of as clinical facilitators are not always considered to be of key importance to healthcare organisations in their day to day setting of hospital management and indirect payrolls. The recommendation of this study is that the focus of healthcare organisations and nursing education institutions should remain on creating a positive learning culture and environment within the hospital to improve and maintain quality nursing standards of practice for the staff and student nurses alike.

<p> Health care profession graduates, including associate degree nursing graduates, are required to care for clients with complex medical conditions and multiple comorbidities. The Accreditation Commission for Education in Nursing (ACEN) has mandated the addition of interprofessional education into health care curricula to improve communication, collaboration, and teamwork. Associate degree nursing programs, thus, must implement interprofessional education into their curricula. The goal is to improve patient safety and patient outcomes. There was a gap in the literature about what was known about how associate degree nursing faculty implement interprofessional education. The purpose of this study was to better understand the experiences of associate degree nursing faculty who worked to implement interprofessional education and interprofessional competencies into nursing curricula. The research design was a basic qualitative approach using purposive, nonprobability sampling. The target population for the study was associate degree nursing faculty. Eleven participants who held a minimum of a master&rsquo;s degree and were employed full-time in an associate degree nursing program took part in semistructured interviews. Thematic analysis of the data followed four steps, and four themes emerged from the results of the analysis: lack of knowledge of interprofessional education, barriers to implementation of interprofessional education activities, faculty desire to learn, and improved student outcomes. The results showed none of the associate degree nurse faculty participants could identify the requisite four competencies for interprofessional collaborative practice. Approximately 30% of the participants could articulate ACEN interprofessional standards for accreditation. All 11 participants indicated they were motivated to learn more about interprofessional education if they had the opportunity, and they would participate in faculty development about interprofessional education. The results of the study supported the need for associate degree nursing faculty development about interprofessional education and accreditation standards to better prepare associate degree nursing graduates to practice in complex health care environments.</p><p>