The advancement in ICT in recent decades has transformed every aspect of life, including medical care. The most sophisticated example of this is electronic health (e-health), which in developed counties has been a major contributor to enhancing the overall quality of healthcare services. However, e-health remains primitive in developing countries, whether they are relatively poor like Jordan or wealthy like Qatar. Barriers to successful e-health adoption in developing countries are attributable either to superimposing the technology itself while ignoring staff preparedness to integrated e-health or financial inhibitions to making such fundamental changes to healthcare delivery. Staff preparedness is related to educating or training healthcare staff, particularly nurses, who have fewer opportunities to attend training, or are sometimes ignored. Hence, the focus of this research is to evaluate the preparedness of nursing community for e-health adaption in the developing countries, taking Qatar and Jordan as case studies, in order to identify existing challenges and the key requirements to establish an educational framework that can be integrated in nursing curricula or professional development to promote e-health adaptation by nurses. This research critically reviews previous literature related to the research project, identifying the challenges to e-health preparedness, and analyses nursing and midwifery curricula from different countries with regard to e-health and ICT. The findings show that e-health modules are not generally included in any higher education nursing programme, with only a few transcripts showing basic computing or ICT modules. E-health national strategies for both Jordan and Qatar were analysed to identify whether the inclusion of professional training on e-health has been considered as part of e-heath strategy. In addition, analysis of e-health national strategies for other leading countries in the field of e-heath was conducted, finding that there is a decided gap between developed and developing countries with regard to e-health. The level of readiness in nursing was investigated and to identify the main barriers for using e-health/e-nursing in Jordan and Qatar. The results showed the top challenges facing e-health are educational-related aspects, hence a plan for promoting and providing education on the benefits and use of ehealth processes and applications is advised, with prerequisite ICT training, as the results showed that nurses lack sufficient knowledge about e-health processes and applications. The findings from earlier tasks were used to identify the requirements and then propose the framework to achieve main goal of this research in providing a roadmap. The framework was constructed in accordance to with the Technology Acceptance Model (TAM), followed by evaluation by different expert groups. All the groups voted for the suggested structure of the framework to be taken to the next phase of deployment. The final task was to evaluate the attitude of the nursing community working towards the possibility of implementing an e-learning system, which has been presented as the main platform in the proposed framework. The findings have demonstrated a very positive attitude from the nursing staff towards the idea of using e-learning. There also does not appear to be any apparent obstacles to deploying the concept of e-health as the audience in question have the necessary computer skills. In summary, this research project has contributed in presenting framework and some useful findings related to e-health in general and in Qatar and Jordan in particular. The proposed framework can be as a roadmap for future e-heath/e-nursing projects, in addition, it can be utilised with some modifications to foster similar electronic applications.

The significant influence that practice learning plays within undergraduate nurse education cannot be overstated. By practice learning, I mean work-based learning immersed in the activities of nursing practice, typically involving learning undertaken in placements at hospitals and other clinical worksites. Practice learning is intended to achieve standards defined by professional regulatory bodies, and aims to enhance learners' capability and employability. Learning here refers to processes through which student nurses develop capabilities to practice effectively, critically, confidently and professionally in health care settings. Practice is a key concept in this thesis, much contested in debates about professional learning in practice which I will examine in detail in chapter 2. In terms of current policy regarding practice learning, I would, however, suggest that what we have at the moment is an inherited legacy which to date has not been robustly scrutinised. Based on my experiences as a nursing educator I came to believe that it was timely for a re-examination of policies, practices and philosophies underpinning the duration and structure of the current practice learning model. Taken together, the above experiences led me to focus this thesis on the following research question: How might practice learning experiences be better designed to promote nursing capability? This thesis brings together six published papers reporting studies that I conducted to explore this question, as well as chapters explaining the background literature, theory and methodology guiding these studies. My overarching aim is to contribute to the improved practice learning experiences of undergraduate student nurses, retaining them on programmes and easing their transition into the role of newly qualified practitioners (NQP). Chapter 1 charts the history of nursing educational developments. The aim is to demonstrate the influence of government and professional policy over nursing’s development from an apprentice-style model to the current-day academic model. In charting these developments alongside reviewing the contemporary research literature, what is obvious is that the issues of support, retention, models of practice learning and curricula to prepare nurses are perennial challenges. However, as a practice-based discipline, the focus of preparation has always remained grounded in practice. Chapter 2 sets forth the theoretical constructs of this thesis. During the course of conducting the studies reported in the publications of this thesis, I became frustrated with the relative lack of emphasis on contemporary learning theory in nursing education, and the paucity of supporting evidence for the ‘reflective’ theory that seems to be dominant in nursing. The discussion presented in this chapter aims to provide an overview of the major traditions of constructivism and reflective practice, as well as their historical theoretical foundations, which have been widely adopted in nurse education. I discuss the strengths and limitations of these theories as they apply to undergraduate nurses’ practice learning and capability development. These are then contrasted via the means of a critical discussion with more novel alternative models. These include situated learning theory and legitimate peripheral participation, and practice-based learning theory as advocated by contemporary writers such as Schatzki (2002). These theories changed my thinking about practice learning and informed my efforts to develop a more cogent understanding of learning through, for and at work for undergraduate nurse education. In setting out Chapter 3, I am presenting a brief overview of these publications for a nursing education audience. Firstly, I have included information that is generally considered important to this audience, such as details about the journal’s standing and article citations, the databases searched, and the percentage of my own contributions. Secondly, I report the studies from an evidence-based perspective of prediction and control aligned with the contexts of the commissioning process and the conduct of each project. By this I mean that I treat the findings in these papers as valid and credible within the stated limitations Chapter 4 presents the six publications in their entirety for the reader Chapter 5 explains the research methodology adopted in the papers presented for this thesis, and offers my critical reflections on these methodologies. I outline the philosophy that underpins the approach taken with the research studies, discussing the interpretive stance that was taken to research and the consequent choice of qualitative approaches. The chapter also discusses the strengths and limitations of the methods employed in each of my papers along with the means used to analyse the data, and the ethical considerations that an interpretive researcher must consider. In retrospect, given where my theoretical orientation has moved (as explained in chapter 2), I now look rather more critically on the premises of these studies, their categories of definition, multiple causes and uncertainties at play. In my reflections on the research approach, I explain some of these issues. In concluding this thesis, Chapter 6 details my recommendations and some future implications for policy and practice. It also explains my plans for carrying forward different methodological and theoretical approaches in my future research work examining nurses' practice learning.

Background: Research is essential for the development of a unique body of knowledge, a hall mark of any profession. It should be utilised to provide the basis for professional theory and practice. Aim: The purpose of the study was to develop guidelines that will assist professional nurses in the utilisation of research findings. Design and setting: Quantitative, descriptive research was used to determine professional nurses’ (N=284) perception of utilization of research findings in practice. The structured questionnaire was used to collect data. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 23 since this is a quantitative study. The study focused on professional nurses at the two selected hospitals that were providing the comprehensive programme in the uMgungundlovu district. Results: 284 respondents answered the questionnaire. Of the respondents, 73.3% agreed that they lacked knowledge of research. The frequency of respondents that lacked research knowledge was 208. Of the respondents, 211 (74.3%) recommended use of research findings in practice versus 24 (8.5%) who were unsure and 9 (3%) respectively who did not know whether research should be used or not. Conclusions: The findings revealed that there is a need for changes to be made in the nursing education system to try and improve research utilisation by professional nurses in practice since the professional nurses working in the clinical area are produced by nursing education institutions / Health Studies / M.A. (Health Studies)

Sverige har under de senaste decennierna utvecklats till ett mångkulturellt samhälle. Som sjuksköterska möter vi dagligen situationer där människor, på grund av olika kulturer, har olika syn på hälsa, ohälsa, sjukdom och behandling. Syftet är att beskriva sjuksköterskors upplevelser av att möta och vårda patienter med olika kulturella bakgrunder för att belysa vikten av kulturell kompetens. Studien är en litteraturstudie med en kvalitativ ansats. Totalt valdes sju artiklar som kvalitetsgranskades och användes i resultatet. Resultatet presenteras i fem huvudkategorier och nio underkategorier. Ett genomgående tema i resultatet var att identifiera vilka hinder sjuksköterskor upplevde försvårade vårdrelationen med patienterna som i sin tur påverkade kvalitén på den vård som gavs. I mötet med människor från andra kulturella bakgrunder uppmärksammas behovet av kulturell kompetens. Genom att förstå hur andra människor tänker kan sjuksköterskor tillmötesgå patienten och utforma vården utifrån den enskilda patientens önskningar.

The focus of the research programme within this thesis is an investigation of scenario-based simulation training in undergraduate healthcare education. The aim of the main study was to determine the effectiveness of high-fidelity simulation training with adult branch nursing students. Their acquisition of knowledge and skills was tested using a 15-station Objective Structured Clinical Examination (OSCE) pre- and post- the simulation intervention with randomised control and experimental groups of volunteer students. The results show that simulation training is an effective learning method as students from the experimental group, who were given the opportunity to observe and take part in high-fidelity simulation training followed by debriefing, made significantly higher improvements between their two OSCE performances than students from the control group. The second study focused on interprofessional learning with a randomised control group investigation of the students’ knowledge of the roles and skills of other healthcare professions involved in the same simulation session. The results demonstrate that observing and taking part in multidisciplinary scenarios and their debriefings contributed to the students’ acquisition of knowledge about the roles and skills of other health professionals. The study also showed that students’ perception of multidisciplinary team working was significantly influenced by whether or not they had experienced interprofessional high-fidelity scenario-based simulation training. The main original themes emerging from the research work presented in this thesis comprise the implementation of high-fidelity scenario-based simulation training and debriefing with undergraduate students from a range of healthcare disciplines and the objective measure of the effectiveness of such learning opportunities. This work has now started to impact on simulation practice in undergraduate education within the University and beyond

This research study was designed to investigate the relationship between participation in a nursing education program and the factors of stress, physical illness, anxiety, and self-concept experienced by the participants. Also, the study examined the relationship between age of participants and these same factors. The purposes of this study were (1) to determine if beginning and ending nursing students differ in stress, physical illness, anxiety, and self-concept, (2) to examine the relationship between age of nursing students and stress, physical illness, anxiety, and self-concept, (3) to provide information that may help develop a theoretical base concerning stressful life events and illness in nursing students, and (4) to provide information that may be beneficial with regard to future research involving stress, physical illness, anxiety, self-concept, and age in nursing students.

The problem with which this investigation is concerned is the development of a theoretical framework for a program of graduate education for the preparation of teachers and administrators in nursing education. The theoretical framework for the program was developed after extensive research of the literature concerning graduate education generally and nursing specifically. Additional data were obtained from four different questionnaires sent to the presidents, chairmen, and faculty of all Texas colleges with programs for an Associate Degree in Nursing as well as to 100 students and 100 graduates representing all Texas programs for the Associate Degree in Nursing. The purpose of the study was to review the history of nursing, its development as a profession, and its system of education, including past, present, and future trends in each category of education. This survey gave a perspective to the graduate program proposed in this study. hen all fifty-seven accredited graduate nursing programs in the United States were analyzed to determine the current nature of graduate education in nursing and innovations initiated by specific graduate programs, as substantiated by the literature. The data from the questionnaires sent to all the Texas programs for the Associate Degree in Nursing paralleled the developments and facts revealed in the literature. From all of this information, a theoretical framework for a graduate program in nursing was developed. A description of the program follows. A master's degree received from an accredited university is considered the acceptable minimum preparation for positions of faculty and administrators of basic educational programs in nursing. The following graduate curriculum was developed in order to strengthen this preparation. The student in the master's degree curriculum is provided with the opportunity to capitalize on past knowledge, skill, and education acquired in any setting and to build on this foundation. A research, teaching/administration, and advanced clinical nursing interdisciplinary core of nine credits is required in the program. Then, with the help of the faculty in considering the student's learning needs and career goals, a minimum of twenty-seven additional modular units are incorporated into the program. The student is then assisted by the faculty in determining program behavioral objectives and specific modular unit behavioral objectives. Evaluation of the student's work and progress and successful completion of the program will be based on the developed objectives. These are recorded on the student's transcript in lieu of grades. The minimum criterion of acceptable behavior is a satisfactory completion of the broad expected behaviors established for the graduate program. Implementation, accountability, and demonstration of these objectives are determined by each student as guided by the faculty. When the objectives have been met, the student is eligible for a Master of Arts or Master of Science Degree in Nursing Education. It is recommended that an experimental program be established to test the proposed graduate program and the postulates underlying it. In addition, it is recommended that the findings be analyzed in order to determine the adaptability and applicability of this program to other professional graduate educational programs.

Background: Over one half of all pregnancies in the United States are unintended. Nurses are on the frontlines of the health care work force and often encounter women with unintended pregnancies in the clinical setting. They may find themselves responsible for options counseling and helping these women to explore their options of pregnancy, adoption and abortion. Discussing these three options in a non-judgmental, well-informed manner allows the woman to consider all possibilities. Leading this type of conversation requires specific skills and knowledge as well as the ability to deliver this information in a therapeutic, nonbiased manner. Purpose: The intent of this study was to analyze data regarding the inclusion of options counseling and abortion education in undergraduate nursing programs in New England. Identification of gaps can provide opportunities for curriculum reform. Due to the enormous impact that nurses have with patients, institutions have a responsibility to provide their students with accurate, honest, factual, current knowledge about options counseling including abortion. Doing so is a public health issue with the incentive of not only providing women with optimal health care and better maternal-fetal outcomes, but also to reduce spending nationwide. This study can support efforts to accomplish these goals. Methods: A cross-sectional survey was sent out via email to the faculty members of accredited undergraduate nursing programs throughout New England. It was active for approximately three months between June 2015 and September 2015 with intermittent reminders sent during that time frame. The survey inquired about personal attitudes, inclusion/exclusion of options counseling and abortion education as well as methods used to include this material in the curricula. Results: All states in New England were included in this study. Fifty percent of responding institutions reported that they include options counseling and abortion education in the curricula, while the remaining 50% reportedly do not. When asked to identify reasons that this content is not included in the current curricula, 80% of respondents indicated that it is not a curriculum priority due to time constraints. The main identified methods that support inclusion of options counseling and abortion in the curricula include classroom sessions focused on technical/evidence-based instruction, classroom sessions focused on ethical issues and assigned readings. Conclusions: Options counseling and abortion education is not adequately covered in undergraduate nursing curricula across New England. This data set is remarkably similar to a study done in 1997, showing that in the course of nearly 20 years, there has been little advance in the inclusion of options counseling and abortion education. In many instances, this material is given equal or more attention in ethical discussions rather than focusing on technical evidence-based instruction. Personal attitudes about abortion have been correlated with the inclusions of options counseling and abortion education and likely affect the content that is incorporated in the curricula.

This study described the mentoring relationship between doctoral nursing students and their committee chairs. Twenty-two public university doctoral programs responded to a request for names and addresses of their doctoral candidates. The Major Professor Mentoring Scale was used to measure the mentoring relationship. The survey also included demographic and open-ended questions regarding the student-committee chair relationship. Surveys were mailed to 269 doctoral students with an 86% return rate. A principal components analysis was performed to identify the structure underpinning the relationship. The typical doctoral student in this sample was found to be a 44 year old Caucasian female, married with children, working full or part time while pursuing a PhD degree. Students traveled an average of 85 miles each way to campus and nearly half had selected their program based on its location. The typical committee chair was a Caucasian, tenured, associate or full professor between 46 and 69 years of age. The majority of chairs were married and had funded research projects. The students in the study reported knowing their chairs for an average of five years. The study revealed that mentoring is occurring in the majority of relationships between doctoral nursing students and their committee chairs. Students identified many strengths and weaknesses in their relationships with their chairs although the relationship appears to be largely positive. The mentoring relationship is composed of four principal components, the largest of which is psychosocial support. Dissertation support, role modeling and scholarly collaboration comprise the other three components. The factor receiving the most positive rating was role modeling, suggesting that students see their chairs as intelligent and hard-working. Students also report positive feelings about both the psychosocial and dissertation support they have received from their chairs. Students reported more neutral feelings about scholarly collaboration suggesting that this is not a frequent occurrence in the relationship. Demographic variables including age, sex, race, geographic distance and family status were not predictors for mentoring scores.

This thesis is a story of how I came to construct and illuminate a reflexive narrative as a journey of self-inquiry and transformation towards personal realisation. It shares a view of reflection as lived in being and becoming a reflective nurse educator in higher education. My narrative draws upon, autoethnography, critical social theory and hermeneutic perspectives. Johns (2010) six dialogical movements have been used to give structure to my narrative. Nineteen reflections generate the reflexive narrative in a hermeneutic spiral, as each text informs the other along the journey. Insights become clearer through guidance, dialogue, and engagement with the literature. Early reflections show anxiety, emotional distress and entanglement as I tried to solve student problems. Maternalism influenced my approach to being with distressed and struggling students. Gradually these feelings give way to being available, becoming student kind as an enabling relationship with students. Becoming student kind is framed through my adaptation of the Being Available Template (Johns 2013). It is realised through; listening, presence, caring, empathy, compassion and emotional intelligence. Poise, a self-management practice ensures that personal concerns and tensions do not hinder my relationships with students. Mindfulness expressed as spirituality sustains this process. This path to becoming student kind creates a learning space for student growth and development. In so doing, students are enabled to enter into a nurse patient relationship through being available. I express my empowerment through a dialogical voice, transforming my practice with individual students, in the classroom and beyond. Understanding the tensions within the complexity of university culture influencing nurse education, informs collaboration with colleagues towards a shared vision of nurse education. I turn to reflect on a journey of constructing a reflexive narrative. Five stepping stones for dialogue in advancing guided reflection as a foundation for nurse education are offered. My inquiry weaves a story of reflection as testimony to a fusion of practice and theory. I reveal practice wisdom, informing my day to day work in being available becoming student kind in relationships with students. I explore the contribution to knowledge, my practice and future research, considering the strengths and challenges therein.