Thesis (M.S.)--Boston University

Compassion has been associated with the nursing profession since the days of Florence Nightingale. It is a general expectation that nurses should be compassionate when they are caring for people. In the United Kingdom (UK) concerns have been raised recently that nurses are failing to be compassionate as they carry out their nursing duties. There is little evidence within the literature of how student nurses perceive compassion as they engage in the pre-registration-nursing programme. In this study, I use narrative to produce case studies as a vehicle for the students to voice their perceptions of compassion. My ethnographic analysis of their stories is framed by my own experience as a professional registered nurse and nurse educator situated within their learning environment, and applies theories of compassion and learning. In my study, themes emerge that demonstrate commonalities, differences and tensions relating to the students’ individual beliefs and behaviours, and to the impact of their professional development as they transcend from university learning spaces into clinical practice.

Globally, student absenteeism is seen as a period of time when students do not attend classes. This is a serious concern for lecturers at institutions of higher learning (Lipscomb & Snelling, 2010:573). In South Africa, student absenteeism is rampant amongst university and college students (Wadesango & Machingambi, 2011:89), and it is also a problem in the Limpopo Province (Ramodike, 2008:2). The objectives of this study were to explore and describe the reasons for nursing students to be absent from class in a college of nursing in the Limpopo Province, and to formulate strategies to reduce student absenteeism in a college of nursing in the Limpopo Province. The research design in this study was quantitative, descriptive, exploratory and cross sectional in nature. The sample included nursing students, from level I to level IV of their studies (n=209), registered at a college of nursing in the Limpopo Province. The data was collected using the Factors influencing Absenteeism Questionnaire (FIAQ) (Fayombo, 2012). EpiData and SPSS statistical programmes were used to analyse the data. The results of the study showed that nursing students absent themselves from class due to aspects of student-centred factors, for instance when they want to prepare for examination (53.1%; n=111); and home-related factors, most nursing students reported that they are absent from class when there is death of a family member (63.2%; n=132). Regarding school-related factors, most nursing students indicated that poor infrastructural facilities in school provide reasons for students’ absenteeism (39.2%; n=82). However, the results revealed that there is no relation between social factors and students’ absenteeism, as most of the respondents (48.3%; n=100) disagreed that the unavailability of entertainment like malls or movies around the campus is a cause of student absenteeism. With regard to measures to reduce students’ absenteeism, most of the respondents (73.7%, n=154) indicated that they need a prize giving ceremony for students that are never absent from class. A further 54.1% (n=113) reported that they want a motivating program that will emphasise the benefits of attending classes, and 47.8% (n=100) indicated that they need a program that teaches friendly and mutual lecturer-student relationships. Recommendations for nursing education, practice, future research and a policy were made. / MCur, North-West University, Potchefstroom Campus, 2015

Globally, student absenteeism is seen as a period of time when students do not attend classes. This is a serious concern for lecturers at institutions of higher learning (Lipscomb & Snelling, 2010:573). In South Africa, student absenteeism is rampant amongst university and college students (Wadesango & Machingambi, 2011:89), and it is also a problem in the Limpopo Province (Ramodike, 2008:2). The objectives of this study were to explore and describe the reasons for nursing students to be absent from class in a college of nursing in the Limpopo Province, and to formulate strategies to reduce student absenteeism in a college of nursing in the Limpopo Province. The research design in this study was quantitative, descriptive, exploratory and cross sectional in nature. The sample included nursing students, from level I to level IV of their studies (n=209), registered at a college of nursing in the Limpopo Province. The data was collected using the Factors influencing Absenteeism Questionnaire (FIAQ) (Fayombo, 2012). EpiData and SPSS statistical programmes were used to analyse the data. The results of the study showed that nursing students absent themselves from class due to aspects of student-centred factors, for instance when they want to prepare for examination (53.1%; n=111); and home-related factors, most nursing students reported that they are absent from class when there is death of a family member (63.2%; n=132). Regarding school-related factors, most nursing students indicated that poor infrastructural facilities in school provide reasons for students’ absenteeism (39.2%; n=82). However, the results revealed that there is no relation between social factors and students’ absenteeism, as most of the respondents (48.3%; n=100) disagreed that the unavailability of entertainment like malls or movies around the campus is a cause of student absenteeism. With regard to measures to reduce students’ absenteeism, most of the respondents (73.7%, n=154) indicated that they need a prize giving ceremony for students that are never absent from class. A further 54.1% (n=113) reported that they want a motivating program that will emphasise the benefits of attending classes, and 47.8% (n=100) indicated that they need a program that teaches friendly and mutual lecturer-student relationships. Recommendations for nursing education, practice, future research and a policy were made. / MCur, North-West University, Potchefstroom Campus, 2015

Attrition of nursing students has a negative impact on students, university nursing programs, and the heath care community. At a local university, the nursing program and its stakeholders aspire to increase retention of nursing students in order to mitigate the nursing shortage projected over the next decade. The purpose of this study was to examine issues related to high attrition of 1st- and 2nd-year nursing students at a university located in the mid-Atlantic area of the United States. Tinto's model of retention was used as the foundation to explore variables affecting 1st- and 2nd-year nursing students who remained in (n = 30) or left (n = 10 ) the program. This quantitative, cross-sectional research study explored the root causes of nursing student attrition. A Likert-scale survey was used to gather quantitative data to determine student perceptions of academic expectations and nonacademic issues such as work and stress that may increase the risk of attrition. Discriminant analysis determined that reported levels of self-efficacy, perceived faculty support, outcome expectations, and bullying significantly discriminated between program persisters and leavers. Based upon these findings it is concluded that nursing faculty and administrators can increase student retention by increasing students' level of self-efficacy by providing greater support and reducing instances of bullying. Implementation of these practices may result in more students remaining in school, graduating, and competently serving the needs of patients, thus resulting in positive social change.

Magister Curationis - Mcur / Clinical experiences have always been an integral part of nursing education, and the value thereof to the nursing students is widely demonstrated in research. The purpose of clinical supervision is bridging the gap between theory and practice and ensuring that nursing students are prepared to be competent in their professional duties upon completion of their studies. However, clinical supervision focuses mainly on clinical skills and seems to neglect policies and protocols that govern care delivery, often impacting negatively on the expected quality of service. This problem is more so prominent in policies and protocols pertaining to medication. The Essential Drug List (EDL), which is a useful tool in the South African public health facilities, is one such protocol. Supervision on Essential Drug List as a medication protocol seems to be non-existent in the nursing field despite the expectations that nursing students should be able to implement its contents upon completing their studies. The nursing students' views regarding supervision in this regard are often not sourced despite their importance as stakeholders. However, if positive changes that will serve as a solution to the current problem are to be achieved, the students need to be heard. The study aimed to explore the perceptions of nursing students at a university in the Western Cape regarding clinical supervision on EDL medication protocol.

Master of Public Health - MPH / Background: Globally there is an urgent requirement for skilled nurses. For this reason, interventions in nursing education need to be carefully assessed and strategically planned and coordinated. In order to establish an effective clinical learning environment at education institutions, it is strongly recommended that one should gain insights from the perceptions of students, regarding their experience of their learning environment. Aim: The aim of the study was to investigate the undergraduate nursing students’ perceptions of the psychosocial clinical learning environment in a Higher Education Institution. Methodology: A quantitative descriptive survey design was used for this study in the form of questionnaires. The study utilized the pre-existing Clinical Learning Environment Inventory (CLEI) instrument developed by Chan (2001). The study utilised third year and fourth-year undergraduate nursing students. The target population comprised third year undergraduate nursing students (n=250), and fourth year undergraduate nursing students (n=248). The total target population was (n=498) undergraduate nursing students. A random sampling technique was used to select the study sample size of n=218. Self-administered questionnaires were distributed to two hundred and eighteen (218) respondents during class time and two hundred and eighteen (218) completed questionnaires were returned. The data was analysed using the Statistical Package for Social Science version 25. Descriptive statistical analysis was used to generate frequencies, mean values, median and standard deviation of observations. Reliability and validity of the study was ensured as described in the methodology section. Permission to use students for the study was sought from the registrar of the University. Informed written 3 consent was sought from all the participants in this study. The ethical principles were adhered to ensure confidentiality and anonymity of the participants throughout the study and beyond. Results: The fourth year respondents, 64.7% (n=90) agreed that their facilitators often think of interesting activities compared to their third-year counterparts, 35.3% (n=49); whereas, 63.6% (n=77) agreed that the facilitator thinks up innovative activities for students as compared with 36.4% (n=44) third years. This significant difference between the year levels cannot be justified from the study findings. However, it can be attributed to an underestimation of the impact of innovation and its impact on teaching and learning. The perception of fifty percent (50%) each for both year levels reported that the clinician talks more, rather than listening to the students. These findings indicate that communication between students and their clinical facilitator is hindering the clinical learning experience. There was a significant difference found between the groups (t=1.1, p=.027), as the average opportunities for interaction between students and clinical facilitators were lower for third year [2.3(±0.4)], compared with the average participation score for the fourth year 2.4 (±0.4). Most of the respondents, 81.2% (n=177) reported that clinical placement was a waste of time. The findings showed that the degree of satisfaction declined as students progressed from third to fourth year. There was a significant difference between the groups with 91.1% (n=102) fourth years reporting that clinical placement was a waste of time compared to 70.8% (n=75) of their third-year counterparts. A probable explanation for this might be the fact that the learning objectives and activities differed in the academic progression. The extent to which students are allowed to make decisions and are treated fairly was found to be more favourable by fourth years than third years, with mean scores of 2.7±0.4 and 2.6±0.4 respectively; thus highlighting a greater level of independence at the more senior 4 level. Study findings reported that 47% (n=102) agreed that the preceptor/clinician often became side-tracked instead of sticking to the point and only 45.9% (n=100) stated that clinical placements were disorganized. The findings from this study indicated that half of the students did experience a certain level of clarity and organization across their classes, while others did not consistently receive this level of clarity. Conclusion: The findings of the study indicates that there was inadequate supervision, poor student-mentor interaction, a lack of clarity and organization and ineffective teaching methods that impacted negatively on their decision making skills and revealed the need for new strategies to be implemented in the nursing education system, in order to ensure a successful CLE. Recommendations: This study demonstrated that students perceive the CLE as a place to learn and obtain skills for the nursing profession, yet their perceptions of how they were taught did not reflect their enjoyment of learning, and showed room for improvement in how clinical facilitators used different teaching methods, interacted with learners, and allowed them to make decisions, all the while ensuring that the lines of communication were kept open. Clarity and an organizational culture were lacking in the students learning environment which impacted negatively on their perception of learning. It is imperative that clinical facilitators evaluate their behavior with students consistently, be aware of their behavior and be open to suggestions and recommendations on how to improve their teaching.

This project study addressed the decline in successful passing rates for the National Licensure Exam for Registered Nurses (NCLEX-RN) in a nursing program at a private university in the Midwestern United States. There is support from the literature for a connection between critical thinking skills of nursing students and successful passing of the NCLEX-RN. The purpose of this quantitative study was to examine whether significant differences existed in mean critical thinking skill scores across time within groups (pretest to posttest) and between groups (simulation versus written case studies), as measured by the Health Science Reasoning Test. Cognitive learning theory as interpreted by Ausubel along with the Paul Elder critical thinking model comprised the frameworks for this study. In a quantitative causal-comparative pretest/posttest design, baccalaureate junior nursing students (N = 69) were investigated. A repeated measures mixed analysis of variance indicated there was no statistically significant difference in participants' mean critical thinking scores across time within groups (pretest to posttest) or between a simulation group (n = 36) and a written case studies comparison group (n = 33). The use of high-fidelity simulation as a teaching strategy versus written case studies to increase critical thinking skills of nursing students was not supported. The resulting project deliverable is a skills-development workshop for nursing faculty that would focus on multiple methods (as opposed to one method) of evidence-based teaching strategies that have been shown to increase critical thinking of nursing students. This study promotes positive social change by examining factors that can strengthen critical thinking in nurses. Factors associated with critical thinking can be addressed in training for nurses to enhance patient safety and outcomes.

Simulation is considered a safe space for learning as no patient harm could occur. However, learner safety is equally significant to consider. Despite increased interest in simulation psychological safety, evidence synthesis to support the effectiveness of interventions remains lacking. This systematic review seeks to determine what interventions are effective for establishing and maintaining psychological safety within the three phases of simulation with healthcare learners. A Joanna Briggs Institute systematic review of effectiveness was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses. Articles published from 2011 to 2022 and their references from six databases were searched. Eight articles were included in the analysis. Psychological safety interventions were grouped into two categories: (1) single or (2) multidimensional. Single interventions were more likely to improve learner psychological safety. Several interventions can be used during all phases of simulation to foster a psychologically safer simulation learning environment.

Forskning har visat att empati är betydelsefullt i sjuksköterske-patient-relationen. Då empatisk förmåga tränas under sjuksköterskeutbildningar är mätning av empatinivåerna av betydelse för utbildningens kvalitet. Syftet med studien var att med hjälp av enkäter och intervju undersöka empatinivåerna på andra terminen, sjätte terminen och hos specialiststudenterna på en svensk sjuksköterskeutbildning. Grundstudenterna i termin sex hade signifikant högre empati än grundstudenterna i termin två och specialiststudenterna. Distriktsjuksköterskestudenter hade signifikant högre empati än anestesi- och intensivvårdssjuksköterskestudenter, medan intensivvårdssjuksköterskestudenter hade signifikant lägre empati än barnmorske- och psykiatristudenter. Specialiststudenterna tyckte empati var det viktigaste i mötet med patienten, följt av professionell hållning, kommunikation, allians och tid. En empatiforskare övervägde stress, erfarenhet och desillusion som möjliga förklaringar till empatiskillnaderna mellan termin två, termin sex och specialiststudenterna, medan skillnader i teknikfokus, identifikationsmöjligheter och interaktion, förmodades vara orsaker till empatiskillnaderna mellan specialistutbildningarna. Studiens styrka var metoden då analysarbetet genomfördes med både kvantitativ och kvalitativ. En svaghet var det låga antalet manliga deltagare. Då stress påverkar empatimätningar, föreslås att i framtida studier undersöka empati under mindre påfrestande förhållanden.