<p> Registered nurses practice in an environment that involves complex healthcare issues requiring continuous learning and evaluation of cognitive and technical skills to ensure safe and quality patient care. The purpose of this basic qualitative study was to gain a better understanding of the continuing educational needs of the expert nurse. This study focused on the use of simulation as a learning platform in the continuation of competency. The study was based on the theories of adult learning and novice to expert. A sample of 10 expert nurses was interviewed regarding their experiences in the use of simulation during continuing education endeavors. The finding indicated that the use of simulation in this study population was effective in the maintenance of competency or in the delivery of new information. The study finding also offered developmental ideas for nurse educators in the planning and delivery of simulation to this study population.</p>

<p> Male nurses are but a small percentage of the total nurse population in the United States, and most certainly have potential to increase in numbers if the profession appeared more attractive as a career option for men. The purpose of this research was to discover the decision factors used by males that led them to enroll in Associate Degree nursing programs in Illinois community colleges. To set the background and context, the study explored the history of community colleges and that of nursing. Included was nursing as a profession, nursing in the United States, the country&rsquo;s impending nursing shortage and the role of men in nursing. </p><p> Using a qualitative case study method of design, the study adapted a multi-theoretical framework encompassing gender theory (GT) and career developmental theory (CDT). These theories were further broken down by discussing, in particular, Holland&rsquo;s Theory (HT) of Personality and Vocational Choice and Krumboltz&rsquo;s Social Learning Theory (KSLT) under CDT. Nine first year male ADN students from three separate Illinois community colleges were individually interviewed. Findings discovered that the first year male students experienced a distinctive decision making process with eight emerging themes revealing the males&rsquo; decision making about their ADN enrollment process. </p><p> As a result of the study&rsquo;s findings, MURSE: Resurreccion&rsquo;s Male Nursing Student Decision Making Pyramid model was developed to elaborate the steps of how males make decisions about their ADN enrollment. An understanding of these factors can provide opportunities for community colleges, and perhaps universities, to improve recruitment and retention of males in nursing programs. A result would be increased numbers of males enrolling in Associate as well as Baccalaureate nursing programs. Such knowledge held by colleges may help to address a manpower solution to the impending worldwide nursing shortage. </p>

<p>Critical reflection as a learning tool for nursing supervisors is a complex and multifaceted process not completely understood by healthcare leadership, specifically nurse supervisors. Despite a multitude of research studies on critical reflection, there remains a gap in the literature regarding the perceptions of the individual, the support required in the environment, and stimulus needed to integrate critical reflection into the nurse supervisor role. The purpose of this qualitative hermeneutic phenomenological study was to explore the meaning critical reflection has for nurse supervisors and the role of critical reflection within clinical practice settings. The data obtained through a modified vanKaam analysis employing <i>NVivo 9</i> software revealed five themes concerning critical reflection. These five themes include (a) personal experience, (b) sources of valuing critical reflection, (c) self-awareness as primary competency, (d) time is a function of prioritization and (e) framework tools for workplace integration. Critical reflection meaning developed through nurse supervisors&rsquo; past experiences with critical incidents and a willingness to develop their own self-awareness. The role critical reflection plays in the environment can be enhanced through making it a priority in the workplace and providing training necessary to increase understanding of the process. Workplace integration requires developing nurse supervisors&rsquo; facilitation skills. The study findings support the underlying value critical reflection holds as a significant part of supporting organizational transformation toward a learning organization culture. </p>

<p> <b>Background.</b> Nurse educators are challenged with a new generation of students referred to as the Millennial generation. These millennial students, who have different learning style preferences, are testing the traditional pedagogical methods of nurse educators such as lecture. The social nature of millennial students coincides with the social constructivism theory that students learn in groups. </p><p> <b>Purpose.</b> The purpose of this quasi-experimental study was to examine if there was an improved retention of knowledge in millennial students who were taught by collaborative learning strategies rather than the traditional lecture method in an associate degree nursing program. Additionally, the study examined if learning by the students' preferred learning style resulted in a higher level of achievement on a comprehensive standardized examination versus learning by a nonpreferred style. </p><p> <b>Theoretical Framework.</b> The theoretical framework for this study was founded on the social constructivism theory suggesting students build knowledge through social group interactions. </p><p> <b>Methods.</b> The quasi-experimental study was conducted at an associate degree program in the Midwest. The nonprobability purposive sampling was utilized to examine the means of a comprehensive standardized examination and a learning styles preference assessment. </p><p> <b>Results.</b> The statistical analysis utilizing the analysis of covariance did not produce statistically significant findings in the differences in the comprehensive standardized examination score means between the students taught by the lecture method and students taught by the collaborative method when controlled for the cumulative grade point average. Additionally, the study did not find statistically significant differences in mean comprehensive standardized examination scores when taught by the students' preferred learning style versus being taught by their nonpreferred style. </p><p> <b>Conclusions.</b> Although not significant, the study did find students who were taught by the collaborative method had higher scores than those who were taught by the lecture method. In addition, learning styles preferences were not significant in determining academic success. The implications of the study are significant to nursing education by highlighting the importance of using collaborative activities and multiple teaching modalities.</p>

<p> <b>Background:</b> Implementation of evidence-based knowledge in healthcare is challenging with success rates less than optimal at times. This is particularly true in the area of pressure ulcer prevention. Attention to use of the affective domain in educational interventions to implement best practices may be part of the solution. </p><p> <b>Purpose:</b> The ultimate purpose of this study was to compare the use of two different educational interventions on medical-surgical nurses' behavioral intent to use evidence-based practice in preventing pressure ulcers. </p><p> <b>Theoretical Framework:</b> The theoretical framework for this study was the theory of planned behavior. </p><p> <b>Methods:</b> This study proceeded in three phases and collected both qualitative and quantitative data for instrument development and instrument testing. The resultant instrument was used to collect data for hypothesis testing in a cluster randomized experiment. </p><p> <b>Results:</b> The theory of planned behavior was not fully supported in this study. Attitudes toward pressure ulcers were predictive of behavioral intent. Nurses who experienced the affective domain educational intervention showed significant improvements over the control group on attitude and perceived behavioral control. Behavioral intent and subjective norm were not impacted. </p><p> <b>Conclusions:</b> A reliable and valid theory of planned behavior derived instrument was created. The theory of planned behavior was partially supported. An affective domain intervention has the potential to favorably impact nurses in valuing pressure ulcer prevention, despite any barriers.</p>

<p> Intercultural competence through study abroad is widely recognized as a preferred teaching approach for the development of globally competent health care practitioners. Colleges and universities are looking for multiple ways to encourage students to study abroad because of the noteworthy effects that these experiential opportunities have on students. Sparse research has been conducted to determine if short-term study abroad trips of less than two weeks are achieving these same outcomes. </p><p> The purpose of this basic interpretative qualitative study was to describe the nature and meanings of a short-term international cultural experience for nursing students, and whether or how their understanding of the role of the professional nurse was changed. A group of baccalaureate nursing students traveled to Tanzania and took part in professional and social opportunities over an 8-day period. All participants were required to complete a nursing course with global objectives prior to the trip and pre-immersion seminars. Data were collected from reflective journals during the study abroad experience, focus group discussions one month after returning home, and personal interviews 6 months later. The results indicated that the participants experienced culture shock, but they also gained in self-awareness, cultural empathy, leadership skills, a desire to learn more, and a new perspective of the role of the professional nurse. Langer's theory of Mindfulness, Bennett's Developmental Model of Sensitivity and Campinha-Bacote's Process of Cultural Competence provided the theoretical framework for this study.</p>

<p> The recent impetus to increase the number of baccalaureate-prepared nurses comes from within and outside the profession, prompting increased numbers of registered nurses (RN-BSN) to return to college. Yet little is known about what these adult, non-traditional students do to prepare for the challenges ahead. Therefore, the purpose of this mixed-methods case study was to learn how RN-BSNs prepare for their return to college, why they go about doing so, and what resources they utilize. Secondly, what are the gaps, how do they overcome them, and what is their advice to potential RN-BSN students so they could be better prepared. The Transtheoretical Model and the Epidemiological Model were used to guide the study. The eight participants interviewed ranged in age (32-57). Each had contemplated the return to school since their initial nursing program. Six were enrolled at a rural satellite site at their place of employment. While participants prepared in a variety of ways, findings showed they also did not know what to expect and thus felt unprepared in many respects. The most common type of preparation was mental; whereas the most frequent gap in preparation was academic, including writing papers, presentation skills, computer literacy, citations, obtaining books, information literacy, and study skills. Overall, five themes summarized their advice to future students: (a) obtain academic skills early on, (b) find balance, (c) make connections, (d) embrace the difference, and (e) don't wait; make the decision. Based on the findings, examples of recommendations that are both practical and affordable are outlined.</p>

<p>Death is perhaps the most paramount loss an individual can experience. Many faculty, administrators, and students do not anticipate the sudden death of a student or classmate; however it is estimated that approximately 30 to 40 percent of college students experience the death of a family member or friend within two years on campus. Despite these astounding statistics, the topics of student death, grief, and bereavement are rarely discussed in faculty development workshops or addressed in nursing education journals. Much research has been devoted to end of life care among practicing nurses. Conversely, there is scant nursing research pertaining to the personal experiences and grief reactions following the loss of a friend or nursing classmate. </p><p> The aim of this qualitative phenomenological study was to explore the grief experiences, coping strategies, and reactions of traditional college age baccalaureate nursing students following the unanticipated, sudden death of a classmate. Purposive sampling yielded nine participants from four universities who experienced the death of their classmate within the previous nine months. The source of qualitative data included a demographic questionnaire and in-depth interviews with each participant. Interviews were digitally recorded, and verbatim transcriptions were analyzed utilizing the seven-step Colaizzi&rsquo;s (1978) method. Nine major themes emerged: 1) emotional pain of grief, 2) struggling with the reality of death, 3) void in life &ldquo;empty desk&rdquo;, 4) university and departmental responsiveness, 5) connecting with the deceased, 6) bond of comfort and unity, 7) coping and support structures, 8) linger/dwell versus moving on, and 9) grief as a nurse. </p><p> Findings of this study support contemporary models of grief and bereavement and previous research related to peer grief. However, unique aspects of grief emerged for the nursing student. The participants reflected on their emotional struggle with grief amidst the walls of academia, acknowledging they are in a helping profession and &ldquo;we cannot even help one of our own.&rdquo; This study yielded a rich understanding of the grief experience of nursing students, while providing insights for policy development and supportive interventions for nursing faculty and college administrators. </p><p> <i>Keywords</i>: nursing education, grief and loss, bereavement, nursing student, peer grief, sudden death </p>

<p>It is estimated that over 30,000 applicants to registered nursing (RN) programs are turned away each year following a rigorous selection process for the limited available program admissions. An alarming number of those students who are accepted and enter upper division programs and depart prior to completion do so because of increased stress and anxiety experienced during clinical activities. Attrition occurs when students repeatedly experience levels of stress and anxiety and feel they have reached a breaking point. Self-efficacy impacts the amount of stress and anxiety an individual can tolerate before encountering negative outcome expectations. The theoretical framework for this study was underpinned by Bandura's (1995) theory of self-efficacy. A multi-case study approach and cross-case analysis was utilized to identify if a link existed between simulation and self-efficacy. Beginning nursing students engaged in a simulated clinical experience prior to the initial acute care clinical experience. Nursing students discoursed about physical and sociostructual influences on agency and environment related to self-efficacy and negative affective behaviors. Based upon students' discourse, this study supports a link does exist between simulation and self-efficacy for beginning nursing students.

<p>Researchers have developed strategies used in nursing programs to promote cultural awareness (Hunter &amp; Krantz, 2010). Minimal research has focused on the graduating associate degree-nursing students to determine if a relationship existed between the use of an integrated cultural curriculum and the nursing student&rsquo;s level of cultural awareness (Kardong-Edgren &amp; Campinha-Bacote, 2008, Sealey, Burnett, &amp; Johnson, 2006). The associate degree-nursing program accreditation, statistical, and benchmark reports mandated the integration of diversity content, local, national, and worldwide perspectives in the curricula (NLN, 2008). Additionally societal and cultural patterns must be integrated across the entire nursing school curricula (Board of Registered Nursing, 2012, section 1426-e7). A correlational approach was implemented to determine if relationships existed between the integrated cultural curriculum and level of cultural awareness in graduating associate degree nursing students in a large metropolitan area, such as in Los Angeles (Sealey et al., 2006). The Cultural Awareness Scale (CAS) was used to survey the participants. Based on the findings of the 51 participants surveyed in this study, the cultural awareness level may be attributed to several factors, including the integrated cultural curricula. The nursing student&rsquo;s learning style, perception of faculty, personal experiences, and cultural encounters may also contribute to the cultural awareness level. Analysis of variance results revealed no statistically significant difference on the CAS total or subscale scores based on gender, age, and ethnicity. The outcome of this study may encourage academic affairs leaders to emphasize cultural awareness as a significant student-learning outcome for nursing educational programs. </p>