<p> The health care environment continues to be fraught with errors and poor patient outcomes. Nurses, having the most constant time with patients, are in a position to make a difference in those outcomes. Due to many technological, social, and health care changes and advancements, nurses have responsibilities requiring high levels of clinical judgment. Nursing education must respond to the changes and expanded roles of nurses by changing how students are taught, specifically in the clinical setting. Pedagogical tools and methods are needed to assist the student with making integrations between classroom theory and clinical practice. The purpose of this study was to explore the use of a guided reflection tool based on a model developed from the practice of novice and experienced registered nurses on clinical judgment development as measured by a rubric based on the same model, of associate degree nursing students, in an acute care setting. A mixed methods approach was used. Clinical judgment scores of a comparison group (n = 9) were compared with an intervention group (n = 9) and each groups&rsquo; scores were examined for progression of clinical judgment abilities using a quasi-experimental time series design for the quantitative portion of the study. Using RM-ANOVA, findings indicated there was no statistical significance between the two groups or within the time intervals for either of the groups. A focus group interview was also held to identify perceptions of each group concerning reflective journaling and development of clinical judgment. Both groups felt reflective journaling enhanced development of clinical judgment; however, the intervention group articulated situational learning to a greater degree than the comparison group.</p>

<p> Clinical judgment provides the basis for nurses&rsquo; actions and is essential for the provision of safe nursing care. Tanner&rsquo;s Clinical Judgment Model and its associated instrument, the Lasater Clinical Judgment Rubric (LCJR) have been used in the discipline of nursing, yet it is unclear if scores on the rubric actually translate to the completion of an indicated nursing action. This is important because clinical judgment involves identifying and responding to patient situations through nursing action, and then evaluation of such actions. The purpose of this observational study was to explore the relationship between clinical judgment, as measured by the LCJR, and the completion of an indicated nursing action, as measured by a nursing action form.</p><p> The clinical judgment and completion of an indicated nursing action was measured in 92 participant students at a Midwestern university school of nursing who were enrolled in an adult medical/surgical nursing course that included simulation and debriefing during which scoring occurred. This study explored whether clinical judgment, as measured by the LCJR, was related to the completion of an indicated nursing action. In addition, this study evaluated whether <i> Responding</i>, as measured by the LCJR was related to the completion of an indicated nursing action. The data revealed that a very weak relationship was present between clinical judgment, as measured by the LCJR, and the completion of an indicated nursing action; however, these findings were not statistically significant. The data also revealed that a very weak relationship was present between the dimension <i>Responding</i>, and the completion of an indicated nursing action; however, these findings were also not statistically significant.</p><p> This study expands upon previous clinical judgment research in nursing and identifies a need for additional methods of evaluating clinical judgment in baccalaureate nursing students including action appraisal so that deficiencies are established and targeted for improvement.</p>

<p> The purpose of this study was to examine the relationship between the transformational leadership behaviors of nursing instructors in the clinical learning environment and the level of communication apprehension experienced by associate degree nursing students. The study also examined if this relationship was altered by the moderating effect of age, gender, and previous clinical exposure on the transformational leadership behaviors of nursing instructors in the clinical learning environment. This study employed a non-experimental quantitative correlational survey design. Participants consisted of 481 associate degree nursing students who were members of the National Student Nurses&rsquo; Association (NSNA). Descriptive statistics, univariate, bivariate (correlational) and multivariate (regression) testing were utilized in the analysis of data. Data analyses revealed a statistically significant relationship between all but one of the transformational leadership subscales (providing individualized support) and communication apprehension. Additionally, the data revealed a statistically significant relationship between age, gender, high performance expectations and communication apprehension. However, no statistically significant relationship was found between communication apprehension and previous clinical exposure.</p>

<p> One of the challenges in nursing education is the need to enable students to internalize the skills needed to implement the thought processes of critical thinking and clinical reasoning. The research of Patricia Benner has been instrumental in explaining the need to improve the critical thinking and clinical reasoning skills of newly licensed registered nurses. Dr. Benner&rsquo;s research has changed the focus of nursing to include these skills in the education process. The study was designed to evaluate the efficacy of a classroom educational method designed to help students improve these skills. The ex post facto study was conducted at one Southern community college with students enrolled in an Associate Degree nursing program. The study used the nursing educational theory of Patricia Benner and the general educational theory of constructivist educational theory as a theoretical base. Archived data was collected from the results of two cohorts of nursing students based on their performance on two separate administrations of the Assessment Technologies Institute (ATI) critical thinking examination. The data was analyzed using central tendency statistics and an independent samples <i>t</i>-test. Analysis of the data indicate that the educational implementation was effective in increasing the skills needed for clinical reasoning as evaluated by the ATI critical thinking examination. The cohort that used the Critical Thinking Teaching Method (CRTM) increased their scores by 5.62 percent while the cohort that did not use the CRTM scores remained relatively static</p>

<p> Faculty shortages are a primary obstacle to increasing the supply of potential nurses. Research indicates that few academically qualified nurses are choosing to work in faculty jobs. Among nurse faculty, reported turnover intention rates are high. Faculty departures for non-academic positions contribute to the growing shortage. The purpose of this research was to understand the faculty work experience and identify career decision factors from the perspective of former nurse faculty. The research was designed using Maxwell&rsquo;s (2013) interactive model for qualitative research. The investigator purposefully selected a diverse sample of 12 participants who left academia for other employment. Data were collected with in-depth, semi-structured interviews. Analysis was inductive and used open coding, categorizing, and connecting strategies. Ten themes emerged to answer the research questions. Six themes described the nurse faculty work experience: (a) enjoyment of teaching role, (b) leadership quality, (c) collegial relationships, (d) work hours / workload, (e) career advancement and pay, and (f) student attitudes. The decision to change careers was shaped by two themes: (a) disenchantment, and (b) opportunity. Two themes summarized participant recommendations to make the faculty work experience more enticing: (a) improve compensation and (b) improve the work environment and organizational support. The results were interpreted using a conceptual model of determinants of nurse faculty career decisions.</p>

<p> Student retention is important to higher education institutions (Shoemake, 2017). Nursing programs strive to choose admission criteria which identify students who show the best chance of successfully completing the program and passing the National Council Licensure Examination (Bremner, Blake, Long, &amp; Yanosky, 2014; Chen, Heiny, &amp; Lin, 2014; Knauss &amp; Wilson, 2013). The crisis of a nursing shortage, compounded by the void retiring nurses place on healthcare industries, creates the need for nursing programs to graduate more qualified nurses (Kubec, 2017; Mooring, 2016). The purpose of this mixed-methods study was to investigate factors which influenced completion of a practical nursing program. Quantitative data included admission and demographic criteria. These data were analyzed to identify if differences existed when compared to program outcomes including completion and licensure. A statistically significant difference was found in both program completion and first time passage of licensure exam rates between practical nursing students who held healthcare certification and practical nursing students who did not hold a healthcare certification, with the former group completing the program at a higher rate. To address the quantitative phase of the study, interview questions were constructed using Jeffrey's (2015) nursing universal retention and success model. Then, responses to the questions were obtained from a student focus group of six currently enrolled students. Following an analysis of the qualitative data, two themes emerged: theory and practice and navigating the journey. Based on findings, further research of nursing program completion and licensure is recommended to assist recruitment, application, and programming practices of academic institutions.</p><p>

<p> Currently, the same criteria are being used for admissions into nursing programs in one school of nursing in the Northeastern United States. To date there are no statistically significant data to correlate these criteria with successfully entering the nursing profession. Due to the nursing shortage, limited number of seats available in nursing programs, low nurse retention, and high nursing school attrition rates, it is necessary to use an admissions process designed to select the candidates who are most likely to succeed on the NCLEX-RN, and enter into the nursing profession. A latent class analysis was used, and revealed that the ideal candidate was found to be an individual who is either an optimistic, full-time student, who earned a high ACT score, and had a career prior to enrolling into the nursing program, or was an optimistic, part-time student, who earned a low ACT score, and had a career prior to enrolling into the nursing program. A survey provided further insight and the responses indicated applicants who self-reported that they: have good judgment, seek out challenges, are capable of anything, are professional, are optimist, need to utilize what is learned, are ethical in nature, are able to recover quickly for failure, are motivated by intrinsic factors, are self-directed, complete what they start, have a sense of team-awareness, admit to mistakes, are resilient, have a sense of spiritual well-being, and possess leadership qualities, ultimately entered into the nursing profession. </p><p>

<p> This grounded theory, action research study examined the decision making process that led former nursing faculty of a proprietary college in the Midwest to resign their positions with the proprietary institution. Semi-structured interviews with five former full-time nurse faculty were used to gain a deeper understanding of experiences and influences that contributed to the participants' decisions to leave. The study provides a theory that identifies and explains the different elements of this decision making process and the experiences that led nurse faculty to the quit decision.</p>

<p> This qualitative study examines nursing faculty perceptions related to the use of collaborative testing in nursing education. Collaborative testing, also called group testing or team testing provides opportunities for cooperative learning as students work in groups discussing test questions and choosing answers. Research identifies increased student learning, enhanced communication skills, and improved critical thinking with collaborative testing. However nursing education has been resistant to the use of collaborative testing. </p><p> Nursing faculty participants describe perceptions of collaborative testing by means of an anonymous electronic questionnaire with open-ended questions. Nursing faculty perceptions of collaborative testing include: communication, student progression, NCLEX-RN&reg; performance, and limited use. Faculty perceive advantages of collaborative testing use include: low-performer advantage and learning. Faculty identify two disadvantages with collaborative testing: grade inflation and nonparticipation.</p><p> Nursing faculty views of collaborative testing could promote understanding of low collaborative testing use in nursing education. The nursing faculty perceptions of collaborative testing revealed in this study present an initial look into nursing faculty views of collaborative testing. The identified nursing faculty perceptions provide a stepping-stone for future research into collaborative testing use in nursing education.</p><p>

<p> <b>Background:</b> Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of the nurse as educator, manager, nurse leader, and researcher who will effect policy changes and assume leadership roles as revolutionary thinkers in addition to implementing paradigmatic shifts. </p><p> <b>Purpose:</b> This grounded theory study sought to unearth the critical factors that motivate nurses to advance academically. The study aimed to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance their nursing education. </p><p> <b>Philosophical Underpinnings:</b> A qualitative methodology in the tradition of grounded theory using the constructivist and interpretivist approach was used to conduct the study. </p><p> <b>Method:</b> Data were collected from two groups of participants using a face-to-face semistructured interview. The first group was diploma and associate degree nurses, and the second group was a focus group comprising of baccalaureate, masters, or doctoral degree nurses who have progressed academically from diploma or associate degree level. </p><p> <b>Results:</b> Emerging from the thick rich data that were collected from the research participants were the following core categories that ground the theory: rewarding, motivating, and supporting for diploma and associate degree nurses to advance academically. </p><p> <b>Conclusions:</b> The study concluded by elucidating that professional advancement was the social process that grounds. Hence, the emergent theory was; <i>The Theory of Professional Advancement.</i></p>