Magister Curationis - MCur / In nursing education the clinical component comprises an important part of the students’ training. Clinical teaching and learning happens in simulated as well as real world settings. First–year students spend the first quarter of their first year developing clinical skills in the skills laboratory. In the second-term they are placed in real service settings. This study was aimed at exploring the experiences of first year nursing students of the University of the Western Cape (UWC) during their first clinical placement in the hospital. A qualitative phenomenological exploratory study design was used and a purposive sample of twelve nursing students was selected to participate in the study. The research question was “Describe your experiences during your first placement in hospital?” Written informed consent was given by every participant and ethical approval was obtained from the relevant UWC structures. In-depth, face-to-face interviews were conducted, audio taped and transcribed verbatim. Transcripts were coded and sub-categories, categories, and themes were extracted during the data analysis process. Trustworthiness of the data collection and data analysis processes were ensured. Many of the first year nursing students described their experience in hospital as being stressful. However, the first placement in hospital allowed them to work with real patients and provided them an opportunity to develop a variety of clinical skills. Even though the hospital environment was unfamiliar and the ward staff unwelcoming, the patients’ acknowledged and valued their contribution to patient care. Students tend to seek support from family members and lecturers. It is recommended that first year nursing students be prepared adequately for their first placement in hospital as well as to provide practical and emotional support to students during their hospital placement. / South Africa

Magister Curationis - MCur / In nursing education the clinical component comprises an important part of the students’ training. Clinical teaching and learning happens in simulated as well as real world settings. First–year students spend the first quarter of their first year developing clinical skills in the skills laboratory. In the second-term they are placed in real service settings. This study was aimed at exploring the experiences of first year nursing students of the University of the Western Cape (UWC) during their first clinical placement in the hospital. A qualitative phenomenological exploratory study design was used and a purposive sample of twelve nursing students was selected to participate in the study. The research question was “Describe your experiences during your first placement in hospital?” Written informed consent was given by every participant and ethical approval was obtained from the relevant UWC structures. In-depth, face-to-face interviews were conducted, audio taped and transcribed verbatim. Transcripts were coded and sub-categories, categories, and themes were extracted during the data analysis process. Trustworthiness of the data collection and data analysis processes were ensured. Many of the first year nursing students described their experience in hospital as being stressful. However, the first placement in hospital allowed them to work with real patients and provided them an opportunity to develop a variety of clinical skills. Even though the hospital environment was unfamiliar and the ward staff unwelcoming, the patients’ acknowledged and valued their contribution to patient care. Students tend to seek support from family members and lecturers. It is recommended that first year nursing students be prepared adequately for their first placement in hospital as well as to provide practical and emotional support to students during their hospital placement

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 aim of this study was to examine the generational differences of undergraduate nursing students’ learning style preferences and their preferred faculty teaching methods to the teaching methods used most often by nursing faculty in the classroom. Background. Nursing educators are responsible for creating learning environments that are effective for students that are in different generations and nursing educational pathways. Each generational cohort brings a collective set of characteristics, expectations, and preferences to the classroom, challenging educators to balance the generational learning styles of all students with respectable, evidence-based, pedagogical approaches. This study was one of the first to explore Generation Z’s preferred teaching method preferences used in the classroom. Method. Both descriptive and inferential statistical procedures were used for this study. A one-sample Wilcoxon signed-rank test was performed to evaluate the difference between each of the learning style preferences, followed by a Kruskal-Wallis test that compared the generational differences to the learning styles. A Likelihood-ratio Chi-square (LR χ2) was performed to assess for association between generational cohorts and their preferred teaching methods used in the classroom. Results. One hundred eighty-four undergraduate nursing students; and sixty-seven nursing faculty from ten Southeastern states were included in the sample for this study. Using the Index of Learning Styles® survey, results found nursing students had either a balanced active/reflective and sequential/global learning style, or a sensing or visual learning styles. With regards to preferred teaching methods, lecture, and the use of visual aids in the classroom were identified as the top teaching methods preferred by both student and faculty participants. Conclusion. Nurse educators are responsible for creating learning environments that are inclusive of students from diverse generational cohorts, spanning six decades and in multiple nursing educational pathways. These results provide new information for nursing educators to utilize in various academic settings.

The researcher designed this quantitative dissertation research to explore the perceptions of beginning nursing students toward professionalism in nursing, specific to professional values within the context of curriculum delivery for a leadership and management course in one baccalaureate nursing program. In addition, the researcher reviewed the literature for defining characteristics of professionalism in nursing. Adult students admitted to nursing programs today create multi-generational cohorts with prior learning from experiences and academic degrees in other disciplines. Often, content on professionalism in nursing is integrated in a nursing curriculum. However, students in a leadership and management course were unable to state the meaning of professionalism in nursing shortly before graduation. This study focused on professional values based on the nursing code of ethics as one attribute of the complex concept of professionalism. This exploratory study analyzed responses of students prior to beginning nursing courses to the Nurses Professional Values Scale-Revised (NPVS-R) survey. Findings indicated that beginning student perceptions of professionalism in nursing specific to professional values were generally in alignment with nursing standards. Significant findings suggested a lack of alignment to professional standards under the themes of trust, activism, caring and professionalism through autonomous practice, self-regulation, and participation professional activities positively associated to five variables. Recommendations are made for enhancing curriculum design of leadership and management in nursing content to address these areas.

Nursing students' knowledge deficits, lack of experience, personal biases, and anxiety can ultimately create vulnerability, avoidance, and discriminatory behaviours toward people experiencing a mental health disruption. Nursing students express the need for more innovative educational opportunities to refine skills and enhance knowledge specific to suicidal identification and risk assessment. Virtual simulation has increased significantly within healthcare education to supplement, enhance, and support learning since the beginning of the COVID-19 pandemic. A virtual simulation education module focused on suicidal ideation and assessment of risk was designed and implemented to strengthen the learning, preparedness, and confidence of nursing students providing care in a mental health setting. The purpose of this study is to explore the perceived effectiveness of a suicidal ideation – assessment of risk virtual simulation module for undergraduate nursing students. The sample consisted of third-year nursing students enrolled in a mental health in nursing course from Ottawa, Ontario (N = 130). The research design is a mixed methods explanatory sequential design whereby the dominant data resides in the quantitative portion of the research study. The research study was divided into Phase I, referred to as the quantitative portion, and Phase II, referred to as the qualitative portion. In Phase I, the effectiveness of the virtual simulation focused on suicidal ideation and assessment of risk and were measured using the Simulation Effectiveness Tool-Modified (SET-M). The SET-M is a 19-item quantitative Likert scale tool used to measure the effectiveness of a simulation and its components after its completion. In Phase II, semi-structured interviews were the primary method for qualitative data collection to provide greater insight into Phase I of the research study. The quantitative findings demonstrated a simulation experience that was supportive of the nursing students’ learning, specifically in relation to nursing skills and assessments, problem- solving, clinical decision-making, and communication skills. The quantitative results demonstrated the importance of structure and guidance to achieve the desired outcomes of the simulation. Thematic analysis of the semi-structured interviews revealed that the virtual simulation on suicidal ideation and assessment of risk was associated with increases in learning, preparedness, confidence, knowledge, critical reflection, and a decrease in anxiety regarding suicide ideation and assessment of risk. The virtual simulation module on suicidal ideation and assessment of risk reinforces the need for various educational modalities to engage and increase the preparedness of nursing students entering clinical placement.

Background: Students of diverse ethnic backgrounds, including nonnative English speakers, also known as those who speak English as an additional language (EAL) are increasingly enrolling in prelicensure nursing programs. Information regarding success of EAL nursing students is limited, with emphasis on traditional prelicensure programs. Purpose: The purpose of this study was to explore the lived experience of recent EAL graduates of an accelerated second-degree baccalaureate nursing program by offering a firsthand account of being an EAL student in this type of nursing program. Theoretical Framework: Leininger's Theory of Cultural Care Diversity and Universality and Vygotsky's Theory of Socio-Historical Learning served as the theoretical framework. Methods: The research tradition of hermeneutic phenomenology utilizing the van Manen approach was applied to this study. Results: The study revealed five major themes: bridging cultures, needing more time, myriad of emotions, network of support, and finding my way. Several subthemes emerged to support major themes illustrating the complexity of being an EAL student in a fast-paced and challenging program. Conclusions: Exploring experiences of EAL graduates while enrolled in an accelerated second-degree baccalaureate nursing program offers insight into the challenges faced by EAL students and potentially influences nursing education, practice, and policy to improve the numbers of diverse nurses.

Bakgrund: Sjuksköterskeyrket kräver såväl teoretisk som praktisk kunskap, värderingsförmåga och ett kritiskt förhållningssätt. Arbetet som sjuksköterska i en ständigt föränderlig vårdkontext, kan upplevas som påfrestande och transitionen från student till färdig sjuksköterska kan bli en verklighetschock. För att ge sjuksköterskan en trygg grund att stå på med förutsättningar för att kunna ge en god och säker vård, har förslag gällande utbildning och yrkesintroduktion tagits fram i syfte att minska gapet mellan utbildningen och yrkesutövningen. Syfte: Att beskriva sjuksköterskestudenters och sjuksköterskors upplevelser av transition från utbildning till profession. Metod: En litteraturöversikt baserad på tolv vetenskapliga artiklar, varav nio kvalitativa och tre kvantitativa. Resultat: I resultatet framkom tre huvudteman; Utvecklande av personliga förutsättningar och egenskaper med två underteman: Identitet och självkänsla i yrkesrollen samt Problemhantering och prioriteringsförmåga, Träning och förberedelser inför sjuksköterskeyrket med två underteman: Att vara tränad för att ge en god och säker vård samt Att vara tränad och förberedd för en ledarroll och slutligen Den psykosociala arbetsmiljön med tre underteman: Förutsättningar i organisationen, Stöd och handledning samt Ett accepterande arbetsklimat. Diskussion: Resultatet diskuterades med utgångspunkt i arbetsmiljön och tillsammans med Benners (1984/1993) modell om sjuksköterskestudentens och sjuksköterskans utveckling från novis till expert. Resultatet jämfördes med annan relevant litteratur som berör transitionen och hur den skulle kunna underlättas genom stöd, handledning och reflektion. / Background: The nursing profession requires both theoretical and practical knowledge, judgment and critical thinking. The work as a nurse in a constantly changing health care context, can be troublesome and the transition from student to registered nurse may become a reality shock. To give the nurse a solid base and conditions to be able to provide good and safe care, suggestions have been made regarding training and professional induction in attempt to reduce the gap between the education and professional practice. Aim: To describe nursing students and registered nurses' experiences in transition from education to profession. Method: A literature review with a result based on twelve scientific articles, of which nine were qualitative and three quantitative. Results: The results revealed three main themes: Developing personal prerequisites and characteristics, with two subthemes: Identity and self-esteem in the professional role and Problem solving ability and ability to prioritize, Training and preparation before the nursing profession with two subthemes: Being trained to provide good and safe care and To be trained and prepared of the leadership role and The psychosocial working environment with three sub-themes: Preconditions of the organization, Support and mentoring and An accepting working environment. Discussion: The results were discussed on the basis of the working environment and together with Benner's (1984/1993) model of nursing students´ and registered nurses´ development from novice to expert. The results were compared with other relevant literature related to the transition and how it can be facilitated by support, mentoring and reflection.

Recent reforms in the South African health care and educational system were founded in the ideal that the country would produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Learning facilitators are held accountable for finding adequate learning experiences to prepare nursing students for such practice demands so that newly qualified nurses do meet expectations for entry level clinical judgement ability. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. There is a scarceness of information on the concept of clinical judgement especially within the South African nursing environment. Relevant information in this regard can assist in clarifying the meaning, which will facilitate a common understanding of the concept within the clinical nursing environment. This in turn can lead to the formulation of a teaching-learning strategy to facilitate clinical judgement in undergraduate nursing students, which would be of benefit in the nursing care environment. The objective of this study was addressed in three phases. The first phase of this research analysed the concept of clinical judgement through various data sources and a review of literature to clarify the meaning and facilitate a common understanding through identification of the characteristics and to develop a connotative (theoretical) definition of the concept. The second phase of the research investigated professional nurses‟ understanding of the meaning of clinical judgement, as well as the factors that influence the development of clinical judgement within the nursing environment. During the third phase a conceptual framework for an enabling teaching-learning environment was constructed from a modern day constructivist approach to facilitate clinical judgement. The section included a description and diagrammatic presentation of the framework. The conceptual framework formed the scientific basis from which a teaching-learning strategy for the creation of an enabling teaching-learning environment to facilitate clinical judgement in undergraduate nursing students within the South African nursing environment was synthesised. A qualitative design was used for the study. During the first phase (manuscript 1) an explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search engines were consulted for the time frame 1982-2013. An extensive concept analysis resulted in a theoretical definition of the concept „clinical judgement‟, a complex cognitive skill to evaluate patient treatment alternatives within the clinical nursing environment. The second phase (manuscript 2) is qualitative in nature and explored professional nurses‟ understanding of clinical judgement, as well as the factors influencing the development of clinical judgement in undergraduate nursing students. The findings emphasised clinical judgement as skill within the nursing environment. This assisted in the development of teaching-learning strategy for the creation of an enabling teaching-learning environment to facilitate clinical judgement in undergraduate nursing students within the South African Nursing environment as the third phase (manuscript 3). Such an environment should impact positively to promotion of autonomous and accountable nursing care. / PhD (Nursing), North-West University, Potchefstroom Campus, 2015

Recent reforms in the South African health care and educational system were founded in the ideal that the country would produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Learning facilitators are held accountable for finding adequate learning experiences to prepare nursing students for such practice demands so that newly qualified nurses do meet expectations for entry level clinical judgement ability. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. There is a scarceness of information on the concept of clinical judgement especially within the South African nursing environment. Relevant information in this regard can assist in clarifying the meaning, which will facilitate a common understanding of the concept within the clinical nursing environment. This in turn can lead to the formulation of a teaching-learning strategy to facilitate clinical judgement in undergraduate nursing students, which would be of benefit in the nursing care environment. The objective of this study was addressed in three phases. The first phase of this research analysed the concept of clinical judgement through various data sources and a review of literature to clarify the meaning and facilitate a common understanding through identification of the characteristics and to develop a connotative (theoretical) definition of the concept. The second phase of the research investigated professional nurses‟ understanding of the meaning of clinical judgement, as well as the factors that influence the development of clinical judgement within the nursing environment. During the third phase a conceptual framework for an enabling teaching-learning environment was constructed from a modern day constructivist approach to facilitate clinical judgement. The section included a description and diagrammatic presentation of the framework. The conceptual framework formed the scientific basis from which a teaching-learning strategy for the creation of an enabling teaching-learning environment to facilitate clinical judgement in undergraduate nursing students within the South African nursing environment was synthesised. A qualitative design was used for the study. During the first phase (manuscript 1) an explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search engines were consulted for the time frame 1982-2013. An extensive concept analysis resulted in a theoretical definition of the concept „clinical judgement‟, a complex cognitive skill to evaluate patient treatment alternatives within the clinical nursing environment. The second phase (manuscript 2) is qualitative in nature and explored professional nurses‟ understanding of clinical judgement, as well as the factors influencing the development of clinical judgement in undergraduate nursing students. The findings emphasised clinical judgement as skill within the nursing environment. This assisted in the development of teaching-learning strategy for the creation of an enabling teaching-learning environment to facilitate clinical judgement in undergraduate nursing students within the South African Nursing environment as the third phase (manuscript 3). Such an environment should impact positively to promotion of autonomous and accountable nursing care. / PhD (Nursing), North-West University, Potchefstroom Campus, 2015