<p> Background and Purpose: The healthcare system is currently facing daunting challenges; to increase the number of new nurses needed to provide care to the burgeoning population of seniors, to provide primary care for individuals covered by the Affordable Care Act of 2010 and to fill the vacancies left by retiring nurses. Transition into practice programs are needed to help new graduate nurses develop comfort and confidence in the autonomous Registered professional nurse (RN) role. New graduate nurses are at risk for significant job stress, leading to rapid job turnover, putting patient safety at risk. Recent studies examining transition to practice programs include results and implications that are limited by the sampling of only baccalaureate prepared new graduate nurses enrolled in a structured nurse residency program. </p><p> The purpose of this study was to examine the effects of transition to practice programs on new graduate nurses regardless of transition to practice program type, length of program or degree upon initial entry to practice in the state of New Jersey. Research Question: What are the effects of transition to practice programs on new nurse comfort, confidence and RN role transition? </p><p> Design, methods and participants: The non-experimental, cross-sectional, correlational descriptive study utilized the Casey-Fink Graduate Nurse Experience Survey to examine new graduate nurses' comfort, confidence and RN role transition. The purposive convenience sample consisted of 182 RNs licensed in New Jersey, who were hired into their first nursing job between January 2012 and June 2014. </p><p> Results and implications: Data analysis revealed that there were no significant differences in new graduate comfort and confidence score regardless of length of transition to practice program or entry degree received. Approximately one-third of respondents felt that they were not able to complete their patient care assignment on time, had difficulty prioritizing and organizing patient care needs, and felt that they may harm a patient due to their lack of knowledge and experience. The results of this study indicate that up to one-third of new graduate nurses surveyed, who after completion of a TTP program, are often expected to care for a full assignment of high acuity patients comparable to a seasoned RN, lacked the comfort and confidence to do so. The study also indicates however, that those who participated in a longer TTP program fared best, reporting heightened comfort and confidence responses on the survey instrument.</p>

<p> The millennial generation comprises the majority of learners in the traditional university setting. Nurse educators identify problems developing teaching strategies in education that undergraduate millennial nursing students find engaging and meaningful. To prepare for the challenges of this group, it is imperative nurse educators examine preferred teaching methods, student learning styles, and needs in relation to traditional pedagogies. The purpose of this study was to identify the perception of millennial students participating in traditional pedagogies and its significant implications for nursing education. This interpretive phenomenological study recorded the lived experiences of millennial nursing students&rsquo; experiences in traditional classrooms. One on one interviews with 13 millennial students were conducted. Data collection and analysis aligned with van Manen&rsquo;s method. There are five themes that emerged from the data: physically present, mentally dislocated; unspoken peer pressure; wanting more from the professors; surface learning; and lack of trust. The essence focuses around the central theme of belonging. The millennial students identified the most significant challenge in a traditional classroom was disengaging professors. Recommendations for faculty to engage nursing students through a method of shared responsibility of educational approach are given. Blended teaching pedagogies that offer traditional and active methods such as role playing and discussion forums are recommended.</p>

<p> In contemporary American society, the nursing profession is predominantly made up of white women. Currently, males make up only 6.8 percent of the three million nursing professionals in the U.S. and they are considered gender minorities within the nursing profession and within nursing education. As gender minorities, male students are identified as experiencing nursing programs and the practice of nursing differently than their female counterparts.</p><p> The purpose of this single instrumental, within site case study was to explore the learning environment for male nursing students and to investigate the nature of the interactions between nursing faculty and male undergraduate students in a Pacific Northwest medical university nursing program. Data was collected in the educational setting through observations, participant interviews, and document analysis. In addition, this study used Kanter's theoretical framework of tokenism to uncover if male nursing students were perceived as tokens in the educational environment. The findings showed that the faculty-student interactions were largely positive; they also revealed that having other males in the class was an instrumental factor in their positive perception of their educational experience. However, the male nursing students also identified areas of discomfort in the educational setting, specifically when practicing clinical skills with female peers, feeling pressured to volunteer and to expose skin during in-class demonstrations, and anticipating that they would be excluded from certain clinical situations. This research indicated that gender differences are present within nursing education and contributed to instances of discomfort for male students. Specific barriers occurred most often when men engaged with female peers and were in clinical settings. These findings provide new insight into when and where men begin to experience gender barriers in the educational environment and are pertinent to understanding the educational environment for men in nursing. Recommendations specifically geared towards assisting students in their first term are suggested for nursing faculty and administrators to ensure that the learning environment is welcoming for men. These recommendations include consciously placing males together in cohort groups and in clinical experiences, reducing instances of visibility and pressure on men in the clinical setting, building faculty awareness of perceived and real barriers for men in the educational setting, and providing faculty with tools to assess and address barriers that are present in the classroom environment. </p>

<p> Nurse educators in baccalaureate nursing programs have the daunting task of preparing nursing students to be safe and competent practitioners that provide quality, patient-centered care in a reasonably short duration of time. Advances in current technology have created opportunities for new and innovative teaching strategies in healthcare to meet this challenge. The use of high-fidelity simulation is one technology that is beginning to emerge and be integrated into the nursing curriculum. This study featured a health and environmental safety assessment simulation designed to orient and prepare novice nursing students with competencies to perform a head-to-toe assessment on a patient in a clinical setting. The quantitative study featured a convenience sample of sophomore-level nursing students from a rural Midwestern, private, not-for profit, four-year baccalaureate program. The purpose of the research study was to identify the impact of the health and safety assessment simulation on student anxiety level, satisfaction, and self-confidence. Participants completed a demographic questionnaire, the State-Trait Anxiety Inventory Scale for Adults, and the Student Satisfaction and Self-Confidence in Learning Scale. Student anxiety was measured using a pretest-posttest (repeated measures) design. Student satisfaction and self-confidence was collected at the conclusion of the simulation experience. Simulation debriefing revealed positive remarks from students about the simulation experience but were not evaluated for themes. Results were analyzed using SPSS, Version 20 using descriptive statistics, paired <i>t-tests,</i> and Pearson's Correlation Coefficient. Results of this study support the use of high-fidelity simulation with simulators as an effective teaching strategy to decrease anxiety and increase student nurse self-confidence while performing a health and safety assessment on a patient.</p>

<p> This dissertation presents a quantitative study of the attitudes of staff nurse preceptors toward nursing students with learning disabilities. There are an increased number of nursing students with learning disabilities. These students may have additional challenges in clinical settings, particularly if clinical settings do not understand or support their educational needs. Stigma exists towards people with learning disabilities, and it is unclear if staff nurse preceptors are accepting of nursing students with learning disabilities and willing to serve as a preceptor. </p><p> Attitude was measured with the following four constructs developed for this study: perceived levels of preceptor preparedness, level of confidence in implementation of preceptor role, preceptor beliefs of student potential, and agreement with the provision of reasonable accommodations. These constructs were developed through a review of the literature and found to best represent the dynamic relationship between the preceptor and the preceptee. </p><p> This study analyzed data from an electronic survey to examine the preceptor's attitudes towards learners with learning disabilities and their willingness to serve in the preceptor role for students with learning disabilities. Preceptor's familiarity with learning disabilities, knowledge of issues related to learning disabilities, and their concerns regarding nursing students and new graduate nurses with learning disabilities were assessed. The preceptor's familiarity with learning disabilities and knowledge of issues related to learning disabilities were low, and their concerns were high. However their attitudes were mixed. Preceptors reported that they were not well prepared and had low levels of confidence in their ability to support and accommodate those with learning disabilities. However, they had strong beliefs in the potential of both nursing students and new graduate nurses with learning disabilities, and they had high levels of agreement that reasonable accommodations should be provided. </p><p> The preceptors indicated a high willingness to serve in the role of preceptor for both nursing students and new graduate nurses with learning disabilities. Attitudes toward new graduate nurses with learning disabilities were slightly more positive than the attitudes toward nursing students with learning disabilities, and willingness to precept was higher for new graduate nurses than nursing students. The conclusions of this research are that preceptors are accepting and willing to take on the challenge of precepting nursing students with learning disabilities, however they need information and support from their institutions and nurse educators.</p>

<p> This mixed methods participatory action research study investigated student perceptions of stress within the context of a high stakes testing environment. Participants were prelicensure baccalaureate nursing students enrolled in the final semester of their nursing program. The quantitative method, a prospective correlational research design using the Student Nurse Stress Index (SNSI) provided a quantitative measure of stress. Phenomenography, the qualitative method, was used in order to capture the various ways students experience stress. The combination of these two methods provided a rich understanding of student perspectives regarding the use of high stakes testing nursing as a measure of progression toward graduation. Analysis of the research findings revealed all students experience stress while preparing for high stakes testing. However, students perceived the experience of stress in a myriad of ways suggesting that students view high stakes testing as a threat rather than a challenge.</p>

<p> Health literacy has been identified as a significant factor in health care disparity and access to health care, and must be addressed in health care reform. Although patient education has long been considered an independent role of nursing, nurses often lack the knowledge and skills needed to be effective educators. Nursing as a profession is poised to assume a leadership role in health care reform and in promoting the national goals of health promotion and disease prevention of Healthy People 2020. The purpose of this quasi-experimental quantitative study is to determine if a formal course of education and learning theory in undergraduate pre-licensure nursing programs increases knowledge of health literacy and self-efficacy related to patient teaching. A sample size of 322 senior level undergraduate nursing students from a multi-campus private undergraduate baccalaureate school of nursing were surveyed to assess their knowledge of health literacy and their self-efficacy related to patient education. A 38-item multiple choice questionnaire with a Likert-type scale was utilized to measure the health literacy knowledge and experiences of participants, and a multi-item Likert-type scale measures nursing process steps of self-efficacy related to patient education. In this study, the experimental group had completed a formal course of educational and learning theory, while the control group had not. The experimental group demonstrated more knowledge about health literacy, however, the difference was not statistically significant. They did, however, demonstrate statistically significantly more self-efficacy related to patient health education activities in some areas compared to the control group, but not in all areas of the teaching and learning process. Recommendations for further studies are to conduct the study earlier in the nursing program, before the students complete multiple clinical courses, which require patient education activities, and to expand the study to multiple nursing programs in the region teaching a formal course in education and learning theory for patient education to see if results are consistent regionally.</p>

<p> This quantitative, retrospective, multivariate, non-experimental study examined the first-time performance of 2,673 academic nurse educators who took the CNE examination between September 28, 2005 and September 30, 2011. Post-positivism and Abbott's system of the professions theory served as the philosophical and theoretical underpinnings of this original research which attempted to determine if a relationship existed between educational preparation or years of full-time faculty employment (independent variables) and first-time pass/fail performance on the CNE examination and in each of content areas (dependent variables). The Chi-square test of independence revealed the lack of a statistically significant relationship between educational preparation and first-time pass/fail performance on the CNE examination. Independent t-tests revealed a statistically significant relationship between Option B study participants and content area three (use assessment and evaluation strategies), (<i> t</i>[2,671] = -2.20, <i>p</i> = .03); four (participate in curriculum design and evaluation of program outcomes), (<i>t</i>[2,671] = -2.06, <i>p</i> = .04); and six (engage in scholarship, service, and leadership), (<i>t</i>[2,671] = -2.34, <i>p</i> = .02). Binary logistic regression revealed that a one year increase in full-time employment resulted in a 1.05 times greater likelihood of passing the CNE examination (OR = 1.05; 95% CI 1.03, 1.06; <i>p</i> = .00). Last, simple linear regression revealed that years of full-time faculty employment contributed to 3.2% of the variability within content area four, 2.8% within content area six, and 2.1% within content area three. The results of this study provide insight about faculty development and mentoring needs, present evidence to policy makers and nursing education leaders, and offer guidance to curricula developers.</p>

<p>Instructors are being challenged to evaluate their courses and the manner in which course materials are distributed. Lecture capture technology has enabled nursing instructors to deliver classroom lectures even when class is not in session. This form of technology allows instructors to record lectures as they are being presented or instructors may choose to pre-record lectures prior to class. The purpose of this descriptive qualitative study was to determine how lecture capture technology has been integrated into associate degree nursing programs in Alabama. Nursing instructors were recruited from two-year colleges in the state of Alabama. Instructors selected were asked to complete a demographic survey and participate in detailed interviews that helped determine what factors influenced them to incorporate lecture capture technology into their courses. A purposive sample of nursing instructors, who had utilized lecture capture technology in their courses, was sought. The findings from this study may be used to help other nursing instructors navigate through the process of implementing lecture capture or other technology into their courses. The data collected may serve as a resource to help instructors and institutions overcome barriers and to effectively use time and resources in educating future nurses. This study has implications for nursing practice and policy related to establishing procedures that can assist instructors in adopting technology tools that will be beneficial in presenting course materials. In addition, instructors can determine which method of implementation is best for their work environment.

<p> Professional confidence is an essential trait for new graduate nurses to possess in order to provide safe and effective patient care in today's complex hospital setting. However, many new graduate nurses are entering the workforce with a lack of professional confidence and it was unclear why this is so. The purpose of this basic qualitative study was to find out and understand how new graduate nurses accounted for their lack of professional confidence during their first year of practice in the hospital setting. The primary research question asked about new graduate nurses' experiences during their first year of practice related to the development of professional confidence in the hospital setting. Two sub-questions were used to address circumstances that hindered and promoted the development of professional confidence. Data collection involved two individual, semi-structured, audio recorded interviews which were transcribed verbatim. Each transcript was analyzed through a manual content analysis approach and ultimately, seven themes emerged which answered the research questions. Findings confirmed that seven themes related to a lack of professional confidence in new graduate nurses' experiences: (a) "communication is huge," (b) "making mistakes," (c) "disconnect between school and practice," (d) " independence," (e) "relationship building," (f) "positive feedback is important," and (g) "gaining experience." These findings revealed that new graduate nurses lacked professional confidence upon entry into practice which had implications for both undergraduate nursing education programs and workplace support for new graduate nurses in the hospital setting. Undergraduate nursing education programs may have a duty to improve strategies that prepare graduates for entry into professional practice. Nurse leaders in practice, specifically, nurse managers and preceptors must be mindful of the fact that new graduate nurses are entering the workforce with a lack of professional confidence and that it is in their power to promote the development of professional confidence during the first year of practice.</p>