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Philosophiae Doctor - PhD / Incivility is rudeness, disrespect, disregard for others or their opinions, and a barrier to social interaction that could be associated with stress. The lack of regard for others creates a disrespectful, conflicting, and stressful environment, which could be perceived as an attack on the individual‟s dignity, or sense of self-worth. According to reports, such behaviour could be increasing and affecting the welfare of educators, students, and the overall educational process. Nursing education has not been exempted from this behaviour. Therefore, incivility is a nursing problem, which affects all those involved, from the academics, students, clinicians, patients and families.

Aim The study aim was to explore the issues and challenges facing undergraduate nursing education in one Canadian province from an institutional theory perspective. The research questions were: What is the institutional field of nursing education? What are the issues and challenges facing nursing education? How is the institutional field of nursing education contributing to the issues and challenges? How are the issues and challenges contributing to the institutional complexity? Background Nursing education is essential for the health care of society, yet face various issues and challenges at the system level. Institutional theory has been used in higher education to better understand how higher education institutions are structured and operate. Institutional theory has not been used in nursing education. The issues facing nursing education have been examined from a critical or descriptive perspective, but a system-level perspective is missing. Institutional theory could fill this gap and examine the institution of nursing and how its structure, behaviours, and rules influence those issues and challenges. Methods An exploratory single-case study with embedded units design was used. Theoretical propositions from institutional theory informed the sample, recruitment, data collection, and data analysis. In 2019, representatives from organizations comprising the institutional field of nursing education and senior-level administrators were interviewed and relevant documents were collected and reviewed. The data were analyzed using deductive and inductive thematic analysis, building a case description, and visual analysis techniques. Findings The findings from sixty documents and seven interviews suggested the institutional field of nursing education is composed of postsecondary institutions, health service organizations, the regulatory body, the ministry for health, and the ministry for postsecondary education. The issues and challenges facing nursing education included demands on curricula, teaching and learning values versus practice, the relationship between education and practice, limiting financial supports, clarity of the RN role, and need for faculty. The institutional field of nursing education is complex and includes dominant organizations, such as the regulatory body and health service organization, and the non-dominant organization, postsecondary institutions. Discussion / Conclusion The use of institutional theory was beneficial to explore the issues and challenges facing undergraduate nursing education from a system-level perspective and captured the complexity within the system. The institutional field including the influences of structure, dominance, and complexity impact the issues and challenges facing nursing education. The institutional perspective of the issues and challenges diverges from previous examinations. In addition, the use of institutional theory in higher education offers strategies for advocacy in nursing education. Recommendations for nursing education practice, policy, and research include: (a) awareness of the organizations comprising the institutional field of nursing education, (b) including the nursing education accreditation body and the professional association within the interorganizational structures, (c) acknowledgement of the sources of dominance within the field, and (d) developing strategies for academic nurse leaders to navigate the complexity of nursing education. The most urgent consideration arising from this research is the dominant forces from regulation and health service organizations and the subsequent non-existence of the professional voice of nursing for nursing education within the institutional field. / Graduate

Philosophiae Doctor - PhD / Globally, healthcare curricula are being transformed to serve societal needs and strengthen the provision of healthcare services towards ensuring Primary Health Care. Community Engagement and its typology were deemed significant to redress the nature of healthcare services, as well as the nature of the nursing curriculum, in order to develop socially accountable graduates. SL is known as a philosophy and an approach to community development and pedagogy. In this current study, the primary focus of SL was viewed as pedagogy, with the intention of fostering skills and values associated with accountability.

BACKGROUND A form of social networking, Twitter is considered a useful means of communication, particularly with millennials. This method was chosen based on current literature exploring the characteristics of millennial students. METHOD Ahern's Model of Adolescent Resilience served as the theoretical framework. Participants were 70 junior-level baccalaureate nursing students, ages 19-23, at two state-supported universities. RESULTS Twitter was found to be a convenient, cost-effective, and enjoyable means of intervention delivery for the researcher. Participants in the experimental and control groups expressed positive feelings about the use of Twitter. CONCLUSION The findings contribute to future efforts to use social media in nursing research and education to increase faculty-student engagement, promote critical reflection, provide social support, reinforce course content, and increase the sense of community.

The health-care climate is changing rapidly and in ways that challenge the abilities of professionals who provide health care. Nursing educators are preparing professional nurses who can think critically, use sound clinical judgment, and participate as full partners in shaping health-care delivery and policy. Therefore, many schools of nursing, including five schools of nursing whose experiences are synthesized in this article, are revising their curricula to a community-based nursing perspective. Strategies to assist faculty in the transition to a community-based nursing curriculum include using change theory, creating a supportive environment, reducing tension and isolation, and evaluating. Potential challenges during transition include addressing grief and loss, overcoming the tedium of curricular development, moving the revision along while allowing opportunities for faculty input and consensus building, exploring alternative pedagogies, managing faculty workload and qualification issues, and preparing for transition. Outcomes include a more complete understanding of the community client as a partner in the delivery of health care, increased visibility and role modeling to potential future candidates for health careers, cultural transformations within a university, and promotion of the overall health of a community.

Clinical reasoning is the cognitive process that nurses use to gather and incorporate information into a larger bank of personal knowledge. This incorporated information guides therapeutic actions, and helps determine client care. Since the process guides therapeutic actions regarding client care, failure to use the process effectively leads to poor clinical decision-making, inappropriate actions, or inaction. Because of the criticality of this process, this paper presents an analysis of the literature that reveals the current state of the science of clinical reasoning, identifies gaps in knowledge, and elucidates areas for future research. A systematic review of the databases the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Educational Resources Information Center (ERIC), PsychInfo, the Education Full Text (H.W. Wilson), and PubMed revealed 873 articles on the topic of clinical reasoning. Quality appraisal narrowed the field to 27 pieces of literature. Appendix A gives the State of the Science Coding Sheet used to identify the selections used in this research. Appendix B contains a summary of this literature. Although analysis of this literature shows that three theories exist on how to utilize most effectively the clinical reasoning process presently; a clear consistent definition is lacking. Additional research should focus on closing gaps that exist in defining the process, understanding the process, establishing linkages to non-clinical reasoning processes, and developing measures to both develop and accurately measure clinical reasoning.

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Social media can provide a tool for nursing students, who frequently transition between learning in the classroom and clinical contexts, to consolidate both their formal and informal learning experiences. Furthermore, the majority of baccalaureate nursing students fall within the millennial generation, meaning that they have grown up with computers and other digital tools and likely already use them to share educational resources and maintain contact with their peers. We know little about how health professions outside of Medicine use social media in teaching and learning, especially outside the context of the classroom and assignments. This pragmatic three-phase sequential mixed methods case study explores nursing students’ perceptions of using social media to support their learning and teaching. Phase 1 involves a survey of nursing students at Nipissing University to understand their use of social media for teaching and learning purposes. Phase 2 consists of a digital artifact collection, which involves following nursing students’ social media accounts to see what content they share related to teaching and learning in nursing education. Finally, Phase 3 involves semi-structured interviews to gain a deeper understanding of what motivates nursing students’ decisions to use social media for teaching and learning purposes. Overall, the findings show that nursing students at Nipissing University’s School of Nursing use social media in their formal and informal teaching and learning; they also use it as a ‘third space’ to supplement existing educational and institutional structures. The findings also demonstrate that while nursing students are relatively motivated to use social media in their teaching and learning, issues of quality and reliability of evidence, professionalism, and faculty or program attitudes can influence nursing students’ decisions to use or not to use social media for teaching and learning purposes. Finally, the findings suggest that nursing students share content related to advocacy, health education, and their perceptions and realities of nursing practice. This study contributes practically to the existing conversations regarding teaching and learning, critical inquiry, communication and collaboration, and professionalism in nursing education and practice.

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