The purpose of this naturalistic qualitative inquiry was to determine perceptions of experiences of nontraditional African American nursing students regarding their persistence in or departure from a baccalaureate degree nursing program. The literature reflects that although more people of color are enrolling in higher education, graduation rates remain dismal. Many studies have examined the problem from an institutional viewpoint with a focus on retention and attrition. The present study laid out a blueprint for qualitative research and focused on the individual student so that the problem was approached from the angles of persistence and departure. A bi-polar model of this educational issue was proposed to demonstrate this concept.Convenience sampling was used to identify participants who were assigned to separate focus groups. One group was composed of participants who were departers due to academic dismissal. The second group was composed of participants who persisted and were either currently enrolled or had graduated. Interview guides were developed and participants were interviewed in a focus group setting, followed by individual interviews. Data analysis identified emergent themes from the transcribed interviews that fell into the categories of educational climate, myth of homogeneity, and desire for a level playing field.The findings suggest that African Americans attending predominantly White institutions continue to face racism and oppression, supporting the conclusion of previous researchers on these issues. Implications from this study concluded that to reflect the changing demographics in society, higher education and specifically nursing education must become more inclusive.The conceptual framework for this study was based on the theories of McClusky (1963) from the field of adult education; and Tinto (1975, 1993) prominent in the field of higher education. McClusky's Power/Load/Margin Theory was found to be minimally supportive in describing the experiences of nontraditional African American BSN students. Participants identified barriers that related solely to their status as African Americans and thus eroded the level of Margin. Tinto's longitudinal model of institutional departure was found to be applicable to students who leave due to academic dismissal, an area not previously addressed in the model. Recommendations for further research were given. / Department of Educational Leadership

The purpose of the study was to examine students' perceptions of frequency of clinical teacher behaviors and whether those perceptions change by class level. The theoretical framework for the study was Bevis' paradigm of curriculum revolution.In 1993, Marilyn Simons, DNS gathered data from nursing students enrolled in clinical nursing courses at a Midwestern university. The convenience sample totaled 88 (100%). The data was not analyzed or reported. The current study was a retrospective analysis of that data.Findings of the study showed that students perceived faculty as demonstrating professional competence and interpersonal relationship behaviors in the clinical setting. No significant differences were found in these perceptions by class level on either then total scale or on the subscales.The conclusion from the study was that faculty at this particular university are perceived as practicing emancipatory education as proposed by Bevis. It was also concluded that faculty perform at the same level of competency and use similar approaches without regard to class level, and that students perceived that faculty related to them in similar ways across classes.The study was significant because it helps nurse educators understand the student perspective of clinical teacher behavior. The Clinical Teacher Behavior Tool used in the study could be used to help design a cooperative clinical learning model different from the traditional education approach and in accordance with Bevis' paradigm. / School of Nursing

One of the core issues in distance education has been the adequacy of assessment of student experiences and the interaction between faculty and students. This challenge has become even greater with the increase in the numbers of online courses in nursing. Distance education programs that are delivered totally online have many advantages and some disadvantages. Masters level nursing students are choosing online programs for convenience, flexibility, and quality. The purpose of this study was two-fold: to describe Masters nursing students’ perceptions of online courses between 2005 and 2009, as expressed through word data in a web evaluation survey; and to analyze the student perceptions of the online learning environment for trends and themes. The questions of this investigation were the following: 1. What perceptions do Masters nursing students have of their online courses (2005-2009) as expressed through word data in a web evaluation survey? 2. What recommendations can be made for continuous improvement and best practices in programming and evaluation methods based on student perceptions. This research utilized Constructivist Theory as a theoretical model. There were 1625 student comments and 903 suggestions that were analyzed for themes and placed in categories. A qualitative analysis approach was utilized to create categories and look for trends in the data. There were six categories gleaned from the comments and six more that were found as a result of reviewing the suggestions that were made for future course offerings. The researcher found that there was some overlap between the categories of the comments and those of the suggestions. The perception of the students regarding their online course experience in the graduate nursing program was very positive. The flexibility and independence that the online environment offered was appreciated. Blackboard was viewed very positively and students felt that it was easy to use. Students enjoyed the interaction with peers and with faculty and felt it was a valuable learning experience. Recommendations were identified, based on the findings related to the use of technology, recruitment and retention of faculty, and teaching strategies and learning styles. / Access to thesis permanently restricted to Ball State community only / Department of Educational Studies

Graduate nursing education is a combination of didactic and clinical instruction. Clinical instruction is achieved primarily by pairing a student with either an experienced physician or certified nurse practitioner (NP) who will serve as a preceptor. The student/preceptor relationship may be initiated by nursing faculty or by the student. The quality of clinical instruction is crucial to the professional development of the NP. During this time of intense clinical instruction, students learn the process of applying the principles of diagnostic reasoning in a real world setting. Socialization into the role of the NP is an important component of the clinical education and may be impacted by the relationship established between the student and the preceptor. Multiple factors may have an impact on the resulting experience and relationship. Attitudes of both student and preceptor define and shape the relationship that develops throughout the clinical rotation. The student’s perception of the quality of the clinical experience may impact the outcome of the experience including the student’s sense of self-efficacy and confidence in practice skills and socialization into the role. This study focuses on the student’s perception of self-efficacy and confidence based on whether a mentoring relationship was established with at least one preceptor during the clinical experience. The study, a modified replication of Hayes’ 1997 study, demonstrated a strong sense of mentoring, self-efficacy and self-confidence in students enrolled in the final clinical course of a nurse practitioner program. The single most predictive factor for self-efficacy and self-confidence is length of time the student works with the preceptor as measured by months of clinical rotation. Other predictors of self-efficacy and self-confidence included the students’ perception of a mentor and how that mentorship was instrumental in the development of the skills and abilities necessary for transition into the role of the nurse practitioner. Self-efficacy was found to correlate highly with feelings of self-confidence in beginning skills such as physical assessment as well as higher level skills of diagnostic reasoning. As the students neared the end of clinical courses in the nurse practitioner program, most felt prepared to begin practice and cited traits similar to those attributed to preceptors as indicators of preparedness. / Department of Educational Studies

M.Cur. / Please refer to full text to view abstract

Maintaining high levels of academic integrity in nursing programs is critical to student success and the transition to professional practice. Integrity encompasses the values of trustworthiness and honesty. Nursing faculty need to determine if they are providing students with the resources and communication needed to maintain a culture of integrity. It is important for faculty to determine if students tend to rationalize or neutralize the psychological effects of dishonest behaviors. Finally, it is important to determine methods to eliminate violations of academic integrity in nursing education. The overall design of the dissertation provides three distinct articles designed to stand alone as potential articles for publication. This dissertation is a part of a larger collaborative effort with two other Teachers College Doctoral students. The methods and procedures are the same for all principal investigators. Chapters I through III and Chapter V are all uniquely my own. Chapter IV represents the collaborative effort presented in this dissertation. In a cross-sectional, quantitative study design, McCabe’s Academic Integrity Survey- Modified for Nursing Students (MAIS-MNS), a Knowledge Assessment of Academic Integrity, and a Demographics Questionnaire were completed by 442 pre-licensure nursing students. In the individual portion of this study, the relationships between perceived faculty support of academic integrity policies; perceived faculty response to cheating; neutralization; and age are examined to determine if relationships exist between the variables. Additionally, in the collaborative chapter, the variables of severity and perceived faculty support of academic integrity policies were compared to the willingness to report peer violations and program-wide strategies to improve a culture of integrity. Data were analyzed using IBM SPSS Statistics version 27 (IBM Inc., Armonk, NY, USA). Results indicated students who have higher perceived faculty support of academic integrity policies are less likely to rationalize academically dishonest behaviors. It was also found that younger students were more likely to rationalize dishonest behaviors. It is also important to consider from which source students are receiving academic integrity information. Course syllabi, first-year orientation, program counselors, faculty, deans and other administrators, and other students were all found to be significant predictors related to student perception of faculty support of academic integrity policies. Students who have higher perceptions of severity scores and higher perceptions of faculty support of academic integrity policies scores were found to be more willing to report peers. Additionally, having program-wide interventions, such as an honor code, could help strengthen the overall culture of integrity. Frequent communication and consistent academic integrity policies are vital for faculty to maintain throughout nursing programs Faculty should remain vigilant to changing trends in how students violate academic integrity violations and provide consistent messages.

The use of simulation has increased due to the shortage of clinical sites and nursing faculty. Patient acuity and privacy laws have contributed to the increase. Research science in simulation is established in the areas of scenario execution and with the debriefing phases. However, prebriefing is an understudied phase of the simulation. Prebriefing is the phase of simulation that prepares students for the simulation scenario with an orientation to the room, equipment, and manikin. The objectives for the simulation and patient background information are shared with students. There is a limited amount of literature on interventions in prebriefing related to improved student learning outcomes. An experimental design was used to test the hypothesis that students who viewed two videos of clinical skill demonstrations during the prebrief would demonstrate improved clinical skill performance and increased clinical competency. It was also hypothesized that students would also report decreased anxiety with increased self-confidence related to clinical decision-making during the simulation scenario. Additionally, it was hypothesized students who demonstrated increased clinical competency, reported less anxiety and higher self-confidence related to clinical decision making would achieve higher exam scores on related content. A convenience sample of 129 Junior and Senior baccalaureate nursing students consented to participate in the research. Results of an independent samples t test showed that students in the intervention group demonstrated significantly better clinical skill performance in changing the rate on an intravenous fluid administration (p = < 0.001), and in the administration of medication via intravenous push (p = < 0.001) than students in the control group. Students in the intervention group also demonstrated increased clinical competency (p = < 0.05), assessment (p = < 0.05) and patient safety (p = < 0.05) when compared to the control group. A mixed ANOVA testing for the interaction between group and time of test was used to determine if there were group in the changes from pre to post test in anxiety, self-confidence and clinical decision-making. The results showed no significant differences between groups. A Pearson r was used to evaluate the correlation between anxiety and quiz score; self-confidence and quiz score; CCEI-CJ, and quiz score. There was a negative nonsignificant correlation between anxiety and quiz score, r(105) = -.091, p = .358. There was a positive correlation between self-confidence and quiz score, r(105) = .204, p = .037. There was a positive nonsignificant correlation between the CCEI-CJ and quiz grade r(107) = .082, p = .400. This research study demonstrates that the prebriefing phase of simulation can be enhanced to include elements that will improve student learning outcomes.

Academic integrity, while important for all students, is especially so for those enrolled in nursing programs. Nurses are entrusted by the public to care for those in need from birth through death. A nursing student who graduates through dishonest means jeopardizes the safety of patients in their care. Nursing faculty need to understand the scope of academic integrity violations and develop meaningful, targeted interventions to show students the harm their actions could cause. The purpose of this dissertation is to explore undergraduate nursing students’ knowledge and perceptions of academic integrity and to specifically look at their willingness to report peer violations. This dissertation study was a collaborative effort among three doctoral students. Using a research team-modified version of McCabe’s Academic Integrity Survey as well as a research team-created Knowledge Assessment, 442 nursing students were surveyed. Results confirm a hesitation to report peers for violations of academic integrity. Students’ ability to neutralize their behaviors as harmless, their desire to remain loyal to their peers, and age act as positive predictive variables for willingness to report peer violations. Additionally, participants’ perceptions of the severity of various offenses and their perceptions of their faculty’s support for academic integrity policies are positively correlated with willingness to report peer violations. Program improvement strategies, such as implementing an honor code, were supported by participants and may help foster a culture of academic integrity that promotes peer reporting. Lastly, a targeted intervention designed for nursing students to promote academic integrity and peer reporting is explored.

Empathy is the foundation of caring in the nursing profession. It is critical to an effective patient-nurse relationship and impacts decision-making in nursing care. This study aimed to investigate the impact of virtual simulation on nursing students’ empathy and the relationships of empathy to their demographic characteristics. A randomized pretest and posttest control group design was employed in the study with 140 participants from twelve undergraduate nursing programs across Canada. A virtual simulation scenario was created by the author regarding a patient with substance overuse in an acute care setting. Standardized patients were employed to portray the virtual characters to enhance realism and immersive experience. The participants in the control group reviewed a text-based case study, which consisted of an identical storyline of the virtual simulation scenario, while those in the intervention group experienced the virtual simulation activity. The Kiersma-Chen Empathy Scale-Revised (KCES-R), Substance Abuse Attitude Survey (SAAS), and a demographic survey consisting of age, gender, personal, family, and learning experiences related to substance overuse, were used in the study. The results indicated empathy was significantly increased after the learning activities in both groups, but nonsignificantly different between the participants in the text-based case study and virtual simulation groups before and after the learning activities. Meanwhile, the participants’ attitudes toward substance overuse did not change significantly after their learning activities. All demographic characteristics were nonsignificantly correlated to the participants’ empathy as well. However, the participants’ empathy toward the patients with substance overuse was significantly associated with their attitude toward substance overuse. This study is one of the few studies that employed virtual simulation to promote nursing students’ empathy. Although the study did not demonstrate a significant difference between the text-based case study and virtual simulation groups after the learning activities, it supports that virtual simulation is effective for promoting empathy in nursing education as a text-based application. Future studies will be needed to explore different virtual simulation designs and to determine how individual characteristics influence the cognitive process of perspective-taking in promoting empathy.

This study explored the feasibility of predicting academic achievement in prerequisite Anatomy-Physiology Classes for prospective nursing students and Medical Surgical Nursing Classes for students enrolled in a diploma program. This was accomplished by using three instruments that measure the attitudes of nursing students about the nursing profession or preferences towards learning environments . The purposes of this study were (1) to determine if the subgroup or total scores were correlated with final examination scores for each class, (2) to determine if the subgroup or total scores interacted with one another to increase the power of prediction, and (3) to compare the effects of different teaching styles, upon the instruments used to measure attitudes and preferences