Introduction: Nursing students often encounter stressful situations when navigating coursework, examinations, simulation activities, clinical rotations, and maintaining personal responsibilities. Background: Stress in certain circumstances can negatively impact the attainment of educational goals. Nursing educators must address academic stress by building curriculums that include strategies for enhancing well-being and self-care management. The prebrief in simulation-based learning (SBL) may be a platform for promoting holistic techniques like mindfulness to facilitate self-care management within academic settings and foster skill transfer to future clinical practice settings. Methods: This dissertation aimed to examine using SBL to promote self-care with mindfulness in prebrief. A scoping review (ScR) was conducted to review the knowledge about mindfulness in nursing education and SBL. A research study examined mindfulness in prebrief for improving perceived stress, mindfulness, and awareness. An idea for creating a holistic theoretical model for enhancing prebrief practice was explored. Results: The ScR indicated that mindfulness was used in nursing education and rarely in SBL. The study showed no significance with posttest scores after prebrief mindfulness activities. A proposed model was designed to promote self-care practice in prebrief using mindfulness. Discussion: The findings from this dissertation provide a foundation for exploring ways to implement self-care management, including mindfulness, starting with the SBL prebrief in the academic setting.

abstract: This study is designed to understand the patterns of selection, preparation, retention and graduation of undergraduate pre-licensure clinical nursing students in the College of Nursing and Health Innovation at Arizona State University enrolled in 2007 and 2008. The resulting patterns may guide policy decision making regarding future cohorts in this program. Several independent variables were examined including grades earned in prerequisite courses; replacement course frequency; scores earned on the Nurse Entrance Test (NET); the number of prerequisite courses taken at four-year institutions; race/ethnicity; and gender. The dependent variable and definition of success is completion of the Traditional Pre-licensure Clinical Nursing Program in the prescribed four terms. Theories of retention and success in nursing programs at colleges and universities guide the research. Correlational analysis and multiple logistic regression revealed that specific prerequisite courses--Human Nutrition, Clinical Healthcare Ethics, and Human Pathophysiology--as well as race/ethnicity, and gender are predictive of completing this program in the prescribed four terms. / Dissertation/Thesis / Ph.D. Public Administration 2012

Acts of incivility in nursing education and practice settings are a growing concern. Previous research has indicated that uncivil behaviors, especially among nurses in the healthcare workplace, create toxic work environments and pose risks to patient safety. Uncivil behaviors among nurse educators and students were found to erode the learning environment and lead to poor program outcomes. Researchers provided evidence to show varied levels of incivility in academic and workplace environments and recommended solutions to improve civility, yet little evidence exists to show how nurse faculty approach civility promotion in their practices. This qualitative, descriptive study was designed to explore the actions and decisions of prelicensure nurse faculty who promote civility in their baccalaureate programs. Fifteen full-time, prelicensure nurse faculty from varied baccalaureate programs across the southeastern United States volunteered to participate in individual, online interviews. Husted and Husted's theory of bioethical symphonology was used to support the study design and analyze the findings. Thematic analysis of participant interview transcripts revealed 4 themes to explain civility promotion actions and decisions which included (a) guiding civil professionalism, (b) championing civil communication, (c) negotiating civil partnerships, and (d) empowering civility awareness. The findings of this study are beneficial to nurse faculty seeking civility promotion solutions which will enhance awareness, knowledge, and professional civility skills among nursing students and effect positive social change as new graduate nurses are prepared to promote civility in the healthcare workplace.

Prelicensure nursing students experience high anxiety as they enter the clinical setting, which can have a negative impact on learning care performance and critical thinking. Nursing faculty are faced with the challenges of limited time for clinical experiences, meeting the needs of learners who are technologically astute, and engaging students in the clinical environment to meet learning outcomes. The purpose of this pretest posttest quasi-experimental study, guided by the discovery learning theory, was to determine the effect of augmented reality (AR) 360 photosphere on prelicensure nursing students' level of anxiety as they entered a new clinical environment as compared to prelicensure nursing students' level of anxiety who did not experience AR 360 photosphere orientation. Forty-seven students completed the Spielberger's State-Trait Anxiety Inventory with 17 completing a faculty-led orientation and 30 using the AR 360 photosphere orientation method. An independent t-test revealed no difference between the two methods of orientation in prelicensure nursing students' anxiety levels in the immediate first clinical experience. Though no statistical difference was evident, the technology platform of AR 360 photosphere orientation allowed for autonomous orientation without having to overcome clinical environment variances. The findings of the study contribute to positive social change by indicating that the AR 360 photosphere demonstrated value as a consistent and efficient method of clinical orientation as students' encounter new environments and new evidence-based care that requires orientation.

Healthcare agencies and stakeholders expect registered nurses to be competent at all times. When nurses are not confident in competencies, negative patient outcomes can occur. The purpose of this quantitative quasiexperimental with posttest only study was to investigate Quality and Safety Education for Nurses (QSEN) competency confidence levels of 2 groups of new nurses who had 5-6 months of clinical experience. Framed by the Duchscher theory and the QSEN framework, the research question was developed to examine the differences between QSEN competency confidence levels of new nurses who participated in a prelicensure program plus a residency program and nurses who only attended the residency program. Sixty-eight new nurses from 1 health facility answered the Nursing Quality and Safety Self-Inventory (NQSSI). An independent t test was used to compare each knowledge, skills, and attitudes (KSA) QSEN competency confidence levels for two groups. The results of this study demonstrated a difference between QSEN competency confidence levels between the 2 groups, but not all 18 NQSSI items reached a statistically significant difference. The 7 items that reached a statistically significant difference included the QSEN competency confidence level in knowledge and skills in evidence-based practice, quality improvement, and informatics. A statistically significant difference was also noted in the QSEN competency confidence level for patient-centered care skills. A 3-day professional development (PD) workshop was developed based on the results. Participating in the PD workshop could further increase the new nurses' QSEN competency confidence levels which can enhance patient outcomes resulting in positive social change.

Despite decades of research, academic dishonesty remains a significant concern in nursing education. The connection of academic dishonesty to dishonest clinical practice presents a moral imperative for nurse researchers to find new facets of understanding these phenomena. Literature regarding moral disengagement in health care is minimal and is even less prevalent in the context of nursing education. The purpose of this study was to determine the effects of moral disengagement on prelicensure nursing students’ tendencies to engage in academic dishonesty in their last or next to last semester of a nursing program. A correlational design via survey method was used. The Moral Disengagement Scale (MDS) and Academic Dishonesty Tendency Scale (ADTS) were reliable in this sample, with alpha coefficients of .90 (N = 251) and .86 (N = 242), respectively. Eighty-seven percent (87.2%, n = 219) of participants reported either agreeing or strongly agreeing with at least one item reflecting moral disengagement. Nearly 75% (74.9%, n = 181) reported agreeing with at least one item reflecting a tendency to engage in academic dishonesty, with an additional 44.6% (n = 108) strongly agreeing. A two-tailed single bivariate correlation revealed a strong, positive, statistically significant relationship between the MDS and ADTS, r (236) = .66, p < .001. The findings suggest that nurse educators must emphasize moral development and the students’ ownership of responsibility academically as well as during the provision of care. Due to the uniqueness of various nursing programs, more research is needed to understand the concept of moral disengagement and its influencing factors, outcomes, and interventions in various nursing student populations and the nursing profession.